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Today, we are excited to share a compelling guest post that delves into the transformative journey of surrogacy as a pathway to parenthood, authored by Eva*, a psychologist based on the East Coast. Throughout our discussions, we’ve explored various avenues to parenthood, such as Elizabeth’s experiences with fostering as a single woman, and Auntie M’s insights on the process of egg freezing. Additionally, we’ve tackled crucial topics like determining if parenthood is right for you, career planning for children, financial strategies for raising kids, and heartfelt advice from women reflecting on their pre-motherhood selves. For further insights, check out our colleague’s account on foster care at CorporetteMoms.

We extend our heartfelt gratitude to Eva for openly sharing her experiences with surrogacy and its intricacies. She mentions, “there is a wealth of information that I have left out — I am happy to answer questions in the comments and can also provide my contact information to the editors.”

Admin update: Due to some unkind comments directed towards our guest poster, I am closing the comment section.

Understanding the Journey of Surrogacy for Aspiring Parents

A few months ago, my husband and I found ourselves in an unforgettable moment in a hospital room, alongside Amanda* and her husband, Josh*, as Amanda brought our daughter into the world. The entire experience was much more rapid than we had anticipated, and I couldn’t help but feel tears of joy as I laid eyes on my daughter’s incredibly small form. This profound moment was filled with emotions that I had never expected to encounter.

Within just 72 hours, we were on a flight back to our home state, reflecting on the unexpected path that led us to this milestone in our lives. This journey to parenthood was not what I had originally envisioned, yet it has successfully brought us to this beautiful outcome (twice now), all thanks to the marvels of science, the generosity of women and their families, and our unwavering determination.

*Names have been altered for privacy.

Exploring the Reasons Behind Choosing Surrogacy

My husband and I tied the knot at a young age, both driven by our professional aspirations. Despite our busy lives, we held a strong desire to become parents and even went so far as to create a detailed list weighing the pros and cons of the timing for attempting to conceive, factoring in our graduate studies and career plans.

After several years of marriage, we decided to embark on the journey of not trying, not preventing (NTNP) conception. As we were preoccupied with our education and other commitments, we didn’t initially think much of the fact that conception was not happening as easily as we had hoped. When we neared the completion of our studies, we began to explore further fertility testing, which ultimately led us into a challenging four-year period filled with various fertility treatments.

After enduring multiple unsuccessful IVF cycles, consultations with three different doctors, and visits to two clinics, we made the difficult decision to pursue surrogacy. Although we were hopeful, we remained uncertain about whether this path would be the solution to our struggles. Our infertility was classified as unexplained, meaning it did not align neatly with any specific diagnostic category.

Step-by-Step Guide to the Surrogacy Process

Note: My experience is limited to gestational surrogacy within the United States. Some intended parents opt to pursue IVF and/or surrogacy internationally.

Let’s clarify some terms: Gestational surrogacy involves using embryos created from the eggs and sperm of the intended parents, while traditional surrogacy entails using the surrogate’s own eggs with sperm from the intended parent. Those who are looking to expand their family through gestational carriers are typically referred to as intended parents (IPs).

Beginning the IVF Journey

The first step in the surrogacy process is to create embryos, which involves stimulating ovarian follicles over several days to weeks with injectable medications, followed by the retrieval of eggs and fertilization with sperm in a laboratory setting. This initial phase is crucial for the success of the journey.

Throughout our IVF journey, my husband and I experienced cycles where we produced few or no viable embryos, alongside many attempts to transfer embryos that ultimately did not implant. It was a challenging process, yet we managed to have some embryos available for the next step, which provided a sense of relief as we began to contemplate employing a gestational carrier.

We had to undergo FDA screening to facilitate the transfer of these embryos to the uterus of a gestational carrier. Had we known from the beginning that we would need to use a gestational carrier, we could have completed this step during embryo creation. The FDA screening involved blood tests and a basic physical examination for both of us, ensuring we met the necessary health standards.

Finding the Right Gestational Carrier (GC)

Some intended parents opt to match with a gestational carrier independently, either through personal connections or social media platforms, while others prefer the support of specialized agencies that help facilitate the matching and logistics of the journey. Each option offers distinct advantages and considerations.

My husband and I chose to work with an agency for both of our surrogacy experiences, as it alleviated some of the logistical burdens associated with the process. However, it was essential for us to maintain a high level of detail orientation and open communication with our gestational carriers.

Different agencies have varying fee structures, ranging from comprehensive packages that cover most costs to more itemized billing. Independent journeys can often be significantly more affordable, as agency fees can vary widely. Regardless of the chosen route, intended parents and gestational carriers typically create profiles that detail personal and medical backgrounds. I found this process somewhat challenging, as it felt like we were required to present ourselves as worthy parents, which, while not the intention, was a personal sentiment I grappled with.

Often, the gestational carrier may not reside in the same state or even region as the intended parents, as limiting geographical options can significantly prolong the matching process. In our journeys, we have been located a medium-length flight away from our gestational carriers.

Once a potential gestational carrier is identified and mutual interest is established, a match call is typically the next step. During this call, all important topics should be discussed, including perspectives on termination, the desired relationship during the pregnancy and beyond, and who will be present during the delivery.

For instance, some intended parents attend every obstetric appointment, while others prefer to receive updates from their gestational carrier afterward. Clear discussions about logistics for labor and delivery are crucial to ensure that all parties are on the same page.

Screening and Embryo Transfer Process

Prospective gestational carriers should undergo pre-screening by the surrogacy agency (if applicable) and must meet the basic criteria established by the American Society for Reproductive Medicine (ASRM). They also need to attend a medical evaluation at the reproductive clinic utilized by the intended parents. If the reproductive endocrinologist approves the gestational carrier’s medical examination and history, she will also undergo psychological screening to assess her readiness for the process.

Intended parents are required to meet with a psychologist during this screening phase to discuss their motivations for pursuing surrogacy, their emotional state, and how they plan to communicate their journey to parenthood with their child and others in their lives.

Once everyone has successfully passed their screenings, the next step involves beginning medications for the transfer cycle, after which the gestational carrier typically travels to the intended parents’ clinic for the embryo transfer into her uterus. Good quality embryos generally have a 50-65% chance of successful implantation and resulting in pregnancy.

During our initial journey, the first embryo transfer was a success, and we were filled with excitement! However, our second journey proved to be more complex — the first transfer failed, the second resulted in a chemical pregnancy, and the third gave us our second daughter (a testament to our perseverance!).

Managing the Pregnancy Journey

After a successful pregnancy is confirmed, the reproductive endocrinologist usually provides care until approximately 8-10 weeks, involving frequent lab tests and ultrasounds to monitor progress. Following this initial period, the gestational carrier is transitioned to her obstetrician for continued care. At this stage, the level of involvement from intended parents can vary significantly and should be discussed in advance to set clear expectations.

In collaboration, the gestational carrier and intended parents typically formulate a birth plan, sometimes with the assistance of a social worker or agency representative, to ensure that everyone is aligned on what to expect during the delivery process.

Depending on the laws in the state where the gestational carrier resides, legal arrangements such as pre-birth or post-birth orders may be drafted. These legal documents are crucial in ensuring that the intended parents are recognized as the legal parents of the baby upon birth. Pre-birth orders are typically signed before the baby’s arrival, while post-birth orders must be finalized by a judge subsequent to the birth. This distinction should be factored into the decision-making process when choosing a gestational carrier; more information can be found in our surrogacy law map.

My husband and I opted to focus our search on states that allow for pre-birth orders to avoid any logistical challenges after the birth.

Birth Experience and Postpartum Connection

As previously mentioned, the birth experience can vary significantly based on the preferences of the intended parents, gestational carrier, and her partner (if applicable). Upon the birth of the baby, intended parents are generally provided a separate hospital room to begin bonding with their newborn and typically remain in the hospital until the baby is discharged.

During our first daughter’s birth, we stayed for two nights, benefiting from the support of nurses as new parents! For our second daughter, we departed after just one night. We made an effort to meet with our gestational carrier at least once post-birth, which is often the case, to facilitate closure and express our gratitude for the incredible gift they provided. After consulting with the pediatrician, we arranged our flights home, each time within a few days.

Contact between parents and gestational carriers after the birth varies widely and should be openly discussed beforehand to ensure mutual understanding and expectations. Our relationship with our first gestational carrier was challenging, and we do not communicate often, though we maintain occasional text contact. However, I have an ongoing phone relationship with our second gestational carrier and we frequently exchange photos.

Addressing Common Questions and Concerns About Surrogacy

Understanding the Financial Implications of Surrogacy

While costs can greatly differ, surrogacy is undeniably an expensive undertaking. Compensation for gestational carriers can range widely, spanning from under $30,000 to over $90,000. This amount typically reflects only the compensation for the time and physical discomfort associated with pregnancy; additional expenses such as IVF medications, clinic and physician fees, travel, lodging, meals, legal fees, and agency fees (if applicable) are often incurred on top of this base compensation.

Will I Form a Bond with My Baby?

This question frequently arises among intended parents. It’s important to recognize that not all gestational parents experience immediate bonding with their newborn — this connection may develop gradually as we witness the first smiles and take time to understand their unique temperament.

Nevertheless, the journey is inherently structured to foster immediate bonding opportunities, which I found to be profoundly impactful. Additionally, if the gestational carrier is receptive, you may begin to bond even before the baby is born. For instance, you could request that your gestational carrier play favorite songs or recordings of your voices during the pregnancy!

Will the Gestational Carrier Experience Emotional Challenges Post-Birth?

Gestational carriers undergo thorough psychological screening and preparation for the final phase of the surrogacy process. I have heard many gestational carriers describe their role as “extreme babysitting,” where they feel they are “giving the baby to their parents” to help “complete a family.” It’s essential that they receive ample support during the postpartum period to help manage any emotional complexities that may arise.

Legal parentage orders are a critical final step to safeguard intended parents in case any challenges emerge at the conclusion of the process. I am actively involved in various groups with gestational carriers and intended parents and have yet to encounter a situation where a gestational carrier did not want to “give up the baby.”

Reflecting on My Personal Journey and Insights Surrounding Surrogacy

Our experience with surrogacy was not without its challenges; our first journey, in particular, was incredibly difficult. However, I am profoundly grateful for the advancements in science that have made this possible, as well as for the selflessness of women willing to carry babies for those who cannot do so themselves. My husband and I are preparing to embark on our third and final journey in the coming months.

Additional Resources

Stock photo sourced via Stencil.