Chapter 3: Choosing Your Surrogacy Agency

The quality of surrogacy agencies varies widely. It’s important to thoroughly research and interview your surrogacy agency before making a decision.

Surrogacy agencies are not strictly regulated or accredited by the federal government, meaning quality and experience can vary widely. So it’s very important to do your homework before signing up. You can choose to forgo an agency completely, as there is no requirement that you work with an agency — this type of a journey, conducted without the support of an agency, is known as “independent surrogacy.” In this instance, you will be responsible for building your entire surrogacy team — including finding your own surrogate.

“It is certainly an opportunity to save a little bit of money, but it also introduces a meaningful amount of risk into the process,” said Sam Hyde, President and CEO of Circle Surrogacy. “You will be lacking the support of professionals who have done hundreds or maybe thousands of these journeys and know how to handle a variety of issues that can arise — and issues always arise.”

Experienced agencies will assign you a case manager, who will be your main point of contact throughout your entire journey. “This is someone you can go to at any time if you have questions or need support,” said Stephanie Scott, Co-Owner and Director of the Executive Program, Finance and Legal at Simple Surrogacy.

Before we go into some tips for how to interview surrogacy agencies and make your decision, let’s first review the services that most reputable agencies should be providing you with throughout your journey: 

Insurance support

Obtaining proper insurance to cover your surrogate and egg donor is vital to a successful journey, and your surrogacy agency should help facilitate that process. In some instances, your surrogate’s own insurance will cover her pregnancy, but not always. “We’re seeing more insurance providers create exclusions for surrogates to prohibit them from using their own insurance to carry a baby for intended parents,” said Kristen Hanson, Co-Owner and Director of Finance and Legal at Simple Surrogacy. In these instances, your surrogacy agency will help facilitate the process of obtaining insurance to cover your surrogate’s maternity care, and any potential medical complications that arise. You will also need a special form of insurance for your egg donor, as insurance companies do not cover the egg donation process.

Finding surrogates

Surrogacy agencies will take on the task of finding and matching you with a gestational carrier. The more established agencies dedicate considerable resources to finding and screening qualified applicants. This is important, as maintaining a high number of qualified surrogates is important in the matching process. “Really only 3 to 5% of applicants make it through the screening process,” said Victoria T. Ferrara, Founder and Legal Director of Worldwide Surrogacy Specialists. “So it’s important to keep a steady inflow of high quality applicants.”

Screening surrogates

Surrogate applicants will undergo multiple interviews, and rigorous health screening. This will involve a review of her prior medical history, a physical exam, a pap smear, comprehensive sextually transmitted infections (STI) testing, urine drug and toxicology testing, and a uterine cavity evaluation in consideration of their being considered for surrogacy. This screening process will also include comprehensive psychological testing that will examine her mental health, motivations for wanting to become a surrogate, the support system available to her, financial stability, her communication style and more. Her partner, if she has one, is also included in this screening process.

Matching surrogates and intended parents

Many of the more reputable agencies will pre-screen your surrogate, so by the time you are shown her profile, you can be confident in her qualifications. This screening involves essential things like a background check and health and psychological evaluations. “But there are a myriad of things that go into good, rigorous screening of a surrogate,” said Ferrara of Worldwide Surrogacy.  Your agency should take the time to get to know the personalities of their surrogates and intended parents to ensure any suggested match is a good fit. “This will be the most important relationship you have in your journey, so it’s essential that you feel good about the match on multiple levels.”

Legal services

Your agency should facilitate the process of helping you find a highly qualified reproductive attorney who is knowledgeable about the laws regarding surrogacy in your states. Your lawyer will also help you develop a detailed contract with your surrogate. “That agreement will guide a lot of the ins and outs of the journey, like who will be at the appointments, what to do in case of a termination, in the event of any other medical issues,” said Hyde of Circle Surrogacy. “You need to think through all these options before you start, so in case any of these eventualities occur you have a document to guide you.” Some agencies will refer you to outside lawyers to help facilitate this part of the process, while others have lawyers in-house.

Mental health services

Your agency should provide you and your surrogate with the aid of mental health professionals whenever needed throughout the process. “It can be a stressful process,” said Ferrara of Worldwide Surrogacy. “Not everything always goes wonderfully.” Some of the more stressful points throughout your journey that could possibly arise include a failed embryo transfer, a miscarriage, or a second surrogate if a complication arises with your initial carrier. “You want to have the right support and the right people to help you navigate these hurdles if you encounter them.”

Escrow management

Your surrogacy agency will connect you with an escrow management company, that will be responsible for handling compensation and expenses for your surrogate and donor. Some agencies even have their own escrow team in-house who will manage your funds on your behalf. “During this process, your surrogate is going to have medical bills for prenatal care and delivery,” said Scott of Simple Surrogacy. “Any time those are sent in, they’ll be paid directly from escrow to the companies that provided services for your surrogate.”

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Tips for choosing a surrogacy agency

 Here are some things to consider when making your decision:

Track record of success: As more people turn to gestational surrogacy, new surrogacy agencies have appeared all over the world. Though the United States is home to the longest standing and most established surrogacy programs, the industry is also very loosely regulated, meaning the quality of agencies can vary widely. Make sure your agency has a track record of successful journeys. Ask for evidence of this success: how long have they been in business? How many successful journeys have they completed? What has been the experience of past intended parents and surrogates? What percentage of the agency’s past clients have gone home with a baby? Unfortunately, there are many agencies who have success rates as low as 60-70%. Ask for references, and to speak to previous clients.

Team of staff: Making a proper match between intended parents and a surrogate and egg donors requires a thorough understanding of intersecting laws and policy. Make sure that your agency has a trusted legal team to refer you to that can guide you appropriately through the legal process. Finding an agency with staff members who have personal connections to surrogacy and egg donation can also provide a sense of comfort as they can identify with every step of the journey and help guide you through the process.

Communication Style: Continuous communication is an important part of a successful experience. Be sure that your agency places emphasis on communication between you, your surrogate and your egg donor. Ask who will be your main point of contact throughout the process, and what that communication will look like throughout.

History working with the LGBTQ community: You will want to make sure your agency is not only inclusive of the LGBTQ community, but has a long track record of helping gay, bi and trans men become fathers through surrogacy. Again, ask for evidence of this history: ask your agency how many of their previous clients have been gay, bi or trans men. Look for inclusive language and imagery on their websites, such as photos of same-sex parents, and content targeting the LGBTQ. Ask if you can specifically speak with previous LGBTQ clients of the agency.

Get Answers.  Surrogacy FAQs

CONGRATULATIONS!  You've completed Chapter 3: Choosing Your Surrogacy Agency.  

NEXT UP:  Chapter 4 - Chapter 4: Choosing Your Fertility Clinic

Or, contact one of the experts interviewed for this article:

Sam Hyde of Circle Surrogacy & Egg Donation

Stephanie Scott of Simple Surrogacy

Kristen Hanson of Simple Surrogacy

Victoria T. Ferrara of Worldwide Surrogacy Specialists

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