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A PERFECT MATCH, INC.
A Perfect Match works with intended parents who need the help of a gestational surrogate in order to fulfill their dream of having a child. We believe it requires a very special type of woman to become a gestational surrogate and our goal is to make sure each of our surrogates is matched with a family and IVF center that will treat her with all the respect and care she truly deserves.
Surrogacy Information
We are pleased that you have expressed an interest in helping intended parents through gestational surrogacy. Please keep in mind that this general information is provided only to help you understand the procedures involved for surrogacy and is based on the protocols we have experienced through the gestational surrogacy cycles we have coordinated with IVF centers, but the exact protocol, procedures, medications and timeline for any surrogacy cycle you do may be modified by the physician chosen by your intended parents. If after reading this explanation of the surrogacy process you are interested in becoming a surrogate for A Perfect Match, please e-mail your positive response to Rose@aperfectmatch.com or Darlene@aperfectmatch.com or phone at 1-800-264-8828.
Definitions of surrogate types:
Gestational Surrogacy:
Involves an egg donor or intended mother, a sperm donor or intended father, and a gestational surrogate. Through the process of in vitro fertilization, eggs provided by an intended mother or egg donor are fertilized with the sperm of the intended father or sperm donor. The resulting embryos are then transferred to the gestational surrogate who carries and gives birth to the child.
Traditional Surrogacy:
Involves a surrogate mother who, using her own eggs, is artifically inseminated with the semen of the prospective father. She then carries and gives birth to the child. Some traditional surrogates may also go through the in vitro fertilization process as an egg donor then, after the eggs are harvested and fertilized, the embryos are transferred back into the surrogates uterus. She then carries and gives birth to the child. APM does not work with Traditional Surrogates at this time because we feel the laws are not protective enough of the intended parents.
What to Expect
The first step in the gestational surrogacy process is the recruitment of a surrogate who is between the age of 21-38. We are looking for women who live in a stable home environment, who are physically and psychologically healthy, within the healthy BMI used by the majority of IVF centers, no criminal background and aren't receiving financial assistance from the government. Most importanly, however, we are seeking women who have a sincere desire to help intended parents become actual parents through their generous offer to become a gestational surrogate. Please read the more completed recruitment criteria for gestational surrogates
All candidates who pass our initial phone or in person screening will be asked to fill out a profile and to send photos. Our office will assign a number to your profile and that is the way you will be identified to all potential recipients until you are officially matched. At no time will any identifying information be given to an intended parent without your permission unless you enter into an agreement with the intended parents. A phone conference between the surrogate and intended parents is mandatory in our program and will be arranged by our office once you and the intended parent fill out and sign our paperwork. A personal meeting between the parties is also generally a part of the process, but will not occur until after the phone conversation when all parties agree they would like to work together and desire to meet in person.
Once a surrogate is chosen by a family, she will be asked to have physical, psychological and infectious disease screening. There will be no cost to the surrogate for these screening. Our surrogates are primarily located in southern California, but our intended parents are located throughout the U.S. and the world. Most surrogates will work with an IVF center in CA, however, some may be required to travel to the location of the clinic chosen by the intended parents. If required to travel outside of the surrogate's home area all expenses will be paid for by the intended parents. These expenses will include flights, hotel, meals, etc. Many of the screenings can be performed in the surrogate's home area and the results will be forwarded to the physician who will be performing the embryo transfer.
Click here to read the article "Motivations of Surrogate Mothers".
Screening
Please do not get any tattoos, or body piercings once you apply to the program because the state of California requires a surrogate to wait 6-12 months after having any body piercing and 1 year from receiving a tattoo before she can act as a surrogate. This is due to the increased risk of infectious diseases.
Potential surrogates are carefully screened and must pass a number of tests as required by our program, by the State of California, by the FDA as well as those required by the primary IVF physician involved with the surrogacy cycle. These tests may be performed at a location that is convenient to the surrogate's home unless the IVF center requires that they only be performed at the actual IVF center that will be in charge of the surrogacy cycle.
Home Visit
A home visit is mandatory in our program, performed by A Perfect Match staff member, and is completed after the surrogate's initial profile and medical records have been approved. We are not going to eliminate anyone who doesn't have a beautiful home or a spotless home, rather the home visit is conducted in order to give us the opportunity to meet the surrogate's entire family, give everyone an opportunity to ask further questions, plus make sure our surrogates live in a clean and safe environment...perfection is not required! The visit takes approximately 1/2 hour or longer if the surrogate and her family have additional questions about A Perfect Match or the surrogacy process and has been viewed by our surrogates as a positive experience and a wonderful opportunity to get to know us.
Background screening
This screening is required on all of our surrogates as well as on her spouse, partner or significant other. Every surrogate will be asked to sign a release and provide background information so we are able to receive a copy of this report.
Psychological Screening
The screening is performed by a Psychologist who specializes in working with surrogates and infertile families. The screening is to ensure that a surrogate fully understands the emotional ramifications of surrogacy. An MMPI or other type of personality assessment will be administered at that time as well as a personal consult with the Psychologist. The Psychologist will provide a written report and a recommendation regarding the ability of the surrogate to perform the duties of a surrogate.
Medical Screening
The medical screening is performed to ensure that the surrogate is physically capable of undergoing the surrogacy process. She will also be tested for sexually transmitted or other transmissible diseases which will include: HIV, HTLV-1 & 2, Hepatitis B & C An ultrasound and vaginal cultures will also be required. *The sexual partner of the surrogate MUST be screened for sexually transmitted diseases.*There is a very strong possibility of a urine screening or hair follicle testing for drugs.
If the surrogate is not already taking oral contraceptives, she may receive a prescription for birth control. These are given to help regulate the surrogate's cycle and will allow the physician to coordinate her cycle with that of the egg donor or intended parent. You may be asked to start birth control prior to having the contract signed so that an IVF center can begin to synchronize the cycles of the surrogate with that of the intended mother/donor.
Legal Contract
Once matched, surrogates will receive a referral list of attorneys who specialize in Surrogacy Law. She will be asked to select an attorney. She will have the option to choose "Joint Representation" by National Fertility Law Center, or she may decide she prefers "Separate Representation". Should a surrogate choose separate representation she will be provided with a list of attorneys who specialize in third-party reproductive law. The surrogate's attorney's fee will be paid for by the intended parents. Surrogates will enter into a contract with the intended parents and this legally binding contract should not be entered into lightly. The contract will cover issues such as compensation, legal obligations of the surrogate, conduct, relinquishment of the child, etc. If separate representation is chosen, the intended parents' attorney is called the drafting attorney; and the surrogate's attorney is called the reviewing attorney.
The drafting attorney will send a contract to the reviewing attorney. The reviewing attorney is responsible for getting a copy of the contract to the surrogate Once she has had opportunity to read the contract she will be asked to have a conference, either in person or by phone, with the attorney to discuss any changes she feels don't reflect what she previously agreed to. The surrogate's attorney will relay these requests to the intended parents attorney. Once a contract is decided upon all parties will be required to sign. Medications cannot begin until all parties have signed the contract. A letter will be sent to the IVF physician by the drafting attorney to notify them that we have received legal clearance and the cycle can begin.
Compensation
- First-time surrogates receive a base fee of $25,000 plus additional money for expenses which will include, but are not limited to, maternity clothing allowance, multiple fetuses fee, invasive procedure fee, housekeeping allowance, lost wages and monthly support group attendance fee.
- Repeat surrogates receive a base fee of approximately $30-35,000 or higher, plus additional money for expenses as listed above.
Compensation is generally paid monthly throughout the pregnancy. The amount of $500.00 will be paid to the surrogate by our office through priority mail once we receive confirmation that she began Lupron or any other injectable medication. The second installment is $500.00 paid on the day of embryo transfer. The balance of the agreed upon compensation is usually paid in monthy installments once the surrogate is confirmed pregnant with a fetal heartbeat by ultrasound.
Click here to view a sample of the surrogate's full compensation package.
Sexual Activity
Each IVF center will have its own protocol and restrictions for sexual activity. At most centers, Surrogates must refrain from sexual intercourse once injectable medications begin. You will be extremely fertile during this time and they do not want to have the surrogate become pregnant before she is able to have the embryo transfer. The surrogate will be asked to either abstain from sexual relations entirely or to use a combination of effective barriers prior to starting any of the injectable medications and to completely abstain from the beginning of medications until cleared by the primary IVF physician. This can range from three weeks, to three months, to the end of your pregnancy depending on the status of the pregnancy and the orders of the physician. Surrogates will also be asked to curtail any heavy exercising during the medication stage and possibly throughout the pregnancy if there is difficulty with the pregnancy. This will also be determined by the primary IVF physician.
IVF center (primary physician)
A Perfect Match does not choose the professionals involved with the surrogacy process. We facilitate by acting as the liaison between the prospective parents, the surrogate, and the professionals performing the procedures and screening. Our job will be to act as a support team for the surrogate throughout the pregnancy, as well as to coordinate the entire surrogacy process from screening through birth
All medical professionals are chosen by the prospective parents, not the agency or the surrogate. We do, however, encourage our surrogates to investigate the medical service provider chosen by the parents and satisfy themselves as to their professionalism and expertise. We will give you the contact information for that center so you may speak with the doctor directly. If you are uncomfortable with that center for any reason, we ask that you notify us immediately.
Medications
THERE ARE POTENTIAL RISKS INHERENT WITH ALL ASPECTS OF THE SURROGACY MEDICAL PROCESS AND PROCEDURES, INCLUDING TAKING ANY MEDICATION. IT IS THE SOLE RESPONSIBILITY OF THE SURROGATE TO INVESTIGATE ALL SUCH RISKS AND TO DISCUSS ALL MEDICAL ISSUES WITH THE PRIMARY PHYSICIAN
On day 21 of her cycle a surrogate will begin the first of her medications. A medication called Lupron is a daily subcutaneous injection. (It sounds worse than it is!) This needle is a tiny, 2-inch insulin type needle. It can be given in the upper outer thigh, lower stomach, or upper outer arm. A health care professional will teach the surrogate how to administer this to herself. Lupron is not a fertility medication, Lupron down regulates your cycle so that a woman will not ovulate. It is administered for 14-21 days. Side effects may include, but are not limited to, hot flashes, fatigue, and headaches.A different form of suppression medication is used by some IVF centers and is given as a one time injection. The surrogate will have a flow within a week to ten days. A vaginal ultrasound will be performed to make sure the ovaries are quiet.
Once the surrogate and intended parent, or egg donor all have their flows the next injectable medication will be administered for endometrial stimulation. Some surrogates have complaints of hot flushes, moodiness and headaches We have found that if surrogates lead active lives they generally have fewer complaints and many have no complaints at all.
Estradiol/Delestrogen/Estrogen is a medication that is used to thicken the endometrial lining to prepare for the implantation process. This medication is administered twice weekly beginning approximately two weeks prior to embryo transfer and is continued for approximately 10 weeks after embryo transfer depending on your physician's protocol. This hormone can be taken in a number of forms: oral tablets, injection, or adhesive patch, but most IVF physicians use the injection form. Side effects may include, but are not limited to, weight gain and headaches. Each surrogate will receive further instructions on how to administer these injections by the physician's office.
During the endometrial stimulation phase surrogates will be required to have a blood test and ultrasound performed on day 7 or as directed by the physician Some centers will require the surrogate to have their day 7 ultrasound at their center only. Other centers allow the surrogate to remain in their home area until the day of embryo transfer. Until a center is chosen by the family we will not know the exact protocol the surrogate will be asked to follow, but she will be informed as quickly as possible.
The blood tests and ultrasounds will help the physician determine the thickness of the surrogate's endometrial lining. These tests are generally done between 7-9 am so the primary physician will receive the results same day. Once the endometrial lining is at the appropriate thickness and the intended parent, or egg donor are ready to have the egg retrieval the surrogate will be required to start some form of Progesterone to assist with and sustain implantation and pregnancy. Progesterone is a hormone we normally produce in our ovaries, but in a surrogacy the addition of supplemental Progesterone is essential to convince the body it is pregnant until the body produces this hormone on its own. The form of Progesterone may be in an oil-based, intramuscular injection form or vaginal suppository per the physician's orders. This medication begins approximately one week prior to the embryo transfer and is continued for approximately 10 weeks after embryo transfer. Side effects may include, but are not limited to, fatigue, breast tenderness and mild uterine cramping.
All these medications are extremely important and MUST be taken as instructed by the physician, or otherwise there is a risk of comprising the IVF cycle, having a miscarriage and being in breach of contract. Most IVF centers offer an injection teaching class.
Procedure
The embryo transfer procedure will be performed 2-5 days after the donor or intended parents eggs have been harvested and fertilized. Embryo transfers usually take approximately 30 minutes. Prior to the transfer the surrogate may receive a medication in pill form to help you relax. The embryo transfer is performed with a very fine catheter that is inserted vaginally into the uterus through the cervix. Surrogates will be required to stay and rest in the IVF center for approximately 1 hour following the transfer procedure. Each surrogate will be required to have someone available to drive her home or she may also be required to stay in a nearby hotel for a bedrest period of time as specified by the physician, which is usually between 24-72 hours.
If the surrogate is required to fly for the procedure, she may be required to stay through the period specified for bedrest. This decision will be made by the physician and intended parents. All expenses will be covered by the intended parents.
Following the embryo transfer the surrogate's activity may be restricted. These restrictions will be determined by the physician and intended parents.
Pregnancy
Each surrogate will have a pregnancy test 9-14 days following the embryo transfer. The exact date will be determined by the IVF center, and this date is dependent on how old the embryos where when they were transferred. Some IVF centers will transfer day 2 embryos (2 days post egg retrieval), in which case the pregnancy test will be 12-14 days after transfer. If PGD was performed on the embryos or the decision to grow embryos to blastocyst stage was made, then the embryos will be 5-6 days post retrieval, in which case the pregnancy test could be as soon as 8-9 days after transfer to the surrogate.
If the pregnancy test is positive, then the surrogate will be required to have an additional test two days later to make sure that the beta level doubles as this is an indication of a solid pregnancy.
An ultrasound will be scheduled for two weeks after the 2nd positive pregnancy test, and this will not only show a heartbeat of the fetus, but it will also show how many fetuses there are!
The surrogate will continue with ultrasounds every two weeks until she "graduates" from the IVF care and is seen by an OB/GYN local to her, but chosen by the intended parents. She will continue her care as directed by the OB for the rest of the pregnancy until birth.
Things to Consider
It is very important that you consider the following before you commit to any family. You want to make sure that your expectations should match exactly with those of the intended parents. The matching of expectations will provide a strong basis for your relationship with the intended parents throughout the surrogacy process because you know you and your intended parents agree on the most important aspects of the surrogacy:
Surrogacy really does require a large level of caring and commitment on the part of the surrogate and everyone will be counting on her to do all she can to make the cycle a success. For the surrogate the benefit will be financial compensation, plus the satisfaction of knowing she tried to help someone who might otherwise not be able to have a child. The gift a surrogate offers is beyond measure and we know there is nothing more satisfactory than when the surrogate delivers a beautiful, healthy baby and places that baby in the arms of the waiting parents.
We are deeply committed to each and every surrogacy match and we will do everything in our power to make this a positive experience for the surrogate and the family. We treat our surrogates with respect and we develop a close, caring and supportive relationship with each one of our surrogates and that relationship continues long after the cycle is completed. We really believe the surrogates from APM as the best!
If after reading this explanation of the surrogacy process you are interested in becoming a surrogate for A Perfect Match, please e-mail your positive response to Rose@aperfectmatch.com or Darlene@aperfectmatch.com or phone at 1-800-264-8828.
