10 Common Questions About Gestational Surrogacy
Since gestational surrogacy became legal in New York state in February 2021, the number of intended parent(s) who have chosen this route has increased significantly. The surrogacy process is complex and there are many medical, social, psychological, and legal implications.
For Gestational Surrogacy Month, Dr. Erkan Buyuk, a reproductive endocrinologist and fertility specialist at RMA of New York, compiled a list of commonly asked questions he receives from patients on the surrogacy process.
1. How do I find a gestational surrogate?
RMA of New York will refer you to agencies that we work with. They will help you find a gestational surrogate.
2. How long will the whole process take?
The screening process can take up to a month, while the IVF process, creation, and testing of the embryos can take up to 4-6 weeks. Finding a surrogate is often the most time-consuming, taking sometimes up to one year.
3. What should I look for in a gestational surrogate? How do we choose her?
There are certain characteristics you should look for in a gestational surrogate:
• Surrogates should be between ages 21-45
• Surrogates should have carried at least 1 pregnancy to term and delivered a baby but should not have more than 4 deliveries or 3 cesarean sections.
• Surrogates should not have any condition that would be exacerbated by pregnancy nor would increase pregnancy complications, like miscarriage, preterm labor and delivery, preeclampsia, etc.
Your doctor will evaluate the whole medical history, physical examination and screening test results and will inform you of the suitability of a given surrogate for pregnancy.
4. How can we make sure that the surrogate doesn’t practice any toxic habits during pregnancy?
The surrogate is screened for drugs using a urine toxicology screen and a thorough medical history is elicited. However, there is no way to guarantee that the surrogate will not exercise toxic habits during pregnancy.
5. Can we be at the delivery? Can the surrogate provide milk to the baby after delivery?
These are conditions that you will need to discuss with the surrogate before signing the
contract so that all parties are on the same page.
6. How expensive is surrogacy?
Surrogacy arrangements are quite expensive. RMA of new York has dedicated financial educators that will inform and guide you throughout the process.
7. Will insurance pay for this?
Often, insurances do not pay for the expenses of the surrogate. RMA of New York’s financial educators will inform you about your coverage by your insurance.
8. What happens if the surrogate does not get pregnant or has a miscarriage?
Not every embryo, even a genetically tested and presumed “normal” one, ends up as a healthy baby. In case of a failed embryo transfer or a miscarriage, your doctor will discuss the cycle with you; potential reasons for failed transfer or miscarriage; and the next steps.
9. Can we have twins despite single embryo transfer?
Yes. We always transfer one embryo at a time. However, if the surrogate is pregnant, 2% of the time there may be twin pregnancy. The risk for higher order multiple pregnancy is less than 1%.
10. What happens if there is a complication during pregnancy?
Complications may happen during pregnancy. For example, the fetus may have congenital anomaly (birth defect) that is diagnosed during the second trimester with an anatomy scan. It is recommended that you have a plan of action in your contract for this and similar scenarios. For complications of pregnancy like hypertension, diabetes, etc. the obstetrician of the surrogate, together with a high-risk pregnancy doctor, as needed, will manage the pregnancy.