A growing list of FREQUENTLY ASKED QUESTIONS (and answers) from and for THOSE EMBARKING ON a SURROGACY JOURNey.
If you have a question that you don’t see answered here, we encourage you to reach out.
+ What are standard qualifiers for becoming a surrogate?
The American Society for Reproductive Medicine (ASRM) has set basic guidelines for the ideal surrogate. The RE and fertility clinic will have their own set of standards that may be stricter or more relaxed then this recommended list.
- You must have previously given birth to at least one (live) child. No more than 5 vaginal births or 3 c-sections.
- You are between 21 – 40 years old, and in good health with a recent healthy PAP.
- You are a non-smoker and do not use drugs.
- You are of a healthy weight with a BMI in the normal range, with the maximum BMI allowed usually a 32.
- Have healthy pregnancies with no complications.
- Be financially stable, and not on any form of public assistance.
- Wait at least 12 months from last tattoo or piercing before pursuing surrogacy.
And though it is not required it is highly recommended that potential surrogates be completely done with their own families (surrogacy may result in infertility) and no longer be breastfeeding.
+ Wait… What do you mean Surrogacy can result in infertility?
Remember that all pregnancies come with risks. Any pregnancy can result in the loss of an ovary, fallopian tube, or even a full hysterectomy. On top of the standard risk, some of the medications that surrogates are placed on suppress their own ability to reproduce and can have long term effects. Therefore, it is recommended that surrogates have completed their families before pursuing surrogacy.
+ How long does a typical surrogacy journey take to complete?
It is safe to assume a completely perfect and healthy journey with no hiccups or complications can be completed in 16 months to 2 years. This is not guaranteed, this is just a safe assumption.
+ What is the difference between a Traditional Surrogate and a Gestational surrogate?
A traditional surrogate is the biological mother of the embryo she is carrying. Fertilization occurs via IUI (intrauterine insemination). A gestational surrogate is NOT genetically related to the embryo she is carrying. The surrogate undergoes IVF (in vitro fertilization aka transfer) to become pregnant.
+ What is the difference between an IUI and a Transfer?
An IUI (intrauterine insemination) is the process in which sperm is placed within the uterus to encourage fertilization. IUI increases the odds of fertilization by increasing the number of sperm that make it to the fallopian tubes. It is less invasive than IVF.
Transfer (aka IVF, in vitro fertilization) is the process of fertilization by implanting a fertilized embryo into the uterus. The embryo is grown in a petri dish by combining egg and sperm and then growing for x amount of days before transfer.
+ What is the difference between a 3-day transfer and a 5-day transfer?
Embryos are typically transferred on day 3 or 5. The day of transfer typically depends on the embryo’s quality and laboratory practices. The type of embryo transferred will be up to the RE and IPs.
+ What are some of the common medicines I may be taking?
Each surrogacy journey is special and unique. Some or all these medications may be in your med protocol.
- Birth control- used to regulate the surrogate’s cycle so they can plan the best time for transfer/IUI
- Lupron- a subcutaneous injection, commonly done in the stomach with a 23g needle, used to suppress ovary production.
- Progesterone- used to thicken the uterine lining to prepare the uterus for transfer. Progesterone can be prescribed in many forms. The most common forms being PIO (progesterone in oil) which is an intramuscular injection, vaginal gel (Crinone), or vaginal suppositories.
- Delestrogen- an intramuscular injection form of estrogen used in fertility treatments.
- Medrol- a steroid used to decrease the chance of inflammation in the uterine lining.
- Doxycycline- a broad spectrum antibiotic that insures the uterus is free of bacteria prior to transfer.
- Prenatals- multi-vitamin recommended throughout pregnancy and after birth to insure you are getting adequate amounts of vitamins/minerals (i.e. folic acid).
+ What is a hysteroscopy? And why would I potentially have one performed?
Using endoscopy via cervix, the inside of the uterus is checked for health. A hysteroscopy can be used to diagnosis a bleeding disorder or as a method for surgical intervention.
+ What is an Intralipid fusion?
An intravenous drug that increases the number of calories that a person needs to consume. This drug is used to suppress white blood cells and can potentially protect someone undergoing IVF from miscarriage.
+ What are the steps for the application and screening process if I go through an agency?
All agencies have their own protocol and approval process, but a potential surrogate can expect an initial application, an in-depth look at your medical history, a physical (including a PAP), background checks for surrogate and surrogates significant other, a mental health screening for the surrogate and surrogates significant other, drug testing for surrogate and surrogates significant other, and an in-home assessment.
+ You mention “surrogates significant other” …. What if I am single?
Surrogates come from all walks of life. Having a significant other is not required. Though you will want to have a strong support system while pursuing surrogacy. If you do have a significant other, they need to be 100% on board with pursuing surrogacy.
+ Where can I dispose of my full sharps container?
Each state has their own laws regarding how to handle and dispose of sealed sharps containers. Check out this website for more information https://safeneedledisposal.org/ .
+ I am interested in becoming a surrogate, but I am unsure of the laws regarding surrogacy in my State…
Proceed with Caution states:
- Alaska (too many unknowns),
- Arizona (contracts are unenforceable),
- Florida (for married couples only),
- Indiana (contracts are unenforceable),
- Iowa (surrogacy laws are unclear, Post-Birth orders only),
- Louisiana (some situations are unenforceable),
- Michigan (surrogacy prohibited, compensated surrogacy can face criminal charges),
- Nebraska (compensated surrogates- void and unenforceable contracts),
- New York (contracts void and unenforceable, compensated surrogates can be fined),
- Oklahoma (though surrogacy is allowed legal hurdles are common),
- Tennessee (for married couples only),
- Virginia (surrogacy permitted with stipulations),
- Wyoming (surrogacy laws are unclear).
Surrogacy Fully Permitted/Allowed States:
- Washington D.C.,
- New Hampshire,
- Rhode Island
+ Oh no!! I don’t see my state on either of these lists…
Surrogacy laws are changing and developing every day. Some states allow surrogacy but with stipulations. To check out the exact laws in your state check out https://www.creativefamilyconnections.com/us-surrogacy-law-map/ for a continuously updated map.
+ What is a Pre-Birth Order?
A pre-birth order is the legal document stating who the legal parents of the child(ren) during a surrogacy journey. The process to establish this documentation starts at about 20 weeks gestation.
+ What are some questions the surrogate should ask themselves before they match to help find the perfect match for them?
- Are you comfortable carrying for any couple, single parent, LGBTQ, different religions….?
- How many embryos are you comfortable transferring? How many babies are you comfortable carrying (remember embryos can split)?
- Have you researched the risks that come with carrying multiples?
- How do you feel about termination? Selective reduction?
- Are you interested/willing to pump breastmilk for the baby/babies after birth?
- What kind of relationship are you looking for with the IPs?
Remember there are no right are wrong answers to these questions. These are your own personal preferences and allow you to narrow down who you could potentially carry for.
+ Are there any other helpful websites?
- Fertility Clinic Statistics can be found at https://www.sart.org/
- Agency reviews (Facebook Group) https://www.facebook.com/groups/309663056048549/?hc_location=ufi
- Recommended Attorneys specializing in reproduction and adoption by State https://adoptionart.org/assisted-reproduction/
- Surrogacy legal status per state can be found via this interactive map https://www.creativefamilyconnections.com/us-surrogacy-law-map/
- Fertility Treatment Grants and Financial Advice
+ What about facebook groups?
- California https://www.facebook.com/groups/768383676533173/
- Canada https://www.facebook.com/groups/964764733570234/
- Florida https://www.facebook.com/groups/328899380636177/
- Florida https://www.facebook.com/groups/1433483150202066/
- Georgia https://www.facebook.com/groups/georgiasurrogacy/
- Kansas http://kcsurrogacy.org/
- Louisiana https://m.facebook.com/groups/795246530564869
- Midwest https://www.facebook.com/groups/276911959046461/
- Missouri http://kcsurrogacy.org/
- New England States https://www.facebook.com/groups/1488002701447934/
- N Carolina https://www.facebook.com/groups/SurrogatesandIPsofNorthCarolina/?hc_location=ufi
- Ohio https://www.facebook.com/groups/772807882803476/
- Oregon https://www.facebook.com/groups/492125770960670/
- Pacific Northwest https://www.facebook.com/groups/411979132282944/
- S Carolina https://www.facebook.com/groups/648530788572453/
- Texas Regional https://www.facebook.com/groups/texas.surrogacy/
- Utah https://www.facebook.com/groups/1473264946316960/?hc_location=ufi
- Wisconsin https://www.facebook.com/groups/1510695919222390/