Fairly often, especially after a blog post, I receive emails and private messages from friends and distant acquaintances offering to be a surrogate for us. Fortunately, I am now at a place emotionally where I can see that these offers are coming from a good place and overlook the infertility faux pas these women are making. Three or four years ago, if I had received these offers (which I did on occasion), I would have cut the conversation short, said no without elaboration, stewed about it, and probably would have had a few good cries over it. Why? Two simple reasons in my case: 1) We had never, at that point, brought up that surrogacy was an option for us (it most definitely wasn't for us at that time) so it was a huge assumption on the part of the offerer, and 2) For me, it was the end of the line, the last option for a biological child, and a huge reminder of how I am a failure as a woman, which was further reinforced by those willing to 'do my job'. Through this struggle and with the passage of time (which really does heal the soul), I can deal with these offers more graciously. I can understand that they are coming from the heart, and I can offer advice to those who are interested in surrogacy though it's not in the cards for us right now. But please remember this when you offer surrogacy to the next woman you meet who is struggling with IF - she might not be ready for that offer yet.
Lucky for me, I have some wonderful women in my online community to support me, one of them being a surrogate herself. She graciously offered to address some of the key questions that come up during discussions about surrogacy, and outline the process she went through to be a surrogate (all specific to Canada, but would mostly apply to the U.S. as well). A huge thank you goes out to AG for her offer to educate, her quick response to my questions, and the level-headedness and levity of her answers.
Can you briefly describe the details of your surrogacy situation
I am the surrogate for one of my best friends since grade 9 and his husband. Obviously, being of a two-penis household presents with some difficulties when it comes to reproduction. At first they had discussed adoption, but then had decided that surrogacy was a better option for their family. They had mentioned trying to find a surrogate in Canada and some of the problems that it presented, and I made the offer. About a year and a half passed, and they had contacted me again to ensure that this was something I was seriously entertaining, and that my husband was also on board (essentially, they gave me an "out" so that if I wasn't sure I could revoke my offer, no hard feelings because they are understanding that this is a large commitment). My husband and I seriously discussed the impact it would have on our family (we have two young children), and decided that the positives outweighed the negatives. In fact, he deferred to the logic of Jay and Silent Bob and said "A woman's body is her own fucking business". You see why I love that man?
In your experience, what were the primary steps and how long is the process from the offer to be a surrogate to actual embryo transfer?
I received the "are you SURE sure?" email in spring of 2013, and from then things ran fairly quickly. The first step was for my family doctor to send a referral to the clinic that the fertility clinic IPs (Intended Parents) had chosen, as in Canada specialists require a physician's referral. We had decided that fall was ideal in regards to really beginning the process in earnest, as summer was busy for all of us, and I knew that monitoring could mean significant travel on a frequent basis to the clinic that was approximately 6 hours by car (or two flights) away.
Then I had to do several medical tests to ensure that physically and hormonally I would be an ideal candidate to be a surrogate- as pregnancy in and of itself is a risky endeavor, and there are some factors which can increase the risk to both the carrier and the child.
In September of 2013 we met with the clinic in our province, which is affiliated with the clinic in the United States that we were using for the transfer. They conducted more tests, and also did some testing on the intended genetic father. We met afterwards to discuss the results, and it was determined that we were ready to proceed.
After that the rush was to complete the legal legwork (the clinic, myself, and the IPs all had separate lawyers), finalize the details of our surrogacy contract, and also complete the mandatory physical and psychological screenings (for both me AND my partner). Our monitored cycle began in November 2013, and the transfer was in December 2013.
What is the legal process for surrogacy in your jurisdiction?
Legally speaking, in Canada the laws have not yet caught up with the technology, and unlike the United States, legally you can only reimburse your surrogate for expenses occurred as a result of the pregnancy- you cannot compensate them for the act of surrogacy. Also, there is the potential for a surrogate to attempt to parent the child afterwards, as it is assumed that the birth mother is the parent, regardless of genetics.
Our surrogacy agreement is almost 40 pages long, and covers every possible situation or outcome that one may encounter, including what type of testing both parties agree to, presence at the labour and delivery, and under what conditions both parties would be agreeable to the termination of the pregnancy. My husband and I had to agree to not have intercourse during the FET cycle, and also to sign an affidavit after the birth of the child to this effect. Our agreement went back and forth a few times over some details, and items that I never gave much thought to when I was pregnant with my own two children became things that necessitated more thought, as it wasn't just myself and my husband making the decision, there were two additional people who had their own concerns and preferences. Thankfully, we are all pretty reasonable people and came to agreement very quickly- however, if any parties have strong feelings in regards to termination, invasive testing, or even nutritional preferences there could easily be several problems that can arise.
What kind of medical and psychological tests did you have to undergo?
My husband and I both needed to get STD tested, despite being in a monogamous relationship for over 8 years. We also needed to get an assessment from a registered mental health worker (psychologist, psychiatrist, social worker, etc.) to ensure that we knew what surrogacy entailed, and that there were no red flags that could cause any issues down the line in regards to our mental health. She also wanted to ensure that our expectations were in line with surrogacy, and that we didn't have the expectation that we were going to be an additional set of parents.
In additional to passing the psychological testing, my husband and I had to give the clinic a fairly detailed medical history, including any mental health issues we may have had. Some of this information was shared with the IPs, which is fair considering they needed to make an informed decision as to whether they still wanted to undertake this process with us.
I had to do a complete physical and hormonal profile, along with a Sonohysterogram to ensure that my uterus did not present any abnormalities. On the month of the transfer, I had to travel to the clinic that was chosen once a week for the entire month, to do ultrasound and blood tests to ensure that no problems would present itself for the transfer. Each trip necessitated four flights (two there and two back), and took up almost an entire day. I was able to schedule these for Saturdays, however if this is not possible for your clinic you would need to take a day off work/find childcare. You may be lucky and be able to work with a clinic that is local to you; however depending on where you live this may not be possible.
Prior to the transfer and for several weeks afterwards, I had daily injections of progesterone, and twice-a-week injections of estrogen, to ensure that hormonally my body was prepared to sustain a pregnancy. The side effects of this medication included rapid weight gain (about 15lbs directly in the stomach area...put on pre-pregnancy), and, as my husband states, a case of the mega bitches. I offered to call him a waaaaahmbulance, but he declined.
Did/do you have any fears about the surrogacy process, and if so, what were they?
My main fears revolved around the fact that if the pregnancy was not successful, that I would feel some guilt, even though logically I am aware that in the overwhelming majority of cases there is nothing you can do to prevent miscarriage. Also, though the IPs are friends of ours, there is always the potential for butthurt, as pregnancy can be a psychologically difficult process for all involved. I am really thankful that we have really great IPs, who always put my needs first and are fairly flexible. However, it must also be very difficult for them, as they do not live in my city, and thus have even more limited control.
We did have a major scare at 6 weeks that involved significant bleeding and a trip to the Emergency Department- this drove home the notion that there are more complicated emotions involved when you are carrying someone else's child, as you have to then process your own feelings and be concerned for the feelings of the baby's parents, who are essentially helpless in this situation. As a result I was on some physical restrictions for the following few weeks, which included no housework, no exercising, and no lifting (as the ultrasound noted a fairly large SCH)- all as a precaution. This not only affected me, but of course our family. We were lucky that we had a contingency as part of our surrogacy agreement that covered housekeeping services and snow removal in situations such as this- but it still put a lot of strain on my husband as when I got home from work I usually spent the evening resting and he had to do the bulk of the parenting, as we have two young very mobile children.
I also find that my husband is (understandably) less involved with this pregnancy, as I know he doesn't want to build an emotional attachment when it isn't his child. It doesn't present a problem to me, as I have great support from our IPs and I have to respect his boundaries- however, if you more of a touchy-feely person who NEEDS more support at that level, it can be problematic.
How is it going so far? :-)
Everything is going very well- I am currently almost at the halfway point in pregnancy with a little boy, and the IPs are ecstatic and very grateful for our help in adding to their family. I have no regrets, however I must admit that if it was for anyone else we likely wouldn't have offered to be a surrogate and make the sacrifices that it entails.
It is also an exceedingly expensive process, that isn't necessarily accessible to many people. While we pay nothing out of pocket, all expenses occurred as a result (medical costs, legal fees, travel, maternity clothes- even a portion of our grocery bill) are covered by the IPs, which makes it a more expensive option that either adoption or ART on its own. Please, if you know someone who is struggling with infertility, do not offer to be a surrogate unless they have mentioned that they want to pursue this as an option. I know it likely comes out of a good place, and that you are looking to help, however it may not be an accessible option for them, or emotionally it may not be a good fit.
