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The Surrogacy Process


Starting the Surrogacy Journey

Step 1: Initial Consultation with our Director

As Intended Parents you undoubtedly have many questions about the surrogacy process and our surrogacy agency.  Our consultation period is designed to allow you the opportunity to ask questions about the surrogacy process, determine how Advocates for Surrogacy’s services can assist you in your surrogacy journey and address any particular concerns you may have.  During this time you can expect to receive a great deal of guidance and resources to help you in determining how you want to move forward with your surrogacy journey.   Notice that we call this the “consultation period”.  This is because we believe that you can not and should not make a decision as to which agency whose services you will engage without several consultations, Skype sessions or personal meetings with our President.

Step 2: Complete Application

Complete our application.

Step 3: Finalize Surrogacy Services Agreement and Pre-match Consultation

Once accepted into our program we well execute our services agreement and we will explore further the type of surrogacy arrangement that best meets your needs and desires including the medical, social, and educational characteristics you are seeking in a surrogate candidate and your expectations for communication and personal involvement in the process.  If you also want to engage our services for an egg donor search, discussion of the same issues will take place for the egg donor recruitment as well.  We will assist you in identifying agencies, assessing egg donor programs and coordinate with the egg donor agency once the medical process begins.

Surrogate Recruitment, Screening and Matching

Step 1: Completion of Application

Upon receipt of each Surrogate’s application and profile information, we will interview each Surrogate prior to acceptance into our program.  Each surrogate applicant must complete extensive questionnaires designed to elicit social, educational, and medical history as well as compensation requirements and assessment of their insurance if they have coverage.

Step 2: Matching Process

This phase involves the careful process of evaluating potential surrogate candidates to determine whether the qualities, characteristics and preferences that you and Surrogate candidates each seek mesh together.  This phase involves a comprehensive assessment of personal, social, and financial considerations that a particular situation could involve.   We will provide you with an overall surrogacy plan for a particular situation which provides a summary of estimated financial considerations for the particular surrogate, a summary of the legal process, and provide you with her completed intake forms.  Once we determine that a potentially good match is possible, if both the Parents and Surrogate candidate agree, we move forward with telephone and/or personal introductions.   The matching process is a critical phase and this should not be based on matching you with the next surrogate in line.

Step 3: Psychological and Medical Screening

Once an initial match is achieved, we will coordinate further medical, psychological and background screening of the candidate.  You may also request home visit which we will arrange.  The medical portion of the screening will include blood work, ultrasounds and exams.  The psychological portion of surrogate screening will include a psychological assessment by a licensed psychologist who will administer the MMPI and conduct a clinical interview.

Step 4: Finalization of Agreement between Surrogate and Intended Parent(s)

Once the screening process is complete, and both the surrogate and you wish to move forward, we will draft an agreement and/or terms of agreement that will be negotiated between you, your legal counsel and the Surrogate and her counsel.  For parents or surrogates living in Illinois, our director can draft your agreement and represent you in obtaining a birth certificate in Illinois issued in your name/s.  Once the agreement is executed, funds will be deposited into escrow accounts (which we assist you in setting up) and the medical process proceeds.

Medical Process

Stage 1: Synchronization and Stimulation

Your 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. Your surrogate takes estrogen twice per week by injection – this is to thicken the lining of the uterus. Your surrogate will be evaluated using blood tests and ultrasounds to determine when she is ready for the implantation. Approximately four 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

Note:  This step will not apply if using frozen eggs or frozen embryos.  The Intended Mother/egg donor’s cycle will be synchronized with the surrogate’s cycle.  The health care provider will identify the mature follicles using ultrasound and hormone levels and, 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.

Some parents choose instead to adopt embryos that have been previously formed by other Intended Parents who donate these embryos and in this scenario, the frozen embryos are shipped (if applicable), thawed and transferred in accordance with step 3 outlined below.

Stage 3: Embryo Transfer

The embryo transfer is performed with the Surrogate Carrier 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 Carrier 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 Carrier is released after the embryo transfer, she will be given instructions for activity restrictions that typically include:

  • 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 approximately 10 days following the embryo transfer. If a pregnancy occurs, the Surrogate Carrier 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.

Case Management During Pregnancy and Delivery

Scheduled payments will be made according to the contract between Intended Parents and Surrogate Carrier and we will be in continual contact with the Surrogate Carrier ensuring compliance with appointments, following up with medical providers on medical reports, and mediating any issues that arise between Parents, Surrogate Carrier or other professionals. We are here for both parties each and every step of the way to offer our expertise, counseling, and continuous guidance throughout the pregnancy, delivery and beyond.