FREQUENTLY ASKED QUESTIONS
What is Surrogacy?
The definition of surrogacy is the act of one woman carrying a child that belongs to someone else.
Why Does Someone Choose Surrogate Parenting?
The reason one chooses to use a surrogate mother can vary amongst individuals and couples alike. It's unfortunate that some public opinion still views choosing surrogate parenting based off the myth that the “Recipient Mother” is being inconvenienced by pregnancy or does not want to lose her “figure” by a pregnancy, this is after all California, the land of Hollywood and Celebrities! And sometimes for personal reasons, there may not be a fertility issue, yet their desire for a child is still the same. But, more often the truth is far worse, the devastating stories I have heard throughout the years will never stop breaking my heart. Every prospective parent I have come in contact with has longed to be a parent and although some may not have gone through the same trials or losses as other parents they still have overcome obstacles to get here. These are wonderful people whose only wish is to have a child but are unable to do so without the assistance of a Surrogate Mother. Everyone's journey may be a little different but all have at some point, undergone frustration, devastation and sometimes scrutiny or lack of support from family or friends who may not fully understand their decision. It's certainly a grieving process that still leaves many fearful and guarded of being hurt again. Thanks to some of these Celebrities and high profile people for having the courage to come forward and share their wonderful surrogacy stories and/or how they have overcome infertility in their own lives. It's because of these brave people bringing surrogacy and infertility to the forefront that gives others going through this hope and inspiration.
I am thinking about whether I should go Independent verses an Agency, why should I choose to work with an agency?
I think it's possible to have a successful independent arrangement. I have seen many “independent” family member/ friend arrangements result in a wonderful outcome. However, I have also seen difficulties arise in independent situations as well. There are exceptions to every rule. Not everyone is “out to get someone,” but there are certain things you should carefully consider should you choose to go independent.
By listing yourself on any on-line publication or classified ad, you are essentially exposing yourself to possibly a dangerous and/or fraudulent situation. Generally people looking to find a surrogate are trying to avoid added costs of agency and some are also trying to avoid the added costs of either or both necessary psychological and medical screening, not to mention any background screening. You may have the very best of intentions but could be risking a lot in your quest to help someone. The lack of screening is just one example, the financial situation is another. Often times, in these arrangements you are dealing with the parents directly for your compensation and expense reimbursement, putting you in an awkward position. Without a third party to mediate the finances and ensure that sufficient funds have been provided before you start the cycle could become a serious situation, possibly leaving you a very heavy burden of paying items such as costly medical bills which would be in your name. Aside from these scenarios are also other factors like working with parents who may not be local to you and may either want you to undergo a procedure or a birth in another state which may not be legally a forum for the process. Who will be looking out for your interest?
In the many years I worked in the legal industry on fertility related matters, the only times that I experienced clients whether recipient parents or surrogates seeking legal advice or litigation assistance against the other party has been in independent arrangements. Financially speaking, the money spent in attorney fees and litigation costs far surpassed their “savings” from avoiding the agency involvement. An agency can provide you far more security and services especially for the first time surrogate. Now, I am not saying that an agency match is completely free of pitfalls, but from what I have seen, people who choose to forego the services available to them by means of reputable professionals can become subject to a disastrous outcome.
Should you choose to participate in an independent arrangement, be cautious and aware of the “to good to be true” scenario, use your best judgment and always insist on having your own attorney representation and work with only a trustworthy fertility office.
How do I know that I am working with a reputable agency?
Besides experience, longevity in the industry, being in good professional standing within the fertility industry, local community and Better Business Bureau, the best advice I can offer is do your homework! Ask many questions, below are a few examples:
How do I know I am choosing the right Surrogate Agency for me?
- Where does the agency's experience originally stem from medical, legal, etc.?
- What do they offer in terms of support and alternative services if something does not go as planned?
- Are they knowledgeable regarding the legal aspects in the State they do business in and/or the States their Surrogates reside?
- Is the Agency licensed in the City or State doing business in?
- Will the Agency provide you references to other Surrogates they have previously worked with?
- Does the agency following the guidelines/standards/requirements set forth by the ASRM and FDA?
The Agency selection process no doubt can be difficult. How do you choose? Should the compensation package influence your decision? Should you go with the oldest known or largest agency in the industry? These are probably some of the questions you might be asking. Be sure to research the differences and find out exactly what the agency you are considering will provide to you and what you feel you personally need from the agency. There may be services you may need or want in terms of on-going support, participation in group surrogate activities etc., or maybe you don't need or want as much support or involvement. What about the matching process, do they let you have a choice in who you will be working with, what about a say in the number of embryos transferred, multiple pregnancy, termination or selective reduction? All these are important topics to discuss with the agency and see what their take is on allowing a surrogate to have her own voice in these decisions. No matter what option or what your specific needs are, find out who in the agency will be responsible for your case and can you reach them at any time, day or night, week day or weekend. What about emergencies or complications in your pregnancy, what is their protocol to handle these circumstances? You should feel comfortable and confident knowing the person managing your case is accessible and can thoroughly answer all your questions. Your agency choice should be willing to provide you an in-depth consultation, even if by phone, and be willing to discuss the details of their program and surrogacy process. Above all you should feel comfortable and confident in your relationship with your agency and the agency representative assigned to your case.
How long does it generally take to become matched?
The matching process must be one that's mutual for everyone involved. This may be as short as a few days or as long as several months. We feel it best to keep a realistic approach to the matching process. Don't set your expectations so high that you don't allow for someone that could be the right match for you slip by. It's also important to keep in mind that our economy remains in state of flux and while many are still seeking surrogacy to create a child, financially there are fewer resources available in terms of financing and other assistance to parents going through this process.
Will I have a choice in the selection of the couple or individual I work with?
Yes, you will actually be presented with profiles for all available couples or individuals who fit your desired criteria and/or have the same goals/beliefs as you. Because we work with prospective parents from all over the world, who are single, married or gay, we want to ensure that everyone has an equal opportunity to become matched with the right person for them. The matching process is based off of finding you an individual or couple who you feel one hundred percent confident in traveling this journey with. This is a huge step in your life and experience that we want you to enjoy and remember for years to come. Taking the time to review parent profiles carefully, meeting with the parents, possibly even meet with the parents and a therapist or psychologist in a joint therapeutic session can help to discover what each person is hopeful for achieving and learn more about how each person deals with stressful situations. Although every situation is different, finding a common ground between parent and surrogate is of the upmost importance to us. A strong connection with your prospective parent based on mutual trust, respect and understanding is crucial to a successful journey.Will my eggs be used to create the child I carry?
No, our surrogacy program is a gestational surrogacy program. In gestational surrogacy the child you will be carrying for another person will not be your genetic child, the medical process involved (In Vitro Fertilization) entails embryos created from the parents' (or a donor) genetic material which is then transferred to your uterus. Both you and the parents (also referred to as Intended Parents) will enter into a contract (Gestational Surrogacy Agreement) which specifies that in this arrangement the Intended Parents will be the legal and/or genetic parents of the child.Will I have a say in the number of embryos transferred to me?
Yes, as part of our screening and interview process, we will educate you on the IVF process, the standard protocol for embryo transfer and above all get a feel for what your comfort level is.What is Coastal Surrogacy's Screening Process for Surrogate applicants?
Surrogates candidates initially apply with our company either on-line or contact us by phone to receive a surrogate application and program information. A series of basic questions are asked to ensure the surrogate candidate meets the general criteria. Once this has been met the Surrogate proceeds to an extensive application and list of program requirements that she must complete and/or obtain in order to be considered for our program. An in-person interview is conducted with both the surrogate and her spouse/partner. We obtain your previous birth records from your OBGYN and require that a current physical exam and/or pap smear also be completed either by your own OBGYN or primary care physician or one of our choosing. A background investigation and psychological screening will also be completed prior to your profile being made available to any recipient parent. Once matched, you will be sent to the prospective parents' reproductive physician for an in-depth physical exam, testing for both infectious disease screening (would also include your husband/partner) drug screening and any other testing deem necessary by the physician to determine your suitability and ability to conceive and safely carry a child. Any additional psychological or medical testing/screening can be performed at the request of our office, the prospective parents or the fertility physician.
What are the next steps following the matching process and how long does it take?
Generally the entire process of the screening, completing the legal contract and actual surrogate cycle can be completed in as little as two months or may take up to six months.
The next steps summarized are as follows:
- Medical Evaluation of the Surrogate with the Fertility physician (2-6 weeks)
- Psychological Consult for the Parents (1-4 weeks)
- Medical Evaluation of the Parents (1-4 weeks)
- Review of Health Insurance for Surrogate, Child & Parents (1-2 weeks)
- Agency Match Agreement between Parents and Surrogate (1-4 weeks)
- Establish the Escrow Account (1-2 weeks)
- Legal Contract Process (2-6 weeks)
- IVF Cycle (3-4 weeks)
- 1st Pregnancy test following the embryo transfer (10-15 days)
- Pregnancy (36-38 weeks)
Where will I give birth?
All our Surrogates are required to reside and give birth in California. We would prefer you to utilize the same hospital and obstetrician you worked with for your own pregnancies/births. If this can not be accommodated, (OB physician is no longer practicing/hospital does not have sufficient resources for complication or multiples) then we will assist you with locating another obstetrician, specialist and/or hospital closest to your home.How am I paid during this Surrogacy Arrangement?
All compensation installments and/or expense reimbursements will by paid by an escrow holding company. You will be required to complete an expense/compensation payment form each month which will first be reviewed by our office. A copy of this form will also be provided to your Intended Parents who may also need to sign and authorize payment. We request that our Surrogates submit their expense forms on or before the deadline each month to ensure their payment is sent on time.What type of support is provided to me during the surrogate process and pregnancy?
Our surrogates well being is extremely important to us. We remain actively involved during the entire process including the pregnancy, birth and post birth. Each surrogate is provided with a case manager who will be your on-call support, providing you with the knowledge, encouragement and guidance you will need to make this process smooth and memorable. Aside from this, we offer psychological support both individually, as needed and monthly support groups. We have added the resources of other professionals such as Nutritionists, lactation specialists and birth coaching.
Frequently Asked Questions by the Spouses of the Surrogate Applicants:
So Husbands, your wife wants to become a Surrogate but you have some concerns, right? This is perfectly normal; we have addressed some of the frequently asked questions or commons concerns posed by husbands:I am not sure how I feel about my wife's desire to have child for someone else, what if we still want to have our own children? Or, maybe you have not had any children together (second marriage)?
This is definitely a question you and your wife should discuss in depth. It is advised that our surrogate applicants be in a place in their life where they feel their family is “complete” but we understand that this may not be the case for everyone and it does not mean that should you and your wife decide to pursue helping another family through surrogacy that you can not still have more children of your own. The decision to help someone achieve a family through surrogacy is a very important decision which should be explored including the “what if's” worst case scenario and yet very rare, would be what if there are complications that prevent your wife from being able to have another child.
Should she be able to do this without my consent?
No, absolutely not. It is imperative that she have your full support both in her decision to become a surrogate and even more importantly during the pregnancy. We don't want this process to negatively impact your family's life, relationship/marriage and above all add more stress on your wife during the pregnancy. Although your wife will be carrying the child, this is a “team” effort. Surrogacy can be challenging physically and emotionally for both the surrogate's family and the Intended Parents. A good marriage should be based on a foundation of trust, open communication and finding that middle ground. You both should sit down and thoroughly discuss this process and decide whether or not surrogacy is right for your family.How is my family, particularly our young children, to deal with the fact my wife won't be coming home from the hospital with a baby?
I think its best to keep an open and honest approach with children regardless of their age. Even young children are very receptive and understanding of the surrogate process when explained in terms that are age appropriate for the child. Children are also very visual. From my experience, our surrogates who have immediately indentified the Intended Parents as the baby's parents, for example stating “the baby in Mommy's tummy is Michael and Jane's baby” etc. introducing the Intended Parents to their children or by showing photos of the Intended Parents, helps for the surrogate's children to better understand the situation. Very young children may not understand or even remember but toddlers and school age children can easily understand terms like, “Jane's tummy is broken so Mommy is helping her by carrying Jane's baby in Mommy's tummy”. Older children again easily get the concept and again in our experience are very supportive of the idea. Children are so open minded and non-judgmental, I think often times its easy to worry what they will think but I believe you will be pleasantly surprised how supportive your children will be. There are great books available on this subject and with the assistance of our therapist and psychologist who are available to help you prepare your children for the birth, you will have all the tools available to you.
I am worried that me or my wife may become attached to the child which could have serious emotionally consequences for our family?
While I don't yet know you or your wife personally, I think this is very rare. Most surrogates know in their hearts that they will not become attached to the child. As for you, this is yet to be determined. Going into the process, knowing this child is not your genetic/biological child helps to provide some separation or a healthy detachment. There will always be some form of attachment but we want to help you and your wife foster a healthy attachment. Without it, a surrogate will not possess the caring qualities that are needed to provide for the child's well being. Think of yourselves as the guardians or nannies of this child for nine months. Just as nannies/school teachers, love and nurture children under their care they also know at the end of the day they go home with their parents. They know that the child is loved and in the best place it should be, with his/her parents. It's normal and healthy to experience some grieving following the birth. This is generally not grief because there is a “loss” of a child but just that everything has come to an end. For close to one year your life and involvement will revolve around conceiving and caring for this child. Often times, the surrogate and her family become very close to the Intended Parents and once this chapter is over, there may be some sadness, but this is usually mixed with the positive feelings and knowledge of how much you have given this family and the happiness you feel for them. As one of the requirements for our screening process, we will have both you and your wife meet with a psychological professional where you can openly discuss any concerns or fears.How do I explain that my wife is a Surrogate to our friends or family?
This is something that should be a personal decision. You are not required to tell them anything however we have found that most surrogates and their spouses are very excited about their impending adventure and are happy to share this with their close friends and family. Although you will always be confronted with mixed emotions and many questions, most people encounter more positive responses. I think many people, who are parents themselves, feeling blessed to have their own children, can relate to a couple who want a family so badly. With strangers, it's not really necessary to explain the pregnancy or the process; you find that you are inundated with questions and comments. So only disclose what you want and to whom you want. We have many spouses who get quite a laugh when people comment about their wife's pregnancy stating “It's not my baby”! Even funnier when this comes from the Surrogate! The looks on people's faces can be priceless. We encourage keeping a good sense of humor during this process!
What happens if there is a complication during the pregnancy or birth?
Complications can happen in any pregnancy or birth and that will be part of the risks you and your wife must be willing to take. However, your wife is at no greater risk for undergoing a surrogate pregnancy than a pregnancy carrying a child which is yours. Although complications are rare, it's recommended that you and your wife have a consultation with your wife's Obstetrician to discuss the potential risks. Our goal is to provide your family with the resources and help it will need to get through the tough times. This process is not intended to cause harm or added stress whether emotional, physical or financial. We will take every step necessary to ensure your wife and family is taken care of.
What happens if my wife becomes severely sick during the pregnancy?
Morning sickness in pregnancy can happen especially with the addition of IVF medications which some people can be more sensitive to, or if your wife becomes pregnant with multiples, the pregnancy hormones in her body are increased which can result in stronger than normal pregnancy sickness. A good rule of thumb is if your wife suffered with pregnancy sickness with her own pregnancies, chances are this may re-occur in the surrogate pregnancy and for reasons stated above may increase in the intensity. Both of you should discuss if this is something you feel that you are both prepared to tolerate and maybe come up with a plan to help deal with the symptoms which might mean that a greater part of the family responsibilities will fall on you until your wife's symptoms decrease or fade away.What if death occurs?
I think it is safe to say death during child birth or death due to complications from the pregnancy is extremely rare. According to an online search, in the United States, the maternal death rate was 11 maternal deaths per 100,000 live births in year 2005. Even still, statistics indicated that many of these deaths could have been prevented. We do everything possible to ensure the health and safety of our surrogates. All of our surrogates are provided a life insurance policy to help provide some additional financial security for the Surrogate's family.
Will I be involved in the matching process?
Yes, it is just as important for you as for your wife to happy with the couple selected to carry this child for. Again, everything should be based off of a mutual desire to work together, compatibility on all levels including the tougher subjects such as what if each of your beliefs whether religious or personal are not the same? What if there is an abnormality with the child? How does everyone feel about multiples or selective reduction? How much communication is expected both during and after pregnancy? These are some sample scenarios to consider in the selection process. It's important to understand what beliefs can't be changed in individuals and what things some people might be more flexible with.