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Part 1: Essential criteria and the psychological screening

By Mary Ellen McLaughlin

One is a 25-year-old single mom of two. Another is a 32-year-old married mother of three. A third is a 36-year-old lesbian mother of one. They are stay-at-home moms, nurses, part-time teachers. Who are these women?

They are the demographic of gestational surrogates I have worked with over the past 10 years. These women are smart, mature, well-rounded individuals who just want to help someone create a family.

These surrogates also have a few things in common: Most have finished creating their own families, they had easy, uncomplicated pregnancies, and they loved being pregnant!

Not just anyone can be a surrogate. As these women found, before starting the surrogacy journey, there are a lot of questions to answer and specific criteria to meet. So you have a better understand what a gestational surrogate goes through, let me take you through the first stages of the process. Next week, I’ll look at the medical aspects.

When a potential surrogate calls our agency, they must first answer a series of “deal breaker” questions to make sure they fit the criteria. Most who make the initial call are not, in fact, eligible to be a surrogate. Our vetting process ensures that potential surrogates are psychologically and medically fit for the journey.

All surrogates are required to be in strict compliance of each criterion, including that they:

  • Are between the ages of 21 and 38.
  • Have given birth to one healthy child, and are the parent to that child.
  • Had no complications with a previous pregnancy.
  • Had no more then two cesarean sections.
  • Do not smoke/are on no medications.
  • Have no current/chronic medical conditions.
  • Have private health insurance and not on government assistance.

1 out of 50 women pass this criterion.

Women who meet those standards, fill out an 18-page questionnaire. It asks very personal and descriptive questions about, for example, candidates’ personal support system, their delivery experience, and their personal strengths and weaknesses. It also asks for an in-depth OB history.

This questionnaire is reviewed by the agency. Once approved, the surrogate and her partner are then scheduled to meet with a licensed psychologist, which can take up to four hours. Surrogates also take the MMPI2 test, which explores motivation, attitude and commitment to the surrogacy process.

We have to ensure that the gestational surrogate is mentally prepared to handle this arduous journey.  If all goes well, she and her partner sign a commitment agreement with the agency (terms and compensation). Then they will be introduced with potential intended parents.

After the psychological screening is complete and the surrogate chooses her intended parent, we ask the surrogate to take a physical exam.

If she passes her physical exam, she meets with a lawyer to get into legal contracts and agreements with the intended parents.  If all goes well, she is then ready to start the fertility treatments to get pregnant.

Next week: The medical side to surrogacy, which discusses fertility drugs, synchronizing the cycles, pregnancy and after the baby is born.

Mary Ellen is the Surrogacy Spotlight’s featured expert of the month! If you have questions or are looking for more information about surrogacy, visit


By Mary Ellen McLaughlin

Last week, two surrogates won their battle with their insurance companies when the Wisconsin Supreme Court unanimously ruled that insurers cannot deny benefits to pregnant women based on their reasons or methods of becoming pregnant.

It’s an important step forward for surrogates in Wisconsin, but women in other states aren’t so lucky. Most surrogates are still denied benefits during their pregnancies.

Most insurance policies have an exclusionary clause regarding reproduction or maternity, which denies any benefits related to a surrogate pregnancy. Most policies also include a one-year waiting period from the time coverage begins before a woman can get pregnant and receive benefits.

It’s an issue. More than 90 percent of the surrogates we at Alternative Reproductive Resources work with are not covered by their own policies. And we’re seeing more and more exclusionary language in insurance policies, regardless of the state.

Ideally, we’d like for gestational surrogates to be able to use their own insurance policies during their pregnancies. More often, the policy excludes any treatments related to surrogacy. The intended parents become responsible for medical costs when a surrogate isn’t covered and usually have to purchase an individual policy for her. Several companies offer policies specifically for surrogates, including New Life Insurance, but the policies are extremely expensive and can cost anywhere between $35,900 and $47,900.

It seems insurers still have a long way to go when it comes to covering surrogates. Our attorney, Nidhi Desai, who specializes in fertility law, understands that insurers feel they can exclude surrogates because they receive financial compensation. From a legal standpoint, however, she thinks it’s unfair. “I think it is very important to focus on the principle of the matter, that pregnancy is a health condition, period,” she said.

The ruling in Wisconsin leaves us with some questions. What does this mean for other states? Will others follow suit, and when? There’s no way to know for sure but it’s certainly encouraging to see changes taking place. Federal healthcare reform has also been heading in the right direction with the Affordable Care Act that guarantees coverage to those who have been denied because of pre-existing conditions. The act hasn’t had an effect on surrogates yet, but nationwide changes could be on the way as well.

By Jodi

I was recently the proud surrogate of two wonderful intended parents who happen to be gay. For me it wasn’t a decision of whether I should carry for a gay couple or not. They are both marvelously caring and compassionate people, and I know they will be great fathers to their twins.

I feel very strongly about equal rights, and I hate that it’s so hard for gay parents to adopt. When I decided to become a surrogate, both my husband and I had stated that we were open to carrying for a gay couple. When we were almost immediately matched with one, I was excited but also nervous. I wanted to like them, but I wanted them to like me too.

The moment my intended parents walked into the room at Alternative Reproductive Resources, one of them cracked a joke and I knew we were going to get along. They were both very respectful of me and told me that because it was my body, they would let me make any decisions regarding my health and pregnancy. We knew right away that this was the right couple for us. The fact that they were two men
instead of a traditional couple wasn’t even a factor.

A son, a daughter and a year later, I have to say that my surrogacy was perfect. Every step was easy and I couldn’t have asked for better intended parents or friends. The hardest part about leaving the hospital after giving birth was leaving the guys. I can’t say that I will ever be a surrogate again, but thanks to these men, I would do it for them all over again.

Jodi is The Surrogacy Spotlight’s featured surrogate of the month! Visit to ask her questions or find out more about her journey.

By Jodi

My husband and I have known each other since we were 16, and we started our family early.  After two healthy children, we decided our family was big enough, but I was still young.  Previously, my sister had been diagnosed with a mild case of endometriosis.  It was a hard time for my family, but we stayed by her side and another sister and I both knew we would be willing to carry a child for her in the future if the endometriosis caused permanent damage. Luckily, she recovered well and now has a wonderful 3-year-old son.

My family is very tightly knit, and my sister’s brush with infertility left me contemplating the importance of family.  It had never been a question that surrogacy would be an option if she was left without the ability to carry a child. I knew that I was young enough and healthy enough to make the dream of a family come true for someone else who hadn’t been as lucky as my sister. I also heard from a co-worker that a friend of her daughter’s had just signed up to be a surrogate. It made me realize that people actually did it, and that I could do it too.

After finding Alternative Reproductive Resources in February of last year, everything started to happen very quickly. I was matched with a couple in April and pregnant with twins by July. ARR was with me every step of the way, and my intended parents were too. They were extremely respectful of me and concerned for both the twins and my health. We got along so well that we started to feel like family. After giving birth to a healthy girl and boy, I wasn’t sad to leave the babies, but I did miss the daily excitement of the pregnancy and knew communication with my intended parents would be less frequent with them caring for the twins.

Though I miss my surrogate family from time to time, I feel fulfilled too. My intended parents have graciously let me continue to be a part of their lives, and we’re still very close. I miss seeing the twins, but I miss them like I miss my nephew, not like my own children. Getting updates like pictures and e-mails make me feel happy and proud. I was able to help two wonderful dads create a family, and that’s the most important thing. It was the perfect surrogacy, and I couldn’t have asked for a better experience.

Jodi is The Surrogacy Spotlight’s featured surrogate of the month! Visit to ask her questions or find out more about her journey.

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About Us

Conception Connections is a blog about alternative paths to family creation. It is maintained by Alternative Reproductive Resources. Contributors include intended parents, egg donors and gestational surrogates in addition to ARR staff. Our goal is to facilitate conversations about trends, issues, current events, technology and personal stories surrounding infertility, egg donation and gestational surrogacy. If you'd like to contribute, please e-mail We also welcome your comments and suggestions. Note: Comments are moderated and posted on approval.


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