In the very early days of surrogacy (prior to in-vitro fertilization) surrogacy was a relatively simple process involving a man and his sperm, a surrogate and her uterus, and perhaps a doctor to help facilitate the insemination (but not always – home inseminations weren’t uncommon back then). Most likely there was a consenting wife of the man and a consenting husband of the surrogate, as well. But for the most part, there were only a few people involved in the surrogacy arrangement.
As IVF developed and became the standard method to achieve a surrogate pregnancy, so developed the industries surrounding it as well. Which in most cases is a good thing – each professional has their own unique role to play in the process and each member is a valuable part of the whole team. For each piece of the surrogacy puzzle, the goal is to ensure that gestational surrogacy unfolds smoothly and safely for all parties.
So who are these people, and what roles do they play? Let’s take a look:
Reproductive Endocrinologist (or RE)
The RE is the doctor who oversees your care at the fertility center as well as approves your gestational carrier and oversee her care as well. He or she is the main medical person on your team.
The Fertility Nurse is the person you will likely have the most contact with at your fertility center, as she will manage all of the details of your treatment such as schedules, lab tests, medications, etc. Once you begin your actual treatment cycle, you will be in frequent touch with her as she checks in with you on your progress, lab results, and schedule for upcoming treatments.
Most fertility centers offer various programs to help manage the cost of IVF, and your financial counselor is the person who works with you to choose the program that best suits your individual situation. He or she is knowledgeable about different treatment options and the costs, risks, and benefits of each.
If you do not have a friend or family member who will carry for you and you’re not looking for a gestational surrogate independently, the surrogacy agency is who will find, screen, and match you with potential carriers. Some agencies only do the matching process, while others are full-service and make arrangements for attorneys, escrow, the psychologist and social worker. Full-service agencies (meaning they continue to work with you beyond the initial matching) also check in with you and your surrogate throughout the pregnancy to make sure everything is going smoothly, and they can help resolve issues should things not be going smoothly
Most surrogacy agencies and fertility centers require psychological screening for any woman who wants to be a gestational carrier. This screening generally includes a face-to-face meeting between the psychologist and the potential carrier, as well as the successful completion of a written mental health screening test.
Many, but not all, fertility centers require a meeting between intended parents, their chosen gestational carrier, and a social worker. This is to ensure that all parties have a full understanding of the process and each has a full understanding of everyone’s wishes and expectations.
Attorney for Surrogacy Agreement for the Intended Parents
Most surrogacy agencies have an attorney on staff or one they work closely with who draws up the legal agreement used between the intended parents and the gestational carrier. The attorney explains the agreement to intended parents and can also make any changes they request prior to presenting the agreement to the gestational carrier.
Attorney for Surrogacy Agreement for the Gestational Carrier
All gestational carriers should have their own attorney review their agreement, explain any ambiguous or confusing parts, and prepare any changes that she might request. Should any legal issues arise during or after the pregnancy, this attorney can also offer her counsel. The intended parents pay this attorney’s fees for the initial contract review and revision.
The escrow agent manages the finances between the intended parents and the gestational carrier so that money does not have to pass between them directly, which can make either party uncomfortable. Most agents expect that the full amount of the carrier’s fees are deposited prior to the start of the fertility cycle, and the escrow agent disburses the funds to the carrier according to the terms of the agreement between them. In some cases the surrogacy agency handles this, while in others a third party escrow agent does it.
Attorney for Birth Order/Birth Certificate
Some agencies offer these services to their clients, while others refer intended parents to attorneys in their home states (or countries) to complete any pre-birth or post-birth paperwork that’s necessary to establish full and legal parentage for the intended parents.
Should you decide to use a surrogacy agency, they will tell you which parts of the process they are able to manage and which parts you will need to handle yourself. Even if you have to secure some of the services on your own, your agency should be able to give you referrals and guidance on who to contact. If you decide to pursue an independent surrogacy agreement, be sure to do your research on which professionalsto use and whenever possible, get a personal recommendation.
They say it takes a village to raise a child, though in the case of surrogacy, it’s clear that it takes a village to make a child! With each professional performing their own expert role in the process, your surrogacy experience should unfold smoothly and successfully.
Surrogacy just might be the ultimate team sport!