Surrogacy Medical Process | American Surrogacy Blog

3 Things to Know About Surrogacy Insurance

Insurance can be a tricky thing to navigate during any pregnancy — and surrogacy further complicates the issue. Whether you’re a surrogate or intended parent, you’re not alone if you’re wondering exactly how surrogacy insurance works.

Fortunately, the specialists at American Surrogacy are familiar with the intricacies of surrogacy insurance and can help answer your questions when you contact us at 1-800-875-2229(BABY). In the meantime, here are three things you need to know about insurance coverage for surrogate pregnancies.

1. Coverage varies from company to company.

As surrogacy has become increasingly common, insurance companies have become more selective regarding the types of pregnancies they will cover. Whether a surrogate’s pregnancy will be covered by her health insurance today depends entirely on her individual policy.

As part of our surrogate screening process, American Surrogacy will conduct an insurance review for every prospective surrogate who joins our agency. If her insurance includes a surrogacy exclusion (as many policies today do), the intended parents she is matched with may need to purchase a supplemental insurance policy to cover the costs of her pregnancy.

It’s important to note that if you are a surrogate, your pregnancy costs will always be covered for you, regardless of your insurance situation.

2. In vitro fertilization costs may be covered.

Even in cases where a surrogate’s medical expenses cannot be covered by insurance, some insurance companies will cover infertility treatments up to a certain amount. This means that for some intended parents, insurance will cover the costs of the in vitro fertilization (IVF) process to create embryos.

Intended parents should check with their insurance company to learn whether IVF treatments may be covered by their plan. In some states, this coverage is mandated — but only for employers with certain plans and of certain sizes.

If you live in a state where infertility coverage is not mandated, or if your state’s mandate doesn’t apply to your specific situation, whether IVF will be covered by your insurance depends entirely on your individual policy.

3. A supplemental plan may be necessary.

Because many insurance plans today do not cover surrogate pregnancies, it is common for intended parents to purchase a supplemental surrogacy insurance policy. Companies like ART Risk Financial and New Life Agency offer surrogacy insurance plans that can be purchased to cover a surrogate’s medical costs.

While these additional surrogacy insurance costs can be expensive, they can also offer great peace of mind throughout the medical process and pregnancy — both for surrogates and intended parents. Hopeful parents should carefully research surrogacy insurance (as well as other surrogacy financing options) so they can be fully prepared for the costs ahead.

For more information about surrogacy insurance, contact your insurance representative or a financial advisor. You can also learn more about how our program addresses surrogacy insurance issues by calling 1-800-875-2229(BABY) or contacting us online.

The Truth About Multiple-Embryo Transfers

It’s an important conversation that every prospective surrogate and intended parent should have with their medical professional: How many embryos should I be comfortable with in a single transfer?

Ideally, this conversation should take place well before an embryo transfer — even before someone starts the surrogacy process at all. However, new research from FertilityIQ estimates that 1/5 of all patients undergoing infertility treatments are only educated about the facts of a multi-embryo transfer immediately before the procedure itself.

Clearly, both intended parents and surrogates need to advocate for themselves while preparing for this step of the surrogacy process.

At American Surrogacy, our specialists will help connect you with an appropriate medical professional early on in the process. This way, you can learn about the pros and cons of transferring multiple embryos to make the best decision for you.

Rather than solely relying on one doctor’s recommendation, it’s important that intended parents and surrogates do their own research to learn about this topic from several resources. To help you start that process, we’ve listed some of the basic information you need to know in this article.

The Basics and Risks of the Transfer Process

In every in vitro fertilization process, intended parents will need to decide how many embryos they want to transfer to the mother’s (or surrogate’s) uterus. Usually, this decision will be influenced by several factors, like:

The health of the mother or surrogate
The results from pre-implantation genetic screening
The intended parents’ budget and wishes

A fertility doctor should speak at length with intended parents about this decision, as it’s one that has many different repercussions for all involved. Unfortunately, not all doctors take this approach — instead recommending one path over another, after which intended parents often go with the suggested embryo transfer number.

While each medical situation is unique, it’s important to note that transferring more than one embryo comes with well-documented risks. Carrying multiples increases medical complications for both mothers and children by almost five times. These medical complications, like early birth, can cost parents more money and cause more emotional distress than a single birth resulting from a single-embryo transfer.

Still, doctors may recommend multiple embryo transfers in older women to increase their chances of pregnancy, despite these risks. No matter what the situation, all intended parents should be fully educated about both options long before the transfer takes place.

So, Which is Better: A Single- or Multiple-Embryo Transfer?

It would appear that single-embryo transfer is the safer path to take, right? It may be, but many American intended parents today aren’t following this path.

As a whole, intended parents in the U.S. complete far more multiple-embryo transfers compared to single-embryo transfers than other countries — in fact, more than twice as often as intended parents in Australia, based on FertilityIQ’s research. This is due to several factors.

In the U.S., the cost of an IVF process is much more expensive than the cost of those in countries where the healthcare system is paid for or greatly subsidized by the government. Therefore, intended parents often transfer more than one embryo their first time to reduce the chance that they need to pay for more than one transfer process.

Research also shows that there is no consistent education offered to intended parents among fertility clinics. The amount and accuracy of information will vary based on the doctor being used — which could be a possible reason why so many intended parents choose to do a multiple-embryo transfer early in the process.

The discussion about how many embryos to transfer in the surrogacy process is an even more complicated one. After all, the risks of a multiple-embryo transfer will not be carried by the intended parents but by the surrogate — which should impact the intended parents’ desire to transfer multiple embryos in the first place.

The American Society for Reproductive Medicine usually only advises one healthy embryo be transferred in women up to age 38, because “in patients of any age, transfer of a euploid embryo has the most favorable prognosis and should be limited to one.” Therefore, many surrogates and intended parents will determine during their legal contract phase that their embryo transfer will be limited to one for each transfer process. If it is decided that multiple embryos will be transferred, the contract should also address the financial protections for the possibility of carrying multiples and any subsequent complications.

If intended parents or a surrogate are considering a multiple-embryo transfer during surrogacy, we recommend you speak in detail with your surrogacy specialist and your fertility doctor for more information about the risks and benefits of doing so. The surrogacy specialists at American Surrogacy are always available to discuss your personal surrogacy situation if you call them at 1-800-875-2229(BABY) today.

Can You Choose the Gender of Your Baby with Surrogacy?

Often, when intended parents consider in vitro fertilization and surrogacy, they wonder, “Can you choose the gender of your baby?”

With celebrities like Chrissy Teigen and John Legend openly speaking about their own gender selection of their daughter, the question of choosing a boy or girl through the IVF process has historically been a bit ethically complicated. Medically, however, the answer is straightforward — those pursuing IVF can choose the gender of their baby.

Those pursuing in vitro fertilization will learn that there are many steps to this medical process, especially if it will be followed up with a surrogate pregnancy, and how to choose your baby’s gender as a part of this is equally as complicated.

In short, the IVF process itself doesn’t automatically allow for the creation of an embryo of a certain gender, so to say, but rather lends itself to gender selection before the embryo is transferred.

Why Gender “Selection” Isn’t What You Think

While intended parents may theoretically have the ability to “choose” the gender of their baby with IVF, the selection is a bit more complicated than just telling their doctor “boy” or “girl.”

Before an embryo can be cleared for transfer into a uterus (whether that’s an intended mother’s or a surrogate’s), most fertility clinics will complete preimplantation genetic screening. This screening takes a detailed look at an embryo’s chromosomal makeup to determine whether it is healthy enough for transfer and in-utero development. As part of this screening, medical professionals are also able to identify the sex of the embryo.

Intended parents should not prioritize the sex of an embryo in choosing an embryo to implant. Instead, a fertility professional will examine the results of the screening to determine which embryos appear to be the healthiest. From there, intended parents may be able to choose gender of their baby if they have two equally healthy embryos of different sexes.

The likelihood of this happening can be small; one doctor estimates that only about 15 to 20 percent of IVF cases result in equally healthy embryos of each sex. Of these, only about half of intended parents choose a specific gender.

Keep in mind: Most fertility doctors will encourage intended parents to transfer the embryo(s) of higher quality, regardless of its sex.

Ethical Considerations of Choosing the Gender of Your Baby

Being able to choose the gender of your baby, while only available to those who complete the IVF process, is more common than it used to be. In response, choosing baby genders has become a hot-button topic for many people.

However, even in these situations, gender selection is more a matter of personal preference than discrimination against one sex or the other. For example, intended parents who select a certain gender most often do so to bring a sense of balance to an existing family — like if they already have a boy and want a girl, or vice versa.

Some critics do argue about the “slippery slope” of choosing sex during the IVF process, claiming it will lead to genetic modification and other “unnatural” changes to the reproduction process. Unfortunately, there have always been critics of any medically assisted pregnancy — and these critics often offer the same arguments.

In response to this, it’s important to remember that embryo health and safety is the most important factor in selecting a viable embryo. Doctors will always encourage intended parents to do what is the most likely to result in a successful implantation, which usually involves choosing the healthier embryo (no matter which sex) and refraining from additional medical procedures that could make it more vulnerable to miscarriage.

If you are interested in whether it is possible to choose baby gender in your IVF process, discuss the topic with your doctor. They may or may not allow for sex selection when transferring embryos. If they do, they can explain what their specific requirements are for a healthy embryo and to what degree your own preferences will make a difference.

What Happens After a Miscarriage in Surrogacy

It’s a situation no intended parent or surrogate wants to experience: a miscarriage. While fertility clinics and fertility doctors take every step to make sure an embryo and a surrogate are healthy before the transfer and implantation of the embryo, miscarriages do sometimes occur.

Miscarriages are still a rather taboo topic, but that doesn’t mean they don’t happen. They’re more common than you may think; between 10 and 25 percent of known pregnancies actually end in miscarriage. Rarely is a miscarriage someone’s “fault,” as it’s usually the result of an abnormal embryo that would not have survived to term anyway.

Experiencing a miscarriage during the surrogacy process can be even more devastating because of the time and effort put into creating an embryo and the past failures an intended parent may have had with their own fertility. A miscarriage can seem like an impossible setback, but know that your surrogacy specialist and fertility doctor will be with you as you cope with this loss and decide what to do next.

Intended Parents

For many intended parents, a miscarriage during surrogacy is a reminder of their own past miscarriages or inability to get pregnant. It is heartbreaking to see your dreams fail again, but it’s important to understand the vast scope of the surrogacy process and stay positive.

There is no dramatic difference in miscarriage rates for those who conceive an embryo via in-vitro fertilization. A miscarriage during surrogacy is a natural thing, although that will likely not come as any condolence to you in your grieving process.

If your surrogacy results in a miscarriage, it’s important to take the time you need to grieve (your surrogate will also need time to physically recover before another embryo transfer can take place). This is also a good time for you and your surrogate to reevaluate your thoughts before moving forward; it’s important that both of you are still committed and comfortable continuing the surrogacy process at a time that’s best for both of you. When you’re ready, your fertility clinic will begin the necessary steps for another implantation cycle.

Remember, miscarriage is a common occurrence, and it’s no one’s fault. Your fertility clinic will have usually prepared you for the possibility of a miscarriage, and American Surrogacy will always give you the support and counseling you need to get through this difficult time. We know that it takes time to heal from a difficult loss like this, which is why you and your surrogate have the right to decide together when to start the transfer process again.

Surrogates

If you experience a miscarriage as a surrogate, it’s common to feel like you’ve failed your intended parents. This is completely untrue; a miscarriage is not your fault but instead a natural phenomenon you have no control over. Still, this can be difficult to accept, especially because it’s your body that has expelled the pregnancy.

A miscarriage will not affect your ability to become pregnant again. Your surrogacy contract will state how many transfers you will complete for the intended parents, so it’s likely that you will have another embryo transferred whenever you are physically and emotionally ready. Depending on how far along your pregnancy was, this recovery period may take longer or shorter than you expect. However, it’s important that your emotional recovery is complete before you move forward with another embryo transfer.

It’s normal to feel a range of emotions after a miscarriage, even if the embryo was not genetically related to you. We can always provide you trained counseling to help you cope with these emotions and prepare for your next embryo transfer, whenever you’re ready. Usually, within the first three transfers you complete with your intended parents, one embryo will result in a successful pregnancy and birth — so, while it may be tempting to give up after this disappointment, remember that it’s highly likely you’ll find success in your subsequent transfers.

—

Remember, surrogacy is a marathon — not a sprint. It’s a long process that will come with many emotional ups and downs, which is why American Surrogacy’s specialists will be there for you every step of the way. Miscarriage is always a difficult event to process but know that it’s not the end of the line. A successful surrogacy is possible, and we’ll help you complete it.

What to Expect When Testing for a Surrogate Pregnancy

Everyone knows: The surrogacy medical process is long and can seem to take forever. After months of testing and measuring cycles in preparation for the embryo transfer process, waiting for a positive pregnancy result after the transfer can seem like an impossible feat, no matter whether you’re the surrogate or the intended parent.

When you’re in the middle of the surrogacy medical process, your fertility specialist will explain in detail what to expect. But, what if you haven’t started the process or want more information on exactly what to expect when testing for a positive surrogate pregnancy?

You can read more below about what happens during the testing process for a surrogate pregnancy. As always, we recommend speaking to your surrogacy specialist and fertility specialist for more detailed information about what your personal medical process will look like.

The Clinical Process

After a surrogate’s embryo transfer process is complete, her fertility clinic will eventually test for her pregnancy with an hCG level blood test. hCG levels are the hormone levels that determine if a woman is pregnant or not. How high a surrogate’s level needs to be, however, will depend upon her individual situation, including when the embryos were transferred during the incubation period and how many days have passed since the transfer was completed.

But, how long before you can expect a result?

How long a surrogate needs to wait before a beta blood test will depend on the fertility specialist’s instructions, but the first testing process usually occurs anywhere between eight to 12 days after transfer. If hCG levels indicate a surrogate might be pregnant, she’ll return a couple of days later for another blood test to see if the levels keep rising. Ideally, hCG levels should double every 48 to 72 hours.

If her levels rise enough, the fertility specialist will likely confirm the pregnancy. This is usually confirmed after the third beta appointment.

Home Pregnancy Tests: Are They Worth It?

If you’re a surrogate who is part of online support groups, you may see other surrogates post pictures of multiple home pregnancy tests from different testing times. But, if all surrogates know for sure at a fertility clinic testing whether their pregnancy is positive or not, why do they do this?

Taking home pregnancy tests is just another way for surrogates to track their increasing hCG levels. Typically, women will wait three days after an embryo transfer to take a pregnancy test — although it can take at least five days after transfer for a positive pregnancy test to show up. From there, surrogates may take a test twice a day to compare the results; if a pregnancy line is getting darker, it’s usually a sign that their hCG level is rising and they are, indeed, pregnant.

While some surrogates will wait until their clinic beta testing just to be safe, other surrogates are anxious to see whether the embryo transfer worked. This comes from the desire and hope riding on their pregnancy, so it make sense that they want that validation, even if they wait to tell intended parents until a medical confirmation.

However, it’s important to note that just because a home pregnancy test comes back positive does not mean a pregnancy is in the clear. You may receive a false positive reading, or there may be other medical issues that arise later on. So, while home pregnancy tests are a good way to relieve anxiety after an embryo transfer, it’s always a good idea to rely on your fertility clinic for a secure medical result.

If you ever have any questions about testing for your surrogate pregnancy and the process involved, we encourage you to reach out to your fertility specialist for accurate, personalized information.

What is Preimplantation Genetic Screening in Surrogacy?

You may have heard that an important part of the surrogacy medical process is the preimplantation genetic screening, or PGS. But what exactly is PGS, and why does it need to occur?

PGS is the medical process that determines whether an embryo is healthy enough to be transferred to a surrogate’s uterus. Rather than chance a miscarriage or the birth of a child with a genetic condition, PGS allows fertility professionals to gauge the health of an embryo ahead of time — reducing the likelihood of unsuccessful results.

PGS examines the specific chromosomal makeup of each embryo. This is where genetic disorders or conditions can be detected. If an embryo does not have the proper number of chromosomes (26 — 13 from each parent) or seems to have another abnormality in chromosomes, it is known as an aneuploid or abnormal embryo. These embryos are usually not suitable for implantation, and a fertility specialist will seek out another normal embryo instead.

PGS is usually completed in all surrogacy processes, no matter the genetic history of the intended parents or gamete donor (some intended parents who have already completed IVF will have completed this screening, as well). While the screening does help to confirm whether either parent is a carrier for a genetic condition or passes on increased chromosomal abnormalities because of their age or other factors, it’s also completed for the safety of the surrogate. By screening multiple embryos from the intended parents, fertility specialists can choose the healthiest one for transfer — eliminating the need to transfer multiple embryos “just in case.” This protects the surrogate from the risks of carrying multiples.

So, how does PGS work?

The PGS process takes place after embryos have been successfully fertilized and incubated. About 5 to 7 days after the fertilization process, fertility specialists remove certain cells from the embryo that will eventually develop into the placenta (this does not impact the development of the embryo). These cells are passed along to a laboratory, where specialists examine them for chromosomal abnormalities. Results are usually made available to the fertility clinic and intended parents after 7 to 10 days.

While intended parents have the chance to choose their fertility clinic, they usually will use the genetic screening company that their clinic has already developed a partnership with.

It’s important to note that PGS does not screen for specific diseases but just for at-risk embryos with genetic abnormalities (some chromosomal conditions, like Down’s syndrome, are easy to detect by counting chromosomes). To identify diseases, intended parents and their fertility clinic may instead choose to complete pre-implantation genetic diagnosis, which screens for single-gene defects. Both PGS and PGD can be performed at the same time.

Keep in mind that neither of these processes are a replacement for prenatal screening later on in a pregnancy.

Why is PGS in surrogacy so important?

While genetic screening can be important in every in-vitro fertilization pregnancy, it’s especially important in surrogacy. Because the woman carrying the child is not the intended mother, it’s important that her safety is protected, as well. Completing PGS makes sure only the best embryos are transferred to her uterus, decreasing the chance that she experiences a miscarriage or other pregnancy complications later down the line.

It’s also helpful for the intended parents, who may have already gone through years of infertility before deciding on surrogacy. By only transferring the best embryos, they reduce the chance they will experience more disappointment if an embryo does not successfully implant.

When you work with American Surrogacy and the fertility clinic for your surrogacy process, we will coordinate to make the embryo transfer process as safe and efficient as possible. Your surrogacy specialist will always be there to offer you advice and support, especially if your genetic screening and IVF process takes longer than anticipated.

To learn more about how American Surrogacy will coordinate with your fertility clinic, or to learn more about the medical process of surrogacy in general, please contact us today.

The Truth About Genetic Modification of Embryos

A U.S. team of scientists made headlines this summer when they were the first to successfully correct a disease-causing mutation in a human embryo. While the embryo was not and never intended to be transferred into a uterus for implantation, the announcement did open up a larger discussion about genetic modification of embryos and its future moving forward.

There is a lot of confusion today in the U.S. about genetic modification of human embryos and an even greater ethical conversation about this practice. If you are considering entering into the surrogacy process, whether as an intended parent or a prospective surrogate, it’s important you understand the realities of this scientific find and what it may mean for surrogacy moving forward.

The best source for information about genetic modification of embryos will always be a fertility specialist, as they can explain in detail not only which processes are possible but which are available at their own organization. But, to help you grasp the basics of the process, we’ve answered a few of your questions below.

What Kind of Genetic Modification is Available?

In the U.S. today, it is illegal to perform genetic modification on a human embryo for the purpose of implanting it in a woman. While research is allowable for scientists as long as they destroy the experiments and don’t receive federal funding, genetic modification for intended parents is not a possibility.

But, just because an intended parent cannot genetically modify their embryos does not mean they are limited to unhealthy possibilities. In fact, it is common today for embryos created in vitro to undergo preimplantation genetic screening. This screening tests for chromosomal abnormalities and certain genetic diseases, which means intended parents can avoid transferring an embryo that is not desirable — i.e., one that has a genetic disorder or another mutation that will prevent it developing to term.

Your fertility specialist can give you a better idea of what kind of screening and testing can be done to ensure a healthy embryo for transfer.

Could Genetic Modification Play a Role in Creating “Designer Babies?”

One of the concerns that people have about scientists moving forward with genetic modification of human embryos is what they see as a potential for “designer babies” — embryos that are modified for not only dangerous mutations but also characteristics like eye color, height and more.

However, the National Academy of Sciences (an organization of leading researchers) explicitly states that genetic modification should never be used for enhancement purposes. In addition, researchers have not yet isolated genes for those kinds of traits, making any modification of them impossible. Any researchers who are testing genetic modification focus on more critical characteristics, like disease-causing genes, and are well aware of the ethical concerns of focusing on more superficial traits.

When Can I Expect Genetic Modification to be Available?

While genetic modification could theoretically be applied to thousands of genetic diseases, the testing behind approval of this technique will take years — especially because of the restrictive U.S. laws and lack of funding regarding this technique. Therefore, it’s likely that genetic modification for many traits and diseases will not be available until at least the federal laws on the practice are changed.

In the meantime, methods like preimplantation genetic screening and egg, sperm and embryo donations can help reduce the likelihood that a child is born with genetic diseases and disorders. For more information about how you can have the healthiest child possible through the surrogacy process, contact a surrogacy professional and a fertility clinic.