Why do I need a fertility clinic and surrogacy agency?

It’s no secret that the family-building process (especially via surrogacy) can be complicated and overwhelming. However, with the right support, resources, and guidance, it can also be incredibly rewarding.

Surrogacy can also be expensive – so much so that one of the first questions many intended parents ask is why they need both a fertility clinic and a surrogacy agency. I understand where they’re coming from – with the costs of surrogacy, it seems that cutting out just one of these parties could save you valuable funds.

However, it’s important to understand how complex an IVF and surrogacy journey can be. Enlisting the expert guidance of trusted surrogacy care leaders can help you avoid any unnecessary roadblocks or speed bumps along the way.

So sit down, relax, and read on to find out why you really DO need both a surrogacy agency and a fertility clinic on this unique path to parenthood.

What is the role of a fertility clinic for gay couples?

The fertility clinic is in charge of all of the clinical (AKA medical) aspects of your surrogacy journey – from your genetic screening all the way through embryo transfer and the first eight weeks of pregnancy.

From your first consultation to your last monitoring appointment, these services often include:

• Fertility testing for you and your partner (if applicable)
• Genetic carrier screening for you, the intended parent
• Testing and screening for your chosen egg donor (if applicable)
• Completing an IVF cycle – including either a donor egg retrieval or retrieval from one intended parent
• Preimplantation genetic testing of your embryos (an optional test, typically shortened to “PGT-A”)
• Gestational carrier screening
• Embryo transfer to your gestational carrier 
• Remote or in-house monitoring of your carrier up to 10 weeks of pregnancy

Fertility clinic services may also include any of the following:

• Storage of any specimen (eggs, sperm, frozen embryos) until ready to be used
• Screening services for all parties to ensure all are mentally, physically, and emotionally ready for this process
• Counseling services

Many times prospective parents will connect with a fertility clinic first, as baseline fertility tests can be an easy introduction into family building. However, you can also start your journey by meeting with a surrogacy agency whose reputation you trust.

What is a surrogacy agency, and what services do they offer?

A surrogacy agency helps coordinate your surrogacy journey to make it as easy to navigate as possible. They will provide all or most of the services needed to complete the surrogacy part of your family-building journey. This may include:

• Matching services to find your gestational carrier 
• Screening services to ensure both you and your surrogate are mentally, physically & emotionally ready for a surrogacy journey
• Legal services
• Coordination of information and services between fertility clinic and agency to make sure all steps are completed
• Counseling services
• Nurturing the relationship between you and your gestational carrier

While many of the agency tasks may seem more administrative, they play a crucial role in your surrogacy success. While we luckily live in a surrogacy-friendly country, there are still states where compensated surrogacy is not yet legal. Making sure that your rights, your gestational carrier’s rights, and the rights of your future child are protected is the job of your surrogacy agency and their legal team.

In addition, we know that surrogacy is expensive. It truly is the common goal shared by all involved that you complete your journey to parenthood as efficiently as possible – you don’t want to miss a crucial step because you declined the help of an agency or legal representation. In order to emphasize this further, many clinics will not move forward with couples trying to pursue surrogacy without the aid of a reproductive attorney or an agency.

So, why do I need both an agency and a fertility clinic?

1. Surrogacy is a complicated legal process

It is the responsibility of your agency to help you not only match with your gestational carrier, but to also help negotiate the terms of your contract with this person. These contracts cover everything from medical procedures to the surrogate’s compensation to her relationship with you and your child after birth.

Although some surrogacy agencies don’t have legal counsel on staff, it is helpful to choose a “full service” agency, whose staff includes an experienced legal team who will take care of all of these matters efficiently.

Depending on your citizenship, residence location, and the location of your gestational carrier’s home, the legal work related to your surrogacy journey may include a pre-birth order, a voluntary acknowledgement of paternity, a custody order, or an adoption.

2. Gestational carrier screening is a two-way street

The clinical team at your fertility clinic (which will most likely consist of your doctor, an assigned nurse, and a patient navigator – along with other support staff) has a few very important jobs.

Before you are even matched with your gestational carrier, it is the reasonability of your clinic to medically screen each surrogate, even after she has been accepted by the surrogacy agency. It’s nice to have two separate groups reviewing these records, to allow you a solid foundation to build the relationship with your surrogate.

It is rare that a fertility clinic would disqualify a surrogate who had passed agency screening, but certain factors (such as previous risky pregnancy history or number of births/C-sections) are things that are reviewed by your physician and their staff.

3. Clinical success matters – and so does your relationship with your physician

Whether you have existing embryos at one facility and need to transfer them to a clinic in a surrogacy-friendly state or you’re starting from square one, choosing a clinic you trust is crucial.

Most clinics have their success rates posted on their website, and you can also use SART as a great neutral resource to scope out your options.

Another thing that’s important to keep in mind is that a single surrogacy journey can take anywhere from 15 months to beyond two years. Your relationship with your fertility clinic team and your doctor there will be a long-term one – make sure that you feel comfortable asking questions, communicating concerns, and genuinely feel taken care of.

Your doctor will be helping you through the process of choosing a donor, retrieving their eggs, fertilizing eggs in the lab, maybe genetically testing your embryos, and ultimately transferring an embryo to your gestational carrier. They will be a key player in your surrogacy journey as they guide you through the entire IVF process.

4. What happens after embryo transfer is important

After embryo transfer, most gestational carriers will return home within the next few days. Oftentimes, they don’t live locally to the clinic where the transfer was completed – remember intended parents, their gestational carrier, and the fertility clinic can sometimes all be in different states. However, your fertility specialist will order bloodwork and ultrasounds in your carrier’s local area to continue their monitoring. Once your gestational carrier is 8-10 weeks pregnant, all care will transition to their local OB/GYN.

Over the next few months, and until your due date, your surrogacy agency is responsible for helping to nurture your relationship and helping to complete any outstanding paperwork before your child arrives. They will also help you to build a birth plan that everyone is comfortable with.

Although the fertility clinic and surrogacy agency have different responsibilities, they all share one common goal – to help you have a healthy, happy family. And as a physician who frequently works with parents pursuing surrogacy, I can confirm that we all love receiving baby pictures at the end of the process!

The surrogacy journey may seem like a long road, but your support teams at your clinic and surrogacy agency are there to support you every step of the way. Understanding the important roles both fertility clinic and surrogacy agency play and choosing a provider who has your back is an important first step. 

This article first appeared on Gay Parents To Be, here.