What to Consider Before Using a Family Member’s Gametes

Thinking about using a family member’s sperm or egg to create your embryos? It may seem like an easy and obvious solution in a long and complex journey to become a parent.

There are a number of reasons you might be considering partnering with a family member as part of the surrogacy process. Maybe:

  • you’d rather talk to someone you know and trust about an intimate genetic donation.
  • you hope that by using gametes from within the family gene pool, the baby will look more like the intended parents.
  • you want to cut costs by not having to pay gamete donor fees.
  • you worry about working with a donor you don’t know.

However, this type of gamete donation requires more thought than an outside-the-family donation. The Ethics Committee of the American Society for Reproductive Medicine (ASRM) advises that “programs that choose to participate in intra-familial arrangements should be prepared to spend additional time counseling participants and ensuring that they have made free, informed decisions.”

Fertility clinics and professionals such as American Surrogacy take extra care to educate people who are considering using a family member’s gametes as part of the surrogacy process. You can always contact our specialists anytime to learn more about this kind of surrogacy journey.

In the meantime, learn about a few unique aspects to this type of gamete donation.

Emotional Considerations

Gestational surrogacy and gamete donation within the family can be an intimate experience that brings family members closer together forever. But, despite the potential for benefits, these experiences can also be emotionally challenging and put strain on even the strongest family bonds.

Family members should be counseled about the ways in which gamete donation could affect their relationships, including how to prepare and work to preserve their bonds. The emotional implications of gamete donation should not be downplayed. Remember:

  • Your family relationships will be permanently changed.
  • The relationship of your child with some family members will change because of unique biological connections.
  • Existing insecurities, jealousies and tensions are often heightened, possibly permanently.

With proper counseling from a surrogacy professional, family members can decide if they’re ready for the benefits and challenges they may face with this specific type of gamete donation. They can also learn how to appropriately prepare themselves.

Financial Considerations

Using a family member’s donated gametes rather than selecting a donor from a cryobank, for example, may save you some time and money. This is one reason why intra-family gamete donation is often considered.

The costs of working with a donor through a gamete donor bank will vary, so ask your fertility clinic if they have an in-house gamete donor program or if they offer discounted rates when you work with a certain donor bank. Often, fertility clinics will have at least one donor bank that they frequently work with. They can provide advice about minimizing costs if you’re interested in that route.

If you do decide to work with a family member, remember that intended parents should cover the costs of the necessary procedures. This usually includes screening for health concerns, the cost of egg harvesting and the related fertility medications (if applicable), and more.

Legal Considerations

You already know and trust your family member, so why would you need to involve a lawyer?

The fact is many custody disputes in surrogacy occur when an extended family member is the biological parent of the child involved and the participants fail to receive proper legal counseling or contracts.

The ASRM recommends that “participants in these arrangements, including partners of donors and surrogates, should seek independent legal advice from attorneys with specific expertise in third-party reproduction to determine their legal rights and duties in entering into these relations.”

Surrogacy professionals, including American Surrogacy, also always encourage everyone involved in these arrangements to retain separate attorneys experienced in assisted reproduction law. Even when you’re entering into a donation agreement with a loved and trusted family member, it’s important that you establish a legally binding donor contract, just like you would with anyone else. This protects everyone involved (including the child) from future legal complications.

In family gamete donations, the donor is literally closer to home. Therefore, there should be additional discussions in the legal contract regarding inheritance, biology and the donor’s social role in the child’s life.

Always remember: Third-party reproduction laws vary by state and situation, so it’s even more necessary that you consult an experienced ART lawyer about this type of gamete donation, regardless of family ties.

The Takeaway

At first, using a family member’s gametes to create your embryos for surrogacy may seem like the obvious choice. But you should spend some time talking with an American Surrogacy professional about it to make sure that everyone involved is truly ready.

The ASRM agrees: “Providers should be prepared to spend more time screening and counseling participants compared to anonymous or unrelated known collaborative reproductive arrangements.” It goes on to say that, “Programs should strongly recommend that prospective participants, including partners of donors and surrogates, undergo psychological counseling by a professional experienced in surrogacy or gamete donation. These visits should focus attention on how participants will cope with the unique aspects of the proposed arrangement and on the consequences for the prospective child.”

American Surrogacy is equipped to talk to you and your family member about gamete donation, so you can mutually decide whether or not it’s right for you. If you decide against family member gamete donation, we can talk to you about finding a gamete donor from outside your family to help you complete your surrogacy journey.

Call us now at 1-800-875-BABY(2229) to learn more.

How to Save Money on Surrogacy Fertility Meds as an Intended Parent

It’s well-known that surrogacy can be an expensive family-building choice for hopeful parents, often costing in the $60,000–$150,000 range. It’s only normal that intended parents look for ways to bring those costs down.

One of the costs that intended parents have to worry about is the fertility medications that their gestational surrogate takes in preparation for the embryo transfer procedure. If an intended mother plans on using her own eggs to create the embryos used in this process, she’ll also be prescribed a course of fertility medications prior to an egg retrieval procedure.

The costs of the required medications can certainly add up, and they’re not cheap. There are, however, a few ways you can try to save on the costs of those fertility medications:

Talk to Your Surrogate and Your Doctors

Your gestational surrogate doesn’t want you to have to pay a fortune for medical expenses, so she’ll help you out whenever possible. Ask her if she’ll talk to her fertility specialist about money-saving tips on meds. Her clinic might have recommendations for lower-cost brand substitutions that are equally effective, or offer medication promotions or discounts and other helpful suggestions.

Fertility clinics don’t always offer you the lowest-cost medications unless you specifically mention your budget desires. That means you need to ask, and ask early on!

You can talk to your own fertility specialists, but it’s a good idea if your surrogate does this, too. Her doctors will have her medical history, so they can make sure any brand swaps won’t interact with what she’s currently taking, won’t trigger an allergy she may have, or cause another harmful result.

Wait for a List of Your Surrogate’s Prescribed Medications

Remember that not every gestational surrogate will be prescribed the same medications or dosages, so there’s only so much price research you can do in advance. But, once your surrogate has been prescribed her regimen of fertility drugs and has been given a list of supplies to purchase by her fertility clinic, you can use that list to look for potential deals.

Doing some price-scouting and research ahead of time won’t hurt — just as long as you know that your surrogate might not end up taking certain types or brands of medications.

Resources for Fertility Medication Comparison Shopping

Your fertility clinic’s pharmacy partners aren’t always the cheapest option, although the clinic may have some recommendations about places you can look. Checking around for discounts can yield some decent results.

Here are some websites where you can compare medication and pharmacy prices and check for discounts. These specialty pharmacies may have cheaper meds than traditional pharmacies:

If your surrogate has a local specialty pharmacy, check there, as well. Specialty pharmacies tend to carry the correct medications and supplies — and at a better price than the place you go for your everyday medication!

Always talk to your doctor about any specialty pharmacies to ensure they provide legitimate products. American Surrogacy cannot ensure the validity of or endorse the specialty pharmacies listed above.

Save on Supplies

Some of your surrogate’s medications will need to be administered using specific medical supplies, and you may be able to save some money by shopping around for those supplies. She’ll likely need a stash of particular syringe sizes, alcohol wipes to clean injection sites, and more. Talk to her fertility clinic about what she’ll need, and be sure to get your surrogate’s input on products she prefers. You may be able to find your surrogate some coupons for her supplies, or discount offers for options like bulk purchasing or recurring deliveries.

Again, do your research to ensure the supplies you receive from non-traditional pharmacies are new and safe to use.

Other Options

The fertility drugs themselves can be extremely costly, yes. But keeping medical costs low starts at more immediate sources: your insurance and benefits.

Ask your employer if a flexible spending account (FSA) or a health savings plan (HAS) is available to you. These plans allow you to use your pre-tax income for medical expenses, and fertility treatments are usually a permitted spending use for these types of plans by most employers.

If you aren’t already, make sure you’re working closely with your insurance provider to get the most out of your plan throughout the surrogacy process. Your American Surrogacy specialist can help guide you through this to make sure you’re as covered as possible.

Saving money on IVF medications themselves is often possible; there’s no doubt about that. Just make sure you first double your efforts on getting medications covered by insurance whenever possible and see if there are any benefits available through your employer you may have missed.

Need more help financing your surrogacy journey? Learn more cost-saving strategies here, or reach out to American Surrogacy at 1-800-875-BABY(2229) to talk to a surrogacy specialist.

4 Ways to Choose the Best Surrogacy Clinic for You

Just as selecting the right surrogacy partner and primary surrogacy professional is integral to a successful surrogacy experience, choosing the right surrogacy clinic is an important decision. Whether you call them “surrogacy clinics,” “fertility clinics,” or “IVF clinics,” intended parents and their gestational surrogate will all need to coordinate with this type of professional to complete the medical steps of the surrogacy process.

Here are four things you should always take into consideration when choosing a fertility clinic:

1. Location

Typically, both the gestational surrogate and the intended parents will work with the same fertility clinics individually in coordinating for certain appointments. The intended parents will work with a fertility clinic to create and prepare embryos, using gametes from the intended parents or donors. There may also be egg retrieval involved for the intended mother in some surrogacy situations.

Meanwhile, the surrogate will work with the intended parents’ fertility clinic to prepare for embryo transfer by taking the necessary fertility medications. She’ll need access to the clinic for scheduled testing, monitoring and more. For a surrogate, a conveniently located surrogacy clinic is a very important consideration, because she may be traveling back and forth to this location for appointments regularly until she’s pregnant.

Convenient and consistent access to a reputable surrogacy clinic isn’t always easy to come by, especially if you live in a rural area. Does a larger national clinic have a branch or an affiliated doctor at a local hospital near you? Can you realistically travel back and forth to a certain location? Location is something you’ll need to consider at the beginning of your surrogacy journey.

At Surrogate.com, you can find local surrogacy resources listed by state, including surrogacy clinics. Just click on your state, and go to the “Surrogacy Professionals” page listed there.

2. Cost

Surrogates will have the medical costs of their surrogacy journey covered, but finding a cost-effective fertility clinic that accepts your insurance is an important consideration when choosing a surrogacy clinic. Intended parents have probably invested a large sum of money toward having a child already, and they’ll need to budget their expenses at the fertility clinic carefully.

Your reproductive endocrinologist can help walk you through different IVF package options that a prospective clinic may offer, so you can choose what’s most cost-effective (and what’s most likely to be successful) based on your individual situation. That way, you’ll know you aren’t paying for anything you don’t need. We’ll also help intended parents and surrogates sort out their insurance policies, so everyone is covered as much as possible before you begin.

Of course, choosing a clinic exclusively on cost isn’t a good idea. The cheapest options aren’t always going to be the best options. You can always ask American Surrogacy for recommendations when you’re comparing costs of fertility clinics.

3. Success Rates

You’ll likely see intended parents and gestational surrogates discussing statistical success rates of fertility clinics in online forums. Another quick scan of these discussions, and you’ll also learn that some fertility clinics consistently accept patients with a lower (or higher) chance of success, which can skew their overall success rates.

There are organizations in the U.S. that track the reported success rates of surrogacy clinics, but you always have to take those reports with a grain of salt. Those numbers often don’t reflect the types of patients they work with, the cases they’re best qualified to handle, the experience of the providers, how many cases they take on, and other factors — so choosing a surrogacy clinic based solely on their statistical rate of success is never a good idea.

You can certainly take a clinic’s reported success rate into account when selecting the clinic you’d like to work with, but it shouldn’t be the only criteria you examine. You can view reports of IVF success rates for fertility clinics in the U.S. with these resources:

4. Ability to Meet Your Needs

Finding a surrogacy clinic that offers the services you’ll need may take a little research. For example, you may need to check to make sure a particular clinic offers:

  • Medical screening
  • Cryopreservation
  • Genetic screening of embryos
  • In vitro fertilization (IVF)
  • Connections to gamete banks
  • Gamete retrieval
  • Pregnancy testing for gestational surrogates
  • And more

What you’re looking for in terms of services will depend on your individual surrogacy situation, but take note that not all fertility clinics or endocrinologists will offer the same range of services. Know what you’ll need, and what you can do without. Your American Surrogacy specialist can be a good voice of experience here.

Asking plenty of questions will be a good way to assess whether or not a surrogacy clinic is going to be the right fit for you and your surrogacy partner, so write down everything you can think of! Not sure what to ask? Your American Surrogacy specialist and former surrogates/intended parents who have been through this process themselves can give you suggestions to start with, so ask others for their advice. It’s a big decision, but you don’t have to make it alone.

Need some help finding the right surrogacy clinic? Ask an American Surrogacy specialist now by calling 1-800-875-BABY(2229).

Tips for Surviving a Failed Transfer: Surrogates

You’ve spent weeks preparing for your embryo transfer date. You’ve taken the pills, given yourself the shots, gone to the appointments and “thought sticky thoughts” at your transfer procedure. Now, you learn that this transfer failed.

Every gestational surrogate will have a different reaction to a failed embryo transfer. However, the following general tips may help you cope with this loss and begin to take the next steps in your journey as a surrogate:

Do:

Acknowledge your intended parents’ feelings.

If your intended parents struggled with infertility or pregnancy loss prior to pursuing surrogacy, this failed transfer may come as a serious emotional (and financial) blow to them. They may pull away for a while, or they may turn to you for support. Try to be aware of their needs, and acknowledge the importance of this loss for them. It can be tempting to want to “fix” this for them, but letting them know that you’re there for them will be more important.

Acknowledge your own feelings.

The intended parents aren’t the only ones who will need to grieve a failed transfer. Gestational surrogates often say they feel a sense of guilt or failure, in addition to sadness and disappointment. You put so much effort and hope into this transfer, and finding out that it failed is a loss for you, too. Talking through what you’re feeling can help you begin to process this. Talk to your loved ones, your surrogate specialist, a counselor or other gestational surrogates who have been in your shoes. You’re not alone!

Understand the many reasons why this happens.

An embryo’s failure to implant can happen for any number of reasons, but ultimately, this particular embryo would not have been able to survive a pregnancy. All of the conditions have to be absolutely perfect for a human being to be created — on a chemical level, within an embryo, within a woman’s body and more. This is nature’s way of trying to create only healthy babies. That doesn’t make this loss any less sad; it’s just important to remember that this was out of your hands.

Don’t:

Blame yourself.

Again, those feelings of guilt are not uncommon for surrogates (and women in general) who have experienced a failed transfer. You may feel as if you’ve let your intended parents down somehow. You might wonder, “Did I do something wrong? Could I have done something more carefully?” The answer is, emphatically: No.

You’ve done (and are doing) an amazing job! Failed transfers are not uncommon, and they’re not anyone’s fault. If you’re struggling with a sense of guilt, please reach out to your surrogate specialist and your support system. We’re always here for you!

Lose sight of the big picture.

After weeks of a careful routine, medications, preparation and excitement, only to be let down by a failed transfer, it can be easy to feel overwhelmed and a little lost. In the emotions of a failed transfer, you can become caught up in second-guessing and questions like, “Is this worth it? Will this work?”

It’s not always easy in these low moments, but try to remember why you wanted to do this in the first place: to help your intended parents. Don’t forget that a failed transfer doesn’t mean a failed surrogacy journey.

Rush into another cycle if you’re not ready.

The preparation necessary for an embryo transfer is physically and emotionally taxing. You may still be recovering from the physical effects of the medication involved in the last cycle, and you may still be emotionally recovering from this failed transfer. Regardless, you might feel like you need some time before you try again.

This is something you’ll need to talk about with your intended parents, surrogate specialist and fertility clinic. That way, your next transfer attempt can be timed correctly with your cycle while still giving you space to rest.

Need to talk to someone after a failed embryo transfer? You can always contact a surrogate specialist at American Surrogacy by calling 1-800-875-BABY(2229).

Tips for Surviving a Failed Transfer: Intended Parents

You’ve waited for this moment and put a significant amount of hope and money on the line — only to find out that this embryo transfer failed and your gestational surrogate is not pregnant this time. Now what?

Everyone’s reaction to a failed transfer is going to be different. But, these general tips may help you cope with this loss, so you can start to move forward with the next steps in your surrogacy journey:

Do:

Allow yourself a moment to feel whatever you’re feeling.

If you experienced infertility prior to pursuing surrogacy, then you already had to grieve that loss. For some, a failed transfer can feel like an IVF failure all over again. It’s OK if you’re feeling hopeless, frustrated and disappointed. Talk to your spouse, partner, surrogacy specialist, counselor or whoever you lean on for support to help you deal with this loss in a healthy way.

Connect with your surrogate and with other intended parents.

Your surrogate is also grieving for, and with, you. It wasn’t her embryo, but her hopes were high for you, and she’s probably going through some guilt and sadness of her own. Turning to one another for support can be comforting — you’re in this together, after all. Talking to parents via surrogacy or IVF who experienced similar setbacks can also be reassuring, and they can often offer perspective and tips for coping.

Focus on your surrogacy plan.

When you created your surrogacy contract, you agreed on a maximum number of embryo transfers with your gestational surrogate. This wasn’t your only chance. Failed transfers aren’t at all unusual. Your fertility clinic and surrogacy specialist know that, and they’ll help you to stay focused on your next step.

Don’t:

Indulge the urge to jump ship.

It can be tempting to switch fertility clinics, gestational surrogates, surrogacy professionals, or even run from your surrogacy journey altogether when something goes wrong. It often takes more than one transfer to become pregnant, and failed transfers aren’t a sign that any person within your surrogacy team is failing you. Stick with it, and stick with them for a while longer. Everyone is doing their utmost for you.

Blame yourself.

You might look for someone else to blame, or you might try to blame yourself. Ultimately, there’s no one at fault. Somehow, it’s more frustrating to shrug and say that, “These things just happen,” but unfortunately, it’s true. You’re doing everything you can for your future baby, and nothing you or anyone else could have done would have made this transfer magically successful.

Become overwhelmed by this loss.

Again, a failed embryo transfer can be incredibly devastating — even more so if you have experienced pregnancy losses in the past. However, it’s important that you don’t lose sight of something important: If you stick with this, you will become a parent. This is easier said than done when you’re grieving a loss, and it sometimes feels like it’ll “never happen,” but it will.

If you’re struggling after a failed transfer, or you need some guidance about emotionally moving forward with your surrogacy journey, you can always contact a specialist at American Surrogacy for help.

Dual Transfers: What to Know Before Considering This Path

As you consider your medical options for surrogacy, you may have heard one phrase pop up: “dual embryo transfer.”

If you’re an intended parent, the promise of a dual transfer may seem exciting. But, there are a few things to know before you decide to take this path.

Below, find out a bit more about this medical option. Remember, our surrogacy specialists are always available to answer your questions, as well.

Keep in mind: In this blog post, “dual transfer” and “double-embryo transfer” are two separate things. Read more about the latter here.

What is a Dual Transfer, and Why Do People Choose this Option?

A dual transfer occurs when both a gestational carrier and her intended mother undergo an embryo transfer at the same time. Usually, it’s a way for an intended mother to have one more chance at getting pregnant. It also sets up the possibility that both women will experience pregnancy together.

While there are no official statistics on dual transfers in gestational surrogacy, it’s reasonable to assume that this occurrence is fairly rare. After all, many intended mothers come to surrogacy after failed IVF attempts; that’s why they’ve chosen someone else to carry their child for them.

For the women with the means to do so, however, dual transfers are one final way they can try to become pregnant and carry their own child. This can be a complicated process, though, so it’s only one to be pursued after much discussion with surrogacy and medical professionals — not to mention a prospective surrogate.

What are the Pros and Cons of a Dual Transfer?

The decision to pursue a dual transfer should only be made after intended parents and their gestational carrier have talked at length about it. The worst thing you can do is surprise your gestational carrier on embryo transfer day when you get prepped for the procedure, too.

As you discuss the possibility of dual embryo transfer with your prospective surrogate, refer to these advantages and disadvantages:

Pros:

  • There is a higher chance of a successful pregnancy. Looking solely at numbers, having both a gestational carrier and an intended mother undergo an embryo transfer increases the chance that there will be a successful pregnancy. However, if a reproductive endocrinologist has determined that an intended mother is highly unlikely to become pregnant, a dual transfer may not increase the overall chances of pregnancy that much.
  • An intended mother gets another shot at carrying her own child. If an intended mother has unexplained fertility or a doctor has determined she may be able to get pregnant, a dual transfer gives her one more chance at becoming pregnant. In this way, she can pursue her own pregnancy dreams with the simultaneous “backup” that her gestational carrier may become pregnant instead.
  • There are fewer “leftover” embryos. One of the biggest questions for intended parents is what to do with their remaining embryos. It can be emotionally difficult to discard or donate them, but frozen storage is not a permanent solution. If an intended mother undergoes an embryo transfer, she may feel like she “used” all of her embryos, even if a pregnancy does not result.

Cons:

  • Dual transfers are emotionally complicated. If an intended mother is interested in a dual transfer, it’s usually because she has not properly grieved the loss of the pregnancy experience. In the best case scenario, she gets pregnant during her dual transfer — but what if she doesn’t? She may be devastated by another failed pregnancy, and her emotions will likely be compounded if her gestational carrier becomes pregnant. What should be a happy time will be a sad one — not a wonderful start to their partnership together.
  • Dual transfers will cost more. It seems obvious, but just because you are doing two transfers at the same time doesn’t mean you will get two-for-one pricing. And, with the average IVF cycle costing $12,000, an intended mother is looking at a huge increase to her overall surrogacy costs.
  • Many surrogates will not agree to a dual transfer. Intended mothers who are thinking about a dual transfer should be upfront with their surrogate about their desires — before even signing the legal contract. Ideally, your plans to do a dual transfer should be a part of your initial search for a surrogate. Many women will not be comfortable with the complexities and unknowns of carrying a pregnancy at the same time as their intended mother, so it may be harder for you to find a surrogate with whom to take this path.
  • Intended parents can get more than they bargain for. Those who consider dual transfers often don’t consider the possibility of both transfers being successful — but it can happen. Are you prepared to care for two babies if so? Or four, if you both receive a double-embryo transfer?

Choosing to move forward with a dual transfer is a highly personal decision — but it is one that must be approved by your reproductive endocrinologist and your surrogacy professional. To talk to one of our surrogacy specialists about our agency policies on this and other procedures, please call us at 1-800-875-2229(BABY) or contact us online.

Surrogacy Medication: Advice from a Former Surrogate

Every gestational surrogate’s medications and timeline will vary somewhat, depending on what a fertility clinic prescribes. Still, most women who are thinking about becoming surrogates want to know what that medical process is like — including side effects from medications, the types of medications they might have to take, and more.

Here, Chelsea, a former American Surrogacy surrogate, explains the surrogacy medications she took, some tricks she found helpful, and more:

Chelsea’s Medication Experience

The first medication that the clinics will generally put you on is birth control pills. Even people who have their tubes tied are required to use this. This helps the clinic manipulate your cycle to line up with your transfer date. They’re very precise and tell you when to begin the pills and when to discontinue them.

Next, I was on Lupron. The needle size didn’t faze me at all. It was an easy shot to take, and one or two equated to the feeling of a bee sting. I was on this for 26 days. The Lupron did give me some killer headaches. I wanted to stay in a dark room, and I was very sensitive to sounds. Drinking a lot of water helps.

After 12 days, I began taking estrogen, as well. I took estrogen in the form of Estrace pills (two pills, twice a day) and an estrogen patch called a Vivelle Dot. I switched this patch every Monday, Wednesday and Friday. They leave behind a lot of sticky residue that is impossible to clean off. I had sticky marks until I was done with my meds at 14 weeks. The estrogen caused a lot of discharge. I had even emailed the clinic about it at one point to make sure it was normal.

My clinic was stricter about monitoring so, on day 22, I was required to have my ultrasound and blood work done at the clinic. This was the only ultrasound and blood work I had during the cycle. They checked my ovaries to make sure they were “quiet” and checked my uterine lining. I was good to go at 8mm. Then, they checked my blood estrogen level.

I began taking progesterone five days before transfer. This lines up with the age of the embryo(s). The needle is quite large: 22-gauge. This is due to the fact that it’s an intramuscular injection. You really only feel that initial poke; the length of the needle isn’t felt. The size of the hole of the needle is because the medication is in oil (sesame, olive, ethyl oleate). I actually had to switch from sesame to ethyl oleate after weeks on the injections because you can develop a delayed allergic reaction, which was a large rash in my case.

Some tips for this medication:

  • Warm the vial in your bra, on a heating pad or in your hands prior to injection. The oil is thick, so warming it helps inject easier.
  • Rub the area after injection thoroughly. The oil needs to be dispersed. I was on 2cc of PIO (progesterone-in-oil) so it was quite a large amount to put into the muscle daily.
  • You will develop lumps so massage, massage, massage. (Yes, rub your butt!)

I used a cheap Walmart drawer container to store my medications. I’m very type A, and it helped organize things. I was constantly getting new shipments and refilling it. I also downloaded blank calendar pages to fill in what medications I took each day. I marked them off as I took them. It was taped to my bathroom mirror.

All of these medications need to be taken at the same time every day. So, if you have a job, plan to take them when you know you will be home!

We’re so grateful to Chelsea for sharing her experiences and advice with future surrogates and for being such a great ambassador for American Surrogacy! If you’d like to talk to Chelsea about what it’s like to be a surrogate with American Surrogacy, contact us now at 1-800-875-BABY(2229).

How Skin-to-Skin Contact Works in Surrogacy

Parents of a baby born via surrogacy don’t have the opportunity to carry their baby in utero, which is how many parents emotionally and physically bond with their baby before he or she is born. But this certainly doesn’t mean that you’ll have a weaker bond with your child if they are born via surrogacy. It simply means that you might need to play catch-up and bond a little differently.

Like in any new relationship, you and your baby might need to spend some time working on your physical and emotional bond. Remember that families who come together through surrogacy love each other no more or less than any other family, and they’ll tell you that. It might be disappointing if you don’t feel that magical instant bond with your child right now, but don’t worry — it’ll happen!

This is where these surrogacy-specific bonding tactics come in.

The Benefits of Skin-to-Skin Contact

There have been many studies on the physical, emotional and mental benefits of skin-to-skin contact for babies and their parents. Here are some of the findings:

  • Healthy infants were shown to have reduced responses to painful stimuli like vaccinations, blood sampling, or cord cutting during skin-to-skin contact.
  • Babies cried less, were calmer and went to sleep more quickly when on their parents’ chests.
  • Newborns that had immediate skin-to-skin contact experienced physiological benefits that included improved thermoregulation, cardiopulmonary stabilization, blood glucose levels, enhanced oxygen saturation levels, breathing and sleep patterns.
  • For preterm infants who spend time in the NICU, skin-to-skin contact is even more important for brain development.
  • Skin-to-skin contact has been linked to decreased separation anxiety.
  • Reduced risks of hospital-acquired infection were shown in babies who received skin-to-skin contact, as they acclimated to the surrogate’s and intended parents’ bacteria and received the protective benefits of that bacteria.
  • The salivary cortisol levels (a biochemical marker for stress) were significantly decreased in all babies when the length of skin-to-skin increased beyond an hour. The levels continued to decrease with longer contact periods.

You can learn more about the research on skin-to-skin contact through these sources:

How to Do Skin-to-Skin Contact with Your Baby

Skin-to-skin contact is simple. When the baby is born, parents often like to place the naked baby on their bare chests as quickly as possible, for as long as possible, sometimes even while the baby is being cleaned and the cord is being cut. This is recommended for a minimum of an hour, if possible. You may have also heard this method called “Kangaroo Care.” Some parents will delay routine medical steps until after this bonding time if their baby is healthy and stable.

If you’re unable to have skin-to-skin contact with your child moments after he or she is born, don’t worry. Bonding through physical touch with your child is something that will continue to be beneficial to both of you as they grow up. Physical contact between a parent and their child is a good way to strengthen bonds, no matter when it starts.

If you do plan on trying to initiate skin-to-skin bonding with your baby at his or her birth, here are a few tips:

  • When packing to meet your baby at the hospital for the first time, include shirts that can be unbuttoned to allow quick access for skin-to-skin contact with your baby on your bare skin while preserving your modesty and comfort.
  • You and your surrogate will need to talk to your hospital nursing staff in advance about your wishes for skin-to-skin contact, and explain that you’re the intended parents in this birth plan. You’ll likely need to remind the hospital staff of these details in the busy aftermath of birth, but this way they’ll know not to swaddle the baby immediately, to avoid placing the baby into an incubator right away, or to hold off on some of the routine medical procedures like weighing your baby until after you’ve had time to hold him or her.
  • There are some studies that show that having skin-to-skin contact with the surrogate first may be beneficial for the baby, as a newborn is able to colonize her bacteria (maternal flora vs hospital flora) faster. This may reduce the chances of your child forming allergies and getting an infection. If everyone is comfortable with this, your baby’s health can benefit from this step, and then you would be able to have skin-to-skin contact with him or her next. This is another transitional step for your baby; remember that they’ve become attached to your surrogate in the previous nine months of development.

Remember to follow the advice of the hospital staff at your baby’s birth! Sometimes even carefully planned births don’t go exactly as we envisioned, so you may not be able to have that early skin-to-skin contact with your baby for whatever reason. Again, don’t worry. You’ll have plenty of opportunities to bond with your child soon.

Other Ways to Bond with Your Baby

Bonding with a baby born through surrogacy doesn’t start and end at birth or is achieved solely through skin-to-skin contact. Here are a few ways you can bond with your baby before he or she is even born:

  • Talk to your baby in your surrogate’s womb. Try giving your surrogate a recording of your voice reading books to play to your baby through headphones on her belly so your child can hear your voice.
  • Give your surrogate a “transitional item.” This could be a teddy bear that your surrogate sleeps with that will later go home with you after the baby is born, so that your baby has the familiar scent of your surrogate to help her or him transition. This can help with “emotional transference.”
  • Stay active in the pregnancy process as much as your surrogate feels comfortable with. This is more for your sake than for your baby’s, but participating in your surrogate’s pregnancy and staying in touch with her can help you feel more like your baby is “yours” and facilitate your own emotional attachment.
  • If you want and are able to, you can try to breastfeed your baby. This is not a necessity for bonding with your child, but it can be a wonderful experience for both of you. Breastfeeding is possible for many intended parents with preparation.

On the other hand, there are some ways you can bond with your child after he or she is born. These are applicable not just to parents of children born via surrogacy but also for families who come together through adoption, “traditional” methods or any other way. Try these bonding tactics:

  • Give lots of gentle touch and physical affection. Hugs, baths, play time, holding hands, brushing hair, carrying your baby in a sling or just holding and cuddling your child is important for newborns as well as for young children.
  • Talk to your child. Studies have shown that talking to your children at any age vastly improves their language skills in addition to promoting bonding. Tell them the story of how they were born, sing to them, read them lots of books, give them verbal praise and affection or even just tell them again how much you love them.
  • Prioritize routines. Getting into a regular feeding and sleeping schedule can sometimes be tricky, particularly with newborns. However, the ritual of those routines will not only make your life a little easier, but your child may also benefit from the bonding time during those daily rituals. Bath times, getting dressed, feeding times, reading a book together in your arms before their nap, singing the bedtime song — whatever you do for your daily routines, try to use it as an opportunity to spend some quality time together and focus solely on your child.

With time, you’ll likely find ways of bonding that work best for you and your baby, because every family is different. In the meantime, don’t stress too much. The parent-child bond may or may not be immediate for you, but it’ll happen, and when it does, it’ll be just as strong as it is with any parent and child.

You can always contact an American Surrogacy specialist at 1-800-875-BABY (2229) if you need additional post-surrogacy resources.

What to Expect at the First OB Visit in Your Surrogacy

Prior to your surrogate’s first visit with her obstetrician (OB), she and you will have primarily worked with your fertility clinic, which will be very familiar with the surrogacy process. But your surrogate’s OB may have never experienced a surrogate pregnancy before and may not know what to expect. You and your surrogate may not know what to expect, either!

We know how confusing this time can be, which is why we’ve answered some of your biggest questions about prenatal appointments in gestational surrogacy journeys below.

What the Average OB Experience Is Like

The first OB visit generally occurs between 8 and 12 weeks of pregnancy. The surrogacy process won’t affect this first OB visit much, although the doctor may ask a few questions about gamete donors, if applicable.

If you’ve never experienced one before, a prenatal visit can be a little scary. Here’s what happens in the standard first trip to an OB for surrogates, depending on the week of pregnancy and the doctor’s recommendations:

  • The surrogate’s health and vitals will be checked, and she’ll be asked a lot of questions to make sure her first trimester is going well so far.
  • Your surrogate may receive a full physical, so you’ll need to step out and give her some privacy.
  • Your surrogate will have her blood drawn to test for fetal abnormalities.
  • There may also be a urine test, a pap smear, or other tests to check fetal and maternal health.
  • A transvaginal ultrasound may be performed to evaluate early development.
  • You may be able to hear the baby’s heartbeat.
  • The doctor will review the next steps and schedule the next routine appointment.
  • You and your surrogate will sign a lot of paperwork, usually HIPPA consent forms to release medical information. Most of this paperwork will be completed by your gestational carrier.

The first visit to the OB consists mostly of the doctor asking questions, some of which may be rendered inapplicable as a result of the surrogacy process. This is usually an exciting time for surrogates and intended parents alike, so enjoy the moment together!

How to Prepare for Your Surrogate’s First OB Appointment

These five steps may help you navigate your first visit together at the OB:

Step 1: Jointly Decide How Much You’ll Participate in Your Surrogate’s Pregnancy

You’ve probably already talked about this when you created your surrogacy contract together, but you’ll need to have an honest conversation with your surrogate about how much of your involvement she feels comfortable with during the pregnancy and about how much you’d like to participate, if possible.

Not all intended parents accompany their surrogate to her first OB visit — maybe they’re unable to due to distance, or maybe the surrogate feels more comfortable going to this appointment without them. Regardless, you’ll have the rest of your child’s life to participate in important milestones, so missing the first OB visit certainly isn’t the end of the world.

Step 2: Talk to the OB Before the Visit

This may require leaving multiple messages, talking to several nurses and playing phone tag, but it’s important that everyone involved (especially the doctor who’ll be overseeing the surrogate’s care) knows about your surrogacy partnership, and is aware of everyone that will be attending the appointment. The OB may need to talk to the patient (your surrogate), as well as you, prior to this visit.

If they’re prepared for intended parents and the surrogate, plus her spouse (or whoever might be attending the doctor’s visit), then they’ll be better prepared to do their own job of walking you through what comes next in your surrogate’s pregnancy.

Step 3: Be Prepared for Some Insensitivity

Not everyone at the OB’s office will be aware of your surrogacy partnership. Even those who are aware may slip up and say things that are insensitive. Try to be patient and understand that out of the many pregnancies this office sees daily, surrogate pregnancies are rare.

Remember that you’re in this together with your surrogate. People may congratulate her on “her” baby or ask her unwelcome questions about surrogacy. Remember that both of you will likely be subject to uncomfortable moments, but that you’ll get through those moments together.

Step 4: Remember that Conflicting Feelings Aren’t Unusual for IPs

It’s not uncommon for intended parents to have complicated feelings throughout a surrogate pregnancy, and these feelings may be especially heightened at your first OB visit. You may:

  • Feel jealous that your surrogate is the one experiencing this visit with the doctor.
  • Grieve that you’re unable to carry your baby.
  • Be hurt or feel awkward when office staff ask questions or make assumptions about the baby’s genetic background.
  • Feel frustrated that you’re not in control of the pregnancy and your baby’s health and protection.
  • Be scared that you’ll lose the baby, especially if you have experienced previous pregnancy loss.

These types of emotions are usually coupled with the excitement, joy and nervousness that is typical of parents in an OB’s office. If you need to talk to someone, remember that you can always turn to your American Surrogacy specialist for support.

Step 5: Your Surrogate May Look to You

Surrogates have their own emotional support systems, but they’re doing this to complete your family. They want to make sure that you enjoy this appointment at the OB, too.

This appointment is a good opportunity for you to grow closer together and to remind your surrogate of how much you appreciate her and how much you’re looking forward to meeting your baby. Some ways to affirm your excitement to your surrogate can include:

  • Going out to lunch before or after your appointment together
  • Bringing her a little gift, like a card or a pregnancy pampering kit you put together
  • Giving her a hug
  • Taking a photo together to mark the occasion
  • Showing her something you plan to give to the baby, or telling her about name options
  • Or simply telling her how excited you are and how happy you are to have her in your life.

Seeing that you’re excited is what makes surrogacy worthwhile to surrogates!

Remember that if you have any questions about the medical processes of surrogacy, including the upcoming OB appointments, you can always call American Surrogacy at 1-800-875-BABY(2229).

How Strict Are Surrogacy BMI Requirements?

The Body Mass Index (BMI) is a measurement of body fat based on your height and weight, taking into account whether the two are proportional. In surrogacy, almost all professionals will require that you fall within a certain BMI range in order to become a surrogate. This may seem like an insensitive requirement, but, like most rules, they’re there for an important reason.

Here’s what you should know about the BMI requirements for surrogates:

Why is a Surrogate’s BMI Important?

There are a number of reasons why a woman’s BMI is important to her eligibility as a surrogate.

  • A higher BMI has been associated with preeclampsia, gestational diabetes, pregnancy hypertension, an increased rate of cesarean section, postpartum hemorrhage and other pregnancy complications.
  • A higher BMI has been linked to complications with the baby after the birth.
  • A too-low BMI has been associated with an increased risk for preterm delivery and small-for-gestational-age (SGA) babies.
  • A too-high or too-low BMI takes longer for you to become pregnant — about twice as long if you have a higher BMI versus a healthy BMI. With surrogacy, time is literally money for the intended parents, because it means more embryo transfers.

These requirements can be frustrating for healthy women who don’t seem themselves as “malnourished” or “obese,” as the BMI index may label them, or who fall outside the required range for surrogates.

However, your BMI when you’re trying to become pregnant can directly affect your health and safety, the baby’s safety and the legal safety of the intended parents you’re hoping to help. By applying to become a surrogate, it can be assumed that you’re an incredibly loving and generous person who wants to help others. If you don’t meet the health requirements, you could put yourself and others at physical, emotional, financial or legal risk. So, to minimize the possibility of these risks as much as they can, surrogacy professionals establish rigorous health requirements for surrogates, like BMI.

What is the Typical BMI Requirement that a Surrogate Must Meet?

These can vary slightly from one surrogacy professional to the next. At American Surrogacy, we work with women who have a BMI of 19 to 32, based on the fertility clinic’s recommendations. This is what health professionals have determined to be a healthy BMI range for adults, so most surrogacy professionals stay within that range fairly closely.

Remember that the BMI requirement is just one of many requirements that prospective surrogates must meet. There are also emotional, legal and other health requirements that you’ll need to complete, which can vary slightly depending on the state you live in and the surrogacy professional you work with.

If you’re not sure if you meet the BMI requirements to become a surrogate, ask your surrogacy professional.

What Happens if a Surrogate Doesn’t Quite Meet the BMI Requirement?

While most of the health requirements are pretty strict for a very good reason, the BMI requirements may be a little more flexible, depending on the clinic you’re working with and your individual situation.

Many surrogacy agencies are adamant about their BMI requirements, but if you’re close to the target range, we tend to evaluate things on a case-by-case basis and will simply prioritize overall health.

American Surrogacy may work with women who have a BMI as high as 35, as long as the surrogate is in good health, meets the other requirements and her fertility clinic approves her. If her BMI is high, we usually ask that the surrogate start working to safely bring down her weight before she becomes pregnant, so that we can minimize health risks wherever possible.

So, if you’re close to the required BMI range for surrogacy but aren’t quite in the target range, don’t panic. Talk to an American Surrogacy specialist at 1-800-875-2229 to see if you’d still qualify to become a surrogate, and talk to your doctor about creating a health plan to help get you closer to the ideal BMI range.