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By Mary Ellen McLaughlin

One of the common questions we see on the discussion boards of the surrogacy communities we follow is typically posed by women who are considering becoming surrogates for the first time:  “Do I do it myself or go through an agency?”

Responses from others who have taken this path before vary, but lean toward recommending registering with an agency for the first time. At the same time, many say they have been do-it-yourselfers for subsequent surrogacies, recommending that route only after learning the ropes via the first agency experience.

Of course, I represent an agency, so forgive my bias. But the fact is that not all agencies are alike. And neither are all surrogacy journeys. There are many complexities involved and details to be managed in being a surrogate. The medical aspects aside, issues range from the legalities (contracts, compensation, meeting state laws over surrogacy arrangements, for example) to the surrogate’s emotional readiness to day-to-day dealings with the intended parents.

Frankly, once our surrogates begin the process, they’re happy to have an agency in their corner. If you’re thinking about embarking on this journey yourself, here are four reasons to consider an agency, and key points to keep in mind as you’re talking to likely candidates.

  1. The agency is your advocate in this process, representing your interests in everything from finding the right intended parents for you, helping to navigate issues that arise during your journey, to ensuring that you have someone in your corner with your best interests at heart. If you’re talking to an agency, ask for specific examples of how this role has actually played out with the surrogates with whom they have worked.
  2. As part and parcel of this role, the best agencies will ensure that their staff is available to you 24/7, to hold your hand, answer your questions and anticipate your needs.
  3. The agency has experience in dealing with all the aspects of the surrogacy journey. It knows what to expect for all the facets and, thus, can anticipate and effectively manage any bumps that may occur on the road.
  4. The agency also has developed the resources necessary to meet the surrogate’s interests, from legal specialists in family law to insurance programs to meet supplemental healthcare needs.

Anyone who’s considering becoming a surrogate knows it’s not a decision to be taken lightly. Once you’ve talked to several agencies using these points as a guide, go back to those message boards and ask members of the community to share their experiences, pro and con, with the agencies in question. You’ll benefit by extra careful due diligence in the long run.

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By Mary Ellen McLaughlin

It is kind of scary to think about the possibility that hundreds of people – thousands, even – are out there, innocently living out their lives and unaware that the guy who lives next door could be a half-sibling – genetically speaking, that is.

It’s a possibility that has the fertility field (and those with an interest in controlling it) fairly abuzz these days. The number of children who could be created by a single sperm donor during his fling with this particular brand of philanthropy is fairly mind-boggling, when you think about it.

One Toronto man tells a Canadian newspaper that he was born in 1952 with sperm from a donor who supplied his semen for over 30 years. It’s likely, he says, that his donor/father has between 500 to 1,000 children in Canada, the U.K., and who knows where else? “Freaky” is one word he uses to describe it.

Why is this cause for alarm? Well, the possibility of inadvertent incest, for one. For another, the possibility that these children might share disease-causing genes that might spread exponentially throughout the population.

Similar concerns have been voiced about children born through egg donation, though the scale of the issue there is far, far smaller – for practical reasons, if nothing else. Women produce far fewer eggs than men do sperm. The collection process entails a comparatively onerous medical procedure that’s a far cry from the “one and done,” if you will, of sperm donation. Women undergo a very comprehensive physical and family health history before qualifying as egg donors, which I’m not certain is as standardized for sperm donors.

There are very clear ASRM guidelines on how often a woman should donate her eggs, at least in the U.S.: No more than six cycles. For men, ASRM guidelines on sperm donation limit donors to 25 live births per population area of 850,000. (Some estimate that only between 20 percent to 40 percent of births are reported.)

In neither case, however, is there centralized tracking. While I can’t speak to sperm donor agencies, in the egg donor community, agencies like ours communicate locally and do a good job of monitoring. Yet there is nothing keeping (or to monitor) either sperm or egg donors from moving to new areas and starting all over.

It’s a concern that’s not going to go away, and has prompted calls for tighter regulations. The thought of more government regulation is always one for concern. Better yet that we, as an industry, revisit an idea that has been discussed for years and find a way to make it work: A centralized registry of egg and sperm donors that is scrupulously maintained. And where participation is a badge of honor.

By Mary Ellen McLaughlin

We recently came across a thread in a Yahoo discussion group from a would-be gestational surrogate. She had completed an agency’s questionnaire to become a surrogate. And while she understood the rationale for the questions (many of which appeared on the surface to be quite intrusive), there was one that had her puzzled for its relevance: “What is your religion?”

That’s a pretty typical question for agencies to ask. It points to the depth that principled and discerning agencies will go to in vetting prospective surrogates.

The religion question can relate to any number of considerations – beliefs that may influence a decision on selective reduction, for example. And, let’s face it, for both Intended Parents and prospective surrogates, religion may be a sticking point whether it’s relevant to the task at hand or not.

Taking a deep dive into the prospective surrogate’s background, beliefs and support network is absolutely essential to ensure she’s emotionally up to it – and, equally important, is a responsible individual who surrounds herself with people who share her principles and behaviors.

The stories about con artists who hold the baby for ransom are the exception, but they’re the ones that people remember. Not surprisingly, they weren’t properly vetted. We’re not about to take that risk.

A typical surrogacy application form can run up to 20 pages. It’s the first screen; subsequent ones include interviews with the agency’s staff and, preferably, independent mental health professionals. It is not something to be completed in an hour, or even a day. Are the questions intrusive? Some are – of necessity. And prospective surrogates should expect no less given the very important role they’re applying to play.

It asks for the candidate’s and her husband/partner’s five-year employment history and educational backgrounds. It asks about family structure – how many children and their ages, and the support network. It asks whether the candidate or her partner have criminal records or substance abuse histories. It asks health questions including a medical and pregnancy history, ranging from how the applicant relieves stress, to whether she’s had an HIV test and the results, to birth control methods and delivery experiences.

And it asks questions to gauge the candidate’s emotional state. What are her hopes, wishes and expectations? Will she work with same-sex couples or unmarried couples? What are her strengths and values? How does she manage difficult times or experiences? Her partner is asked to share feelings about her taking on this role, and how the partner’s family would feel about it, as well. Descriptions of the couple’s children are solicited, along with how they will be prepared and involved in the process.

They’re also asked about issues that must necessarily be grappled with: How will you deal with relinquishing the baby to his or her parents? How do you feel about future contact with the child and his or her parents? How do you feel about carrying multiples, and the issue of a selective reduction if you’re carrying more than two fetuses?

This is only a sampling of the ground covered in the surrogacy application form. It is exhaustive, though we prefer to think of it as thorough. But that’s what it takes to make sure the surrogacy experience lives up to its promise for everyone involved.

What kind of guidelines are out there for gestational surrogates and intended parents? Does it vary state by state? These questions and more are answered by Mary Ellen McLaughlin, partner and surrogacy expert at ARR. Watch her explain surrogacy guidelines in the video blog below:

By Mary Ellen McLaughlin

A recent article in the National Post highlights an issue in the fertility industry that is ripe for discussion. A couple that had turned to surrogacy after failed infertility treatments subsequently urged their surrogate to get an abortion after doctors found abnormalities in the fetus. The surrogate initially refused.

One quote in the article really stood out. “The physician…said it appeared to him that the three had never seriously considered such a scenario before the pregnancy.”

Wow. When intended parents and prospective surrogates meet for the first time, it’s ideal for them to get along and have a warm fuzzy feeling about each other. But at the same time, this is an arrangement that requires a legal contract. It’s essential to like each other, but it’s also essential to make sure your interests are protected. Every scenario, no matter how small, should be taken seriously.

Luckily, this type of situation is rare. We at ARR have been lucky (okay, careful) enough to have never had a situation in which these issues were not thoroughly considered prior to pregnancy. We work with both parties to ensure they discuss and agree on issues like abortion and selective reduction before taking any next steps. It’s something we take seriously – and so should anyone taking this journey. (Read a surrogate’s blog post on the hard choices surrogates and parents often must make.)

This is one of the most intense conversations these three adults will share.

Our psychologist encourages both parties to first discuss abortion and selective reduction with their support network, which is the first place they’ll turn if the situation ever arises. They’re encouraged to discuss their beliefs openly. The reality is that while they may get along beautifully, if they don’t share the same views on these sensitive issues, this partnership will never work.

No one ever wants a situation like this to happen. Intended parents and surrogates need to be prepared for all types of outcomes, whether it’s abortion, selective reduction, miscarriage, or, hopefully, a happy, healthy baby.

Visit our Web site at www.arr1.com.

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 shodge@hodgemediastrategies.com. We also welcome your comments and suggestions. Note: Comments are moderated and posted on approval.

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