Intake Form

Phone Meeting

The first step starts with filling out the intake form on the website to indicate interest in becoming a surrogate. Once that happens one of our intake coordinators will reach out to have a phone conversation with every person who wants to be a potential gestational carrier. This conversation is about verifying information submitted in the form, talking about the basic qualifications of surrogacy and answering your questions. Our intake coordinators are experienced surrogates that want to help you through these beginning steps of the surrogacy process. It is meant to be a casual conversation to get to know you a little and see if surrogacy is a good fit for you.

Submit Documentation

Once you meet the minimum requirements and are ready to move forward with surrogacy, you will fill out a long application. We will then gather medical records and documents, talk with you about the process, you decide on your compensation, background checks are conducted, personal interviews happen and so much more! Parts of this process must include your partner or spouse or other adults in your household, such as the background checks and the interview. This process typically takes 3-6 months. This timeline depends on your responsiveness as well as how quickly we can obtain medical records.

Interview and Education

PSYCHOLOGICAL EVALUATION

The psychological evaluation process consists of a personality inventory and a discussion with a licensed social worker or psychologist. This evaluation is to make sure that you (and your spouse/partner) understand the surrogacy process and meet the requirements to continue. There are so many variables and additional pieces it’s important to talk about those expectations before getting too far in this process. This evaluation is typically done either in person or via zoom with the psychologist or social worker. This may be done as part of the agency clearance process and/or at the clinic as part of their screening process.

REVIEW INTENDED PARENT PROFILES

Once you have completed the screening process, the next part of the process is matching. There are a lot of things our team considers in the matching process before ever presenting a profile to either the Intended Parents or to you, the Gestational Carrier. The first thing we consider is clinic criteria and who they are likely to approve to move forward according to medical records. Then we consider vaccination status, termination beliefs, number of embryos being transferred, location of the surrogate relative to Intended Parents, communication style, how much involvement each party wants, and so much more. This relationship lasts for at least a year, and it is best to be on a similar page. The items that we consider should be things you consider as well; think about your expectations for the journey and choose someone you feel is similar to what you are expecting. Typically, our agency presents gestational carrier profiles to the Intended Parents first. If they say yes, then we present the Intended Parents’ profile to you. If you say yes to being interested then we schedule a match meeting. It is important to know that each person always has a chance to say yes or no to moving forward with the other party.

MATCH MEETING

The match meeting is like a blind date, with a third wheel, as the meeting is facilitated by a Bright Futures Families team member. The meeting can be conducted in person or via video conference. We want everyone to get to know each other, confirm all parties have similar expectations and make certain it is a good match. It is meant to be a conversation, frequently in depth, about vaccination status, termination, location of the surrogate to intended parents, consideration of how much involvement each party wants, communication style, delivery room desires, pumping, and so much more. After this meeting each party has the choice to move forward or not. If everyone says yes, it’s a match!

Escrow

Escrow

Escrow is initially used as a surrogate expense account while you are going through the clinic screening process before legal agreements are completed. Promptly after the legal contract is completed, escrow will be funded to cover all expenses reasonably anticipated through the surrogacy contract, generally $75,000 to $90,000.

Clinic Screening - commonly called the “One Day Work Up (ODWU)”

There are several pieces to the clinic screening and clearance process. First the Gestational Carrier’s medical records are sent to the Intended Parents’ clinic to be reviewed and approved by their doctors. This process can take anywhere from 1-6 weeks, depending on the clinic, before we hear whether you, the Gestational Carrier, is approved to proceed. Once records are approved, depending on cycle timing and the clinics procedures, you will go in for in person medical testing by the clinic. This testing typically happens in one or two appointments, and usually is scheduled between days 6 and 12 of your cycle. The appointments can be several hours long and some clinics’ screening timing/window may vary. As part of the screening process the gestational carrier’s spouse/partner, or any sexually intimate partner, will also need to be tested. Depending on the clinic your spouse/partner may need to attend the same workup appointment with you. Other clinics will send a lab slip home with you and allow the partner to be tested at a separate time, but this is a decision that varies between clinics. After all testing is complete, it usually takes approximately 10 to 14 days for all test results to come back to the clinic before full medical clearance can be granted. The clinic may also require additional items as part of their screening as well as retests. It is not unusual to have a request to complete a mammogram or take vitamin D supplements, vaccines, or thyroid medications.

Legal Agreement

Once full medical clearance is granted, the Intended Parents will work with their lawyer and the you (and your partner) will work with your own separate lawyer to establish the Gestational Carrier Agreement. We are happy to help recommend attorneys for this part of the process, but our agency does not require that either side use any specific attorney. The only requirement from us is that the attorneys must specialize in Assisted Reproductive Technology (ART) law and that at least one attorney practices in the state where you intend to give birth. Typically, the Intended Parents choose their attorney first, who is typically the drafting attorney, and then you (and your partner) will choose your attorney as the reviewing attorney.

Occasionally there are situations where the agency may suggest a legal agreement be put in place before full medical clearance is granted. If you fall under that situation, we will let you know! (*The legal agreement must be in place before any invasive procedures are done or any cycle related medication, beyond birth control, is started.)

The legal agreement is called a Gestational Carrier Agreement. This agreement is meant to talk about what everyone’s responsibilities are, plans if any issues arise, and, of course, compensation.

Medications

This is where the dreaded shots (potentially) come in! Every clinic has a unique transfer medication calendar and protocol. In simplest terms, the IVF clinic is trying to prepare your body for embryo transfer. They are trying to limit the gestational carrier’s ovulation while building a lining in the uterus that hopefully accepts the embryo. Typically, you will start taking medications anywhere from 30 days to 2 weeks before the embryo transfer (on rare occasions this may begin more than 30 days in advance). As part of medication and transfer protocol, blood draws are done often to check your hormone levels, both before and after transfer as are uterine lining checks via ultrasound. The number of blood draws and ultrasounds varies between clinics but typically between 1 and 3 checks are conducted between medication start and transfer and 3-6 appointments after transfer. And while not all clinics require shots, most do, and all will involve at least some medications.

Embryo Transfer Cycle

Embryo Transfer

Once legal is complete the IVF clinic will issue a calendar for the embryo transfer cycle. This calendar includes your medication protocol and appointments. We’re here - the reason for all the previous steps – Transfer Day! You will travel to the clinic, and they will transfer an embryo to your uterus. It’s not painful (although, some clinics require a very full bladder, which can be uncomfortable!). For the transfer date and travel time, plan for child care and to be off your feet for bed rest according to the clinic’s guidelines. Post transfer rest guidelines vary widely from clinic to clinic. Feel free to ask your clinic what theirs are at your first screening appointment (we often know what is requested at many of them as well, so ask us, too!). We have seen as lenient as “take it easy the day of transfer” up to as strict as full bed rest for two full days post transfer and lift nothing over 10 pounds for 10 weeks following. Congratulations! On transfer day you are already considered 2 weeks and 5 days pregnant!

Once the embryo transfer is completed you continue medications, according to clinic guidelines, typically for up to 12 weeks. There will be at least 2 blood draws, testing HCG to confirm pregnancy (10-14 days after transfer and usually within 48 hours of each other) Additional blood draws are conducted to continually monitor hormone levels in the gestational carrier’s blood. If HCG is positive, the clinic will request 2 ultrasounds around 6 and 8 weeks along for fetal heartbeat confirmation If you are not local to the IVF clinic, we can assist with finding a monitoring clinic closer to your home. The clinic will continue to monitor you and give you a medication weaning schedule, then once the clinic gives you the go head you will be released to see your own OB/Midwife.

Release to OB

Once released to your OB, you follow their guidelines, and have a happy and healthy pregnancy. This is the point where it starts feeling more like a “typical” pregnancy now that you are under OB care and following the routine pregnancy appointments. It is not uncommon for your OB/midwife have you see an MFM (Maternal Fetal Medicine Specialist Doctor) because this is an IVF pregnancy. Intended Parents may want to be involved in appointments, especially any ultrasounds. There should always be a release on file that allows the Intended Parents to talk to the OB directly about the baby and its care. This is a team effort, and the Intended Parents need to be included in all testing and other decisions throughout the pregnancy.

Pregnancy

The excitement and cheering will be heard around the world! Bright Futures Families remains a supportive presence as you prepare for the birth. We ensure that you and your Intended Parents are prepared as you count down to welcome baby. This is a quieter stage and it is meant for the Intended Parent and Gestational Carrier relationship to grow, and you may experience less interaction with the agency (but we are always available!).

Pre/Post Birth Orders

Establishing parentage is what the pre or post birth orders are for. This process is usually started at 14-20 weeks gestation, depending on the state. Your legal team will file the appropriate documents with the court to establish Intended Parent’s parental rights and have the Intended Parents’ name listed on the birth certificate from the start. International Intended Parents will be directed on obtaining necessary legal documentation for proper court orders and passports for their return home.

Birth

The Birth

Our case management team is excited to help in any way possible during and after the birth. We work with Intended Parents, you, and the hospital to make sure that everything is in order before the birth by sending a letter with contact information of all parties that explains the situation. We also typically include a copy of the PBO and insurance information that will be used for the baby. We tailor our services to each match and what is needed during this exciting time. There is very little that matches the feeling of witnessing the moment the Intended Parents hold their child for the first time.

Post-Partum Support

Everyone is so excited and happy that the baby has been born! While that is the goal of this process, there are still pieces that need to happen after the birth. Psychological support for up to 2 months after the birth can be part of the post-partum process. Escrow wraps up paying fees, lost wages, your medical bills and breastmilk pumping fees, if any. The escrow account closes approximately 6 months after the birth.