By Frank Golden

Immediately before and immediately after we ring in the new year, our agency experiences a flux of inquiries from potential Intended Parents. In celebration of a new year, many individuals and couples make resolutions to start their families. For same-sex couples, single parents, and couples who are unable to carry a pregnancy, Surrogacy may be the key to starting their family.

Starting a Surrogacy journey is overwhelming. There are so many questions to ask, so many pieces of information to gather, so many different agencies, different options, different opinions. It’s a lot. I remember when Adam and I started our first journey. We didn’t know anything about Surrogacy; we didn’t know about IVF, embryos, PGS testing, monitoring appointments, or anything else relating to Surrogacy. We did our research, but with something as complex as a Surrogacy journey, blind research can make things even more overwhelming. We didn’t even know what questions to ask. All we knew was that we wanted a family and we knew that the only way for us to have children with our genetics was through Surrogacy. Many Intended Parents start in a similar place as we did six years ago- a bit lost, confused, and ready for answers. I speak with many Intended Parents, each of them unique with their own personalities, stories, and expectations. Often, as we’re nearing the end of our consultation call, Intended Parents ask me this one question: what next? It’s a critical question and one that deserves a well-thought out answer.

There are four, or depending on your specific situation, five main steps during the initial phases of a Surrogacy Journey: check in with your emotional and financial stability; research and select a surrogacy agency; research and select IVF clinic; select an egg/sperm donor; and create viable embryos. These are not necessarily in the correct order.

Primarily, before moving forward with a Surrogacy Journey, every Intended Parent should have a solid discussion with loved ones and with them self about the emotional and financial implications of a Surrogacy Journey. It’s a big decision and should be approached after careful consideration. Surrogacy Journeys require an immense amount of patience, trust, and a certain level of financial stability. If the financial component of Surrogacy is a concern, there are programs that provide financial assistance for qualified candidates. There are also a number of Surrogacy support Facebook Groups and online communities that offer additional sources of information and support for Intended Parents and Surrogates.

Once Intended Parents have determined that they are ready to move forward with a journey, they can do one of two things: they can begin researching and selecting a Surrogacy agency or they can start with researching and selecting an IVF clinic. This is really a matter of personal preference. At some point throughout the journey, Intended Parents will have to create viable embryos; some Intended Parents prefer to start this process early on so that once they sign with a Surrogacy agency, they’re essentially “ready to go”. Other Intended Parents seek out Surrogacy agencies first. Again, it’s a matter of personal preference. Many times, before signing with our agency, Intended Mothers visit an IVF clinic to have their fertility assessed, and in some cases, have already undergone fertility treatment. I typically recommend for Intended Mothers to visit a reproductive specialist to complete a full analysis of their reproductive health prior to signing with an agency. Surrogacy is expensive and if there are potentially other options available, I suggest pursuing those first.

Choosing the right agency and IVF clinic is a big decision. I suggest that Intended Parents start their search with online research, focusing on reviews and testimonials from current/past clients. The final decision shouldn’t rely solely on online reviews, but with the number of clinics and agencies available, it’s a good place to start and can help narrow down options. From there, Intended Parents should do a personal audit of their specific expectations for their journey. Some questions to consider: How concerned am I with the location of the clinic/agency in relation to where I live; Do I want to sign with a larger organization or a smaller, more intimate setting; Do I want a Surrogacy agency that offers egg donation services or one that specializes exclusively in Surrogacy; What kind of relationship do I want with my program coordinator/physician/support team? Do I want an agency/clinic that has a large database of Surrogates/donors to look through or would I prefer a more personal approach to matching?  Intended Parents might have to speak with a few different agencies and clinics before selecting the best one for them.

Once Intended Parents have retained a Surrogacy agency, the agency should be more than willing to provide a list of recommended IVF clinics.  Most IVF clinics will do the same in terms of recommending Surrogacy agencies. Our agency offers a well-rounded approach to surrogacy support. We don’t offer in-house egg/sperm donation services, we do provide Intended Parents with a list of recommended IVF clinics and egg/sperm donation services. We hold their hands throughout the entire process and answer any questions along the way.

At some point during the initial phases of the journey, Intended Parents will start the process of creating embryos. Depending on specific needs, Intended Parents begin either searching for sperm/egg donor(s) or preparing themselves for an egg retrieval. Frozen embryo donation is another option available to Intended Parents. Your agency and/or IVF clinic can assist with egg/sperm/embryo donation services and what the best options are. For Adam and me, and for many other Intended Parents, the most challenging part of the embryo creation process was selecting an egg donor. We viewed multiple profiles until finally selecting the ideal candidate for our family. Since this is a such a pertinent decision, I recommend starting the egg/sperm donor selection process relatively early during the initial phases of your journey.

Once your IVF clinic has sperm and eggs from the appropriate sources, they create embryos, and later freeze and store them until ready for transfer. At this point, upon having embryos created or selected from an embryo donation pool, I heavily suggest Preimplantation Genetic Screening (PGS). This screens for any genetic abnormalities that might affect the health or life expectancy of an infant and reduces the chance of failed embryo transfers as well as miscarriages throughout the pregnancy. IVF clinics will be able to assist Intended Parents with PGS and explain the process in detail. Surrogacy agencies can also help explain PGS and why it’s important to consider.

After getting through these steps, Intended Parents can rely on their Surrogacy agency to guide and coordinate the rest of the journey. This should include finding an ideal Surrogate, scheduling match calls between all parties, coordinating Surrogate medical processes, scheduling and managing Surrogate travel arrangements, coordinating legal processes for both parties, selecting a delivery hospital, amongst other crucial components of a journey. Intended Parents in our program are provided with twenty-four-hour support throughout the entire course of their journey; it’s our goal, and should be the goal of any agency, to make this entire process as stress free and enjoyable as possible. While this process is new to most Intended Parents, it’s not new to the professionals in the field of reproductive health and fertility. We know the process, we see success stories, and we have the passion to help families grow.

As I near the end of this blog, I realize that there’s one more step I failed to mention, just one more step I encourage Intended Parents to take: get excited. Building a family is a wonderfully exciting, beautiful thing. Enjoy it. Let go of some of the anxiety and enjoy the experience. It will all come together, I guarantee it.