Surrogacy 101

#SurrogacyMyth: As long as you are of legal age (18) & have had a baby, you can become a surrogate

Sorry but NO. Has it never happened before, an 18-year-old becoming a surrogate? I am sure it has in the past but there are many reasons that it is rare, especially in the USA. Here is my take on why it is best to wait until a woman is at least 21 to become a surrogate.

First, an 18-year-old with a baby, because she has to have had an uncomplicated pregnancy and birth AND parenting her own child as per most requirements, will have her hands full just parenting! Secondly, although she is of legal age to sign a contract, it could be challenged in court depending on the circumstances. Third, the rest of a woman’s fertile life has to be considered. There is a chance that she might lose her fertility due to a complication within the surrogacy pregnancy/birth. Although this is the same for older women it can be even more devastating for those under 21.

Very few 18-20 year old’s will pass the psychological evaluation due to maturity. Responsible and mature women with life experience make the better surrogate/carrier (one would hope). I know that statement will not be a popular one among those younger women but the truth is the surrogacy process is very expensive for Intended Parents. Upwards toward $125,000.00 and that means that the majority of the responsibility rests on the shoulders of the surrogate. She needs to take her part very seriously. A surrogate needs to follow all of the doctor’s orders. She needs to take all of her shots, pills, patches etc. at the right times. She needs to have reliable transportation to attend each and every appointment. She needs to take care of herself even if it means putting her own family on the back burner. If she is put on bedrest that means staying on bedrest, if she is told no sexual activities with her partner then that means NONE. If she is told she can’t lift more than 10 lbs. that means no picking up her 30-pound toddler. She needs to keep track of every receipt, bill, statement and parking permit throughout the process.

Needless to say, for those of you who are under 21 and dream about becoming a surrogate, just wait. Do all of your research, read the qualifications and requirements and be ready when the time comes to fill out that application. Your heart is in the right place and that is the first step!

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#SurrogacyMyth: Qualified women who want to become Gestational Carriers are so easy to find

Searching for someone to help you build your family is never easy no matter what you read in the magazines or online.  Because of the long list of requirements and qualifications, even the most warm hearted and kind women can be rejected for seemingly the simplest reasons. This makes it very difficult to find the right surrogacy candidates even for agencies. Think of it this way: First, the age group of 21-38 (sometimes through 40 depending), then only those who have had an uncomplicated pregnancy and birth are considered. Out of that group, healthy weight and lifestyle (BMI below 30, nonsmokers or drinkers, no STD’s or medical issues such as depression etc.) will continue on. The field is narrowed even further with only those women who are not on state or federal assistance and have their own transportation.

Now, if the woman you are looking for has passed all of these hurdles she still needs to pass a psychological and medical evaluation. More importantly she has to WANT to be a surrogate. Most women do not. They are raising their own families and/or have a career to consider. Or they hated being pregnant. These women may not have husbands or partners who would be supportive of the whole idea of surrogacy. Even if a woman wanted to be a surrogate and met every requirement listed above, if she lives in a state that criminalizes surrogacy, you are both out of luck.

On top of all of these guidelines, requirements, stipulations and so on….there are the “wish lists”. Intended Parents may want a woman who lives locally to them or at least in the same surrogacy friendly state, they may want someone who is of the same religion or race, or they may want someone who will follow a certain diet like vegan or vegetarian for example. They may want a “stay at home mom” or someone without very young children. How about a woman who has her own insurance that allows surrogacy arrangements? And what about her base fee? Low compensation in order to save money? Or maybe money isn’t a issue and the IPs are wanting someone who has been a surrogate before. Not just an experienced surrogate but a successful surrogate. Oh! And someone who would be willing to carry twins! The list can grow very long.

Let’s not forget the surrogate’s side of things. She has her own ideas on who she carries a baby for. She may want a couple who are gay….or not. She might consider carrying for someone who is single or International. She will want her husband or partner to like the Intended Parents too. She might want someone who will allow her to keep in touch after the birth, pump breast milk, or she has visions of lifelong friendship. Maybe she has plans for the money she will make as a surrogate so she is asking for top compensation for her services. She might sign on with an agency or feel like she can “go independent” with no representation. The surrogate’s list can be very long too!

Now I know I haven’t listed all possibilities but this post is just to highlight why finding a surrogate mother, gestational carrier is anything but easy. However, don’t give up hope! Keep your wish list short and your expectations reasonable. You can hire an agency to help you but know that it’s not usual for you to find a match in a week or even a month. These things take time and patience. Surrogacy is not for the faint hearted but for those who persevere.

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#SurrogacyMyth: DNA testing is not needed in the cases of Traditional Surrogacy arrangements

There was a recent surrogacy news article about a Dutch gay couple and their surrogate. She gave birth and the couple was very happy…until the DNA test came back and the baby was actually the Traditional Surrogate’s and her husband’s baby girl. How did this happen? Apparently, the surrogate and her husband had intercourse instead of abstaining when she should have. Needless to say, the gay couple had to give the baby back. You can read all about this case here: http://www.dutchnews.nl/news/archives/2017/05/gay-couple-told-to-hand-back-baby-to-surrogate-after-dna-tests/ ‘As gay parents, you actually have no rights,’ Janssen told the AD. ‘Everything depends on the mother’s willingness and good faith. Apart from an internet checklist, we had nothing on paper.’ It seems that they skipped may steps including drawing up a contract!

This is just one of many examples as to why hiring professionals to assist you during the surrogacy process is so important. DNA testing, especially within a traditional arrangement, can be so important. Don't skimp on surrounding yourself with knowledgeable and competent professionals.  

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#SurrogacyMyth: If a family member or friend volunteers to become your surrogate, she is automatically qualified by all professionals

It’s so nice when you are struggling to find someone to carry your baby for you, a person from your friends or family list steps up and volunteers to help you build your family in the most intimate of ways. Some may think that all they need to do is inform their clinic that they have found a woman to be their carrier and assume that the clinic will just walk them through the process. Not so! I strongly suggest that any IP or woman who wants to be a surrogate do some research before spending a dime.

As wonderful as an offer of surrogacy is, make sure that your friend or family member is qualified. After saying Thank YOU! call your clinic and see what their requirements are for a gestational carrier. There might be an age range (21-40), healthy BMI range, she has to have had a uncomplicated pregnancy and currently parenting her child/children, non-smoker, not on (most) medication to name a few qualifications. Don’t assume that just because she has had a good pregnancy in her past that she will automatically qualified. You want the best person to be your surrogate and even if emotionally your choice seems like a good one there is a lot to be said about a healthy body too!

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#SurrogacyMyth: In the USA, Surrogacy arrangements are valid in all 50 states.

Unfortunately, not all US states have jumped on the surrogacy band wagon! These 5 states are not surrogacy friendly at all (meaning that women from these states should not give birth to a surrogate baby within state lines) Louisiana has very limited laws and I suggest that you talk to a reproductive attorney before you even consider LA. Michigan is a very emphatic NO along with New Jersey and New York. A surrogate could be criminally charged. Washington state allows “compassionate, non-compensated” surrogacy arrangements but all other paid arrangements are considered criminal.

Heterosexual Intended Parents from the above states can work with a surrogate in any of the surrogate friendly states. Gay or single intended parents also have to be aware of the laws in certain states. Here is a great website to learn about each states surrogacy laws from Family Connections GESTATIONAL SURROGACY LAW ACROSS THE UNITED STATES.

Remember that these laws often change and contacting a local reproductive attorney BEFORE you get started in a state you are unsure of is the best advice I can give you.

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Awesome New App: FertiCalm Created by Dr. Alice Domar and Dr. Elizabeth Grill

Wednesday I had the pleasure of hearing Dr. Alice Domar speak on the topic of "Reducing the Burden of Care" at the Seattle Tacoma Area Reproductive Society’s meeting (STARS) in Seattle.  What a great subject especially for those in the fertility field who have set out to help their patients and clients navigate the process of infertility treatments and, at the same time, maintaining a positive mind set. Dr. Domar introduced this great phone app that she helped design called FertiCalm. http://www.ferticalmapp.com This app can be used by women who need coping techniques in everyday situations. (Alice says they are currently working on an app just for men.)

Coping for Every Situation…Any time, Any Place, Anywhere. FertiCalm provides a variety of more than 500 custom coping options for over 50 specific situations which have the potential to cause distress throughout the family building journey located right on your phone.

Dr. Domar and Dr. Grill, the creators of this app, are reproductive psychologists with over 45 years combined experience, at two of the most prominent infertility centers in the US. They provide counseling for women, men and couples as they work to build their families and saw an unmet need. Many people don't have the time, money, or geographical access to see a therapist specially trained in infertility counseling. While FertiCalm is not substitute for treatment with a licensed therapist or psychologist, FertiCalm serves as a helpful resource for women in the exact moment they feel distress, whenever and wherever they are, by providing them with coping techniques for many common social scenarios faced by women on their family building journey.

Check it out and let everyone know what you think! Please leave feedback here, in the comments section!

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#SurrogacyMyth: IVF will work the first time with a qualified surrogate!

In Vitro Fertilization is a true miracle to those needing extra help conceiving a child. Sometimes IVF alone is not the answer, especially for gay couples or women with medical conditions like cancer. When another woman is needed, a gestational carrier, IVF breathes new hope into a once seemingly hopeless situation.

No fertility clinic that I know will guarantee a pregnancy on the first attempt of IVF (or on the 4^th attempt for that matter) The intended parents are the people who usually choose the RE/clinic so we all hope that they have done their homework regarding live birth statistics. All involved also hope that any embryos that are made and transferred are of great quality. They hope that the eggs and sperm are from the most perfect source. There is a LOT of hope involved in IVF BUT, surprise surprise, even if everything is deemed A+, Grade 1, “Excellent”, and the carrier has the “best lining I have ever seen” the IVF process can still fail! And because of this fact, the surrogacy agreement often will state that it will cover the time frame of up to 3 IVF attempts.

My best advice beyond “expect the worst but hope for the best” is for intended parents to do their research and find the best clinic they can afford. Secondly, be prepared for an IVF cycle not to work for no good reason. Everyone is doing their job and it will still fail because we are human and nothing is perfect. Keep the hope, follow doctor’s orders, know that you are not alone but be realistic.  Everyone wants the same thing. A healthy pregnancy and birth.

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#SurrogacyMyth: All health insurance policies cover surrogacy pregnancy and delivery!

Don’t we all wish this were true! But over the past decade or so most insurance companies have revised their policies to exclude surrogacy arrangements. Some policies are vague and read as if there is some wiggle room but a surrogate candidate must be very careful as she reviews her policy. If bills pertaining to a surrogacy pregnancy and birth are submitted to an insurance company that decides that payment is not their responsibility, several things can happen. First, remember all surrogacy contracts state that the Intended Parents are responsible for all medical bills in relation to the surrogacy arrangement. Most, if not all, medical bills are in the name of the surrogate so as she receives these bills she is expected to arrange payment. If these bills are submitted in a timely manner then the IPs may pay them as soon as possible, perhaps money from the escrow account would be used or maybe they will arrange payments with the OBGYN or hospital. If the insurance company takes it’s time with the decision, the escrow account could be emptied and closed as well as the Intended Parents leave the state or the country (If they are International) and these bills could be left for the surrogate to be responsible for. 

This has happened several times. What can be done to make sure that an insurance policy will be held up and make the payments expected? First, have a professional review the entire insurance policy. If there is any question then the Intended Parents need to invest in a backup plan or full surrogacy insurance coverage backed by a Lloyds of London policy. No one wants to be left with bills after giving an amazing gift of life and family, just as no intended parent wants to be stuck with unexpected medical debt.

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Surrogacy Myth’s BUSTED

On Twitter and Facebook I have started the #SurrogacyMyth which is a way to not only dispel current myth’s about the surrogacy process but a discussion starter for those who need or want more information. I also have invited anyone who has a #SurrogacyMyth to share in the comments section of this blog! My next few blog posts will start to bust these myths!

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