Surrogacy is a long process before you ever even get to the pregnancy part. This is one of the first things I learned upon embarking on the process!
Since we are still on the road and have no substantive update to offer yet, I thought I would offer some insight into the early part of the process that leads up to the embryo transfer, pregnancy, and birth.
When we first started exploring surrogacy, I was added to some Facebook groups about it and quite honestly, my first response was complete overwhelm as I read through the posts and learned that many couples have multiple failed matches before getting a chance to proceed. It seems so unfair that the matching process would take so long and be so unpredictable, when there's already so much uncertainty in the process. The embryo transfer may fail or a miscarriage might happen... and now we have to worry about having several matches fall through as well?!
I had to go back to the Facebook groups in small doses because I would end up in tears each time over the stories I would see posted there, and the unfairness of it all—that the people writing the posts, who wanted children so badly, would have such a long and thorny path to parenthood with so many disappointments.
But with time, in addition to the venting and requests for support, the happy stories started to stand out—people whose baby had just been born, or who had just gotten the first ultrasound image, after many years of waiting, hoping, and praying to get to this point! I began to see that sometimes it does work out.
The infertility journey we've been on these last six years has been a process of grieving one thing after another, starting with letting go of the notion of anything about growing our family being easy. For reasons I've discussed in other posts, I do feel like this is the right path for us, and I feel like we've been guided down it one step at a time and given just as much as we can handle at any one time. Quite honestly, the process has been extremely time-consuming and emotionally exhausting. I just try to stay focused on the fact that it will be bringing us the greatest joy of our lives! (I'm purposely not going into detail about where we are in the matching process out of respect for the privacy of the other people involved, so I'll just say that we are still working on getting to a successful match so we can proceed with an embryo transfer.)
In my last post, I wrote about how we had to make peace with the significant amount of money surrogacy costs (something we're still working on). In this one, I thought I'd go over what questions we've had to discuss, as a couple and with our potential surrogate. If you know someone who's considering surrogacy, you may want to share this post with them; part of the reason I'm writing it is that I had a hard time finding concise, clear information about how the process works.
One silver lining of this journey has been that it's forced Sean and me to have some deep conversations about difficult subjects. This has drawn us closer as each of us seeks to understand where the other one is coming from on topics where we disagree.
If you are thinking about surrogacy, it's important to discuss these questions with your partner (that is, unless you're a single parent, of course) so you can get on the same page before you attempt to discuss them with a surrogate for the purpose of negotiating a contract.
How many embryos do you want to transfer at once? Would you be OK with twins? What about triplets if you transfer two embryos, both survive, and one of them splits?
Exactly which tests do you want to have performed during the pregnancy, and using what method or technology? Since I was over age 35 when my eggs were harvested, there's a different set of recommendations for me than would apply for younger mothers, and even that has changed quite a bit in recent years with technological advancements and new types of tests becoming available.
Do you want a hospital birth or a home birth? Induction or no? Epidural or no?
Under what circumstances would you want to terminate a pregnancy? Never? If the mother's life was in danger? If the condition were such that the baby could not survive outside the womb? In the case of a disability that would require lifelong care?
The questions in this last bullet are ones nobody wants to think about. I'd venture to guess that many of us have not even talked about them with our spouses before getting married or deciding to have children. We put it off, figuring why bother when it's extremely unlikely we'll find ourselves in that situation, and if God forbid we do find ourselves there one day, there's no telling how we'll feel at that time. These are the type of decisions that are very hard to make as a hypothetical, but suddenly it needs to be specified in a legal contract, and agreed up on by both the intended parents (Sean and me) and the gestational carrier (surrogate).
It's been an interesting exercise discussing all of these questions with Sean. I can't say we've agreed on everything, but for most of the questions we've been able to find common ground because one person's preferences were less strongly felt than the other's. (In other words, he's come to my side on some questions and I've gone to his on others.)
Add to all of these questions, the specifics of the particular person you're dealing with as your potential surrogate. The agencies that conduct matching accept only the lowest-risk candidates, because they want to maximize the chances of a successful outcome. But when you go outside of the matching system and work with someone you know, during the screening process you may find out something about her situation or her history that's less than ideal. At that point it's up to you to decide whether you want to proceed and take your chances. Does the value of working with someone you already know and trust, who is healthy and has a history of healthy pregnancies and deliveries, outweigh the fact that there might be one or two factors that prevent her from looking perfect on paper?
I don't mean to make this whole process sound prohibitively difficult, but I think people need to go in with eyes open, knowing that nothing about it will be fast, easy, or inexpensive. Better to start out with realistic expectations, right?
If the above list of questions seems overwhelming, I would highly recommend working with an agency. They will actually handle all of the communication with potential surrogates—for a fee, of course, but it may be worth it to ease the discomfort of discussing intensely personal topics with an acquaintance or complete stranger. We are working with IARC and they have been doing such an incredible job of handling things diplomatically and heading off potential misunderstandings.
To anyone reading this who is exploring surrogacy yourself—you are brave and you can do this. Lean on the supportive family and friends around you. (And reach out to me so I can get you added into the Facebook group if you like! You'll see both positive and negative stories, as stated above, but the group members are super supportive and understanding.)
If you're not involved with surrogacy yourself, and just reading this out of interest—if anyone in your life has gone through this process (either as a parent or as a surrogate), know they are a warrior!
And if you don't think you know anyone who has been involved with surrogacy... don't be so sure. From what I've observed in the Facebook group, most people keep the decision private, and only those closest to them know. Babies born through surrogacy number about 1 in 10,000 in the United States. People you work with or attend church with may have used a surrogate. Your child may have a school classmate who was born using a surrogate.
Be kind, and remember that comments like "Not everyone is meant to have children" aren't helpful things to say to someone who desperately wants a family. In your mind, the difficulties inherent in surrogacy may look like a "sign" that the person should stop trying so hard, but I think the thousands of people (in the U.S. alone) who have successfully become parents through surrogacy would probably disagree with the idea that they weren't meant to be parents.