Surrogacy is an arrangement often supported by a legal agreement whereby a woman voluntarily agrees to become pregnant, carry the pregnancy, and deliver the child, all of this for another person or persons who have always intended to be the parents or parents of the child.
There are many reasons why a person or persons need the assistance of a surrogate:
- No uterus or related structural problems such as scarring and the inability to develop a thick, supportive uterine lining.
- Advanced maternal age.
- Difficult past pregnancies.
- Delivery complications.
- Serious medical conditions include hypertension, heart disease, spinal issues, etc.
- Recurrent miscarriages or repeat failed in vitro fertilization cycles.
- Single man or gay male couple who want to be parents.
- Unexplained infertility.
- Severe postpartum depression.
- Medications that are essential but unsafe for pregnancy.
Surrogacy can be undertaken as a private or independent journey or with the assistance of a surrogacy agency. Full-service agencies and matching services exist, and surrogacy agencies operate in numerous countries. Choosing the right agency for you is a key part of the process.
Here are 10 tips to guide you:
Choosing the Country
Surrogacy is available in various countries globally, with each nation having unique legal stances ranging from full legality to mere tolerance to banning the practice. The primary factor to consider when deciding on a suitable country for your surrogacy journey is the level of risk you are comfortable with. Countries without any laws supporting surrogacy present a higher risk, while those with legal provisions for surrogacy offer a lower risk. In the latter case, be sure that you adhere strictly to all the rules stipulated.
Engaging legal representation from your home country and the country where the birth will occur is a key element in reducing the risk factor. Certain nations extend citizenship to children born through surrogacy, a positive factor. If the chosen country does not offer citizenship to children born via surrogacy, it is vital that you confirm that your child can acquire citizenship in your home country.
You must understand these pivotal aspects to avoid embroiling in years-long legal battles costing hundreds of thousands of dollars to establish your child’s citizenship. You and your child may have to remain in a foreign country for months or even years if your child is barred from entering your home country due to a lack of citizenship paperwork. Therefore, it is essential to carefully consider these risks, formulate contingency plans, and calculate potential costs. By consulting with an experienced attorney, this pre-planning will give you a comprehensive view of possible scenarios, allowing you to prudently evaluate the risks and strategize your forthcoming steps.
The Costs
Surrogacy is expensive no matter where you go. The question is, how expensive can it be? Each agency that you interview should provide you with an estimate of the costs for a typical surrogacy journey. Be sure to get these in writing. Ask what expenses are not included in the fees that you will most likely incur. In addition, do not forget to factor things in, such as your travel costs, how much time you will spend away from home, legal fees to establish your parental rights, fees to establish your child’s citizenship, and in obtaining a passport for your child. Ask what the surrogate’s medical insurance does not cover and what costs will your newborn baby incur if born premature or in need of a medical procedure. The main point is to ensure you have adequately budgeted for every eventuality.
Experience of the Agency
How long have they been in business? Experience does matter in the field of surrogacy. Since this field deals with people rather than commodities or products, by its very nature, this automatically means that no two cases will be identical – as no two people are alike. Ideally, it would be best to consider working with an agency with at least five years of relevant experience. Of course, every agency may have started with no experience and may have grown to become well respected, but along the way, many agencies still need to make it to the 5-year mark. So, you may consider whether you want to be the one helping them become established or go for a more proven entity; the choice is yours. Also, try to determine the experience of each staff member, as it is to your ultimate advantage to have employees who each have years of experience to offer you. Experience permits an agency to realistically set the expectations of the journey, whereas newer agencies may need more to draw upon. Inexperience could also mean that they are more likely to miss significant aspects of your case that will ultimately cause problems later in the journey.
Consultation
Arrange a consultation with each agency you are considering for your surrogacy journey. Nothing beats direct interaction, even via a digital platform like Zoom. Aspects to consider include the ease of scheduling the consultation, their punctuality and preparedness, the transparency in their responses, or whether they seemed hesitant or vague. Did they allocate sufficient time to answer all your queries?
The consultation presents a unique chance to probe deeper than the information on the agency’s website. Given that a surrogacy journey is expected to last approximately 18 months, from engaging an agency to your baby’s birth, it is essential to invest time initially to establish trust and a connection with your chosen representative. After all, once you have signed up, you will be in their hands for a significant amount of time. Therefore, thorough research is a must!
Services Offered
Each agency will offer specific services, so knowing what is or is not provided is important. Do they offer full-time counseling services? Do their fees include legal services? Where will your surrogate deliver, and will the agency help evaluate the delivery hospital? How many staff members are assigned to your case? What services are offered to your surrogate? How is the money you deposit into the escrow or trust account for this surrogacy journey managed? How is your money safeguarded? How can you be assured your surrogate will receive her fee and reimbursements? Is the agency affiliated with any of the professionals referred to you? If yes, discover the extent of that relationship, as you may not be getting the objective view that you may think. Each agency offers unique services, and it is your responsibility to assess and identify the differences to find the one that aligns best with your needs.
Check References
Ask the agency for references and then follow up on them. Ideally, ask for one from an intended parent who lives close to you. Although agencies are only going to give out names of intended parents who had a successful journey with them, the fact is that they have had a successful journey! They will have information to share with you, albeit only glowing reports, but it is new to you. They may have tips to share about travel or how they developed their relationship with their surrogate, how they dealt with insurance issues, how they prepared to travel with a newborn, etc. You can inquire about which attorney they worked with, the process, and the costs involved. If you ever find yourself in a difficult situation, you may be able to contact this reference and ask for their advice or suggestions.
Screening of the Surrogate
Invest some time in understanding how the agency selects and screens its surrogates. Knowing the process your potential surrogate underwent can be enlightening. Does a licensed mental health professional screen their surrogates? If yes, was psychological testing done or just the psychological interview? Consider asking if you could consult with this counselor to glean further insights about your surrogate beyond the information provided in her application.
Was she medically screened? Ideally, the embryo transfer doctor should be the same doctor or the doctor’s colleague who screened your surrogate. If she is married or has a partner, was this individual screened, and to what extent? Note that some agencies will screen your surrogate before you meet her, and others will screen her after you agree to work with her. There are no absolute rights or wrongs, and each agency has its unique process that works best for them.
It may, however, be important to understand the costs involved when a surrogate does not pass the screening process. If you, as the intended parent, must incur these costs, what will they amount to? Similarly, are there limits to the amount you are responsible for paying for someone who cannot ultimately work with you?
The Matching Process
The surrogate matching process can significantly differ among agencies. Some may ‘assign’ a surrogate to you, while others present several candidates for you, the intended parent(s), to select from. When multiple candidates are presented, it is not uncommon to instinctively form a bond with one of them.
When evaluating agencies, note all the differences in the matching process and compile a list of pros and cons. Determine upfront what your deal-breakers, or ‘red lines,’ are. Then, take a break from all this research, ensuring you are away from immediate emotions or impulsiveness. Come back and revisit your list, and at this juncture, you should be equipped to decide which agency’s process aligns best with your needs.
Involvement in the Pregnancy
How involved do you want to be in this pregnancy? Do you want to participate in some or all medical appointments? Do you want regular updates along the way? Do you want to be present for the birth of your baby? Some agencies will take care of the entire process, give you monthly updates, and, after delivery, present you with your newborn. Other agencies encourage interaction between the intended parent and surrogate directly. Once you have decided what level of involvement feels right for you, choosing an agency offering your preferred journey will make your choice much easier.
Working Remotely & Pandemics
A lesson was taught to us all in 2020. Pandemics are a reality and will likely happen again, but maybe not with the same public level of fear attached. Every company must equip itself to cope better with a pandemic or natural disaster. Evaluating agencies should include asking them how they coped with the COVID-19 pandemic. If the agency has paper files, how did it access them? Does the agency have an online database system, or even better yet, a CRM (customer relationship management), readily available to staff working from home? None of us know what the future holds, but we are all better equipped and wiser about what must happen to prepare for the future. You should inquire about what the agency has done to date or their plans to prepare for potential catastrophes. We have all read stories of babies being left isolated from their parents because of Covid-19 when travel between countries was restricted. A key question would be how and when these agencies could reunite their intended parents with their babies. What lessons were learned, and how will these changes benefit you? Determining what level of risk is involved in working with this agency during another shutdown could be the best research you could ever do.
If you take your time and research, you can rest assured that you have mitigated the risks as much as possible and made the best agency choice. Remember that various professionals, such as mental health experts, case managers, and legal advisors, can assist and guide you. While cost is invariably a consideration, we encourage you to carefully evaluate the associated risk factors.
Author: Karen Synesiou, Infertility Portal, Inc.
