Have questions about the US surrogacy process? CSP answers them This step-by-step guide from the Center for Surrogate Parenting can tell you about the US surrogacy process. It gives an interesting insight into the process and how it all works. The first thing to do is visit creatingfamilies.com and click on the ‘PARENTS APPLY’ button. The information requested is minimal, but necessary to answer your questions. It provides data about your attempts to create a family including your IVF history, medical necessity for surrogacy, doctor contact (if any) and whether you have embryos. We also require basic contact information such as your names and Skype addresses. This information is confidential and we do not share it with any entities outside of the CSP surrogacy program. The consultation at CSP You will receive introductory information about CSP, the program and the case manager for your area. You can contact your case manager to ask questions and schedule a consultation. We can conduct consultations at our offices in California or Maryland, or via Skype for your convenience. They include at least hours with your case manager, an intake with an independent psychological counselor and a meeting with an independent legal professional. Your case manager will discuss the US surrogacy process, estimated costs and CSP’s role. CSP works with psychological counselors universally recognized as the most experienced and knowledgeable in this field. Since our matching is psychologically based, the counselor will get to know you from a psychological perspective. He or she will also discuss your expectations for the relationship with your surrogate mother, your position on certain sensitive topics and what brought you to surrogacy. The legal professional will discuss the various factors which might have a legal affect upon your journey as well as surrogacy contracts, the finalization of your parental rights and insurance matters. Sign retainers and send deposits as the next step of the US surrogacy process If you are comfortable with our program, you would request to retain our services. We will send all necessary documents via email. Upon receipt of your signed agreement and the appropriate fees, you will get access to our online portal where you can create your profile, update your application, complete forms, review important information and view surrogate mother profiles. If necessary, find egg donor and create embryos Some people come to CSP having already worked with a fertility doctor and have embryos created. Some are in the process of creating their embryos. Others are new to the entire US surrogacy process, in which case we can help you find a fertility clinic and egg donor agency. Complete a profile letter Your profile is your chance to share your story with potential surrogates. The more open you are, the more likely there will be a connection. CSP will provide you with guidelines and topics to cover. Write your letter as if you are writing to a friend. Include family and relationship history, details about your career and hobbies, and what led you to surrogacy. Most importantly, say who you are going to be as parents and what a surrogate should expect out of the relationship during the US surrogacy process and after the birth. It should be a true reflection of yourselves and your relationship, accompanied by photos. The legal and matching process You should retain your attorney and review a contract. The surrogacy contract sets out the expectations and legalities for all parties involved. It is a detailed document, which we should review thoroughly. It includes the compensation schedule and expenses which will be reimbursed. At CSP, surrogate mothers choose the IP’s they would like to help. As our surrogate mothers are completing the screening process, the counseling team, will send profiles of intended parents who are a good match. The surrogate mother will choose from the profiles she receives. If she picks you, we will send her information to you, and if you pick her, you can speak with the psychological counselor who screened and cleared her. If you are comfortable, you move on to the next step of meeting your surrogate. The match meeting of the US surrogacy process You will first meet your chosen surrogate mother and her partner via Skype. If everyone agrees to move forward, CSP will assist you and your surrogate mother in completing the medical clearance with your doctor. At this time, you will begin the legal contract process as well. Sign Tentative Match Agreement (TMA) and fund Trust Account with initial deposit The TMA insures that the candidate presented to you will not be presented to any other intended parents. It also gives approval for your chosen SM to complete her medical screening and to reimburse her for any expenses related to this visit. The TMA also provides payment to the counselor for her professional time in screening your surrogate mother and assisting in the matching process. The Trust Account is the account out of which all your SM’s expenses (travel reimbursement, lost wages, compensation etc.) are paid. Medical clearance and completing medical contracts Your surrogate will be screened by the fertility doctor with whom you are working. This initial appointment may include blood tests, as well as an ultrasound, or other mid-cycle exams to check her uterine cavity to make sure there are no fibroids, polyps, or scar tissue. Your surrogate mother cannot take any medication in preparation for the embryo transfer until your case receives legal clearance. This means that all parties sign the legal contract after consulting with their attorneys. When the legal contract phase is complete, the attorney will provide CSP with a legal clearance letter which is then forwarded to your doctor. This allows them to proceed with the medical process. Fund the balance due to your Trust Account and the medical process begins Your surrogate mother cannot take any medication in preparation for the embryo transfer until your trust account is full funded. CSP requires the full amount to ensure that there will always be funds in your account to cover your surrogacy journey. This reduces your liability and provides assurance to your surrogate mother. As soon as the doctor’s office receives the legal clearance letter, the nurse can issue a calendar for the embryo transfer. The calendar provides instructions for the medication and potential embryo transfer dates. The SM has medication to prevent ovulation and prepare her uterine lining to receive the embryo. You would have set up a billing account for your surrogate at your clinic at the TMA phase as you are directly responsible for any and all bills incurred at your fertility doctor’s office. In-person match meeting CSP requires that you meet your surrogate mother in person prior to the first embryo transfer. This can take place at CSP’s offices or an alternative location that works for both parties. CSP and the counselor will facilitate this meeting and guide you through some topics that should be addressed. You will then be given time alone with your surrogate mother to get to know each other. IVF transfer and release to OB after pregnancy confirmation The transfer will take place at your fertility clinic. Any remaining embryos may be frozen for later use. About ten to 15 days after the transfer, the SM will do a pregnancy blood test, commonly known as a Beta, which measures the level of hCG hormone present in the SM’s blood. Doctors are looking for this figure to double every 48 hours in the early stages of pregnancy. After the six to eight week ultrasound, your surrogate mother will be under the care of her own OB. This is usually the doctor who has delivered her own children and is covered by her insurance. For the remainder of the pregnancy CSP, the counselors and attorneys are there to support and guide both parties. You should communicate regularly with your surrogate mother and your counselor. Our goal is to keep you as involved in the pregnancy as possible. Your counselor is there to help ensure a great relationship with your surrogate mother and will assist you in coordinating many necessary aspects of the surrogacy process. CSP is here to take care of any financial matters as we know this can be a sensitive area and do not want it to affect your relationship with your surrogate. Your case manager will continue to oversee your surrogacy journey and provide help and guidance. Mid-pregnancy visit As part of the US surrogacy process, plan to visit with your surrogate mother and her family around 20 weeks of pregnancy. Your surrogate mother will schedule an appointment with her OB so you can meet the delivering doctor, have an ultrasound, and tour the hospital. The visit also provides the opportunity for you to research local accommodations for when you arrive for the birth of your baby. Second trimester: Finalize legal aspects and research newborn insurance The actual steps you will have to take to finalize your parental rights will be based on where your surrogate mother lives. In some cases, it may also be necessary to retain the services of a local attorney in the state where your surrogate mother lives. Your attorney can advise you about medical insurance for your newborn. Once your child is born, you are responsible for any and all medical expenses incurred by your child. Your surrogate mother’s medical insurance will not cover the medical expenses incurred by your baby after birth. At this time, if you live overseas, you will also want to ensure that passport requirements will be met. Delivery and welcoming the baby This is what it’s all about – the moment you have been waiting for. Many surrogate mothers are happy for their intended parents to be in the delivery room. They have looked forward to this beautiful moment of seeing you become parents for a long time. We advise IP’s to travel to the SM’s location at least a week before the due date as we want you to be present when your child enters the world. When the baby has been medically cleared, you can leave the hospital. Your counselor will advise you to have a ‘goodbye’ meeting outside of the hospital with your surrogate and her family. However, this is often a continuation of a friendship for many years, built on the foundations of something truly wonderful. Child issued with US birth certificate, passport and SSN Your attorney will assist you in obtaining these documents. International IP’s will also need to look in to registering their child in their country of residency. Around 15 days post-delivery, you can return home as a family. This article originally published by IVF Babble.