Becoming a Surrogate: Everything You’ve Wanted to Know

Embarking on the journey of introducing a child into the world for someone unable to carry a pregnancy is a testament to profound generosity and empathy. Becoming a surrogate mother is more than just a medical process; it’s a heartfelt commitment, a dedication to transforming someone’s dream into reality with the unparalleled gift of life. If you are moved by the idea of helping to create families, and if you are drawn to the noble act of carrying a precious life for nine long months with grace and care, then surrogacy might just be your calling. While the anticipation of carrying a baby is filled with emotions and expectations, it is essential to note that the surrogacy process, from start to finish, generally spans about 12 months.

Whether you are contemplating the idea or simply seeking a deeper understanding, our comprehensive guide delves into the heart of the matter, providing insights into the health, legal, and emotional aspects of the surrogacy journey. As you embark on this transformative experience, it’s essential to be informed and prepared for what lies ahead. Let’s explore some of the most frequently asked questions and concerns that potential surrogate mothers face.

What Does It Take To Be A Surrogate Mother?

Becoming a surrogate mom is one of the most remarkable journeys you can go on, but at the same time, it is also a challenging job. You will be choosing to become pregnant for another family, thus dedicating nearly 12 months to the process, starting from matching and ending with giving the baby to the intended parents. This pregnancy will be different from your own pregnancy as it involves many professionals, many conversations, and many stages. However, before diving into this transformative experience, it’s essential to ensure you meet the surrogate mother’s requirements.

Requirements for Surrogate Mothers in the U.S.:

1. Age: Between 21 and 40 years.
2. Body Mass Index (BMI): Ranging from 18 to 32.
3. Residency: Must be a U.S. citizen, legal resident, or legal immigrant residing in a surrogate–friendly state.
4. Health: Non–smoker living in a non-smoking home, free from illicit drug use.
5. Parenting: Must have given birth to and be raising at least one child.
6. Reproductive Health: A healthy reproductive history with no significant complications during prior pregnancies and births. A minimum of 6 months since your last birth and a maximum of 2 cesarean deliveries.
7. Mental Health: No antidepressant or anti–anxiety medication use in the past 12 months. No history of clinical mental illness.
8. Financial Stability: Not dependent on governmental financial support.
9. Medication: Comfortable with administering subcutaneous and intramuscular injections.
10. Legal Background: No criminal history or felony convictions.
11. Background Checks: Both you and your partner must undergo background checks.
12. Psychological Evaluation: Both you and your partner will be required to undergo psychological consultations.
13. Availability: Ability to travel for surrogacy–related appointments, including potential overnight stays.
14. Home Environment: Consent to a home visit, ensuring all residents are present.

Can I Become A Surrogate Mom If I Have Faced Fertility Issues?

Facing fertility challenges doesn’t prevent you from considering surrogacy, but the cause of these challenges is essential in determining your suitability as a surrogate mother. If your issues arise from factors unrelated to your general health or the health of your uterus, you may still be an excellent candidate for surrogacy. On the other hand, if your fertility issues are associated with recurrent pregnancy losses or significant complications during pregnancy, a surrogacy team would prioritize both your safety and that of the potential baby before making a decision. Always consult with professionals to evaluate your specific circumstances.

If I Have Had A Miscarriage Previously, May I Become a Surrogate Mother?

Experiencing a miscarriage is a sensitive topic, but you should know that it doesn’t automatically disqualify you from becoming a surrogate mom. Miscarriages can happen because of a variety of reasons, many of which may not impact future pregnancies. As long as the miscarriage wasn’t a result of an ongoing health condition or an issue with your uterus, and you have had successful, full–term pregnancies and uncomplicated births, you could still be a perfect potential candidate for surrogacy. Each situation is unique, including miscarriage and pregnancy loss, and will be thoroughly reviewed by the medical team to ensure the safety and health of everyone involved in the surrogacy process.

Can I Be A Surrogate Mother If I Have Had An Ectopic Pregnancy?

In a normal pregnancy, a fertilized in the fallopian tube egg is transported to the uterus, where it attaches to the uterine lining and begins growing. But in the case of an ectopic pregnancy, a fertilized egg implants before reaching the main cavity of the uterus. Usually, implantation occurs in the fallopian tubes, causing tubal pregnancy (tubal ectopic pregnancy), or in the cervix (cervical ectopic pregnancy), an ovary (ovarian ectopic pregnancy), or the abdominal cavity (abdominal pregnancy). 

A tubal pregnancy can occur because of damaged fallopian tubes, inflammation of the fallopian tubes, hormonal imbalances, or improper formation of a developing fertilized egg. Ectopic tubal pregnancy is treated either by medication or by surgical intervention, during which a part of the tube or full tube is removed.

Having had an ectopic pregnancy does raise certain considerations when contemplating becoming a surrogate mother. If you have experienced an ectopic pregnancy, especially a tubal pregnancy that led to the removal of one or both fallopian tubes, it doesn’t necessarily prevent you from carrying a pregnancy to term. However, the underlying reasons for the ectopic pregnancy and the overall health of your uterus are vital factors.

Most surrogacy arrangements involve gestational surrogacy, where an embryo is implanted directly into the surrogate mother’s uterus, bypassing the fallopian tubes. Thus, the status of the fallopian tubes might not be as essential as in traditional pregnancies. Nevertheless, a history of ectopic pregnancy would require a thorough medical evaluation. The surrogacy agency and its medical team will ensure that your uterus is capable of supporting a healthy pregnancy and that there are no lingering issues or risks that might jeopardize your health or the health of the baby.

If I Had An Inflammation Of The Fallopian Tubes And/Or Their Scarring, May I Still Be A Surrogate? 

Having had inflammation of the fallopian tubes (often referred to as salpingitis) or scarring doesn’t exclude you from becoming a surrogate mother. In gestational surrogacy, the primary concern is the health of the uterus since the embryo is transferred directly into the uterus, bypassing the fallopian tubes. However, the underlying causes of the inflammation or scarring, as well as any other related health issues, need to be taken into consideration. It’s essential to undergo a comprehensive medical evaluation to ensure that your uterus can support a healthy pregnancy and that there are no residual health concerns that might pose risks to you or the baby. A good surrogacy agency, in collaboration with a medical team, will review your medical history and guide you through the process to determine your eligibility as a surrogate mother.

If I Have Had My Tubes Tied (Tubal Ligation), Can I Apply to Be a Surrogate? 

Certainly, however, the type of surrogacy you can pursue may differ based on your tubal ligation.

Gestational Surrogacy: In this process, an embryo (which is created using the intended parents’ or donors’ sperm and egg) is implanted into the surrogate mother’s uterus. Your fallopian tubes play no role here. Hence, even if you have had a tubal ligation, you can become a gestational surrogate mom because your ability to carry a pregnancy isn’t impacted. It’s essential to understand that having your tubes tied doesn’t stop you from ovulating — it merely prevents the egg from meeting the sperm in the fallopian tubes.

Traditional Surrogacy: Here, the surrogate mother’s egg is used, making her the biological mother of the child. If you have had your tubes tied and wish to be a traditional surrogate mother (say, to assist a family member or friend), the process becomes more intricate. Normally, a simple IUI (intrauterine insemination) would suffice. However, due to the tubal ligation, you would likely need to undergo IVF treatment to extract your oocytes (eggs) for fertilization with the intended father’s or a donor’s sperm.

It’s important to note that natural fertilization occurs in the fallopian tubes, where the sperm meets the released egg. After a tubal ligation — which involves cutting, tying, or blocking the fallopian tubes — sperm can’t reach this egg. Therefore, in the case of traditional surrogacy, most surrogacy agencies or teams will recommend IVF. In rare instances, they might suggest a Tubal Ligation Reversal, but success isn’t guaranteed.

If I Have Had A High–Risk Pregnancy, Am I Suitable for Surrogacy?

Having had a high–risk pregnancy is not the reason to stop thinking about becoming a surrogate mother, but it does raise some considerations. Certain high–risk conditions from previous pregnancies, like preeclampsia, gestational diabetes, high blood pressure, or autoimmune disease might affect your eligibility. If you had a high–risk pregnancy associated with multiples, like twins or triplets, it could be evaluated differently than if the high–risk factors were related to maternal health conditions. The surrogacy process involves careful assessment of your medical history. Your previous pregnancy records, the nature of the complications, and how they were managed will all be reviewed. Additionally, the outcome of the high–risk pregnancy — whether it resulted in a premature delivery, the need for a C–section, or any postpartum complications — will also be taken into consideration. It’s necessary for the surrogacy agency and its affiliated medical professionals to ensure that any future surrogacy journey is safe for both you and the baby. If you are considering surrogacy after a high–risk pregnancy, it’s essential to have open communication with your potential agency and undergo an inclusive medical screening. Every woman’s situation is unique, and decisions are made based on the individual’s health and well–being, with the primary aim of ensuring a safe and successful surrogacy experience.

Does My Location Matter as a Prospective Surrogate?

The answer is no. Prospective surrogate mothers often wonder if they need to reside in the same state as the surrogacy agency they wish to collaborate with. In reality, as long as you live in one of the Surrogate Friendly states that the agency actively recruits from, your location shouldn’t be an impediment. If you are uncertain about your state’s surrogacy stance, it’s always advisable to contact a surrogacy agency for clarity.

Nevertheless, while many agencies are flexible about city or state of residence, it is imperative that surrogate mothers reside in a country or state where surrogacy is legally recognized. The nuances of surrogacy and parentage laws vary widely, making contract enforcement between intended parents and a gestational carrier potentially challenging when they hail from different jurisdictions, making cross–state surrogacy arrangements somewhat complex.

Fortunately, many agencies are adept at managing cases where both the surrogate mother and intended parents reside in different states. They often have the expertise to ensure proper legal counsel for all parties involved. Once you are successfully matched with the intended parent(s), they typically cover all costs associated with your travel to their chosen clinic for screening. This means you don’t have to be in the same state as either the intended parents or their clinic. With the agency acting as a guiding force, they will coordinate all your travel arrangements and medical appointments, ensuring your surrogacy journey is as seamless and stress–free as possible.

Is Surrogacy Legal in Every State or Not?

If you are considering becoming a surrogate mother, it’s essential to understand the legal landscape surrounding surrogacy. Not all states view surrogacy in the same light. While most states have embraced and fully legalized surrogacy, a few have set specific conditions or restrictions, and some have even prohibited it entirely.

To navigate these intricacies, reputable surrogacy agencies maintain adept legal teams well–versed in state–specific surrogacy legislation. They are primed to guide both intended parents and surrogate mothers smoothly through their surrogacy journey. It’s worth noting that these agencies predominantly work with surrogate mothers from states that either outright permit surrogacy or where it’s possible to proceed, albeit with caution.

Currently, surrogacy remains off–limits in three states: Nebraska, Louisiana, and Michigan. Meanwhile, states like Arizona, Idaho, Indiana, New York, Tennessee, Virginia, and Wyoming allow surrogacy, but caution is advised due to potential complexities or ambiguities in their regulations. The other states permit surrogacy.

How Often Will I Need to Travel as a Gestational Carrier?

Embarking on a surrogacy journey does entail some travel commitments. For many surrogate mothers, this typically means traveling to specific locations several times. These trips are essential for obtaining medical clearance, initiating medication protocols, and undergoing embryo transfers. It’s understandable to have concerns about the expenses and logistics of such trips, but rest assured, all travel–related costs will be covered by the agency or the intended parents to ensure a smooth and hassle–free experience for you.

How Do Surrogates Become Pregnant?

There are two types of surrogacy depending on the genetic material used to create an embryo: gestational and traditional. Gestational surrogacy is the most common type as it has fewer legal nuances, and a gestational surrogate mother has no genetic link to the baby she carries. Traditional surrogacy is less common as the traditional surrogate mother is the child’s biological mother, which may introduce more complex emotional and legal dynamics.

Gestational surrogate moms become pregnant through the process of in vitro fertilization (IVF) using the genetic material chosen by the intended parents (intended parents or donors). The embryos are then transferred into the surrogate mother’s uterus through a simple medical procedure known as embryo transfer. Depending on the country’s legislation on assisted reproduction and surrogacy, either single elective embryo transfer or multiple embryo transfer (two or three embryos) is performed. 

If the implantation is successful, the surrogate mother will become pregnant and carry the intended parents’ child through gestation until birth. The gestational surrogate moms don’t donate their eggs to create the embryos; thus, they do not share their DNA with the baby. 

Traditional surrogate mothers become pregnant through the process of intrauterine insemination (IUI) or IVF using the intended father or the donor sperm. IUI procedure is less invasive and less expensive, and it does not involve egg retrieval, fertilization, and embryo transfer. When undergoing an IUI, the surrogate mother is inseminated by depositing a sperm sample at the time of her ovulation. In case of successful ovulation and the egg release, already deposited sperm meets the egg in the fallopian tube, and if the sperm and egg binding results in fertilization, a fertilized egg is transported closer to the uterine cavity and will implant inside the uterus. The IUI procedure is optimal for surrogate moms with functional fallopian tubes. In other cases, when fallopian tubes are damaged, tied, or have limited function, an IVF is recommended. During an IVF treatment, the traditional surrogate mother donates her eggs, which are picked up, fertilized, and transferred as embryos back to her womb.

What Is My Compensation for Surrogacy? 

The surrogate mother’s compensation consists of base compensation and a benefit package totaling a minimum $70,000 cash value. Factors that may affect a surrogate mother’s total compensation include: 

• The number of prior surrogacy experiences;
• Where the surrogate mother lives;
• Number of babies carried;
• If the surrogate mother has a C–section.

Your compensation will be clearly outlined in your surrogacy benefit bundle so you know exactly what to expect. Almost all surrogacy agencies prioritize complete transparency, not only to avoid any surprises but also to provide monthly tracking, ensuring you can monitor payments coming in on schedule.

Do I Need To Pay For Anything While Carrying a Surrogacy Pregnancy? 

Absolutely not. All financial aspects are handled for you. The surrogacy agency takes care of all initial expenses before the contract signing. Once you are matched, the intended parents will cover all subsequent costs as outlined in your surrogacy contract. This encompasses everything from travel reimbursements (including flights, hotels, mileage, and meals) to compensation for unforeseen circumstances that might prevent the completion of surrogacy. Even unexpected expenses such as wage loss and childcare are taken into account. Beyond the financials, the agency continuously expresses its gratitude by hosting retreats and gatherings for surrogates. Throughout this journey, they stand by your side, ensuring you always feel supported, secure, and deeply valued.

Can I Continue Seeing My Current OB During the Surrogacy?

Generally, most agencies are supportive of surrogate mothers continuing care with their preferred OB once they have been released from the IVF clinic’s care. However, there are instances where intended parents might request a change in OB. This could be influenced by factors such as the location of the OB, the associated hospital’s facilities and its reputation for quality of care, or even specific legal considerations related to establishing parental rights. Nevertheless, in the majority of cases, surrogate mothers are usually allowed to retain their current OB.

How Do I Begin My Journey as a Surrogate Mother?

Becoming a surrogate mother is an incredible gift, and if you feel this profound calling, we are here to walk this journey with you. Start by reviewing the requirements for surrogate mothers on the agency’s website (the agency you are interested in working with) to ensure you meet the criteria. Once you have familiarized yourself with the qualifications, proceed to complete the online application. 

After submitting your application, one of the agency’s team members will get in touch to discuss further steps, including background checks, review of medical records, and a personal interview. After approval, the agency’s dedicated case manager will embark on the exciting phase of matching, guiding you to find your perfect intended parents.

How Long Does It Take To Become A Surrogate Mom?

The timeline to become a surrogate mom varies, but embryo transfer usually happens about three to four months after you meet your intended parents.

• It takes between two and four weeks to complete the background checks. 
• It takes between one to three months to get your medical and psychological screening results back. Sometimes, it may take up to three or four weeks, depending on the clinic that runs tests, screenings, and other medical procedures. 
• It will take another three to four weeks to go through legal processes. 
• Once you are cleared to begin your IVF Transfer Cycle, it will take another three to four weeks to build your uterus lining.

During this waiting period, the surrogacy professionals will help you build a strong bond with your intended parents and get ready to start the surrogacy journey. 

How Long Does It Take to Get Matched With Intended Parent or Parents? 

The duration to find a match can vary widely — ranging from weeks to several months. After you submit your application to become a surrogate mother, the agency typically reviews it within three business days and schedules an initial call with the Program Manager. This call aims to help you complete the application, familiarize you with the agency’s procedures, and give you an insight into your potential surrogacy journey.

Your responsiveness in providing necessary documentation can influence the speed of the next steps. The agency will need you to complete an online profile and sign several forms, including an agency agreement, background check authorization, insurance verification, and medical release documents. Once these are in place, the agency will request your medical records, which can take one to three months to be received, depending on your medical provider and the extent of your pregnancy history.

Upon reviewing your records and confirming your eligibility, the agency moves to the matching phase. While the average duration to find a suitable match is one to two months, some cases may extend to three months.

The Bottom Line

The path of surrogacy is one of profound generosity, filled with emotions, medical processes, and legal considerations. And becoming a surrogate mother is both a selfless gift and a tremendous responsibility. For those considering this journey or simply seeking to understand its depth, we hope this guide has provided clarity and insights into the many aspects of surrogacy.