Gestational Surrogacy Process FAQ

Gestational surrogacy is a complex and beautiful process that some families who are unable to naturally conceive and birth a child choose. At Hope Surrogacy, we want to answer all your questions and dispel some common misconceptions about the gestational surrogacy process.

What is gestational surrogacy?

Also called a surrogate, a gestational carrier is a woman who carries and delivers a child for a couple or individual. Surrogates (sometimes called surrogate mothers) are impregnated through the use of in vitro fertilization (IVF). This is a treatment option for managing infertility, in which doctors create an embryo by fertilizing eggs from the intended mother or an egg donor with sperm from the intended father or a sperm donor. Because the gestational carrier doesn’t provide the egg, she is not genetically related to the child.

How long does the gestational surrogacy process take?

Gestational surrogacy is rarely a straightforward journey. If everything goes perfectly, then the process could happen in as little as 12 months after you’re matched with a gestational surrogate. But sometimes, unexpected things affect the timeline. A more typical timeline is 13-18 months after you’re matched. See what you can expect from a typical timeline in the surrogacy process here. We’re with you throughout your journey, through all the ups and downs.

After you’ve been matched, everyone must be medically cleared to continue. You will then continue to the legal process. Finally, the surrogates will be prepared medically before the embryo is transferred. From there, you must also wait for the pregnancy to be determined. And then, as you know, you’ll need to wait for your baby to grow and develop until he or she is born.

Learn what is involved in the Medical Clearance for surrogacy.
Learn what the Legal Contract for surrogacy includes.
Learn about the medical preparation involved.
Learn how an embryo is transferred.
Learn how and when pregnancy is determined.

How long does it take to match a gestational surrogate with intended parents?

Gestational surrogates and intended parents go through a vigorous vetting process. We believe that finding the best match between the surrogate and the intended parents is crucial to a successful outcome. Surrogates and intended parents both have specific priorities and non-negotiables that affect who they could be matched with. Some surrogates are matched within a month or two of being accepted into our program. Others wait for several months to a year for the right intended parents. Similarly, intended parents could be matched right away, or for others, it could take a year or more to find the best gestational surrogate for their family.

What are the gestational surrogacy process ethics followed by Hope Surrogacy?

We follow the American Society for Reproductive Medicine guidelines. These ethical principles are established to keep people safe and cover medical, legal, and financial issues. In addition, we have our own ethical principles we adhere to, some of which are included here:

Intended parents must have a medical need for choosing surrogacy and be under the age of 50.
Everyone must undergo a mental health evaluation—the gestational surrogate, her husband, and the intended parents.
The surrogate must be between 21-42 years old, with a BMI under 32, have had healthy pregnancy(ies) / delivery(ies), and have a clean mental health history.
All members involved must pass criminal and financial background checks.
The surrogate and intended parents have independent legal representation.
Money paid to the surrogate stays in an independent escrow account.
Intended parents cannot use two surrogates simultaneously or transfer two embryos to have twins.

What are common misconceptions about the gestational surrogacy process?

“The gestational surrogate will want to keep the baby because she will think it’s hers.”

Every gestational surrogate we accept into our program has passed a mental health screening. She understands that she is providing a service to intended parents who are not able to carry their own child. She knows that the baby growing inside her is not hers, but that of the intended parents. Read more about why we don’t call surrogates “surrogate mother.”

“The surrogacy process is straightforward and goes pretty quickly.”

It takes a long time! Once a surrogate is matched with intended parents, she must begin the medical process to get her body ready for the embryo to be implanted in her uterus. Additionally, the embryo must also be ready to implant. Not every embryo that is implanted leads to a successful pregnancy. On average it takes 13-18 months from the time a surrogate and intended parents are matched.
Learn more about the timeline here.

“Intended parents are just paying the surrogate for a baby.”

First of all, it is illegal to buy or sell a person. Babies are not bought or sold—whether through surrogacy or adoption.

Secondly, a surrogate is being paid for her risk in carrying the baby. She is paid throughout the pregnancy. It would be coercive to pay her a lump sum at the beginning or end of the pregnancy for a specified outcome.

“Surrogates are in it for the money or to get rich easily.”

The surrogacy medical process to prepare a woman’s body to receive and grow an embryo isn’t easy. It involves weeks of daily hormone injections and visits to a fertility clinic.

Pregnancy and delivery aren’t “easy,” either. Pregnancy takes a toll on a woman’s body. Women who choose to become a surrogate don’t do it for the money—they do it out of selfless generosity so they can help another family achieve their dreams.

Additionally, the surrogates who join our program are already financially stable.
Read more about why and how much surrogates are paid.

“People should just adopt instead.”

For intended parents, surrogacy is the absolute last resort. Adoption isn’t an easier option. It also isn’t the best solution for everyone. In fact, some of our intended parents turned to surrogacy after already attempting adoption. Wait times to adopt an infant can be just as long (or much longer) than wait times for surrogacy. Depending on the state where the birth mother gives birth, she may have up to 6 weeks or longer to decide if she will place her child for adoption, even after being matched with adoptive parents.

How do you get pregnant using a surrogate?

The surrogate uses hormones that emulate her natural cycle. Scientists are still perfecting this process.

First, Lupron is used to suppress her ovaries. She is then given estrogen to thicken the lining of her uterus. A few days before the embryo transfer, she will receive progesterone injections that “trick” her body into believing it’s already pregnant. She will continue receiving these injections after the embryo transfer until the placenta has grown and developed enough to produce the progesterone on its own. She will be highly monitored for 8-10 weeks by the fertility clinic. By the end of the first trimester, she will be released to her own OBGYN.

What is the fertility treatment for surrogacy like?

The intended parents must create embryos or provide a donated embryo. Whoever is providing the eggs to create the embryo must hyperstimulate their hormones. This takes about two weeks. Typically, a woman’s ovaries prepare and release 1-2 eggs per month. But the goal with hyperstimulation is to create and retrieve 15-20 eggs. The eggs are then put in a petrie dish with the sperm. The fertilization rate is approximately 70%. Once fertilized, it is grown to a 5-day blastocyst before being vitrified (a flash freeze process, so the embryos can be stored for later use).

Sometimes, pre-implantation genetic testing for aneuploidies (PGT-A) is done on a subset of the embryo’s cells. This is the process of screening IVF embryos for chromosomal abnormalities prior to a transfer with the goal of increasing the likelihood of achieving a successful pregnancy.

Learn more about choosing a fertility clinic.

The surrogate goes through her own fertility treatments to prepare her body for pregnancy.

What is the screening process for becoming a gestational surrogate?

Before any surrogate is accepted into our program, she goes through a thorough screening process to evaluate her physical, emotional, and mental health. This process typically takes 3-4 months to complete, including a three-hour psychological evaluation interview.

We run criminal and financial background checks on her and her husband. Every gestational surrogate with Hope Surrogacy is financially stable, a non-smoker, insured, and a mother to at least one child living with her. She also has the support of her husband/partner, her OB/GYN, and members of her community. Additionally, we have records of her immunizations, PAP results, and we now require full COVID vaccination as of August 2021.

Can the intended parents go to the surrogate’s doctor appointments?

Yes, intended parents can attend the doctor appointments if they want to. The surrogate welcomes the parents into the process. If they can’t participate physically, they can be there over Facetime or Zoom.

Curious what intended parents should do during the pregnancy? Read our post here.

What does the surrogate tell her family about the baby?

The surrogate knows that her children will be curious about a baby growing inside her. She will know the right way to explain to her children what she is doing—and we will also provide guidance if she is uncertain. Often the intended parents meet the surrogate’s children. This helps the surrogate’s children understand who their mom is helping.

How much can the Intended Parents ask of the surrogate?

For example, can intended parents require that the surrogate only eat organic foods, or that the surrogate play a recording of their voices reading or speaking to the baby?

It’s common for intended parents to feel like they are losing a lot of control during the process of surrogacy. They may want to ensure their surrogate does things the way they would do it if they were carrying the baby. This is why we have such a thorough vetting and matching process. We want to find surrogates who are willing and able to follow the intended parents’ preferences. Our role in the surrogacy journey—from getting pregnant to navigating life after the baby is born—is to be a neutral party who helps both parties navigate the process.

Curious what intended parents should do during the pregnancy?

September 22, 2021/by Mary Murphey