You and your spouse will come to Miami (at no cost to you) for an appointment with our Director of Psychological Care for a psychological assessment to make sure that you and your spouse are ready to provide surrogacy services. You will be compensated for lost wages and travel costs for you and your spouse.
You will also be separately scheduled for a medical examination, blood tests, and an ultrasound to make sure that you are a good candidate for surrogacy. This may take place in your home town or you may be asked to travel (unless you have indicated otherwise in your application).
Step 4: Finalization of Agreement
Either during the trip or on a separate trip, you will meet with Intended Parent(s) at our offices in Miami to discuss and agree on the specific terms of the surrogacy contract.
Advocates for Surrogacy will draft the terms of the Agreement and you will then consult with independent legal counsel (counsel must be experienced in surrogacy and approved by Advocates) at no cost to you.
Once you are cleared medically, psychologically and the Agreement has been signed by all parties, the medical process begins, as follows:
Medical Process
Stage 1:
Surrogate starts taking birth control pill to synchronize her menstrual cycle with the Intended Mother’s or donors. This may also require the medication, Lupron. These medications are usually well-tolerated, and most women do not have any side effects when taking these medications for a short time. However, some women may have hot flashes, fatigue, headaches, irritability or nausea. The Surrogate takes estrogen twice per week by injection – this is to thicken the lining of the uterus. The surrogate will be evaluated using blood tests and ultrasounds to determine when she is ready for the implantation. Approximately 4 days before the transfer and until an ultrasound confirms pregnancy, the surrogate takes injections of progesterone. Progesterone is the hormone produced by the ovary after ovulation. This medication can be given to improve the uterine lining, which may improve implantation of the embryo. It is usually started in the second half of the cycle, several days before the embryo transfer. Progesterone can be given as an intravaginal suppository, oral capsule, or an intramuscular injection. Side effects can include bloating, irritability, and breast tenderness.
Stage 2: Egg Retrieval and Fertilization
The health care provider will identify the mature follicles using ultrasound and hormone levels and the, with a needle, withdraw the eggs while the Intended Mother or Donor is under light sedation. Once the eggs are retrieved, they are examined in the laboratory and each one is graded for maturity. The maturity of an egg determines when the processed sperm will be added to it. The processed sperm is placed together with each retrieved egg in a separate laboratory dish to allow the fertilization process to occur. After a period of time, the eggs are examined under a microscope for the first signs of fertilization. When the embryos have reached the expected stage of development (usually in 3-6 days), any embryos in excess of the number agreed upon for the embryo transfer, are frozen for future use.
Stage 3: Embryo Transfer
The embryo transfer is performed with the Surrogate Mother in a gynecological position and requires no anesthesia. After the proper cleansing procedures, a tiny plastic catheter is introduced into the uterus through the cervix and the embryos are transferred into the endometrial cavity. The Surrogate Mother is required to stay in this position for a short period of time, then the nurse will reposition her per the physician's instructions and monitor her for the required time.
Stage 4: Monitoring and Support
When the Surrogate Mother is released after the embryo transfer, she will be taken to a hotel for complete bedrest; getting up only to use the bathroom. This regiment is continued for 2 more days. After this time, the Surrogate Mother may resume her normal activities with the limitations provided to her by the physician at the time of the embryo transfer. Some of the limitations are:
-Complete Pelvic Rest
-No douching or sexual intercourse
-Showers only - no tub baths
-No strenuous activities - no exercising, running, heavy lifting including children, groceries, luggage, etc.
A pregnancy test will be performed two weeks following the embryo transfer. If a pregnancy occurs, the Surrogate Mother will have several visits to the clinic to monitor the hormone level and the progress of the embryo(s). This monitoring is done by blood tests and ultrasound. If pregnancy does not occur, the physician will instruct the Intended Mother when to stop the medications and when to expect her menstrual period.
Stage 5: After Confirmation of Pregnancy
Advocates for Surrogacy will ensure that scheduled payments, according to the Agreement between Intended Parents and Surrogate, is carried out in a timely and accurate manner. Advocates for Surrogacy will provide continual counseling including individual counseling, monthly group counseling and will be available to mediate issues that arise between the Intended Parent(s) and Surrogate Mother. Advocates for Surrogacy will provide, guidance, assistance, and coordination between Intended Parent(s) and Surrogate in preparation for delivery.
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