HOW TO CHOOSE A SURROGACY AGENCY: A Guide for Intended Parents
One of the biggest challenges intended parents face, having made the decision to build their family with the help of a surrogate, is choosing the right surrogacy program or agency to assist them. Choosing a program you can fully trust can mean the difference between a professional, enjoyable, smooth process and one that is not only stressful, but possibly lengthy and unsuccessful.
Know What Services Are Included.
When engaging your chosen surrogacy agency, make sure you clearly understand exactly what services are included in their program and what services they can not help you with, as well as how much those additional services may cost that you will need from other essential service providers. If the surrogacy agency does not handle every step of the process, will they assist you in locating and connecting with all the outside services you will need — from beginning to end? Or are you expected to rely on your own devices to find the right lawyer, the right escrow manager, and take the right steps to obtain legal recognition as the parent(s)?
Some surrogacy agencies charge a premium for their matching services, yet provide no other support or services at all — and may not make that clear to you at the outset.
Does the agency have a reputation for following best practices?
A critical question is: Are the surrogates fully pre-screened prior to matching? There are surrogacy agencies that do not properly screen surrogates before matching them with intended parents. Without proper and adequate screening, matches frequently fall apart, leading to heartache for all involved, as well as lost time and money. Similarly, there are agencies that may do all the pre-screening, but will not be available when you or your surrogate needs them throughout the process. You want to be able to rely on your chosen agency to assist you in a timely manner no matter what may arise. Ideally, you should work with an agency that offers a comprehensive surrogacy program with a staff that is not only experienced and sensitive but is truly caring, and hands-on — one that will serve as your trusted guide through every step on the way to parenthood.
Bigger is not better.
At ARTparenting, we consider our relatively small size as an enormous advantage. Intended parents tell us time and again that it’s the personal, one-on-one service and availability that they value most about us. Are there larger surrogacy agencies? Absolutely. But be warned that often, those are precisely the agencies in which intended parents get passed from facilitator to bookkeeper to assistant, getting lost in the shuffle. Sometimes, with bigger agencies, you may find yourself not able to get timely answers, and indeed, the process is sometimes not a smooth one. At ARTparenting, our intended parents work with one person who is consistently available at all times, including, frequently, outside regular office hours. With such a personal approach, we often assist the intended parents in communicating with their treating physicians. This includes working through any medical bumps that may arise, though infrequent.
Transparency is vital.
Financial transparency is a critical issue when working with a surrogacy agency. If you find yourself confused by an agency's pricing structure, you are not alone. Trying to sort out exactly what each agency offers and what they will charge over the course of a surrogacy is often confusing for intended parents. It is critical that you get accurate information in order to make an educated decision and, in the long run, to feel well represented. If you dig into the pricing by asking for specific details about what is included in the anticipated expenses and fees for the surrogate, you should be able to uncover and compare the true amounts for each agency. If it is hard to get this information that is a warning sign that you should not consider working with a particular agency.
Is There a History?
Does the surrogacy agency you’re considering have a track record of successful matches? How long has it been in business? What is their standing in the industry? How involved have they been in the field of assisted reproduction? Experience is priceless. When it comes to building your family, choose a program and staff with the right qualifications and years of experience. Read about, our founder, Meryl B. Rosenberg's philanthropic commitment to ART and surrogacy.
Are they open about their surrogate screening process?
What kinds of medical and psychological screening does a particular agency use when reviewing potential surrogates? Have they met them face-to-face? Do they do background and criminal checks? How selective are they? Do they recruit their own surrogates or use an outside source? A respectable, legitimate surrogacy agency will share these details with intended parents, and most important of all — they will be clear about the process.
Be aware of the realities of “screening.”
A majority of agencies only complete a paper review of the gestational surrogate candidate. They do not fully screen their applicants before matching. If a full pre-screening isn’t done before being matched with you, it is not unusual for the surrogate to then be screened out by your fertility center, wasting your time and money. Prior screening provides the confidence that you will be able to smoothly continue with the surrogate who you have started to build a relationship with already.
Fortunately, some agencies, like ARTparenting, only present formally pre-screened surrogates to intended parents.
Proper pre-screening means that the following steps have been completed:
in-person psychological screening for both the surrogate and her spouse or significant other
home visit by a social worker when appropriate
insurance review (to check for the surrogate's prenatal and delivery coverage)/assist in obtaining appropriate health insurance coverage
criminal/civil background checks for surrogate and spouse or significant other
financial review of the surrogate's household income and economic stability
Medical clearance from surrogate’s OB
Review by a reproductive endocrinologist (RE) of prenatal and delivery records*
*It is important that you choose your reproductive endocrinologist (RE) prior to the match for this very reason. Every medical practice has its own standards and qualifications for acceptable gestational surrogates. In order to properly match you with a surrogate, it is critical that your own RE has the opportunity to review records prior to an official match in order to avoid any issues moving forward together.
Once there is a good match with a properly screened surrogate, the only outstanding step is for the intended parents' RE and fertility clinic to complete their required medical screening before proceeding (usually including a group social-work meeting, FDA testing, and other tests as required by your RE). Despite what any agency might say, it is always the intended parent's fertility clinic that will perform their own screening in order to proceed medically.
Those agencies that only perform a paper review of the surrogate are not acting in the best interest of the intended parents or the surrogates. Doing a paper review may allow the agency to claim they have “many” applicants available at any given time. They will introduce and "match" the candidates with intended parents, which appears to eliminate the waiting time to be matched. Unsuspecting intended parents and surrogates then have to go through a formal screening process, where often the surrogate is rejected due to medical, financial, or social history issues — which ultimately forces the intended parents to have to start the whole process over again, costing them not only time but money. All of this can be avoided with proper screening before the match.
It is a disservice to the surrogacy process as a whole when agencies are not completely open and transparent about their matching and screening process. Many intended parents have been misled into believing they were being matched with a "screened" candidate — only to learn that after waiting months and spending thousands of dollars, their potential gestational carrier was never appropriate to begin with. Though the wait to be matched with a properly screened surrogate might feel lengthy, in the long run, this will actually lead to a more positive and successful experience for all involved.
What about litigation?
Has the surrogacy agency been involved in any lawsuits — either by surrogates or intended parents? If so, how have such legal issues been resolved? A lawsuit certainly doesn’t mean an agency is incompetent, but it can help give you a clue to the agency’s professionalism.
Before you are able to move forward, you need to feel comfortable that the agency you’ve chosen is a good one. One that can answer all of your questions and guide you every step of the way, from beginning to baby.
At ARTparenting, we stress the importance of choosing a top-notch agency, whether you elect to work with us or one of our colleagues, to ensure the smoothest, most enjoyable journey possible.