Becoming A Parent Trough Our Surrogate Process
Gestational surrogacy is becoming increasingly common, helping thousands of couples and individuals who are unable to carry a pregnancy to term, grow their families. However, the average surrogacy process requires hundreds of tasks to complete, many of which can make this path to parenthood feel overwhelming and complicated.
First Step Surrogacy and Egg Donation is here to help you not only find the perfect surrogate mother but to also provide the personal guidance and support you desire throughout every step of the surrogacy process and beyond.
Screening of potential surrogates including in-depth applications and consults, criminal background checks (for both surrogate and partner if applicable), medical record and financial reviews, insurance pre-approvals, labs and medical screenings, and psychological evaluations (for both surrogate and partner if applicable)
Surrogate selection and matching as well as support with negotiating surrogate fees
Monitoring your surrogate to ensure she is attending all required appointments and providing updates
Setting up a birth plan for you, your surrogate, and the hospital where your baby(ies) are expected to be delivered
Providing referrals to trusted and vetted resources you may need throughout the surrogacy process, including:
Reproductive endocrinologists and fertility centers for you or your egg donor and your surrogate
Financial, escrow and trust fund managers to help negotiate contracts and establish escrow (where funds for your surrogacy journey are held and paid out)
Legal counsel specializing in reproductive law for support throughout the legal process including contract drafting and pre-birth orders
Insurance experts for obtaining life and/or health insurance for surrogate if she does not have an existing plan
Continuous support and contact throughout the process so you know what to expect at every phase
With First Step Surrogacy and Egg Donation, you’ll get the luxury of a personal experience and customized support without the VIP price tag.
When you’re ready, we encourage you to take your first step and contact us. During your initial consultation, we will walk you through the surrogacy process in detail and/or answer any questions you may have completely free of charge.
How the Surrogacy Process Works
The length of the surrogacy process can vary and there could be minor differences in your journey. Below is a common outline of how the surrogacy process works. We encourage you to be as involved as you’d like to be throughout the process. From your first consultation to your baby’s delivery, First Step will be by your side every step of the way. There is plenty more information in our page How to become a surrogate mother.
THE FIRST STEP
1. Your initial consultation
Choosing surrogacy is a big decision and we want you to feel confident in knowing you have all the information you need to make the right decision. During your 60-minute consultation, we will answer any questions or doubts you may have. You will also learn more about our surrogacy program and your options so you understand what to expect throughout the entire process. Our consultations are currently held through video conferencing and are offered in either English or Spanish.
2. Getting started
This is the official first step of the surrogacy process! In order to match you with the perfect surrogate and/or egg donor, we need to get to know you. To do this, we’ll have you fill out a detailed questionnaire that will include your preferences to be used when finding your surrogate match. Then we’ll schedule a meeting with your Case Manager who will walk you through the next steps and provide you with support throughout the remainder of your surrogacy journey. You’ll sign an agency agreement and return it with an initial agency fee to continue with our program. Accepted payments include secure online transactions with PayPal or bank wire transfer. Financial assistance resources can also be provided if needed.
At this stage, we also will help you understand the legalities of surrogacy and provide guidance in selecting a reproductive lawyer if you don't already have one. If you need an egg donor, we will match you with one at this stage, before finding your surrogate. Unlike many other agencies, we do not provide open access to our donor database but rather hand-select donors that fit your criteria and preferences.
3. Surrogate screening and matching
Before any matches are made, our surrogates are extensively pre-screened to be sure they are physically, emotionally, and financially ready and able for surrogacy. This helps mitigate the risk of a surrogate not passing part of the screening and delaying your process. You will only be matched with a surrogate after she has passed the high standards of our screening process. To complete our screening process, surrogates are required to complete and pass the following standards:
Application and Background
Complete an in-depth application and personal interview with First Step that includes details about her family life, employment, medical history, and motivation for being a surrogate
Be a citizen of the United States and between the ages of 21-45
Live in a state that is surrogacy friendly. States where surrogacy is illegal include: Alaska, Arizona, Indiana, Louisiana, Michigan, Nebraska, and Wyoming.
Pass a criminal background check (for both surrogate and partner if applicable)
Complete a full medical record review by IVF physician including previous pregnancies and deliveries, with completion of at least one full-term pregnancy and delivery of her own
Complete and pass medical examinations that include an intrauterine ultrasound and infectious disease screening with written consent from OBGYN to carry a pregnancy
Have not had a past occurrence of serious pregnancy complications. We value the health and safety of our surrogates and the babies they carry so we do not accept surrogates with a history of pregnancy complications.
Do not have any health conditions that can become worse with pregnancy.
Be in overall good health with a BMI of 35 or less
Evaluation and Insurance
Complete and pass a drug screening of drugs and nicotine.
Complete psychological evaluations (for both surrogate and partner if applicable) and not have any psychiatric illness
Receive third-party review and pre-approval of health insurance policy to determine if an existing policy can be used for surrogate pregnancy
Be financially fit enough to support herself with no form of government financial assistance and be in a healthy living situation
At First Step, we put a lot of effort into finding the best match possible for both the intended parent(s) and the surrogate. We don’t have you sift through hundreds of potential surrogates in a database but rather, we personally review and hand-select potential matches that fit the predetermined preferences and criteria for both parties. We never want a match to feel forced so we match based on the following criteria:
Personality fit: Compatibility matters because we want you to have a comfortable and natural relationship with your surrogate throughout the entire process.
Surrogacy expectations: This includes the number of embryos to transfer and preferred level of communication throughout the journey.
Views on termination and selective reduction: This is particularly important in that if a situation ensues where a reduction or termination must be considered, we want the views of both parties to coincide.
Location of surrogate and legalities: Surrogacy laws vary state by state so we want to ensure that the laws from each party's home state complement each other.
Once both parties agree to a match, we will set up a meeting to meet your surrogate either in person or through video conference, with the assistance of your case manager. Simultaneously, the next step of the process begins. If the match doesn't work out, we will rematch at no cost to you as long as the legal and medical process has not started.
4. Legal contracts and escrow
After being matched, each party will work with its legal representative to discuss risks and responsibilities, negotiate legal contracts, and establish escrow for the surrogate’s compensation. This is the time to discuss and mutually agree on any issues regarding the pregnancy. The escrow or trust account must be funded before the medical cycle can begin. Funds are paid to the surrogate in amounts predetermined by both parties and as specified in the agreed-upon contract.
Surrogacy laws vary state to state and it is illegal in a handful of states. Your reproductive attorney can help you understand the laws in your state and your rights.
THE MEDICAL PROCESS
5. The medical cycle
Once everyone is in agreement and the contracts are signed, your surrogate will start to be prepped for the embryo transfer process at the IVF clinic of your choice. Your reproductive endocrinologist will provide a more extensive medical evaluation of your surrogate and a cycle calendar that details the date of embryo transfer. From this point on, the general medical cycle will look something like this:
Preparing the embryo for transfer
Your surrogate will be prescribed self-administered hormones to prepare her body to accept the pregnancy, as well as estrogen patches to help thicken the lining of her uterus. The timing and process of transfer will depend on whether you are using frozen or fresh embryos. If using frozen embryos, the transfer will be done according to your surrogate’s cycle.
With a fresh cycle, you or your egg donor will make embryos to be transferred. First, to stabilize your hormones, you (or your egg donor) will be given birth control. Then in order to synchronize your cycles, you (or your egg donor) and your surrogate will be given Lupron injections that suppress hormone production, helping create more balanced hormone levels throughout your cycle and giving the physician more control over both cycles. This also ensures that your surrogate’s uterus will be ready to receive the embryos at exactly the right time.
Following Lupron, you (or your egg donor) will begin taking injectable fertility hormones (FSH) which stimulate the ovaries to produce several eggs. Once ready, you (or your egg donor) will be given an HCG shot which will prepare the egg for retrieval 36 hours later. On the day of retrieval, your surrogate will begin her hormone shots to prep the lining of the uterus and will continue on hormones through the 12th week of the pregnancy.
If using fresh embryos, your surrogate's cycle will be synchronized with that of the intended mother's or an egg donor's cycle through the use of medication. Assisted reproductive technologies , such as in vitro fertilization (IVF), have revolutionized the field of reproductive medicine. Traditional surrogacy, where the surrogate is also the biological mother, is much less common these days, and gestational surrogacy, where the surrogate carries an embryo that was created using either the intended parents' or donors' gametes, is the preferred method.
The American Society for Reproductive Medicine recommends that all parties involved in surrogacy have independent legal representation and that the intended parents and surrogate have psychological counseling prior to entering into a surrogacy arrangement.
Transferring the embryo
Depending on the agreement laid out in your contract with your surrogate, one or two embryos will be drawn up into a thin, flexible catheter and then transferred into your surrogate’s uterus using an abdominal ultrasound to ensure exact placement of the embryo. Embryo transfer will take approximately 30 minutes. The transfer tends to be a quick and painless process.
If possible, you can be there for support as this is an exciting step in the process to growing your family!
Around 9 days after the embryo transfer, your surrogate will have her first pregnancy test via a blood test. If she is pregnant, she will be monitored to ensure her HCG levels continue to rise and that the pregnancy remains viable. If this is the case, an ultrasound will be conducted around week 5 or 6 of the pregnancy to check if a heartbeat is detected. If the heartbeat is heard, your surrogate can officially be considered pregnant!
She will continue to be monitored at the fertility clinic until the end of the first trimester (around the 12 week mark). She will also begin to see her OB/GYN between week 6-8 and continue for the remainder of the pregnancy. We understand you may feel anxious as your surrogate transitions from your IVF doctor to her OB/GYN. We ask our surrogates to keep open communication with you and if possible include you in her appointments.
About 6 weeks before the birth we will begin to prepare you, your surrogate, and the hospital for the delivery of your baby! The goal is for everyone to be prepared and for expectations to be addressed before your surrogate arrives at the hospital to give birth.
7. Labor and delivery
Intended parents usually want to be a part of the labor and delivery if possible. However, hospital policy and your surrogate’s preference will determine who will actually be present in the delivery room. After delivery, the baby(ies) will not be released from the hospital until your surrogate has been released. Providing breast milk is not mandatory but should be discussed during the surrogacy, with expectations and compensation agreed upon beforehand and included in the contract. The baby(ies) will be released to you and you will have some legal paperwork to complete in order to obtain the birth certificate(s) (and passport(s) if you are international). Your surrogate will be required to fill out some paperwork as well to help you establish guardianship and legal rights to your child(ren).