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Everything you need to know about how to start the surrogacy process

If you or your partner are unable to carry your own child, the surrogacy process could be the option you’re looking for. It’s possible to have a baby genetically related to you and/or your partner and to be there along the way as your baby develops even if it’s not in your own body. Of course, that begs the question, how does surrogacy work?

A surrogate can carry a baby for you if you’re not able to. The process can be expensive, but if other family building options like adoption are not on the table for you, surrogacy is a gift that can help make your family a reality. There are different types of surrogacy and the term often refers to gestational surrogacy, also called full surrogacy, where the surrogate carrier has no biological connection to the baby. Read on to learn more about this type of surrogacy and how to get started with the process.

Pregnant woman feeling baby kicking

How does surrogacy work?

Surrogacy is the process when one person carries another person’s baby in their uterus. The couple or individual provides the embryo to be implanted in the surrogate’s uterus. The embryo could be formed from a donor egg and/or sperm or the couple’s egg and/or sperm. The baby doesn’t have any genetic relation to the surrogate unless she is also the egg donor. The surrogate may be considered a birth mother but she is not the intended parent.

By using a surrogacy agency, the legal paperwork will have been drawn up and clear expectations will have been laid out to dictate if the surrogate will have any contact with the baby after birth. She might be asked to donate her breastmilk, and the intended parents might be willing to share photos or visits, but it is not the same as an open adoption. In many cases, a couple and the baby may not have any or much contact with the surrogate again after the days or weeks right after the birth, other times she might become a family friend of sorts.

A surrogate has her own life and family and carries someone else’s baby to help them become parents when choices and circumstances might dictate otherwise. Surrogates are popular options for couples made up of two men or couples of a man and a woman where the woman cannot carry a child because of an issue like a hysterectomy, hypertension, PTSD, history of multiple miscarriages, heart conditions, or other issues that would make pregnancy impossible, dangerous, or unhealthy.

How do I get started finding a surrogate?

The first step is to find a reputable agency to guide you through the surrogacy process and match you with a surrogate. It isn’t recommended to go out on your own to find someone online or through word of mouth because of the background checks and accountability the agency can provide. It’s hard to imagine a more important job in the world you’re considering someone for so you want to be thorough. Depending on your area, there are also laws around surrogacy to consider.

When considering an agency, you want to ask them what they screen the surrogates for. You want to make sure all of the physical screenings are covered like HIV, hepatitis, anemia, hypertension, heart problems, and so on. Since the baby is not genetically the surrogate’s, a family history of things like cancer is not really a problem, it is mostly about the surrogate’s current physical health and her personal medical history. Within the physical screenings, there are also fertility questions. Ideally, she will have carried a baby to term in the past and given birth so that you know she is able to get pregnant, stay pregnant, and deliver. There is also the psychological screening to make sure she is mentally ready to carry a baby that isn’t hers and hand the baby over after giving birth. That can be emotional for anyone of sound mind and counseling for all involved is a good idea, and often required. There are also criminal background checks, financial reports, letters of recommendation, family interviews… Ask about how in-depth the process is for surrogates.

In addition to their screenings, ask about what services they provide. Do they have in-house lawyers for drawing up contracts? How much of the fertility work like embryo transfer is done in-house after the match is made? Do they work with social workers to facilitate the process? The answers to these questions are good or bad or right or wrong, but they will help you understand what you are and aren’t receiving for what you are paying.

Above all, ask about the agency’s success rates. According to the CDC, which monitors all IVF data in the United States, 23.6% of IVF embryo transfers result in a live birth. Are their rates on par with the average? Do they find a match for every person seeking a surrogate? Do they make any guarantees?

Every surrogacy journey is different

Once you have an agency, the process to match you with a surrogate will depend on their own procedures. In many cases, the agency will interview you in-depth for what you are looking for and then present you with a surrogate match. Of course, finding your surrogate is only the beginning! But you’ll be well on your way from there to beginning a pregnancy that will lead to the baby that will add a missing piece to your family.

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Sarah Prager
Sarah is a writer and mom who lives in Massachusetts. Her writing has appeared in The New York Times, The Atlantic, National…
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