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Steps Of Surrogacy Program
STEP 1: REVIEW OF GENERAL INFORMATION
This website contains all of our general information. Please review this information and call the IARC® office or e-mail us if you have any questions firstname.lastname@example.org. You are also welcome to visit our office in Maple Grove, Minnesota. Additionally, you may wish to tour the medical facilities you are considering in order to meet the physicians, embryologists, and/or staff members.
STEP 2: SIGN UP
Once you decide to proceed with our program, you will need to send in your completed Intended Parent’s autobiographical sketch, personal photographs, copies of your passport/birth certificate and photo ID, your signed agency contract, and the initial agency fee of $9,000 plus $2,000 for setting up expense account. For more information about the EA, please refer to the fee section.
STEP 3: SURROGATE REVIEW
Most clients have an idea about what they consider to be desirable traits in a surrogate. IARC® will discuss your “wish list” with you and send surrogate profiles for your review. Each profile includes a detailed medical history of the surrogate and her family over three generations, information about her physical appearance, personal interests, and her educational, employment, and obstetrical background. Pictures of the surrogate and her children are also included. You will choose your own surrogate based on these profiles.
STEP 4: SURROGATE INTERVIEW
Once you have selected a potential surrogate, we will share some of the information in your autobiographical sketch with her. If she is interested in working with you, you will have the opportunity to speak over the phone in an anonymous conference call organized through IARC®. We will suggest some guidelines about issues that are helpful to cover in these phone interviews. It is fine to hold several phone interviews in order to help you find out all the information you require. Personal interviews between you and your surrogate are also encouraged because it helps increase the surrogate’s commitment to you and the program. Upon mutual agreement, the next step will proceed.
STEP 5: SURROGATE CONTRACT
A surrogacy agreement will be sent to you for your input. IARC® will help you contemplate some of the issues that need to be detailed such as amniocentesis, abortion, multiple birth payments, lost wage and child-care reimbursement, and insurance coverage. Sometimes negotiations are required, and we find that it can help your relationship if IARC® facilitates these negotiations. The agreement will be reviewed by the surrogate and her attorney, and we recommend that you have the agreement reviewed by your own attorney in the state in which the surrogate resides on your behalf. Because your baby will be born in the surrogate’s home state, much of the legal work will be completed there as well. Once matched, IARC® requires you to hold a phone consultation with an attorney from the surrogate’s state to help you understand the legal road ahead. We will assist you in locating experienced attorneys who are familiar with surrogacy law in the relevant state, if possible. You have the choice of using one of the attorneys we locate, or you can find your own attorney.
STEP 6: INSURANCE REVIEW
The insurance industry in the United States has a great deal of control over every area of medical coverage. Since IARC® is not an insurance company, agency or broker, we can only assist your surrogate in finding medical coverage and offer some insight into the terms of the policy based on our general experience. The surrogate’s existing insurance policy will be reviewed for surrogacy exclusions and maternity coverage. You will also have an opportunity to see the insurance policy. If her existing insurance needs to be changed, this must occur before any medical treatment occurs. IARC® can help to coordinate this, if possible.
STEP 7: PSYCHOLOGICAL TESTING
All surrogates must undergo psychological testing with a licensed psychologist, including an MMPI-2, which is the most widely researched and clinically used of all personality tests. IARC® will organize this appointment and will receive a written report regarding the surrogate’s suitability. The results will be shared with you. You are also welcome to request IQ testing, drug and nicotine screening, or chromosomal analysis, at your additional expense. IARC® will coordinate all testing as required. All of IARC®’s surrogates are fully screened BEFORE their profiles are distributed to any intended parents.
STEP 8: MEDICAL TESTING
All parties involved in the conception of the child are required to undergo medical testing. If the couple is providing their embryo, the husband, wife, surrogate, and surrogate spouse must be tested. If an ovum donor is used, the husband, wife, ovum donor, surrogate and surrogate spouse must be tested. IARC® will provide direction about medical testing requirements and will have your doctor review all findings. Retesting is typically required every 6 months and will be organized by IARC®’s staff. Specific ethnic groups will be screened accordingly.
STEP 9: FERTILITY TREATMENT
IARC® will assist in organizing all medical fertility treatment by coordinating the medication protocols from the doctor in charge. Medications and their instructions will be sent directly to the surrogate. IARC® will organize airfare, travel arrangements, accommodations, and schedules for medical treatments.
The idea behind IVF is to harvest as many mature, good-quality eggs as possible. Large numbers of eggs retrieved does not always mean a large number of resultant embryos since some eggs may be too immature or too mature to progress into an embryo. With a normal semen sample, we expect a fertilization rate of approximately 80% of the mature eggs. The mother or ovum donor is placed on a combination of fertility medications to increase the number of eggs produced in one cycle and to enable us to synchronize her cycle with that of the surrogate carrier. These medications are given by injection and start 21 days after the first day of her menstrual cycle. Close to the time of ovulation, the mother/donor will travel to the fertility center where she will receive daily blood tests and ultrasounds.
According to the results of these tests, her medication can be adjusted to improve her egg production and to reduce the chances of hyperstimulation, which is a potential adverse side effect of fertility drugs. IARC® will organize all travel arrangements and will organize payment of all expenses for the surrogate from your expense account. Instructions will be given to all parties about medications and retrieval dates. The surrogate carrier will take Lupron to help synchronize her cycle to that of the mother/donor. She will also take Estrace to increase her uterine lining so that it can accept the embryo for implantation.
STEP 10: EGG RETRIEVAL/IMPLANTATION
Transvaginal egg retrieval is now accepted as the preferred and safest procedure for egg collection. This will be done by the doctor with embryologists, anesthetists and ultrasonographers assisting. A transvaginal probe is inserted into the mother’s/donor’s vagina, and a needle guide is placed onto the probe to allow direct and accurate access to the follicles. The eggs are removed through this needle guide. All women are given sedation before the egg retrieval through an intravenous line in the back of the hand. Most patients experience some discomfort; approximately 10% of the patients sleep through the procedure.
Oral antibiotics are routinely given to reduce the risk of infection, and an antibiotic cream covers the area before and after egg retrieval to minimize the possibility of a pelvic infection. On the day of the retrieval, the husband will need to produce a sperm sample for insemination of the eggs. If the sperms’ final count and motility are not adequate for conventional IVF, Intra-Cytoplasmic Sperm Injection (ICSI) can be done. This is a procedure that actually injects one sperm directly into the cytoplasm of one egg. (There is an additional fee for this procedure.) The embryos are incubated for 3 days before the embryo transfer occurs. Blastocyst transfers require a 5-day wait. Once the embryos/blastocysts reach the desired stage, they are implanted into the surrogate’s womb.
STEP 11: PREGNANCY
IARC® will arrange the BETA HCG pregnancy test approximately 12 – 14 days after implantation was to have occurred. We always hope for a positive test result, and we certainly celebrate when that happens! An ultrasound will be done to detect a fetal heartbeat several weeks later. Our surrogate program coordinator will provide support throughout the pregnancy. We will obtain prenatal pregnancy reports and share all information with you. Of course by this time, you and your surrogate’s relationship will be more personal, and you will be calling each other as you wish. IARC® will assist your lawyer with legal arrangements as required.
STEP 12: LEGAL ARRANGEMENTS AND BIRTH
IARC® has formed excellent working relationships with various attorneys who are familiar with surrogacy laws. Mr. Snyder has knowledge about the required preparations for each state in which our surrogates reside. Whether you decide to use an attorney that we have located or one of your choosing, IARC® requires a phone consultation with the attorney at the time you are matched with your surrogate. This will help you to understand the legal atmosphere in your surrogate’s state.
After achieving a pregnancy, IARC® will compile all appropriate information and will work closely with the lawyer in charge of your baby’s birth. IARC® coordinates the hospital, medical and legal issues involved at this time and offers emotional support to all. Upon the client’s request, an IARC® staff member can travel to the birth site to assist in coordinating appointments and to help everyone to acclimatize to the attorney, hospital, hotel and courthouse. (There are additional charges for this service.) It is a happy time but also one that is emotionally (and hormonally) charged!
STEP 13: BABY GOES HOME!!
It is your turn to take over. IARC® has finished our work, but we always look forward to hearing about your baby in any way you would like to share with us! Pictures are always enjoyed! We wish you heart-felt good wishes for the years to come and look forward to working with you again if baby #2 is in the picture!