How do you start the surrogacy process?

Good morning Bill,
Thanks for all the help — especially the videos. Based on our research, my husband and I are ready to begin our journey… How do we start?
— Vincent

Hello Vincent,
I’m glad the videos have been helpful. I plan on making more of them — and I’m now posting them to our social media accounts as well. The video below answers your specific question.

Whether in Kiev or California, a reputable clinic will ask you to prove that you are Healthy, Fertile & Safe. Here’s what that means…

Medical Tests (To Show You’re Healthy)

The first step in your process is to show that you’re healthy. That generally means blood tests for basic infections that may be harmful to either the baby, the pregnancy or the surrogate. The United States has the most exhaustive set of medical tests of any country worldwide. The tests below comprise the standard “FDA Donor Screening Assay” which is the criteria for all tissue donations in the United States.

These tests will be performed by the clinic at the time of your donation — and if you test positive for any of them, the clinic will not accept your sperm sample. So it’s always smart to have the tests done in advance so that there are no surprises when you arrive at your clinic for sperm donation.

It’s also worth noting that if you conceive your embryos at an overseas clinic, you won’t be able to bring them into the U.S. unless this entire set of tests was performed at the time of the egg and sperm donation. The tests need to be performed by a registered FDA tissue facility… which are very rare overseas. So it’s nearly impossible to bring embryos conceived at an foreign IVF clinic into the United States without overcoming some complicated hurdles.
 

HIV: Human Immunodeficiency Virus
Anti-HIV-1/2 Assays Types 1 and 2

Hepatitis B

• HBsAg Assays – Hepatitis B Surface Antigen
• Anti-HBc Assays – Hepatitis B Virus Core Antigen
• HBV Nucleic Acid Assays – Hepatitis B Virus

Hepatitis C

• Anti-HCV Assays – Hepatitis C Virus Encoded Antigen
• HCV Nucleic Acid Assays – Hepatitis C Virus

HTLV

Anti-HTLV-I/II Assays – Human T-Lymphotropic Virus Types I and II

Other STDs

• Anti-T. Pallidum Assays – Treponema pallidum (Syphilis)
• Nucleic acid amplification tests – NAATs (Gonorrhea)
• Urethral swab, or urine for GC (Chlamydia)

Other Infections

• Zika Nucleic Acid assay (Zika)
• Anti-CMV Assays (Cytomegalovirus)
• WNV Nucleic Acid Assays (West Nile Virus)

Common Fertility Exams

Bot the egg and sperm donors need to show they are fertile, and that together they are capable of conceiving a baby. These tests can be done at any fertility clinic or hospital with a fertility department.

Male Fertility Screening (For the Donating Father) All sperm donors need to demonstrate that their sperm is capable of producing a child. ICSI techniques lessen the importance of sperm count, but sperm quality is still a strong indicator of overall fertility health.

• Standard semen analysis, including sperm count, motility and morphology.
• We also recommend a “sperm fragmentation” test for men over 45 years — this will show the sperm is genetically healthy and not just appears outwardly healthy.

Note: If your semen analysis is poor, the clinic may recommend some supplements to improve your chances. If your blood test shows positive for Hepatitis or HIV, sperm washing will be required for an additional charges. (The surrogate mother may also be entitled to additional compensation.)
 

Female Fertility Screening (For the Donating Mother) For couples donating their own eggs, the genetic mother will need a blood test on Day 2 of her natural cycle. Along with other basic information, the scans should include these specific hormone levels:

• LH Hormone
• FSH Hormone
• Estradiol
• AMH hormone levels.

Note: If the egg donor’s FSH level on day 2 is more than 10 and the AMH level is less than 1.0, you would not be considered a viable candidate for egg donation. In addition, the clinic normally requires a minimum of 6 visible follicles.

In most cases, a follicle ultrasound scan is also recommended to show “Ovarian Volume”, which is a visible count of the follicles available to be retrieved.
 

Background Check (To Ensure a Safe Home)

Many agencies will also ask Intended parents to provide a simple online background check through either BeenVerified.com or GoodHire.com. These services are quick and inexpensive, and a search of the sex offenders registry or felony convictions database will help us ensure potential surrogates that the IPs will be fit parents for the baby.
 

Counseling (To Help You Prepare for the Journey)

Finally, many clinics also ask Intended Parents to spend a short counseling session with a Therapist. This will help them know the parent is emotionally prepared for the journey ahead, and will give the IP an opportunity to voice any fears or concerns about the surrogacy journey (or being a parent in general).