Surrogacy 101: Everything You Need to Know

A few years ago, many of us may have heard of surrogacy but we knew little nothing about it. But it is becoming much more accepted, and less stigmatized these days. Getting pregnant isn’t easy and as surrogacy becomes legal in more and more states and countries, singles and couples – both gay and straight – are opting for it as a chance to start the family they never thought they could have. Unfortunately it’s far from a straightforward process. It’s both financially and emotionally draining, so it’s imperative to understand how it works.

To find out about the basics we turned to Dr. Jenna McCarthy, the medical director for WINFertility.

Momtastic: Who is a candidate for surrogacy?

Dr. Jenna McCarthy: Laws vary from state to state. For example, in the state of Florida, women can only use gestational carriers for medical reasons. Some states do not allow paid carriers at all while other states allow social surrogacy in which women use a carrier for any reason. The ideal gestational carrier is a healthy woman between the ages of 21 and 45, who has had at least one full term pregnancy. In addition to women who have found their carriers through an agency, I have worked with women who have used their friend, their sister, their cousin or their coworker as their gestational carrier (GC).

Momtastic: What is involved in the process from a medical standpoint?

Dr. Jenna McCarthy: Typically the first step of a gestational carrier cycle is for the intended parents (IP‘s) to create embryos using IVF. Once they have embryos cryopreserved (frozen), they then identify a gestational carrier.

Gestational carriers go through a multi-step screening process before they are selected, including a full medical exam and psychological evaluation.

During the cycle itself, the GC will take hormones to prepare the lining of the uterus for an embryo to implant. Once the uterus is ready, the GC comes in for her embryo transfer. The embryo transfer is simple and painless. A soft, flexible catheter is passed through the cervix under ultrasound guidance and the embryo is gently deposited near the top of the uterus. Most of the time, the intended parents are present for the embryo transfer.

Momtatic: Are there legal issues people should know about?

Dr. Jenna McCarthy: The laws regarding gestational surrogacy vary from state to state and it is critical to consult with an attorney who is an expert in these matters in your state.

Momtastic: How long does the process usually take from start to live birth?

Dr. Jenna McCarthy: It varies widely on each couples’ circumstances, but typically it takes at least a year before they’ll get their first positive pregnancy test. This time frame includes the time needed for the intended parents to go through the IVF process and freeze embryos, then find a gestational carrier and for her to complete all of the screening and legal contracts (legal often takes longer than the IPs expect it to), and then go through an embryo transfer cycle. Unfortunately, sometimes the first cycle doesn’t work, in which case the GC will need to go through another embryo transfer cycle.

Momtastic: Do you see many people going to foreign countries to save money? 

Dr. Jenna McCarthy: While international surrogacy exists, I do not recommend this for my patients because of the potential legal and health risks.

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