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By Robin von Halle

Donor Agent Provocateur appeared last week in the New York Times Magazine column, The Ethicist, by Ariel Kaminer. The Ethicist responded to a reader’s questions regarding the ethical implications of a situation involving a fertility consultant hired by a Chicago couple interested in finding an egg donor sharing some of their ethnic background. The fertility consultant was ultimately unsuccessful in finding a donor of the particular ethnicity; however, she now refuses to refund their retainer. Did the fertility consultant behave ethically? ARR agrees with The Ethicist’s assertion that, as a professional consultant offering a service, it is unequivocally unethical to charge a fee for a service which, in reality, the fertility consultant did not intend to provide.

As a third party reproductive agency facilitating roughly 130 matches each year, ARR serves as an advocate and support system for donors, surrogates and intended parents alike. Our role is to be a resource,  providing the tools and expertise to help intended parents to make informed decisions and navigate a complex process. As opposed to the fertility consultant, ARR does not ask for a deposit until we have successfully matched a couple and donor. We do not believe it is ethical to accept payment until all parties involved are ready and willing to move forward. Intended parents are under no financial obligations until an official match has been made, and if for some reason a donor is unable to move forward, the couple would be re-matched at no additional fee.

Above all, ARR never promises unrealistic matches. It is not uncommon for intended parents to request a donor that shares some of their own traits or cultural background. We do work with couples seeking a donor of a specific ethnicity. If we do not have a donor in our database matching the particular criteria desired, then we direct the couple to Donor Network Alliance to continue their search. That being said,  in our twenty plus years of experience, an ethnic match is typically not deal a breaker. More importantly is finding a healthy, young, fertile donor with traits similar to that of the intended parents, if so desired. The majority of the time, when working with a reputable agency, a fertility consultant becomes a duplication of services, which add another layer of cost to the intended parents.


Part 2: fertility drugs, synchronizing the cycles and pregnancy.

By Mary Ellen McLaughlin

Once a candidate passes the psychological screenings and physical exam and has chosen her intended parents, she is ready to get started on actually becoming a surrogate. Medically, there is a lot to learn, and that can be scary if you don’t know what’s coming next.

The first step in this stage is the hysteroscopy (HCG), which is a visualization of the uterine cavity through a thin scope inserted through the cervix. This determines the shape and size of the uterus and whether the fallopian tubes are clear. She also goes through a series of infectious disease testing. This is done to ensure that all parties are clear of transmittable disease such as AIDS, herpes, hepatitis, etc.

Once the tests come back, the surrogate is ready to go through a mock cycle, which puts her on the same drugs that she’ll be on for the real transfer (except Lupron), so her physician can check her uterine lining’s response to estrogen replacement. The doctor also performs a trial transfer, where the angle of the cervix and the length of the uterine cavity are measured. This determines how far to insert the catheter loaded with the embryos for exact placement.

If all goes well, the surrogate and intended parent/egg donor synchronize their cycles using birth control pills. About 14 days into this stage, both the surrogate and intended parent/egg donor usually start taking Lupron, a hormone that dramatically lowers estrogen levels. (Check out our March post on terms it’s helpful to know.)

The surrogate is typically about a week or so ahead of the intended parent/egg donor to ensure her uterus will be ready when the eggs are retrieved and fertilized.

When the surrogate’s menstrual cycle starts while on Lupron, her Lupron dose is normally decreased by half and she starts adding estrogen replacement to the mix (in the form of pills, patches, or shots, depending on the doctor). Some doctors prescribe other medications as well (Dexamethasone to suppress male hormones to increase implantation, antibiotics to guard against any infection that might have gone undiagnosed, etc.).

The retrieved eggs are fertilized with sperm from the intended father/sperm donor and incubated for two to five days. The surrogate’s Lupron injections stop the day before egg retrieval. Progesterone replacement starts the day of the retrieval and continues until the 12th week of pregnancy or a negative pregnancy test. Estrogen replacement also continues until the 12th week of pregnancy (when the placenta takes over hormone production). Because the surrogate was on Lupron, her natural hormones were suppressed. She will need external sources of these very important hormones in order to maintain any pregnancy that occurs.

When the fertilized embryos are at the proper stage, they are loaded into a special syringe with a thin flexible catheter at the end. The catheter is inserted through the cervix into the uterine cavity where the embryos are “injected.” Most doctors will only transfer three to four two-day-old embryos or two five-day-old embryos. Any unused embryos are frozen for future use if a pregnancy doesn’t result from the fresh cycle. The surrogate is then put on bed rest. Some surrogates are on bed rest a couple of hours following embryo transfer. Others have been on bed rest for up to three days.

A quantitative HCG, in which the amount of pregnancy hormone is measured, is usually done 14 days after the egg retrieval. At that time they are looking for the HCG level to be 50 or higher. Anything over 200 is indicative of a multiple pregnancy. The surrogate will have a second quantitative HCG test two days later to verify that the pregnancy hormone numbers are going up (they should double about every two days). If the quantitative HCG is negative, all external hormones are discontinued and a menstrual cycle starts within five days.

If a pregnancy has occurred, an ultrasound is usually done at six weeks to check for a heartbeat, and again at 12 weeks before the surrogate is released to a regular OB/GYN. During this time, hormone levels are checked several times to ensure that the proper levels are being maintained for pregnancy. Once the placenta starts taking over the hormone production, the surrogate is weaned off the hormone replacements.

The rest of the pregnancy would be the same as any other pregnancy.

This is a long process and can take up to two years to complete from start to finish. But once you see that the new parents hold their child for the first time, everything you have done instantly has a greater meaning.

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 Robin von Halle

Surrogates are unusual women who selflessly carry a child to term for someone who cannot otherwise do so. They endure psychological counseling, fertility treatments, pregnancy cravings, swollen feet and more, all with a smile on their face. The end prize: happy families that they help create.

What these surrogates don’t have much of is a network just for them.  A place to go when the hormones are raging, to question other surrogates about the legal process or just to express how they’re feeling after the baby is born.

Alternative Reproductive Resources has created and is sponsoring an option for this community. “The Surrogacy Spotlight” is a Facebook community for current surrogates, women thinking of becoming surrogates, and surrogacy experts. To join, go to:

We know there are plenty of great surrogacy forums online already, but many of them seem to be a location where intended parents go to solicit them. The Surrogacy Spotlight is just the opposite.

It’s a place to meet other surrogates going through the same experience. It also gives women thinking about becoming a surrogate a chance to ask questions to see if it’s right for them. It’s a place to express their, joys, fears, frustrations, pregnancies, births and more.

If you are, have been or are thinking about becoming a surrogate, please join The Surrogacy Spotlight as a fan, and we hope you’ll recommend it to others in your network who might be interested. (

In addition to welcoming your comments and observations, we’ll have two special features. Each month, we’ll have a Surrogate of the Month and a different surrogacy expert.

Starting Tuesday, July 6, our Surrogate of the Month will be Jodi, who recently gave birth to twins for two wonderful intended fathers. She will share her surrogacy journey and take questions from you throughout the month.

Our expert will be Mary Ellen McLaughlin, an ARR partner and former nurse who works with surrogates. She’ll discuss the psychological and medical aspects of the experience. Future experts will include attorneys, psychologists, physicians and more.

We have been working in the fertility field for more than 15 years, and understand that having an outlet to help get you though the process is therapeutic. We trust The Surrogacy Spotlight will do just that, and welcome your involvement to ensure it happens.

By Cindy

I’m 33 and I live in northern Illinois. I have a 9-year-old son and I’ve been in a relationship with a great, caring woman for nearly 10 years. I also just gave birth to twin boys with a wonderful man. I was his gestational surrogate.

A few years ago, my partner and I were dismayed at the number of people who wanted children but couldn’t have them on their own. These are people who would make great parents and deserved the opportunity. So we just figured we’d like to help.

We found Alternative Reproductive Resources through our local newspaper and decided to give them a call. The process was wonderful, and we were made to feel more like being part of their family than just a client. We met one gay couple, and were excited to get started, but it just didn’t pan out. Then we met our match.

We certainly weren’t going to limit our choices based on something as trivial as whether the prospective parents were gay or single or a different race. In fact, our intended parent was a single guy who hadn’t found anyone yet but decided he didn’t want to wait any longer to have children. He and my partner and I hit it off immediately, as if we’d been friends for years. We could tell he’d make an excellent parent – the man exudes “small-town goodness” from his pores.

We let our family and friends know our decision and there were some obvious concerns, especially from my mom and stepdad. After providing them with some more information, though, everyone has been extremely supportive. To a small extent, I think we also opened the eyes of the gay and lesbian community. Lesbian couples are the perfect surrogates because they’re usually more open-minded about non-traditional families. We’re a group that has experienced an unsettling amount of discrimination with regard to adoption and marriage, so less-than-conventional families are kindred souls. Our friends got a thrill out of watching my pregnancy progress.

When the end of November rolled around, I began to get nervous. My C-section was scheduled for December 3. I had no reason to be concerned though. My partner was holding my hand the whole time. Two beautiful, healthy boys popped right out, two minutes apart, and our intended parent’s life changed. The most rewarding experience of my life, besides my own son being born, was seeing this new father hold his sons. His mother couldn’t stop thanking me.

After it was all over, my partner and I decided we’d definitely do it again. (We’re agreed, however, that we want no more of our own!) We’ve already been able to see the boys once since the delivery and their father is adjusting quite well. We intend to stay in contact with the family, even if it’s just the occasional Christmas card or school photo.

This experience was exactly what we had hoped for. So many worthy people are out there looking for help in creating their own family. An open mind is all they need to make their lives complete.

By Katie

It started for me when I came across one of ARR’s ads looking for egg donors.  Egg donation was something that I had contemplated on various occasions throughout college, but at the time, I wasn’t sure if I was emotionally prepared to deal with it.

After meeting with Mary Ellen, I realized that donating my eggs was something I really wanted to do. The pros by far outweighed my qualms about the procedure.  So, I began my journey.

ARR asked me to provide photographs dating back to my childhood to show to prospective intended parents. I also completed medical forms detailing my personal health history and that of my family members.  The other steps included a psychological evaluation and a gynecological exam.

It’s important to acknowledge that throughout this entire process, Mary Ellen responded to my questions and concerns in a prompt, professional (yet kind) manner. I never felt confused or unsure of what would be happening next.

Once I was matched with the intended parents, I started taking birth control pills to sync my ovulation schedule before starting hormone injections. Other than some initial nervousness about giving myself a shot, it was quick and painless – feeling like a light pinch.

After the egg retrieval, I felt back to normal within about 36 hours. While there are potential side effects to the procedure, ARR and my doctor made sure I was aware of the symptoms and what to do if any complications arose. (They didn’t!)

I recently contacted ARR and found that 22 eggs had been retrieved!  I am quite optimistic that at least one of them was fertilized in the intended mother.  It’s been less than a month since my retrieval, and though I have not heard if a pregnancy has been achieved, I wish the couple all the best and hope their dreams are fulfilled.

This experience was rewarding in so many ways!  I am looking forward to donating again in the near future!

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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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