A Step by Step Guide to Working with our Agency
STEP 1 - Applying to be a Surrogate Carrier
We ask that surrogate candidates contact our office at (415) 485-1969 to discuss our surrogate program and your qualifications. After our initial phone conversation we will ask you to complete the Surrogate Application and set up a face-to-face meeting at our office in San Rafael. During the face-to-face meeting we will review the surrogate process from joining our pool to post-delivery. This is your opportunity to ask questions about the process and make your preferences known. We will also ask you to bring photos of your family and to obtain a note from your OB or physician clearing you to be pregnant as a surrogate carrier. Once you've completed the initial meeting at our office, we will promote you to Intended Parent(s).
STEP 2 - Meeting the Intended Parents
When a particular Intended Parent(s) expresses interest in your profile, we will call you to see if you are willing to meet the Intended Parent(s). During this initial meeting we will discuss the surrogate process and the logistics of working together. If you are in a relationship, we would like your partner to attend this meeting. You will have an open relationship with the Intended Parents you work with, so we want you to discuss how you will work together. Each party will decide within a few days of this meeting if they want to work together.
STEP 3 - Psychological Evaluation
Once you are matched, we will refer you to a therapist for a psychological evaluation. The therapist will interview you and have you complete a PAI (Personality Assessment Inventory test). If you are in a relationship, the therapist will also interview your partner. The Intended Parent(s) you are working with also have to undergo a psychological evaluation. We keep the reports on file at our office and will share a summary of IP's report with you upon request. The IPs will also be able to request a summary of your report.
STEP 4 - Medical Screening Appointment
The fertility clinic you are working with will schedule an initial Medical Screening Appointment (MSA) during your mid-cycle (when you are ovulating). The clinic will do an ultrasound to assess the thickness of your uterine lining. They will also get blood and urine samples for toxicology screening and infectious disease testing. The clinic will also require that your partner undergo infectious disease testing. Based on these test results they will clear you to be a surrogate carrier.
STEP 5 - Surrogate / IP Contract
Our office will draft a Gestational Surrogate Contract and refer you to an attorney to review the Contract to help you understand your rights and obligations. The attorney will also draft an Addendum if any changes need to be made to the Contract. This attorney will also represent you (and your partner) for the Parentage Order once you are pregnant. The Contract and Addenda must be signed by both parties before you start injectable medications.
STEP 6 - Surrogate Maternity Care Insurance
At the same time that you are working on your Contract the Intended Parents will start an application for Medical Insurance on your behalf. The insurance broker will ask you to complete a brief application.
STEP 7 - Medication Schedule
Your fertility clinic nurse will develop a calendar which identifies dates for start of injections and estimated week of embryo transfer (ET). You will inject estrace (estrogen) intramuscularly (IM) into the buttocks twice a week for two weeks prior to the Embryo Transfer (ET). Four days before the ET you will start daily IM injections of progesterone. You will continue the progesterone injections for 6-8 weeks after the embryo transfer as prescribed by the fertility physician. The fertility physician will alternate these injections with vaginal progesterone suppositories and progesterone by mouth.
STEP 8 - Embryo Transfer (ET)
Surrogates are paid $750 of their fee for the ET. The number of embryos transferred is based on the quality of the embryos so that only 2-3 of high quality embryos are transferred. The physician may prescribe bedrest for 24-28 hours after the ET.
STEP 9 - Blood Pregnancy Tests
The fertility clinic will schedule a blood pregnancy test approximately 9-11 days after the ET. If the first blood pregnancy test is positive then they will schedule a second two days later -- looking for the HCG level to double. If the level does increase they will schedule an ultrasound confirmation approximately 2-4 weeks after the ET and you will continue taking progesterone daily. If you do not have a positive blood pregnancy test the clinic will instruct you to stop taking the medications, and they will develop a calendar for a second embryo transfer as long as your fertility physician recommends you as a surrogate.
STEP 10 - Ultrasound Confirmation
Assuming you've had positive blood pregnancy tests, the fertility clinic will schedule an ultrasound 2-4 weeks after your ET. The ultrasound confirms the pregnancy and determines how many embryos are thriving. You will be paid your first $1,500 to $2,000 installment of your fee the day of this ultrasound. At the 8th week of pregnancy the fertility clinic will release you to the care of your local OB after this ultrasound.
STEP 11 - Choosing a Local OB
Before the fertility clinic releases you, you will need to find a local OB who is a member of your insurance plan and has admitting rights at a hospital with a neo-natal intensive care unit in case the baby needs NICU care.
STEP 12 - Life Insurance Application
Once we have ultrasound confirmation that you are pregnant we will refer you to a life insurance broker to apply for life insurance. The broker will guide you through the application process and help you make appointments for any necessary physicals.
STEP 13 - Prenatal Care
Your local OB will attend to the majority of your pregnancy health care. We will also ask you to check in with a therapist each month to discuss any stress related to the pregnancy and/or your surrogate arrangement. If you are pregnant with triplets and must undergo a selective reduction we will refer you to a specialist in San Francisco. A selective reduction is insertion of a needle of saltwater into extra embryos which will cause them to shrivel up. The reduction is done at 12 weeks of gestation and you will be on bedrest for 72 hours after this procedure. Your physician may prescribe an amniocentesis only if abnormal defects are suspected. An amniocentesis would be done at 20 weeks gestation. If the amnio is positive for genetic defects you must agree that the Intended Parents will decide whether to terminate or continue the pregnancy. Intended Parents want to attend several of your pre-natal appointments and tour the OB unit at the hospital so they can also be involved with the pregnancy.
STEP 14 - Parentage Order
The Intended Parents and their attorney will initiate the Parentage Order around the end of your first trimester. The Parentage Order is a court order that removes your name (and husband's name) from the birth certificate and places the Intended Parents name on the birth certificate instead. In case of a stillbirth it would also allow the Intended Parents names to go on the death certificate. The attorney that represented you for the original contract will also represent your interests for the Parentage Order. A certified original copy of the Parentage Order will be placed on file at the birth registry department where you plan to deliver.
STEP 15 - Delivery
When you go into labor you should contact our office and the Intended Parents as soon as possible. If the Intended Parents are near by they will also go to the hospital. If you deliver after the 25th week of pregnancy you will receive your entire fee even if the delivery is stillborn. If you delivery before completing 25 weeks of pregnancy post - ET then you will receive a pro-ration of your fee if the baby doesn't survive 72 hours or your entire fee if the baby lives for 72 hours. If you have a C-Section you will receive an additional $2,500 fee. If you have carried twins to term then you will receive an additional $5,000 fee. Congratulations! You have helped a loving Intended Parent achieve their dream of a family!!!
STEP 16 - Recovery
The IVF contract that you signed states the terms for reimbursement for lost wages, childcare, etc. after delivery. All medical bills and other bills associated with the delivery and your recovery will be covered by the Intended Parents.
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