Over the past few years, you may have seen the topic of surrogacy popping up more frequently in the news. Some celebrity names might come to mind when you think of surrogacy - Kim Kardashian, Andy Cohen, and Anderson Cooper, to name a few. Here at RMA of Connecticut, we have been helping intended parents build families using gestational surrogacy for years, and we’re so happy to see it become a more relevant parenting pathway for all.
You may notice that, aside from being famous, one other thing that Andy Cohen and Anderson Cooper have in common is their status as proud, single, dads. There are many reasons that men might turn to single fatherhood, and many paths to achieve parenthood - all of which we are happy to support! While many people think first of adoption or foster to adopt, biological fatherhood is also a viable pathway to becoming a parent. For dads-to-be who choose to be a “genetic intended father” -- where dad and child are biologically related — your family building will probably take the shape of a surrogacy journey. So how does that process work? In this article we’ll explore the basic framework of the surrogacy process, and introduce the key individuals that will play a role in your family building story.
Before we get started, let’s clarify what we mean when we say “surrogacy”. For the purposes of this article, we will largely be discussing “gestational surrogacy”. This is a well-established path to parenthood, with thousands of babies born over the years. Gestational surrogacy for a single father involves the help of two separate individuals:
- An egg donor, who provides eggs (gametes) and will be genetically linked to your child
- A surrogate, or gestational carrier, who helps carry a pregnancy to term and delivers the baby. A gestational surrogate is not related to the child that she carries, but still is able to create a close relationship with her intended parent, sometimes one that can last for many years!
There is another type of surrogacy, which is called “traditional surrogacy” - in this practice, the egg donor and the surrogate are the same person, so the surrogate is genetically linked to the child that she carries. Traditional surrogacy is not commonly practiced at this time, due to the inherent legal hurdles and lack of protections for the rights of intended parents, surrogates, or future children. While this may seem like an easier, more cost-effective, or quicker way to achieve your dreams of a family, most clinics and reproductive attorneys do not support this practice, and will caution you against it.
Where Do I Start a Surrogacy Journey?
We’ve already touched on your egg donor and gestational carrier, who will each play a major role in your surrogacy journey. But that’s not all! In the words of one successful dad, Will P., it takes a village to complete a surrogacy journey. In addition to your gestational carrier and egg donor, your family building story may also include:
- Fertility doctor (or reproductive endocrinologist)
- Fertility clinic staff (nurses, administrative staff, and a lab team)
- Mental health professional
- Surrogacy agency staff (which may include mental health professionals and attorneys)
- Reproductive attorneys
While this may seem overwhelming, the good news is this: you’re not alone, and each and every person involved in your journey wants the same thing - for you to bring home a healthy baby.
Finding a trusted fertility clinic with a doctor that you trust will be your first step in the surrogacy process. Many dads-to-be choose a clinic that is geographically close to them, which can make it easier to attend any appointments later on. However, the most important factor to consider is a provider who has experience with surrogacy. Many dads-to-be are able to move through the surrogacy process via video calls, texts, and emails, and travel to their offices for a few crucial appointments. This allows them to choose a provider that they trust, connect with, and who has a proven track record of surrogacy success.
Your first step with your doctor will be to complete an initial consultation. This is a brief chat, during which your doctor will ask you about your family building goals, personal and medical health history, and begin to help you build a plan. They will probably ask you to complete a semen analysis at an office local to you - this test results quickly, and can tell your physician a lot about your sperm health. It’s an easy step to cross off your personal checklist! Your physician may also ask you to conduct some additional genetic testing — screening for recessive traits that may carry disease is important for the health of your future child.
Where Do I Find An Egg Donor?
The next step will be to choose your egg donor. This step can take some time, as this person will be contributing their genes (via eggs, or oocytes) to your future child’s genetic makeup! When it comes to where to locate your donor, your fertility doctor will be able to steer you in the right direction. Many clinics have in-house egg donor pools, of young woman who live locally and have completed some level of pre-screening. If you are searching for a specific physical trait (height, eye or hair color, or specific ethnicity), you may be pointed in the direction of an egg donor agency to help you locate your donor match.
For most dads-to-be, the surrogacy process will include what is called a “fresh donor egg cycle” - this means that once you decide upon your donor, she will take medication to optimize her fertility, and then undergo a short, in-office procedure called an egg retrieval.
You may have heard of frozen donor sperm banks, and wonder if there is an egg donor equivalent. There is! However, because of oocytes’ delicate structure, the rate at which they thaw after freezing is not always optimal. Your clinic will probably suggest the fresh donor egg cycle that is explained above.
What Should I Look For In An Egg Donor?
Many parents get caught up in their donor choice, as this person will be contributing to your future child’s genetics. However, when making your donor choice, Lisa Schuman (Director of Mental Health here at RMA of Connecticut) counsels parents to think about how they’d like to speak to their future child about their donor conception. Yes, traits like height, hair color, and eye color are important, but so are shared hobbies, personality traits, and things that you’ll be able to tell your future child that stood out. The staff at your fertility clinic and a mental health professional will help guide you with this decision, just as they will counsel your chosen donor. Egg donors are typically compensated between $8,000-$15,000, but it is not a decision made lightly. Most egg donors are young, healthy women, who are happy to help someone else complete their family.
Is IVF Involved in Surrogacy?
Yes! Part of the reason that your surrogacy journey may start at a fertility clinic, is that you’ll need the help of embryologists and lab staff to complete an IVF cycle as you build your family. So what do the steps in the IVF process look like for single dads?
- You will come to the office and give the lab a specimen of your sperm. This does not have to be on the same day as your egg donor’s retrieval, as sperm can be frozen and stored safely for years!
- As mentioned above, after taking medication, your egg donor will complete their egg retrieval on a designated day. At that point, your fertility clinic will probably call you and update you, letting you know how many eggs were retrieved.
- Next, eggs and your (thawed) sperm are combined in the laboratory to form embryos.
- Over the next few days, the embryologists at the clinic watch over the embryos as they develop, keeping you in the loop as that happens.
How Many Embryos?
Many dads don’t know that there is a natural rate of attrition that happens during the IVF process. Not every single egg will be mature, and not every fertilized egg will develop into a Grade A embryo, but this is normal! The lab staff and your physician are trained to be the best possible babysitters for your developing embryos.
- After 3-5 days, embryos are usually cryopreserved until the surrogate’s uterine lining is ready for implantation.
You can complete PGT-A at this time - that stands for preimplantation genetic testing for aneuploidy. This test allows you to check for chromosomal abnormalities in each embryo, although the chances of that happening are rare when using a young, healthy, egg donor and healthy sperm. Although it’s not required, many dads like to complete this test because it allows them to determine the gender of each embryo.
Finding My Surrogate
I have to admit, the episode of Friends where Phoebe agrees to be her brother’s surrogate vastly downplays the amount of screening required to become a gestational carrier. Today, most prospective dads connect with their surrogate through a surrogacy agency, whose role is to source, screen, and connect gestational surrogates with intended parents.
Surrogates come from all over the country (in states where surrogacy is legal), and are typically healthy women, who enjoyed being pregnant and had minimal birth complications, and who truly want to help someone else have a family. Surrogates are usually compensated $40,000-$60,000, in addition to health insurance, travel, and maternity expenses.
Once you connect with a surrogacy agency, if you have certain things you’re looking for in a gestational carrier, be specific! Your agency wants your match process and surrogate connection to go smoothly, so giving them all the information that they need is crucial. Certain things that intended parents request are:
- A surrogate who lives locally
- Dietary preferences such as eating only organic foods during pregnancy
- The amount of contact and the way you’d like to communicate with your surrogate.
Your agency will connect you with prospective surrogates based on a mutual evaluation of personalities, needs, and many other factors. There will also be additional counseling to make sure you, your surrogate, and her partner are all on the same page. Once you’ve connected, it’s on to the embryo transfer!
What is an Embryo Transfer?
An embryo transfer is a quick procedure in-office at your fertility clinic, that is performed on ultrasound so you can see. The embryo is put into a catheter, and then placed into the surrogate’s uterus to hopefully implant! Most dads prefer to be at the clinic in the room for embryo transfer day with their surrogate and her partner - it is a special shared experience.
After your embryo transfer, your surrogate will travel home, and then you play the “waiting game”. After 8-10 days, a pregnancy test will determine whether the transfer was successful. Once you receive a positive pregnancy test, your surrogate will continue to monitor locally under your fertility clinic’s guidance, and then around 8-10 weeks of pregnancy they will be discharged to her local OB-GYN for the rest of your pregnancy!
What Do I Do While My Surrogate Is Pregnant?
Over the course of the pregnancy, you and your surrogate will connect often, over video, phone call, and text. Some dads-to-be even record their voices, so their surrogate can play it for the baby to hear in utero! At the same time, your surrogacy agency will be helping you to complete any additional paperwork, and necessary legal documents. These may include
- Pre-birth order
- Parentage documents
- Helping to build a birth plan
When the time comes, you and your surrogate will follow your birth plan and you will take your child home with you - and then the parenting work begins!
The surrogacy process may seem like a long, winding, road, but building your family is worth it. While it may take some time, you’ll have teams of surrogacy professionals by your side, working hard to make your dreams a reality.
Ready to begin your surrogacy journey?
Emma Lott is the former brand specialist for Gay Parents To Be and former Project & Events Manager for Illume Fertility. Her efforts focused on supporting and resourcing LGBTQ+ patients on family-building journeys, and project management and event production for our greater Illume community.