Progyny Webinar: LGBTQ+ Family Building: Surrogacy 101

Progyny is proud to offer inclusive and equitable family building benefits that support all paths to parenthood and celebrate all families. The family building journey with surrogacy can be complex, especially with the legal and financial components. This webinar helped break down the process from experts and those who have experienced the journey firsthand, including what you need to know about surrogacy, how to build a relationship with your surrogate, and frequently asked questions.

Featuring:

  • Samantha Wright, RN, BSN, Progyny PCA and Surrogacy Expert  
  • Anthony Brown, Manager of Client Services at Circle Surrogacy & Egg Donation and Attorney and the Chairman Emeritus of Men Having Babies  
  • David Reed, Progyny member  

Getting Started with Surrogacy 

There are many reasons to consider growing your family through surrogacy. Whether you are an individual or couple who has struggled with infertility, someone who may have a medical issue that precludes from carrying a pregnancy, you are a member of the LGBTQ+ community, or you’re looking to expand your family as a single parent – regardless surrogacy might be an option for you.  

Surrogacy is the process where a female carries a child for the intended parent(s), and the child is typically not genetically related to the surrogate. The intended parent(s) create embryos either using their own egg and sperm or donor egg and/or donor sperm, and the embryo is transferred to the gestational carrier, and she carries the pregnancy. 

Surrogacy can be a very complex and emotional process and there isn’t always a clear path. From the time that you are matched with the surrogate to the time the baby is born, there are many ups and downs throughout the process. It’s important to be prepared when thinking about what could happen, while also understanding that there is no way of controlling every aspect of the journey and that you must take a leap of faith and trust yourself along the way as you make decisions.

While surrogacy is a positive life-changing experience, it’s important to understand the associated costs based on the path you choose to take. One of the first key costs is working with a fertility clinic and confirming what you need, such as donor eggs, creating embryos, etc.  After embryo creation, additional costs include screening the carrier, sending medication, and completing the embryo transfer. Second key cost is whether the surrogate is independent or through an agency.  Through the independent journey, there will be a lot of legal and attorney fees associated with the carrier, egg donor (if applicable), and you. When working with any agency, they will handle the legal aspects, but you will incur agency fees, screening fees, matching and rematching fees, insurance, etc.  Additional costs include compensation for the carrier to cover travel and medical costs, along with costs for an insurance plan for the carrier and newborn. All in all, the total cost can be up to $200,000, according to Circle Surrogacy, prior to any benefit coverage, which will vary based on specific needs.  

There are also many legal considerations when going through the surrogacy process. Legal contracts are required before the process begins in order to protect the rights of the intended parent(s), the gestational carrier, and the child. Both the surrogate (third party) and parent(s) should have separate legal counsel. If you aren’t working with an agency and are looking for an attorney, choose a lawyer who practices assisted reproductive technology (ART) law, so they can best help you through the process. Some questions to consider when selecting a lawyer include how many cases they do a year, do they work with same-sex couples, and what states they are admitted to.

While these fees and legal processes do seem intimidating, access to fertility benefits can substantially help reduce the cost. Progyny members can contact their dedicated Patient Care Advocate (PCA) to better understand what surrogacy benefits are available and the expected costs. 

Selecting an Agency and Surrogate

One of the first steps in the surrogacy process is to select a surrogacy agency if you’re not going through an independent surrogate. Each agency provides services like matching, screening, case management, support, counseling, legal services, and more. There are different types of agencies—some may be full-service while others may be a la carte based on the services needed.

It’s important to find an agency that has alignment with who you are as people, as well as extensive experience in the space. When deciding which agency to choose, consider asking some of the following questions about their process:

  • What is the timing of this full process? How long will it take?
  • What do surrogates and egg donors look for when they are looking to match with a family?
  • What is usually important to gestational carriers so that they also have a good experience?
  • How does the location of the surrogate affect the overall process?

One main question during the surrogacy process is, how will we know if we found the right carrier? Surrogacy agencies go through an in-depth process with rigorous standards to review surrogacy applicants to approve and match with intended parents. The surrogate application process typically includes a detailed questionnaire, interview with a social worker, interview with their spouse if applicable, criminal and financial background check, psych assessment, and pregnancy record review. It’s important to get to know about their lives and feel like you really know the carrier. 

How to Build a Relationship with Your Surrogate 

Identifying a surrogate can be one of the most important parts of this process. When working to find the right surrogate, there are key things to consider:

  • What were their previous pregnancies like?
  • How many babies are they willing to carry?
  • Are they open to selective reduction?
  • Would they be willing to terminate the pregnancy if complications were found?
  • What kind of communications would they like to maintain after birth?
  • What questions or hesitations do they have about you or the process?

Once you’ve been matched, it’s important to build a solid relationship with the surrogate. This relationship could have an impact on your child, the pregnancy, the surrogate, and you. It’s important to share your goals of this experience with each other early on and to align on expectations upfront. It also helps to have regular and open communication about life in general and not just surrogacy to build that personal relationship. In addition, it’s also important to connect with their support system and involve them in the process as well. Allow your relationship to develop organically over time and understand that no two journeys are the same and there is no level of communication that is considered “right.” Do what feels right for you and your surrogate so that you both feel it’s a positive experience.

Common Surrogacy Myths and Q&A

  1. Is it true that the intended parents will have trouble bonding with the baby?
    • This is a common worry but to emphasize, the bonding process happens after the child is born. Once they are born, they will immediately be handed over to the intended parents where that bonding experience will begin.
  1. What are the requirements to become a surrogate?
    • There are three different levels of requirements. The requirements could come from a statute in the state, agencies may have requirements, and the most important would be the fertility clinic’s requirements. The clinic’s requirements could be related to B.M.I. or age, multiple embryo transfer protocol, psychological evaluation, and many others. Most clinics would like someone who has a history of easy pregnancies and no other medical reasons as to why they cannot carry. A possible restriction could be related to the number of previous c-sections, or if someone has had a miscarriage. It’s important to ask the clinic what the criteria are and if you are working with an agency or an attorney, they will be able to talk to you about the specific requirements. 
  1. How long does the surrogacy process typically take?
    • The pandemic has increased wait time to match with a carrier. It was six months prior to the pandemic and now it’s 13-14 months. From when you start to when you finish, it will probably end up being a little over two years from signing on with an agency to the end of the process. Some agencies will not sign with you unless you have embryos already created so that is something to take into consideration. Most people start with the clinic and then move to matching. However, now people are starting with the agency because they know there are longer wait times, and they can go to a fertility clinic to create embryos while they wait. 
  1. Any advice on waiting to be matched with a surrogate?
    • Everyone has their own journey in the matching process. During the process, it’s important to determine your own values, what you are seeking or wanting, and then putting it down on paper. This process takes a lot of research and time with the different carriers’ profiles. Although a surrogate’s profile may not fully match, it allows you to go through your lists and highlight what is a top priority. Although this matching process can take a long time, it is important to be patient, go through the options presented, and also ask questions to all participants in the process. 

We hope you found this information helpful and informative. Progyny is always here to support you on your family building journey.  If you have any other questions, please don’t hesitate to reach out to education@progyny.com or contact your dedicated Patient Care Advocate. Progyny is committed to helping you on your family building journey and always here to support you.