The surrogacy process is this long because it involves various stages and requires input from multiple professionals. The process also depends on a number of factors that fall outside of one’s control, such as a successful embryo transfer and pregnancy. In the grand scheme of things, it’s worth the wait – as each day gets you closer to hopefully welcoming your little one.

For many intended parents researching their surrogacy journey, creating a realistic timeline in advance is really helpful. Seeing the entire process broken down into smaller, achievable steps helps you focus on each stage and know when to expect the next. With that said, let’s get into the entire surrogacy process and the stages you should expect along the way, with approximate timelines for each:

Research Surrogacy 

The decision to build your family through surrogacy is a big one. And, as with all big decisions, research goes a long way. The time you need to weigh your family building options and to address any complicated feelings you (or your partner) may be dealing with is completely personal. When you’re sure that surrogacy is the right path for you, it’s time to decide whether to enlist the help of a surrogacy agency or go ahead on your own. Here are a few articles that can help you start to think this through:

• How do surrogacy agencies help intended parents?
• How do I choose a surrogacy agency that’s right for me?
• How can I finance surrogacy?

Consultation and Application: 1-3 Months

If you decide to work with a surrogacy agency for your journey, the first step is to choose the right one for you. Here’s one place GoStork can really help you save time: we’ve researched and vetted top surrogacy agencies across the US, so you don’t have to. Rather than managing accounts with multiple agencies, you can view (and easily compare side-by-side) many different options on our platform, including all of the important information about their services offered, ratings and reviews, number of babies born, team profiles and much more. We’re also the only place where you’ll see costs published upfront, saving you the time it takes to call agencies or attend initial consultations to get them. All of this combined reduces what used to take many weeks of research into as little as a few hours.

Once decided on your top choice (or choices), you can instantly message the agency or schedule a phone consultation, where you can discuss the surrogacy process and your wishes in more detail, get to know the staff, and start building a relationship with them. It’s important that you develop a good rapport – knowing you can trust the agency, and that its staff will help you manage any difficult situations that may arise. A service agreement is signed once you’re sure the agency is right for you. 

If needed, at this stage you will also match with an egg donor and create your embryo(s). 

Matching with a Surrogate or Carrier: 3-6 Months

The agency will ask you to complete an intended parent profile, which they will present to potential gestational carriers. (As a note of clarification: a gestational carrier is a woman who carries a pregnancy for someone else but has no biological link to the fetus. When the carrier also provides the egg, she is called a surrogate. Most surrogacy arrangements today are gestational surrogacies). The agency helps to find the most ideal carrier that meets the intended parents’ requirements and then presents the match to both parties. If everyone is happy with the match, the agency facilitates a meeting (which happens over a video conference in current times or if you don’t live close to each other) where you get to learn more about each other. If everyone’s excited about taking things further, the journey can officially begin! 

The length of this stage greatly depends on the criteria you have for your gestational carrier. If you’d prefer that she is a specific age, or from a specific location, for instance, this can lengthen the process. Some intended parents reach an agreement at the very first video call – others meet with more than one gestational carrier before finding a match.

Here’s another helpful article where you can learn more about the Essential Qualifications to be a Gestational Carrier.

Medical Screening and Contracts: 1-2 Months

A number of milestones mark the next few weeks, all of which have a big impact on the overall surrogacy process. 

The gestational carrier undergoes medical and psychological screening to ensure that all is well for her to carry a child and in general to successfully complete the surrogacy process. 

During this time, you will also work with your surrogacy attorney to draw up the surrogacy contract – while the gestational carrier simultaneously works with her own lawyer. Once all points are made clear and agreed upon, both parties sign the contract – another milestone successfully reached!

Embryo Transfer: 1-1.5 Months

Once the legal agreement has been finalized, the IVF clinic provides the gestational carrier with her protocol and the required medication for her Frozen Embryo Transfer. She is also advised on the monitoring required ahead of the embryo transfer. 

If you already have embryos available, this stage will take an estimated 4-6 weeks. For the embryo transfer itself, many parents choose to join their carrier and experience this important moment together – if they can’t be there in person, a video call is often organized. 

While we all hope for success at first try, in reality there are instances where the transfer is not successful. In that case, you will have to wait another 6-8 weeks before a second transfer attempt. 

Following the transfer, your gestational carrier visits the local clinic for beta tests until a heartbeat is confirmed.

Pregnancy: 9-10 Months

Congratulations! Next up is the longest stage of the surrogacy journey, but also an amazing one. A full term pregnancy takes 40 weeks, but a couple of weeks would have already passed at the point the pregnancy is confirmed. Your gestational carrier will keep you updated as the pregnancy progresses. At this stage, she’s cared for by her own OBGYN. Depending on the legal framework in your gestational carrier’s state, your attorney may be able to start the pre-birth order process around the 16th to 20th week mark. We’ll go into more detail on this in a later section.

If you’re considering breastfeeding (or if you’re reading here first that it’s even possible to breastfeed if you don’t carry the baby), you can speak to your doctor early on in the pregnancy about inducing lactation. In this article, Candace Wohl, infertility advocate, co-writer of Our Misconception blog, and mom to two daughters born via a gestational carrier, writes about her experience of deciding and then preparing to breastfeed.

As the pregnancy progresses, it’s time to create a birth plan, book any travel as required, and prepare the hospital bag including everything you need (carseat, etc) to take the baby home. A note on car seats: all states require parents to have a car seat before leaving the hospital – some hospitals offer car seat safety classes and can also check your seat for correct installation. For international parents, the surrogacy agency can help you source a car seat and any other baby gear you may need before you travel back to your home country. You should also take the time to research, interview and choose a pediatrician. Most hospitals ask for the name of the pediatrician as soon as your gestational carrier is admitted to deliver the baby. 

Birth and the Postpartum: 1.5-3 Months

When the doctor gives the all-clear, you can head home. International parents, however, will have to stay in the state the baby was born in for a few more weeks until all paperwork is complete and the baby has a passport. 

Establishing Parental Rights

The Uniform Parentage Act provides a legal framework for establishing parent-child relationships. Under this act, the woman who gives birth to the child is presumed to be the child’s mother, both biologically and legally. Because of this, the gestational carrier (and if applicable, her husband) have to formally establish that they are not the child’s parents. 

Once your baby is born the carrier and her partner sign and relinquish any rights they may have. Your attorney submits this documentation to the court, together with other paperwork to prove the baby’s parentage.

As noted earlier, in some states, the process of establishing parental rights can start before your little one’s birth. At around the 16th and 20th week of pregnancy, your attorney starts the pre-birth order process which establishes the baby’s legal parentage.

If one of the intended parents is not genetically related to the baby, they may need to complete an adoption, or (a more straightforward) stepparent or second-parent adoption. In cases where neither intended parent is related to the baby, a full adoption or embryo adoption is required.

In Conclusion

We’ve gone over all the main elements of the surrogacy journey so you should now have a better idea of what to expect. That said, this is a general outline: surrogacy is a very human and highly personal experience, with variables that can affect the overall length of the process. Focusing on each step as it comes and remaining flexible throughout will help you stress a bit less and be at peace with the fact that there may be some unexpected situations along the way. 

As you start your search for a gestational carrier, we hope you’ll take advantage of our free platform where you can find, compare, and connect with top surrogacy agencies across the US, already researched and vetted for you with profiles including all of the important criteria (years in business, number of babies born, costs, ratings and reviews, team profiles, and much more) you need to make an informed decision. Find your ideal surrogacy agency, here.

Originally published by GoStork.com. Re-published with permission.

The post Considering Surrogacy? Here’s What You Need To Know appeared first on Embie | IVF, IUI ; Egg Freezing Tracking App!.

The egg donation process – a quick overview

Through egg donation, a donor chosen by the intended parents provides her eggs to be transferred via IVF. Fertility clinics follow a rigorous screening process when it comes to clearing egg donors. Prior to starting the egg donation process, the egg donor undergoes a thorough medical screening to ensure that she is fit to receive the stimulation medication required (more on this below). Her egg reserve is assessed, and her medical history and family and genetic history evaluated. Blood tests are done to check for undiagnosed medical conditions or infectious diseases.

Once the egg donor is cleared by the clinic, she is prescribed hormone medications to stimulate ovulation and the production of multiple eggs. If it’s a fresh cycle, the intended mother will be prescribed estrogen and progesterone to build up the uterine lining and prepare it for implantation.

The next step is the egg retrieval and fertilization with sperm from the intended father or a sperm donor. The best embryo is transferred to the uterus using a thin catheter, a procedure known as a fresh embryo transfer (FET). The intended mother continues her medication (progesterone). If the transfer is successful, once a heartbeat is confirmed, the pregnancy progresses from there, hopefully making it successfully to term.

While there are various reasons why the use of an egg donor may be recommended, the first step is to understand if egg donation is right for you. 

Is egg donation right for you?

Deciding to grow your family via egg donation is not easy, however it may be an ideal solution if conceiving naturally isn’t possible. The first step is to consult a reproductive endocrinologist (RE) or your fertility clinic to go over your options. Egg donation may be recommended in the following scenarios:

1. Advanced age: fertility naturally diminishes with age as changes start occurring in the ovaries
2. Diminished Ovarian Reserve (DOR): when the ovaries no longer produce quality eggs in adequate numbers. This generally occurs with ageing and menopause, but genetic abnormalities, medical treatments or injury may also lead to an earlier DOR 
3. Primary Ovarian Insufficiency(POI): women naturally experience reduced fertility around 40 years old but for those with POI, this starts earlier – in some cases even as early as the teenage years
4. Absence of the ovaries: due to surgery or a congenital malformation
5. Poor oocyte quality: an oocyte is an immature egg cell. During ovulation, the oocyte matures and becomes an egg. The number of oocytes decreases with age, as does their quality 
6. Poor embryo quality: this could be due to a genetic abnormality in the egg or sperm of the male or female partner, or a genetic abnormality in the embryo
7. Prevention of genetic diseases: if the intended parent is aware of a condition that could be inherited by the baby
8. Previous IVF failure: when IVF was attempted using one’s own eggs
9. Men: who are single or in a same sex relationship need the help of donor eggs to conceive

If a medical issue is keeping you from growing your family, the news that you will need an egg donor can be difficult to take. It’s important that, if necessary, you seek support to come to terms with the news and to discuss the way forward. It’s also completely understandable that you may feel wary of using an egg donor for some time, but chances are the desire to have a baby will help you overcome your reservations and concerns. 

So, give yourself the time you need. Remember that, donor eggs or not, you will still 1,000,000% be your child’s parent. And then once you and your partner feel ready, it’s time to start searching for the ideal egg donor, one that matches all of your preferences.

Factors to consider when selecting an egg donor.

Choosing your specific egg donor is one of the most personal and important decisions you’ll make. Many intended parents choose to seek the services of an egg donor agency – however, choosing which agency to work with is a big decision in itself and many intended parents go to multiple agencies before they find their perfect donor. To make the process easier, GoStork provides the largest free online database of over 10,000 egg donors from various egg donor agencies all in one place, allows you to compare egg donors side-by-side, then connect directly with the agencies of your favorites.

Egg donor profiles you review include the donor’s physical attributes, education level, medical history, as well as family history, among other elements such as ethnicity and religion. Undeniably, you are presented with a large amount of information, but in this case, the more information the better! To get started, you’ll want to decide what characteristics matter personally to you. Here is a list of criteria you’ll have to consider:

• Age – Donor must be between the ages of 21 and 30 but if you prefer one on either the younger or older end of that spectrum, that’s a valid decision
• BMI – Donors must have a healthy Body Mass Index (BMI) between 18-27, but as far as the donor’s specific weight – that may be a consideration that’s important to you.
• Medical History – Personal health history (ideally, a non-smoker, non-drug user and non-alcohol dependent, has no STDs, and is not undergoing treatment for depression or anxiety – these elements are pre-vetted and indicated for you to consider), family health history (ie. you would be looking for egg donor profiles with no family history of genetic disorders, and no significant family history of cancer).
• Reproductive history –  If applicable, you’ll see information about ‘proven fertility’ in egg donor profiles, ie. a previous successful pregnancy shows that the donor has the potential to provide healthy eggs. You may also learn that the donor has donated eggs prior that resulted in a successful pregnancy.
• Appearance – You’ll see the donor’s photos, (ideally current as well as from childhood) and – when available – videos, natural hair color, eye color, height, and, as already mentioned, you’ll see her weight. Many intended parents are interested in donors with similar physical features to themselves, while others are interested in dissimilar features. Again, these are personal decisions and any preference is valid.
• Personal Background – This can range across heritage, religion, characteristics, education, career, and even criminal record. This is obviously a wide range of criteria – so just to explore one example; a donor with a graduate degree or high test scores may be someone you’re ideally looking for – so you could, as a starting point, filter your options through the lens of your desired standard of education. Also, many intended parents look for egg donors with a similar heritage or religious background as themselves.
• Compensation: Fee can range from $2,500 to $30,000 – and even upwards. Donors may charge more when they have proven fertility or a higher level of education, among other factors.
• Location – An egg donor close to your IVF clinic can help save you money in covering her travel costs. That said, this may not be your most important criterion – in which case it’s totally up to you to prioritize other factors over where the donor lives.

Choosing Between Frozen or Fresh Donor Eggs

Both fresh donor eggs and frozen donor eggs have specific pros and cons which you should consider:

Advantages of using fresh donor eggs

1. Better odds of live birth– IVF with fresh donor eggs has been widely researched and found effective. A national study published in the journal Obstetrics and Gynecology found that the use of fresh donor eggs in IVF has a small advantage in birth outcomes. According to the study’s lead author, Jennifer L. Eaton, M.D., “the odds of a good birth outcome were less with frozen than with fresh, but it was a small difference.” Data from the Centers for Disease Control and Prevention (CDC) also shows that, overall, 55.3% of embryo transfers from fresh donor eggs resulted in a live birth vs. 46.7% for embryo transfers from frozen donor eggs.
2. Larger number of eggs – A fresh egg donation cycle will give intended parents anywhere from ten to twenty eggs. This is ideal if you plan on having more than one child: a fresh donation cycle will likely provide you with a good number of embryos to pursue more than one pregnancy. 
3. No need for ICSI – with frozen eggs, an extra procedure known as intracytoplasmic sperm injection (ICSI) becomes a must (which also adds to the overall cost). The freezing and thawing process makes the shell surrounding the egg hard for the sperm to penetrate on its own. ICSI bypasses this as a single sperm is injected directly into the egg. 

Caveats with fresh donor eggs

1. Longer timeline – using fresh donor eggs is a longer process: it takes time to match a donor to the recipient and then to synchronize schedules and cycles.
2. Greater cost – fresh donor egg IVF is typically more expensive than the frozen alternative: as noted by what to expect, at an average of $25,000, fresh donor eggs amount to around twice the cost of frozen eggs.
3. Potential for cancellation – donation cycles can on occasion get cancelled due to poor medication response or issues, or because of an insufficient amount of eggs obtained. Medical issues more specifically may include uterine cysts or bleeding, which can have a negative impact on implantation, preventing the cycle’s success. 

Ultimately, when it comes to choosing between fresh or frozen eggs, it all comes down to your personal situation. There is no easy answer as to which is best. Success rates can depend on each individual’s specific case, as well as the expertise of the clinic you’re working with. A doctor and the clinic can help you assess your options based on your medical history and specific circumstances.

We hope that this helped provide the information you need. And remember – the right decision is whatever feels right for you. All the best on your journey!

This article was originally published on GoStork.com and re-published with permission.

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