Step 2 – The Screening Process 

Medical Records

It is important for us to have copies of your OB medical records from your previous pregnancies.  In the application you will be asked to sign a medical release form and provide the names and contact information for your previous obstetricians.  We will take care of requesting medical records for you.

Home Visit

The next step of the application process will be a home visit conducted by A Perfect Match representative. We are not going to eliminate anyone who doesn’t have a beautiful home or a spotless home.  Rather, the home visit is conducted in order to give us the opportunity to meet the surrogate’s entire family, ensure our surrogates live in a clean and safe environment, and give everyone an opportunity to ask further questions—perfection is not required!

The visit takes approximately 1/2 hour or longer if the surrogate and her family have additional questions about A Perfect Match or the surrogacy process.  The home visits have been viewed by our surrogates as a positive experience and a wonderful opportunity to get to know us.

Psychological Evaluation

After the home visit is completed, we will provide you with the contact number of a psychologist who specializes in working with surrogates and infertile families.  The purpose of the evaluation is to ensure that you, as a surrogate, fully understands the emotional ramifications of surrogacy and to give you and your partner an opportunity to discuss:

• Your decision to become a surrogate
• Your support system
• Current stressors in your life
• Your partner’s feelings
• Your ability and strategies to navigate the relationship with the parents-to-be.
• Any other topics that need to be discussed

The Minnesota Multiphasic Personality Inventory (MMPI) or other type of personality assessment will be administered at that time as well as a personal consult with the psychologist.  The psychologist will provide a written report and a recommendation regarding your ability to perform the duties of a surrogate.   It takes approximately 2 weeks for the report to be processed before clearance can be authorized by the psychologist.

Background Check

We want to ensure the safety of the intended parents’ child, so as an added precaution, we perform a background check on both the surrogate and the surrogate’s spouse or partner.   This is very similar to the type of background check down when applying for employment.

Step 3 – Making A Perfect Match

Profile Available to Intended Parents

Congratulations! Your application has been approved and you are now ready to be matched with Intended Parents!  Your online profile will be made viewable to Intended Parents, and A Perfect Match will begin working to find you a match.   At no time will any identifying information be given to an intended parent without your permission unless you enter into an agreement with them.  Most surrogates will be matched within two to four months, but the process can be as quick as a couple weeks.  Factors taken into consideration include your travel preferences, willingness to carry twins, and individual feelings about critical decisions (such as selective reduction or genetic testing).

A good match between a gestational surrogate and parents-to-be is like any good relationship: both parties communicate and contribute and the quality of the relationship will grow and evolve over time. When each participant makes kind, honest, genuine efforts to build a solid relationship based on respect and trust, the outcome is ideal.

Meeting with the Intended Parents

Once a potential match is made, a phone conference between the surrogate and intended parent(s) is scheduled.  This is an important part of the process because it is your first opportunity to talk to the person or couple that you would be carrying a baby for and it is a nice opportunity for both parties to get to know each other and make sure it is the right “fit” for everyone involved.  If both you and the Intended Parent(s) are comfortable moving forward after this meeting, then it is considered a match! Congratulations!

Paperwork is then completed and signed by intended parents and the surrogate.

A personal meeting between the parties is also generally a part of the process, but will not occur until after the phone conversation when all parties agree they would like to work together and have a desire to meet in person.  An in-person meeting might happen quickly if all parties are local, or might not happen until the birth if the intended parents are international.  Even with international parents there is often considerable communication through Skype and email.

Before treatment begins, you will undergo a medical screening, sign legal contracts and start medications

Medical Screening

Once a match between a surrogate and a family is made, the surrogate will be asked to have a medical screening.  This is to ensure that you are physically capable of undergoing the surrogacy process.  There will be no cost to the surrogate for this screening.  You will schedule an initial appointment with the doctor chosen by the Intended Parents, and a full medical evaluation will be conducted. Your medical screening will typically include a full physical, ultrasound, infectious disease screening, drug and nicotine screening, and other testing that will determine your ability to carry a pregnancy.  The sexual partner of the surrogate must be screened for sexually transmitted diseases as well.  Upon all results coming back from the screening, the physician will determine if you are medically eligible to go forward with the process.

Our surrogates are primarily located in southern California, but our intended parents are located throughout the U.S. and the world. Most surrogates will work with an IVF center in CA, however, some may be required to travel to the location of the clinic chosen by the intended parents. If required to travel outside of the surrogate’s home area all expenses will be paid for by the intended parents. These expenses will include flights, hotel, meals, etc. Many of the cycle monitoring appointments can be performed in the surrogate’s home area and the results will be forwarded to the physician who will be performing the embryo transfer.

If the surrogate is not already taking oral contraceptives, she may receive a prescription for birth control. These are given to help regulate the surrogate’s cycle and will allow the physician to coordinate her cycle with that of the egg donor or intended parent. You may be asked to start birth control prior to having the contract signed so that an IVF center can begin to synchronize the cycles of the surrogate with that of the intended mother/donor.

Legal Contract

Once you have been medically cleared, your coordinator will refer you to an attorney with expertise in third party reproduction. The Intended Parents will have a contract drafted by an attorney that will be sent to your attorney for review.  You will schedule a consultation (over the phone) with your attorney, who will review the contract with you in detail. This legal document explains the rights and obligations of both parties. Once both parties agree to all the terms, the legal document is signed.  If you are married or living with a partner, that person will need to sign legal documents as well.  Your legal fees will be paid for by the intended parents.

Medications

Once you have been medically cleared, the physician handling your care will provide you with a timeline and instructions to begin taking a series of medications that will help synchronize your menstrual cycle with the Intended Mother’s or egg donor’s cycle. The medication will also thicken the lining of your uterus in order to accept the implanted embryos. These medications are self-injectable, so you will need to administer shots to yourself for approximately 6-12 weeks.

Step 5 – Getting Pregnant

The Embryo Transfer

The embryo transfer procedure starts by placing a speculum in the vagina to visualize the cervix. Carefully selected embryos will be loaded into a catheter. The catheter is inserted through the cervical canal and guided into the uterus, where the embryos are deposited. The catheter is then withdrawn and an abdominal ultrasound is often used to ensure correct placement.  The process feels similar to a pap smear and anesthesia is generally not required. Following the embryo transfer procedure, you will be placed on doctor-ordered bed rest for 24-72 hours. If the physician’s office is located near you, bed rest will take place at your home. If the physician selected by the Intended Parent(s) is located out of town from where you live, travel will be necessary. All travel will be coordinated by your case manager, and travel costs are paid for by Intended Parent(s). Depending on the location, you may need to stay in the location of the physician’s office for up to a week, and that amount of time will be determined by the physician coordinating your cycle.

Pregnancy Test

Approximately 12 days following the embryo transfer procedure, you will go into a local lab or to the physician’s office that was handling your care for a blood test to determine if a pregnancy has been achieved.

If the first embryo transfer does not produce a successful pregnancy, then medications and transfer may be repeated a second and sometimes third time.

Step 6 – The Pregnancy and Delivery

Pregnancy

They say every pregnancy is different. A pregnancy as a gestational surrogate is surely unlike any pregnancy you have had with your own children.  A whole team of people helped make this pregnancy possible: the medical staff at the fertility clinic, attorneys, psychologists, your support network, the Parents to Be, and you.

That means many emotions are present. Mostly, there is happiness and excitement. But, you should also be prepared for other feelings. Some mothers-to-be who have had multiple miscarriages may associate your positive pregnancy test with the beginning of a time for worry. Some gestational surrogates say they feel an enormous sense of responsibility, as if so much is riding on their every move.

Throughout your pregnancy you will attend routine doctor’s appointments beginning with appointments with the fertility specialist. Generally, after 10-12 weeks of the pregnancy, you will be released from the fertility specialist’s care, and will then attend standard maternity appointments with an obstetrician.

Delivery

Congratulations! The day that both you and the Intended Parent(s) have been waiting for has finally come!  The intended parents will usually be present at the time of birth and will either be in the room with you, or anxiously waiting nearby.  They will happily take their newborn home. You can enjoy the feeling of having just provided an incredible gift that the new parents will be forever grateful for.

Step 7 – Life after Surrogacy

You have been the center of attention for the parents-to-be for the last nine months, but now they will be turning their focus to the little bundle of joy they have dreamed of having. The relationship between you, the parents, and the child certainly changes after the delivery.

Perhaps receiving limited updates of the baby is what you have agreed upon. Your own family will likely welcome you back into the fold of family life. Recovering from the delivery and looking ahead for yourself and your family will be your focus.

Each gestational surrogacy match is different. Sometimes, the two families become very close. Other times, they tend to go their separate ways, always cherishing the chapter of the book they shared creating that little boy or girl.

Whatever life after delivery is like for you, A Perfect Match’s vision is to be a foundation for you over time. Maybe you even return to be a gestational surrogate again?