Clear the confusion: The 10 key surrogacy questions to ask your doctor

Your fertility specialist (reproductive endocrinologist and infertility, REI) and office are generally where your journey will be starting. It’s easy to think about using a surrogate as being like a usual IVF cycle, but with the embryo being transferred into your gestational carrier instead. When it comes to third party reproduction, though, there are a lot of added steps. This is where your REI will play a leading role. Your REI is pivotal in organizing genetic and infectious disease screening, offering guidance on the need for donor egg or sperm, creating your embryos, approving of your gestational carrier, reviewing your legal contract and much more prior to the long awaited embryo transfer to your gestational carrier.

It’s important to know that not every fertility office has a surrogacy program. If you’re already receiving care, your doctor may have to refer you to another center. Our first fertility office was small and didn’t do surrogacy cycles. Our second center had one specific REI that would care for all surrogacy situations. So this means starting fresh with a new provider. For someone that is taking such an important role, you will want to feel confident and comfortable with them. Here are some questions you should consider asking when you consult with your fertility specialist about your surrogacy journey.

Do you recommend that we have genetic screening or testing on us or our embryos?

Based on your age, medical history, family history and circumstances, genetic screening or other testing may be recommended. There are some benefits, risks, and even controversies in this area and your fertility specialist should be the one to guide you.

How do you define success and what are our chances?

Some fertility statistics are built on “pregnancy” as the key result. What was most important to us was knowing our chances of a healthy baby. Consider asking what your chances of success are with our own genetics? Or how many egg retrievals will you need for X number of babies?

What will the medication protocols look like and what does each medicine do?

Education is critical as you go through this process. It is good to know the medications that will be used and what they are supposed to do.

What are the extra steps or screenings for our IVF cycle knowing that the embryos will be transferred into a gestational carrier?

Your fertility specialist should guide you on any specialised infectious testing, additional lab work, psychological evaluations, and physical exams that may be needed.

What are the clinic’s requirements and criteria for gestational carriers?

Your fertility clinic will have set criteria for age, BMI, number of prior pregnancies etc and will need to approve of her health history. You don’t want to match with a surrogate only to find out that she wont be accepted by your doctor.

Who will be our contact person during the process?

It should be clear to you who your point person will be and the best way to get a hold of them. This could be your REI themselves, but usually an IVF nurse or third party coordinator.

What is the clinic’s process?

The details of the process do vary from office to office. For example, will there be a medicated mock embryo transfer? Are there certain services that must be completed in-house such as the psychological evaluation? Do they only work with particular surrogacy agencies?

How will results and instructions be communicated?

Knowing how and when communications are expected will make your experience smoother. Will they go to you, your gestational carrier or both? Will they be on the web portal or will there be a phone call?

What will increase chances of success in the first transfer?

Not much of an explanation needed here, but it is important to know how hopeful to be after transfer. It will also allow you to plan your budget and heart around multiple transfers if needed.

How much does each item cost?

Get a breakdown of all costs related to IVF, including mock cycles, gestational carrier screening, and any surcharges for using a gestational carrier. Charges for donor and gestational carrier cycles can be surprising so you will want to be prepared.

Hopefully this is a great conversation starting point when discussing surrogacy with your REI specialist. These questions should help you feel informed and increase your understanding of the process.