Surrogacy is complicated, and getting good information about how to work through the steps is hard. Your fertility doctor no doubt recommended that you contact a surrogacy agency. But agencies aren’t created equal, with some being lackluster, some prey on desperate intended parents, and a few have even been caught running scams.
Once you pay an agency, it can be challenging to get that money back. Therefore it’s crucial to make sure you choose one of the excellent surrogacy agencies.
What is a surrogacy agency
A surrogacy agency is similar to a wedding planner. They will help you plan everything down to the fine details, put you in touch with other professionals (vendors), make helpful suggestions, mediate when emotions run high, and coordinate so that the process runs smoothly. Agencies will help you with everything from matching with a surrogate to delivery of your baby and maybe even beyond.
Alternatives to a surrogacy agency
Did you know you don’t need an agency to have a successful surrogacy journey? Many intended parents will curate their own journey, following the same steps as an agency in what is called an “independent” journey.
For those looking for some support but do not need a complete agency experience, surrogacy consultants can help with matching or support along the way. Some agencies offer matching services only and let you work through the rest of the process together with your surrogate. Still, other agencies can come in after you’ve matched with a surrogate and help you to work through the steps, similar to a day-of wedding coordinator.
What makes an excellent surrogacy agency
An excellent agency should be professional, ethical, communicative, knowledgeable about surrogacy, pregnancy, and IVF, and support intended parents and surrogates. Agencies are essentially project managers who take care of all the tasks on the to-do list so you can focus on the relationship with your surrogate and on welcoming your baby.
I completed my surrogacy journey without an agency, but I still recognize the value agencies can offer. In fact, we tried to sign up with a few agencies, but the ones we were interested in had long matching times or paused taking on new clients due to the pandemic. When we finally found a couple of agencies we loved, we met an independent surrogate and continued with her.
Having gone through the work of a journey independently, hearing about both steller and terrible agencies, and understanding the price tag and emotions at stake, I have a lot of opinions on how agencies should operate. If you were to ask me what you should look for in a great agency, here is what I would say.
Anatomy of an excellent surrogacy agency
1 Doesn't use in-house escrow or legal
There have been cases of agencies using funds for their own purposes, leaving both intended parents and gestational carriers without their money. A separate, independent entity (unrelated to the agency) should hold the funds for protection and peace of mind.
Similarly, an agency shouldn’t require you to use their in-house legal counsel. Will in-house attorneys be looking out for you or the agency? A great agency will provide you with some options for attorneys. You should be free to find your own attorney who will represent your interest.
2 Allows you to speak with former parents and surrogates
Great reviews are telling. An agency that is providing outstanding service with a mound of happy clients should have an easy time finding ones willing to speak with you and share their thoughts.
3 Has a fair policy for rematching
The agency’s job includes pre-screening surrogates and finding top candidates. If that surrogate is not accepted by your REI or backs out of the process before embryo transfer, then maybe the pre-screen missed a red flag. A good agency will rematch you for free or at a significantly reduced cost, and you certainly shouldn’t have to pay the full agency fee again.
4 Short matching times and waitlists
Matching times are primarily a factor of surrogate supply and Intended Parent demand, but agency practices also play a role. If an agency has collected way more Intended Parents than the number of surrogates they can recruit, the wait times will start to creep up.
To prevent this, great agencies don’t continually collect fees from new Intended Parents, tying them financially to the agency and having them wait seemingly indefinitely. A great agency will cap the number of intended parents waiting and focus on matching the ones already in their program. Ask about the length of waitlists before signing up for an agency.
5 Recruit and pre-screen candidates before matching
A thorough surrogate pre-screen should include criminal and financial background checks, home visits, psychological evaluation, OBGYN pregnancy clearance, and medical records review. An excellent agency would have medical records reviewed by an OBGYN physician- general OBGYN, REI, or MFM. An adequately pre-screened candidate is more likely to pass your REI’s medical screening and follow through with being a surrogate.
6 Be a Stellar matchmaker
One of the most critical roles of an agency is matching. An agency should be able to match Intended Parents and Surrogates based on their shared values, complementary personalities, expectations for the journey, and logistics, such as location. Agencies shouldn’t ask Intended Parents or surrogates to compromise on essential matching points like the number of embryos to transfer, willingness to terminate a pregnancy, amount of communication, or vaccinations.
7 Review medical insurance and find in-network Obgyns
Some insurance policies will not pay for surrogacy-related medical expenses. A surrogate’s existing policy must be reviewed to ensure it can be used. If not, the intended parents need to buy a new surrogacy-friendly insurance plan. Medical insurance review should happen before matching so intended parents don’t fall in love with a surrogate only to have a surprise expense.
With timely insurance review, the agency should help find an in-network Obgyn or midwife who delivers and your preferred hospital. Alternatively, they should refer you to an insurance professional who can assist with this.
8 Coordinate and schedule
Surrogacy requires moving parts to be put in place at specific times to avoid delays. These include medical appointments, medication orders, travel arrangements, hospital tours, and parentage orders. A great agency will coordinate with the fertility and OBGYN offices, call pharmacies, search for travel options, reserve rental cars, etc. and keep you informed of all dates and times. As intended parents, the steps should flow seamlessly.
9 Communicate with OBGYN/midwife and hospital
The agency should reach out to your surrogate’s OBGYN to inform and help organize the surrogacy pregnancy. The organization includes:
- Introducing the staff to you.
- Providing a copy of the contract.
- Assisting your surrogate with signing HIPPA releases so you can get information about prenatal appointments.
- Following up with you and your surrogate after every appointment. Some agencies have case workers available to attend appointments.
- Liaising with the hospital social worker or attorney regarding the pending delivery, again making sure they have a copy of the contract, parentage orders, and birth plans.
- Advocating for you to have your own room to care for your newborn.
- Making sure you are treated as parents, are called mom and dad, and receive security bands.
The agency should ensure that you are informed, included in the pregnancy, and treated as the parents throughout your journey.
10 Mediate in conflict and assist with awkward conversations
Surrogacy is beautiful, but sometimes the relationship can have road bumps and strain. A great agency is a neutral mediator that can listen and help to smooth the wrinkles. Agencies should also help to communicate challenging things, like if your surrogate has difficulty telling you about a miscarriage. Agencies can also help with awkward conversations, like money, that can harm the IP-GC relationship so everyone can focus on the baby and the journey.
11 Recommend reputable third parties
Surrogacy is a team sport with psychologists, attorneys, escrow managers, insurance reviewers, and monitoring IVF centers. A great agency will be able to refer you to quality, reputable professionals and not companies with whom they have special deals or kickbacks.
An agency can be indispensable to a surrogacy journey, provided you pick a great one. When you speak with agencies, see how they stack up to this list. Don’t be afraid to ask questions and choose the best agency for your needs.
