Medical Procedures for Becoming a Surrogate

Becoming a SurrogateIt’s common for women who are considering becoming a surrogate to have questions about the medical procedures that are involved for becoming a surrogate mother.

If you choose IARC as your surrogate agency we will walk you though the entire process and will be there to answer questions every step of the way. However, here are some basics on what is medically required to be a surrogate mother.

Medical Testing

You’ve made the decision to become a surrogate, have been matched with IPS, and signed the contract. The first medical step is infectious disease testing. Your IARC® Program Coordinator will assist you with scheduling an appointment to complete this testing. This testing may be done in your local area. The testing will involve a blood draw and vaginal/cervical swabbing. Clinics will often require an in person visit for this testing as well as a uterine evaluation.

Mock Cycle or Mock Transfer

A mock cycle involves going through the medication regiment to ensure your body responds to the treatment.  This is not common. A mock transfer involves inserting a catheter similar to one that will be used for the transfer in order for the physician to determine your cervical shape, etc. This is more common and would be completed at your screening appointment.

Fertility Treatment

After you’ve completed your medical testing requirements, we will coordinate with you and the intended parents’ clinic to prepare for the medical procedure.

For Gestational Surrogates, this will mean preparing your uterine lining for the embryo transfer. This involves

  • Tracking your menstrual cycles so they are in line with the intended mother’s or ovum donor’s cycles.
  • Taking fertility medications, some of which may be daily injections.
  • You will be required to travel to the intended parents’ fertility clinic the day before the embryo transfer date and will return one to two days after the embryo transfer occurs.
  • You will then be on bed rest for at least 24 hours after the transfer.

For Traditional (AI) Surrogates, you will administer medications, usually via injections, that will improve the quality of eggs produced. This means that:

  • You will likely have several appointments in your local area to monitor your hormone levels prior to when you travel to the intended parents’ fertility clinic for the insemination.
  • The Artificial Insemination procedure feels similar to a pap smear.

In both cases, you will need to complete a blood pregnancy test at your local doctor approximately two weeks after the insemination/embryo transfer.

Medications

The fertility medications you will be taking are all very safe. However, there are some minor side effects that women can experience.

  • Estrace: These are synthetic estrogen tablets. The purpose of these tablets is to thicken your endometrial lining in preparation for the embryo transfer.
  • Progesterone: This medication can be administered as a vaginal suppository, oral medication, or intra-muscular injection. Progesterone is the natural hormone your body produces to maintain a pregnancy. Following an embryo transfer (or occasionally artificial insemination), doctors prescribe these medications to increase or help support your own progesterone to assist in maintaining an early pregnancy.

For more information about medications involved in becoming a surrogate, please visit American Society for Reproductive Medicine’s website.

Pregnancy and Delivery!

All of your prenatal appointments will happen in your local area, so the only travel required will be for the actual insemination/embryo transfer. Even after a pregnancy is achieved, your IARC® Program Coordinator will stay in regular contact with you to make sure that everything is going smoothly with your program, that you are being reimbursed for program-related expenses, and that contact between you and the intended parents is going well.

Bottom Line

We are here to make sure that as many administrative responsibilities as possible are taken off of your shoulders so you and the intended parents can enjoy the pregnancy and the relationship that will develop between you!  This will be an incredible experience for everyone, and we truly appreciate your willingness to give this amazing gift to another family; it is truly remarkable!

Please contact us if you have further questions about the medical procedures involved for becoming a surrogate mother.

Sperm donation requirements: A look inside the Kansas sperm donor legal case

Sperm Donor Legal RequirmentsThe case of a Kansas man who is being sued by the state for child support is gaining national attention. If you are considering donating sperm (or eggs, for that matter), it is important to know the donation requirements and laws to protect yourself from legal implications, such as this one.

Sperm Donor Laws: The Kansas Case

According to the Associated Press, in 2009 a Kansas man answered an online ad for a sperm donation for a lesbian couple looking to have a child. The three signed an agreement that they believed severed the man’s parental rights. However, Kansas law states that a sperm donor is not the father of a child only if a doctor handles the artificial insemination. The law does not specifically address the donor’s rights and obligations when no doctor is involved, which was the situation in Kansas.

A few years after the child was born, the couple fell on tough times and needed to receive state assistance. This caused the state to look to the father to pay the state for approximately $6,000 in public assistance that was given to the couple, as well as pay child support.

Sperm Donor Requirements: How to Protect Yourself

Know sperm donor laws

Although the laws may be in need of updating to keep up with modern family planning, it is important to know the specific sperm donor requirements and laws in your state before you make or receive a donation.

Many states have similar laws to Kansas that require a doctor to assist in the insemination process.   Other state laws allow donation only to a married couple with written consent from both the husband and wife.

Every state may have a different law, and, if two states are involved the process can be even more complicated. If the necessary requirements to address the donor’s presumptive parental rights are not taken, it may be the law of the state where the custodial parent lives (and applies for state aid) that will govern, not the state where the original insemination took place.

Most states still determine parentage based on either giving birth to the child, being married to the birth mother, or being genetically related to the child, among other tests. Progress is being made and some states have begun to implement “the intent tests” – a determination of parentage based on the intent of the parties rather than genetic or birth relationship. Our hope is that the laws will continue to evolve to keep up with modern families, but since the original intent of the parties is now the most important factor in reproduction using a donor and/or surrogate, making sure that intent can be effected under the existing laws of the governing state is critical to success.

Seek professional help

The laws can be complicated and are constantly changing, which is one of the main reasons why fertility lawyers and agencies exist. To help donors and intended parents navigate the process and ensure a successful, legal experience for all parties.

Cheaper is not always better

Can you go on amazon.com and buy a home insemination kit for $29.95? Sure. But as the man in Kansas is learning, that is not always the best—or in the end, the cheapest—option.

The Bottom line

Cases like these are only going to become more prevalent as people and science redefine ways to make a family. The best way to protect yourself is to seek professional help as you are beginning to research your options.

How To Find A Surrogate

How to Find a SurrogateChoosing a surrogate mother can be a challenging first step for many intended parents. However, there are several sources that intended parents can use to find a surrogate mother who is appropriate and reliable.

Surrogate option: Relatives, Friends or Co-workers

One potential source for a surrogate is relatives, friends, or co-workers.

One of the advantages of finding a surrogate whom the parents have an existing relationship with is that it maximizes the feeling of comfort and trust among the parties. This initial trust level can help minimize the parents’ inherent fear that the surrogate will change her mind and want to keep the baby. The ongoing relationship among the parties also increases the likelihood of a continued relationship between the family and surrogate after the child’s birth. This allows the intended parents to have access to the surrogate’s developing medical history, which is important if the surrogate’s own egg is used because her genetic make-up is passed on to the child.

Another advantage is that when intended parents have a relationship with their surrogate it is more likely that the surrogate will charge only a modest fee or no fee at all.

It is important to also weigh the disadvantages in using a relative, friend, or co-worker as a surrogate.  The first is that, in order to volunteer, that person must know of the parents’ situation that led to them deciding to use a surrogate. Not every intended parent discusses such private family issues openly. Additionally, becoming a surrogate is a big commitment and not everyone is lucky enough to find someone willing to help.

Another potential disadvantage is that these volunteers have not been screened and may not be medically, psychologically, or emotionally suited to participate in third-party reproduction. Substantial screening must take place before an agreement can be made, and, if the volunteer is not suitable, there may be a delay while the parents look for another candidate.

There is also a very real risk that going through the surrogacy process together may create conflict among the parties and that unrelated conflict in the parties’ relationship may unnecessarily complicate the surrogacy process. Although there are many success stories involving sisters who have carried babies for their siblings, there are also parents who have regretted using a sister to carry their child because of various negative emotional family issues that have surfaced only after the pregnancy has occurred.

Using a surrogate who is already part of the parents’ social network also complicates the issue of the surrogate’s post-birth contact with the child, especially if the parents want to minimize such contact.

Finally, many administrative details must be managed for the process to go smoothly, and one of the parties will have to take on these administrative responsibilities unless they hire an attorney or other entity to do so.

Surrogate option: Surrogate Mothers Online

Another way to find a surrogate is to surf various websites and find a surrogate who is individually marketing herself to intended parents. Finding a surrogate online has the advantage of significantly increasing the number of potential candidates that the parents can consider.

If the surrogate’s egg will be used, this allows the parents to more easily select a surrogate who shares certain physical characteristics with one of the intended parents if that is important to them. They can also select a surrogate who has no prior or ongoing relationship with their family, thereby permitting a more “anonymous” process.

The Internet also expands the geographic scope of the search for a surrogate, which is especially important for parents who live in a state where surrogacy is limited or banned. Since the law of the state where the surrogate resides normally governs the outcome of the process, as opposed to the law of the state where the parents reside, parents can look for a surrogate in a state where third-party reproduction is permitted. In addition, this type of search allows parents to find a surrogate without incurring the additional fee typically charged by agencies who offer to match them with a surrogate.

With these benefits come certain disadvantages. Surrogates who advertise online are typically in close communication with other surrogates on the Internet in various chat rooms. They are educated on the “market rate” for their services and often charge premium fees (currently around $25,000 or more). The motivation for these candidates is usually more financial than altruistic, and this may make the process feel more like a business transaction than warm, cooperative family-building.

Furthermore, these surrogates have usually not been screened to determine their suitability for third-party reproduction, so the potential for them to fail the screening and delay the process still exists.

If inadequate screening is done, these candidates are the ones who may most likely “change their minds,” even if only to leverage better compensation from the parents. While the parents may want to sever personal contact with the surrogate after the birth, it may be beneficial to keep getting medical information about the surrogate. This can be difficult with an individual surrogate since she may be hard or impossible to find several years after the birth.

Finally, if the surrogate is in another state, it is challenging to maintain the communication, arrange the medical procedures, and implement the financial arrangements among the parties. These administrative burdens will fall either on the parents or the surrogate during the pregnancy (while everyone would rather be focusing on the miracle of birth than the business details of the process).

Surrogate option: Surrogacy Agency

The final source for finding a surrogate is to contact a reputable surrogacy agency to find a surrogate that has been identified and pre-screened for suitability.

This source has the same advantages as finding an individual surrogate on the Internet without the disadvantages. Parents can still select from a large pool of candidates, and they still have sole discretion to select a surrogate based on their own individual criteria.

However, a reputable agency will typically have numerous pre-screened and suitable surrogates available to pick from, so there will be no unexpected delay. These available candidates are screened to find a reasonable balance between their desire for compensation and their desire to give the gift of their services. As a result, they are often available for a more reasonable fee, and are much less likely to change their mind.

In addition, once the surrogate is picked, an agency will usually help negotiate the terms of and refer the parents’ to an attorney who can draft the surrogacy agreement on the parents’ behalf. A full-service agency will arrange and manage all of the administrative details of the process, including ongoing communication between the parties, necessary travel and lodging, medical procedures, financial arrangements, and post-birth legal procedures.

An agency will also stay in communication with the surrogate after the birth in order to monitor and facilitate the continuing exchange of necessary information about the surrogate’s medical history, if desired. This allows a buffer between the parents and the surrogate for post-birth privacy purposes when the parents prefer it.

The challenge in using a surrogacy agency is finding a reputable one. Significant inquiry and research should precede the parents’ selection of an agency with which to work. Just as in all professions, there are good ones and bad ones, and the bad ones should be avoided.

Another disadvantage of using an agency is the additional agency fee, which can run as high as $20,000.  This obviously increases the financial burden on the parents in their effort to have a child. Whether the services provided by an agency justify the fee depends on the individual circumstances and perspective of the parents.

(This article is not intended as legal advice and should not be relied upon as such. Each family and agreement is unique, so you should hire a competent attorney to advise you specifically about your particular case.)

Steven H. Snyder is an attorney experienced in assisted reproduction and surrogacy law.

Please contact us if you have questions or issues that you would like him to address.