How to Find a Surrogate

Finding a surrogate is perhaps the biggest challenge for couples considering surrogacy as a fertility treatment. Being a surrogate is a difficult job, and local laws often make it even more unappealing by limiting compensation and professional representation. But for those who are determined to start their own family, resources are available to help you get started.

The easiest way to find a surrogate (aka, gestational carrier) is to hire an agency. Surrogacy agencies specialize in finding and managing surrogate– it is their primary value and how they justify their exorbitant fees.

Agencies are expensive, but they provide all the required services, and the Intended Parents can stay mostly uninvolved in the process. The parent’s role will be to review surrogate profiles, and then give a thumbs-up or thumbs-down approval. Parents can be assured that surrogates provided by an agency will be fully qualified and meet the requirements of the clinic and the courts.

Your agency will have one or more reliable surrogate “recruiters” who will find one or more surrogacy candidates for you to consider. The agency recruiter not only will find your surrogate, but they will manage her medical and legal evaluation, negotiate her compensation, and manage the contract process. The recruiter will be an integral part of your surrogacy team (along with the clinic, the egg donor’s representative, and your own agent).

Surrogates are in short supply — so your recruiter will not provide a catalog of candidates to review (as with egg donors). Instead the coordinator will evaluate surrogates based on medical criteria and forward one candidate they think is suitable. The parents will then review the candidate and either approve/disapprove. If parents disapprove, the recruiter will move to the next most qualified candidate.

Find Your Surrogate with a Freelance Recruiter

A less-expensive way to find your surrogate is to hire a freelance recruiter. A freelance surrogate recruiter is not employed by an agency, but usually has agency experience. The recruiter will perform the same services as an agency recruiter, but you will pay her directly. The freelance surrogate recruiter does not require an agency fee, and so the total cost is far lower than a typical agency program.

A freelance recruiter’s role will end as soon as the surrogate is successfully matched. That includes the surrogate’s medical, legal and psychological evaluation. The recruiter may also negotiate the surrogate’s total pay and benefits package. But the recruiter’s job does not often continue through the contract drafting and signing (for that you will rely on a qualified surrogacy lawyer).

The recruiter’s role also will not include your surrogate’s clinic procedures, fertility treatments, embryo transfer, or the general tasks of getting pregnant. For this, you will want to hire a “Journey Coordinator” who will work hand-in-hand with your surrogate throughout all aspects of the pregnancy.

Find an Independent Surrogate

If you choose NOT to work with a surrogacy agent, you can find and manage your surrogate yourself. (This is called “Independent Surrogacy”.) There are many online communities where would-be parents and surrogates connect. Facebook is a particularly active platform with several surrogacy support groups. But manage your expectations– there are far more parents looking for surrogates than vice versa. Be prepared for a long wait, and make special efforts to “sell yourself” to surrogate candidates who are often approached by many parents.
There are two important Notes to consider:

Not every woman who wants to be a surrogate will qualify.

There is a long list of qualifications. Once you find your surrogate, she will go through a variety of evaluations — medical, psychological, legal, criminal. These should be done by objective service providers. Medical evaluation is usually done by the same IVF clinic that conceived the embryos and that will also perform the embryo transfer.

Not every surrogate will want to be an INDEPENDENT surrogate.

A professional agency provides a lot of services to the surrogate (not just to the Intended Parents). As the IP, you may choose an Indy program because it saves you money, but it may not be as appealing to the surrogate herself.

Without an agency (or a freelance journey coordinator), the surrogate has no professional resources to help her if the process become complicated. She must trust 100% in inexperienced Intended Parents to manage her medical treatments and care for her through the pregnancy. If the relationship with the IPs turns sour, the independent surrogate has no support or recourse other than legal action to help resolve disputes. For this reason, many surrogates will not agree to a 100% Independent program.

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Evaluating Your Surrogate

Many surrogate recruiters will have a short list of women ready to start a program – these candidates may or may not be suitable for your needs. When new Intended Parents request a surrogate, the agency may also begin recruiting more candidates. Parents often can give their own requirements at this point (most often her age, marital status, fertility history, education, etc.). Remember that every added requirement makes the search for your surrogate longer and more difficult.

More in-depth medical evaluations are done after a candidate is matched with a family. Would-be parents often must make a financial commitment before the final evaluations are performed.

• Psychiatric screening
• Fertility and OBGYN evaluation
• Blood/hormone analysis
• Criminal background check
• Insurance review (in the United States)
• Legal/ contracts review.

The steps above take approximately two months from start to finish. Sometimes a surrogate that has been matched to a couple does not pass the full evaluation. Failing a psych evaluation doesn’t mean your surrogate’s crazy, only that the doctor feels she may not fully realize the difficulties of letting go of the baby.) If that happens, the recruiter goes to the next suitable candidate.

While the surrogate is undergoing full evaluation, the parents can look for egg donors (if needed).

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Options for choosing an egg donor

Here is a short and useful article on choosing an egg donor. Your best options will depend on your personal preferences and cost. Searching for a donor can take weeks or longer — but it’s a good activity while you are evaluating your surrogate. Here are some options…

Choose a local egg donor through your IVF clinic.

If your clinic has a partner donation agency, this may be the least expensive option. Some U.S. clinics keep a donor database or partner with local donor agencies. The cost of a local donor in the U.S. is typically quite low because the donor will not need to travel. If the clinic has its own donor list, then you can avoid expensive donor agency fees.

Overseas surrogacy clinics will almost always have a local donor option. However the limitation is that overseas donors are always the ethnicity of the local population (Latina in Mexico for example). For some couples it is important their donor “look like their family”, often meaning a specific heritage. But if appearance is less important, a local donor is often an excellent option. Overseas donors are affordable because the cost of living is often much lower than in the US.

Choose an egg donor through an international donation agency.

International agencies have donors of almost any ethnicity. They also are generally the most thoroughly screened and evaluated donors available. The cost of a donor is high — about $14,000 to $20,000 USD. This cost includes her travel expenses to the clinic for stimulation and donation (which takes about 15 days).

Your agent should be able to introduce you personally to a few excellent donation agencies. They both should then work closely with you to facilitate the donation process. Part of your agent’s responsibility is to make sure you have an excellent egg donation, which will be critical for the success of your surrogacy program.

Have a friend or family member donate for you.

Not many people choose this route, but having a “known donor” can be very inexpensive. If you know someone who is willing to donate, she should first a series of basic fertility tests to ensure she’s fertile. She may then need to spend up to 16 days at the IVF clinic for the stimulation and donation process. (In some cases a portion of the stimulation process can be done at her local clinic, if she has a doctor to monitor her and consult with the IVF clinic’s doctor.)

Buy frozen eggs through an egg bank.

Egg banks keep eggs in frozen storage for sale at a later date. Parents can buy eggs in “packages” from 8 to 12, usually for about $10,000 for 10 eggs (more or less). Most egg banks will “guarantee” only one healthy embryo from an IVF cycle with 10 frozen eggs. That’s not a very convincing statistic. The likelihood of a pregnancy with one healthy embryo is quite small, and it’s common that parents who buy frozen eggs will need to return to the Egg Bank to buy more and repeat the IVF cycle. As we mentioned above, thaw rates of frozen eggs is often disappointing, and pregnancy rates with frozen eggs are lower than with fresh. For these reasons, we always recommend a live donor who will provide fresh eggs rather than buying frozen eggs (although there are some exceptions).

Regardless of where your donor comes from, the cost of your IVF and Surrogacy program is generally unchanged. Your clinic should include the cost of the donation procedure in the standard IVF package. You only need to pay for the compensation to your donor, the costs of her travel, and any fees to her representing agency.

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Find a Surrogate Overseas

To find a surrogate overseas is much simpler than locating and interviewing surrogates in the U.S. Legitimate surrogacy agencies are able to recruit surrogates, offering considerable incentives. Compensation that would be considered modest in the U.S. is often a substantial, life-changing amount in other countries. As a result there is no shortage of available candidates.

Depending on the country where you live, you may need to work with your agency to find a surrogate who is qualified and reliable. In Europe and North America, you would generally meet and interview her, and convince her to carry your child. In other countries (including Mexico and Colombia) your clinic or agency will have a list of available surrogates ready to start. Even so, we always recommend that Intended Parents meet and talk with their surrogate (even if only by video chat).

Once you have met and approved your surrogate candidate, the overseas clinic will prepare her, arrange for her treatments and prenatal care, and make all payments to her. Expenses such as reimbursement for lost income or clothing allowances are paid through her agency. Direct payments to your surrogate, even for out-of-pocket expenses, is very uncommon.

Find a Surrogate in Canada

In countries like Canada, where commercial surrogacy is illegal, agencies cannot find a surrogate through advertising, and they cannot offer compelling compensation. As a result there is typically a long, drawn out process by which your agent will search for surrogates by word-of-mouth and introduce candidates to you. According to the restrictions of Altruistic Surrogacy, the surrogate must offer her services to you, through the agent, essentially unsolicited. The job of your agent will be to introduce women who have chosen to become surrogates to Intended Parents who need surrogates. But because there are far more parents than there are surrogates, the wait can be long, and the surrogate has the freedom to choose among many parents vying for her service.

Find a Surrogate in the UK

In the United Kingdom, local law prohibits any business that profits from surrogacy services, so there are no agencies available to connect would-be parents and surrogates. Surrogacy UK and Childlessness Overcome Through Surrogacy (COTS) are non-profit online platforms to help couples find a surrogate. Couples post their desire for a surrogate, and interested women can peruse the listings for couples they would like to assist. The platform helps facilitate a meeting, and also offers advice on how to move forward on a surrogacy arrangement.

Also, UK law does not recognize surrogacy agreements as binding, so the surrogate and her husband (or legal partner) automatically will be the legal parents of the new-born. This can make intended parents nervous, and compounds the need to find a surrogate who is reliable and will not hesitate to hand the baby to its genetic parents.

Your search for a surrogate should start with a a reputable surrogacy agency. Most agencies work within a single overseas country (and with a single clinic). But you should look for an agent who works with multiple destinations and can advise which makes the most sense given your personal situation.

Choosing a Surrogate from Candidates

It’s typical that parents do not “choose” their surrogate. Where commercial surrogacy is legal, the surrogacy agency or clinic typically finds the surrogate and selects her on your behalf based strictly on medical criteria. Parents may have an option to approve the surrogate, but not select her from a list. Under Altruistic Surrogacy laws, it is generally the surrogate who chooses the parents, although parents may have the ability to interview and accept/reject a woman based on either medical or emotional criteria.

In any case, you will want to ensure your surrogacy agency or clinic finds a surrogate with the best chance of pregnancy and successful delivery. The criteria you should request include non-smoker, a healthy low-stress lifestyle, previous successful pregnancies, and good medical evaluation (including blood hormone levels and endometrial scan). In addition, although there is debate on the benefits, some agents also will prefer younger surrogates (in their 20s) or women who have had a recent pregnancy (in the past 3 to 4 years).

Once you find a surrogate, you will draw up and sign your surrogacy contract. Once signed, funds are generally provided to the surrogate for her expenses and fees, sometimes through a trust account. Most surrogacy agencies will be able to assist you with the legal contracts and payments.

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Treating Your Surrogate Ethically

The surrogacy relationship is a two-way agreement in which the surrogate agrees to care for the pregnancy, but also in which the Intended Parents agree to care for the surrogate. That means treating her ethically, respectfully, and with an appreciation for the service she is performing.

Ethical Surrogacy is focused on the dignity of the surrogate who will be so vital to every Intended Parent’s new family. Advocates of Ethical Surrogacy take special effort to ensure the complete physical and emotional well being of these important women.

We insist that every surrogate and donor receive excellent compensation. For many surrogates the experience is life-altering. We offer financial benefits and opportunities that many of these women could never realize otherwise.

Ethical Surrogacy also provides the surrogate with the best medical care during and after her pregnancy. Care is given through our partner IVF clinic as well as the surrogate’s own obstetrician or general practitioner. We believe the surrogate has a right to her privacy and autonomy (to the extent that the care of the pregnancy is not compromised).

But mostly, we believe “ethical surrogacy” is about building relationships. Unlike typical surrogacy agencies, we encourage the parents to be in regular contact with their surrogate at all stages of the journey. The parents and surrogate are partners, and each has equal obligations to the other.

Ethical Guidelines for Surrogates

We’ve read the reports of unscrupulous profiteers who exploit surrogate. Such practices are a threat to women and to reputable surrogacy agencies, which is why SENSIBLE is committed to the ethical treatment of our surrogates and donors.

SENSIBLE (and our affiliated partners) are proud to take a leading role in establishing Ethical Surrogacy Guidelines to ensure the well-being of your surrogate and donors.

‘Ethical Surrogacy’ includes a set of guidelines that ensure that the welfare of the surrogate is given fundamental importance. Among the components of Ethical Surrogacy:

• Providing the surrogate with independent legal and medical advice
• Providing excellent medical care during and after the pregnancy
• Providing emotional and psychological support throughout the journey
• Respecting the surrogate’s rights to privacy & autonomy
• Offering the excellent compensation, including supportive benefits.

We believe in the philosophy that ‘money is not everything’. Parents often find that Ethical Surrogacy options give them the satisfaction of knowing that they are able to bring a positive change in the lives of their Surrogate.