Here at Gay Parents To Be, we have years of experience helping intended parents build their families through surrogacy, and we know that the process can be complicated and overwhelming, as well as incredibly and hopefully so rewarding.
It can also be expensive - so much so that one of the first questions that many intended parents (dads and/or moms to be) ask is why they need both a fertility clinic and a surrogacy agency. We understand where they’re coming from - with the costs of surrogacy, it seems that cutting out just one of these organizations could save you valuable funds.
However, we know how complicated the process of an IVF and surrogacy journey can be – and we want to help you build your family without any unnecessary roadblocks or speed bumps.
So sit down, relax, and read on to find out why you really DO need both the surrogacy agency and a fertility clinic.
What is the role of a fertility practice for gay couples?
The fertility clinic is in charge of all of the clinical (medical) aspects of your journey to surrogacy – from your genetic screening all the way through embryo transfer and the first 8 weeks of pregnancy.
From your first consultation to your last monitoring appointment, these services often include:
- Fertility testing for you and your partner (if applicable)
- Genetic carrier screening for you, the intended parent
- Testing and screening for your chosen egg donor (if applicable)
- Completing an IVF cycle - including either a donor egg retrieval or a retrieval from one intended parent
- Preimplantation genetic testing of your embryos (an optional test, typically shortened to “PGT-A”)
- Gestational carrier screening
- Embryo transfer into your surrogate, or gestational carrier
- Remote or in-house monitoring of your carrier up to 10 weeks of pregnancy
Fertility clinic services may also include any of the following:
- Storage of any specimens (egg, sperm, frozen embryos) until ready to be used
- Screening services for all parties to ensure all are mentally, physically, and emotionally ready for this process
- Counseling services
Many times prospective parents will connect with a fertility clinic first, as baseline fertility tests can be an easy introduction into family building. However, you can also start your journey by meeting with a surrogacy agency whose reputation you trust.
What is a surrogacy agency, and what services do they offer?
A surrogacy agency helps to coordinate your surrogacy journey to make it as easy for you to navigate as possible. They will provide all or most of the services needed to complete the surrogacy part of your family building journey. This may include:
- Matching services to find your surrogate (gestational carrier)
- Screening services to ensure both you and your surrogate are mentally, physically & emotionally ready for this process
- Oftentimes this will include legal services
- Coordination of information/services between fertility clinics and agency to make sure all steps are completed
- Counseling services
- Nurturing the relationship between you, the intended parent, and your gestational carrier
While many of the agency tasks may seem more administrative, they play a crucial role in your surrogacy success. While we luckily live in a surrogacy-friendly country, there are still states where compensated surrogacy is not yet legal. Making sure that your rights, your surrogate’s rights, and the rights of your future child are protected is the job of your surrogacy agency and their legal team.
In addition, we know that surrogacy is expensive. It truly is the common goal shared by all involved that you complete your journey to parenthood as efficiently as possible - you don’t want to miss a crucial step because you declined the help of an agency or legal representation. In order to emphasize this further, many clinics will not move forward with couples trying to pursue surrogacy without the aid of a reproductive attorney or an agency.
So, why do you need both the agency and the fertility clinic?
1. Surrogacy is a complicated legal process – and we don’t want you to miss a thing
It is the responsibility of your agency to help you not only match with your gestational carrier, or surrogate, but to also help negotiate the terms of your contract with this person. These contracts cover everything from medical procedures to the surrogate’s compensation to her relationship with you and your child after birth.
Although some surrogacy agencies don’t have legal counsel on staff, it is helpful to choose a “full service” agency, whose staff includes a legal team to take care of all of these matters efficiently.
Depending on your citizenship, residence location, and the location of your surrogate’s home, the legal work related to your surrogacy journey may include a pre-birth order, a voluntary acknowledgement of paternity, a custody order, or an adoption.
2. Surrogate (gestational carrier) screening is a two-way street
The clinical team at your fertility clinic (which will most likely consist of your doctor, an assigned nurse, and a patient navigator – along with other support staff) has a few very important jobs.
Before you are even matched with your gestational carrier, it is the reasonability of your clinic to medically screen each surrogate, even after she has been accepted by the surrogacy agency. It’s nice to have two separate groups reviewing these records, to allow you a solid foundation for your relationship with your surrogate.
It is rare that a fertility clinic would disqualify a surrogate who had passed agency screening, but certain factors (such as previous risky pregnancy history or number of births/C-sections) are things that are reviewed by your physician and their staff.
3. Clinical success matters – and so does your relationship with your physician
Whether you have existing embryos at one facility and need to transfer them to a clinic in a surrogacy -friendly state (like Connecticut!) or you’re starting from square one, choosing a clinic you trust is crucial.
Most clinics have their success rates posted on their website, and you can also use SART as a great neutral resource to scope out your options.
Another thing that’s important to keep in mind is that a single surrogacy journey can take anywhere from 15 months to beyond two years. Your relationship with your fertility clinic team and your doctor there will be a long term one – make sure that you feel comfortable asking questions, communicating concerns, and genuinely feel taken care of.
Your doctor will be helping you through the process of choosing a donor, retrieving their eggs, fertilizing eggs in the lab, maybe genetically testing your embryos, and ultimately transferring an embryo into your surrogate’s uterus. They will be a key player in your surrogacy journey, as they guide you through the IVF process.
4. What happens after embryo transfer is important
After embryo transfer, most gestational carriers will return home within the next few days. Oftentimes, they don’t live locally to the clinic where transfer was completed – remember intended parents, surrogate, and fertility clinic can sometimes all be in different states. However, your fertility specialist will order bloodwork and ultrasounds in your carrier’s local area to continue their monitoring. Once your surrogate is 8-10 weeks pregnant, all care will transition to their local OB.
Over the next few months, and until your due date, your surrogacy agency is responsible for helping to nurture your relationship and helping to complete any outstanding paperwork before your child arrives. They will also help you to build a birth plan that everyone is comfortable with.
Although the fertility clinic and surrogacy agency have different responsibilities, we all share one common goal – to help you have a healthy, happy family. And we all love receiving baby pictures at the end of the process!
The surrogacy journey may seem like a long road, but your support teams at your clinic and surrogacy agency are there to support you every step of the way. Choosing a provider who has your back is an important first step. Learn more about how to choose the best LGBTQ-friendly fertility practice here.
Dr. Mark P. Leondires is the Founder and Medical Director of Illume Fertility, an inclusive, award-winning fertility clinic with five locations in Connecticut and New York. Dr. Leondires is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. Dr. Leondires is also the Founder of Gay Parents To Be, a leading family-building resource for the LGBTQ+ community - a passion project created after undergoing his own journey to parenthood as a gay dad.