What to Expect as an Intended Parent
A Step by Step Guide to Working with our Agency
STEP 1 – Initial Contact
After your first inquiry, we send a confidential form to complete and a letter outlining the surrogate parenting arrangement and potential costs. You must work with an IVF clinic in California. If you have not already found a clinic, we can refer you to several reputable clinics.
STEP 2 – Intended Parent Consultation and Surrogate Profiles
We discuss agency services and information on medical, legal, financial, and psychological issues of surrogate parenting. We also give you copies of profiles of Surrogates. We will answer your questions about Surrogate parenting and our experiences with other Surrogate arrangements.
STEP 3 – Retaining our Agency.
Before interviewing any Surrogates you need to sign the Agency Service Contract and to complete a psychological evaluation and any outstanding medical testing. The Agency Service Contract outlines our services and your responsibilities as Intended Parents. When you send in the signed Contract, you include the 50% advance on the administrative fee and a deposit to cover surrogate screening costs.
STEP 4 – Surrogate Meeting
During this meeting you and the Surrogate share background information and we discuss the Surrogate process and the logistics of working together. Typically previous pregnancies and mutual expectations of this arrangement are explored. Each party decides within a few days of this meeting if they want to work together.
STEP 5 – Surrogate Screening
With the decision to work together, the Surrogate completes her psychological evaluation which includes personality testing and an interview of the Surrogate’s support person. A copy of the report is sent to your IVF physician and our office. A summary of the report will be available to you.
After your IVF clinic approves the psychological evaluation, the clinic nurse schedules a Medical Screening Appointment (MSA) when your surrogate is in mid-cycle (ovulating). The MSA will include infectious disease testing, toxicology screens, and an ultrasound to assess the thickness of her uterine lining.
It is possible that your clinic or the therapist may not recommend your candidate. In that case, we introduce you to other Surrogate candidates.
STEP 6 – Surrogate and Intended Parent IVF/Gestational Surrogate Contract
Upon medical clearance of your Surrogate, we send you a copy of the IVF/Gestational Surrogate Contract and refer you to an attorney to represent you regarding your contract rights and obligations. The attorney drafts an Addendum of any changes. This attorney represents you (and your partner) in completing the Parentage Order once your surrogate is pregnant. The remainder of the administrative fee and surrogate fee is due upon completion of this Contract. Before your Surrogate starts injections, proof of contract and adequate maternity care coverage must be received by your IVF clinic.
STEP 7 – Maternity Care Insurance
At the same time that you are working on your Contract, you will contact Art Risk Insurance Solutions that specializes in Surrogate maternity care coverage. If your Surrogate does not adequate maternity care coverage, you and your Surrogate complete an application for Medical Insurance. By law, a 3rd party reviewer must verify that there is adequate maternity care coverage. Art Risk assists you in explaining the fee schedule and completing the application. We send proof of maternity care insurance coverage to your IVF clinic.
STEP 8 – Expense Escrow Account
The expense account holds funds to cover her fee and expenses. We reimburse her for her expenses once we approve her costs as delineated on her expense chart. Once your surrogate has ultra sound confirmation that she is pregnant, she receives $2,000 of her total fee and every 4 weeks thereafter. The balance is paid upon delivery as outlined in your IVF/Gestational Surrogacy Contract. We send you accounting statements every month, and we request funds to replenish the expense account when the balance falls below $2,000.
STEP 9 – Medication Schedule
Once the Contract is executed, all fees paid, and your Surrogate has adequate maternity care coverage, your fertility clinic nurse sends you a calendar which identifies dates your surrogate starts injections and the estimated week of embryo transfer (ET).
STEP 10 – Embryo Transfer (ET)
Surrogates are paid $1,000 for each ET procedure. You and your physician determine the number of embryos to transfer. Usually 1-2 chromosomally screened embryos are transferred. The physician may prescribe bedrest for your surrogate for 24-28 hours after ET.
STEP 11 – Blood Pregnancy Tests
Your IVF clinic nurse schedules a blood pregnancy test at a local lab for your surrogate approximately 9-11 days after embryo transfer (ET). If the first blood pregnancy test is positive then a second test is scheduled two days later. The IVF clinic nurse will schedule an ultrasound confirmation approximately 2-4 weeks after ET. If your Surrogate does not have a positive blood pregnancy test, your Surrogate may be retired or the nurse instructs her to stop taking medications, and a calendar is set up for a second embryo transfer with the same surrogate upon recommendation of the fertility physician.
STEP 12 – Ultrasound Confirmation
If the blood pregnancy tests are positive, the IVF clinic nurse will schedule an ultrasound confirmation of pregnancy approximately 2-4 weeks after ET. Your Surrogate is paid $2,000 of her fee within 5 days of her ultra sound. If your Surrogate does not have a positive blood pregnancy test, your Surrogate may be retired or the nurse instructs her to stop taking medications, and a calendar is set up for a second embryo transfer with the same Surrogate upon IVF physician recommendation.
STEP 13 – Choosing an OB
At the 8th week of pregnancy your IVF physician releases your Surrogate to the care of her local OB. You and your Surrogate locate an OB in her community who is a member of the maternity insurance plan and has admitting rights at a hospital with a neo-natal intensive care unit in case the baby needs NICU care. Your Surrogate files a medical release with her OB so you can discuss the pregnancy with the OB.
STEP 14 – Life Insurance Application
Your pregnant surrogate applies for life insurance around 12 weeks post ET. The broker guides her through the application process and helps her make appointments for any necessary physicals. The IVF/Gestational Surrogate Contract states the value of the policy.
STEP 15 – Prenatal Care
The Surrogate’s local OB provides the pre-natal, delivery and post-natal care. We ask your surrogate to check in with a therapist each month. The attending OB prescribes an amniocentesis only if major defects are detected. An amniocentesis would be done around 20 week’s gestation. If the amino is positive for genetic defects you (as the parents) decide whether to terminate or continue the pregnancy. With a healthy pregnancy you will attend several of your surrogate’s pre-natal appointments and tour the OB unit at the hospital prior to delivery.
STEP 16 – Pre- Birth Parentage Order
Near the end of the first trimester, you and your attorney file the Pre-Birth Parentage Order. The Parentage Order is a court order that removes the Surrogate’s name and husband’s name, if any, from the birth certificate and places your name on the birth certificate instead. A certified original copy of the Parentage Order is sent to the birth registry department at the hospital where your surrogate delivers and copies are sent to all parties.
STEP 17 – Delivery
When your surrogate goes into labor she will contact you and our office as soon as possible so you can travel to the hospital. If you are not local, you may want to discuss with your surrogate traveling to California prior to the due date. As long as a stamped, certified copy of the Parentage Order is on file at the hospital, you will have custody of the baby immediately after the delivery. Congratulations!
STEP 18 – Post-Delivery
The Gestational Surrogacy/IVF contract states the terms paying your Surrogate the balance of her fee and for reimbursing your Surrogate for lost wages, childcare, medical bills and other associated bills, etc. after delivery. If agreed, your Surrogate may express breast milk for the baby for several days or weeks. We hold any remaining funds in the expense account for months to cover any outstanding bills and/or lost wages. We may need to ask you to deposit additional funds in the expense account and we will return any unused balances after all expenses have been paid. We are sure the money will come in handy for your new baby!