In February of 2002, I was the moderator of the Expecting Multiples board here at Pregnancy&Baby. One day, a new member joined the board, and explained that she was pregnant with a set of surrogate triplets. I was instantly intrigued, as I had always considered the concept of carrying someone else's baby interesting.

Until that point, I knew next to nothing about the actual aspects of surrogacy, and was under the assumption that most surrogates were older women who were finished with their families. The poster was young, had two children of her own, and was on her second surrogacy. She referred me to Surrogate Mothers Online (SMO), which is a website devoted to educating about surrogacy and features a message board community of women and intended parents (IP's) involved in all stages of the surrogacy process.

My first visit to SMO was amazing. I never realized that there was so much to learn about surrogacy, and I dove in heart-first, already sure that it was something I wanted to do as soon as I learned as much as I could. My heart just felt like it was in the right place.

I felt that because of my troubles conceiving, I knew something of what it was like to wonder if you'll never be able to have a child, and I knew first-hand what heartache and emotional distress that could cause.

My infertility was solved relatively easily, but I knew that there were plenty of couples out there who needed to use much more drastic and invasive methods than just five days of pills to get pregnant.

I felt that helping another couple have a baby was sort-of my way of saying "thanks" for the blessings that I'd been given, almost a "Do unto others" type of thing. Had Frank and I needed to resort to surrogacy, I could only wish that we had been able to find someone willing to help us in the way I wanted to help another couple.

I understand that there are many of you out there who don't really have the first idea about surrogacy, except for what you hear in the media, which sadly, makes up a mere, almost insignificant fraction of surrogacy stories out there.

It is especially difficult, because the media tends to only focus on the arrangements which have gone horridly wrong, such as the ones that end in a wicked custody dispute, or the arrangements that are completely out of the ordinary, such as the grandmother who gave birth to her twin grandchildren since her daughter couldn't carry her own babies. So please bear with me as I explain the basics of surrogacy to those of you out there who don't fully understand it, and hopefully you can grow to at least appreciate the concept, even if it's something that you yourself would never do.

The first, and perhaps most important thing to learn about surrogacy, is that there are two types: traditional surrogacy and gestational surrogacy. Traditional surrogates (TS) conceive through artificial insemination of the intended father's (IF) sperm, either through basic home inseminations or through a clinic intrauterine insemination (IUI).

Sometimes an anonymous sperm donor is used if the IF and the intended mother (IM) both have fertility issues. In traditional surrogacy, the TS is genetically the mother of baby, and is, in essence, the baby's birth mother.

Gestational surrogates (GS) conceive through IVF transfer of already fertilized embryos. In this case, the surrogate is not related to the baby. Most embryos in a GS arrangement are formed from the IM's eggs and the IF's sperm, so that though the baby is carried by a surrogate, he or she is also completely the genetic offspring of his or her parents.

Sometimes there is a problem with the IM's egg quality, so a fourth party, an egg donor, is included in the surrogacy process. Or conversely, occasionally a sperm donor is used in a GS arrangement.

In a fewer number of instances, a set of intended parents (IP's) will both have such extensive fertility problems that they choose to adopt already fertilized embryos from another couple.

The biggest choice a prospective surrogate has to make is whether she wants to be a traditional surrogate or a gestational surrogate. There are what can be considered pros and cons to each.

The biggest hurdle for traditional surrogacy, of course, is deciding whether or not you could part with a baby that is genetically yours. The biggest hurdle for gestational surrogacy are the invasive screening procedures, hormone injections and medications, and overall extended length of the entire process.

I knew that I didn't have the right mindset to be a TS, so for me, gestational surrogacy was an easy decision.

Next is to decide how you want to go about finding IP's -- either through a surrogacy agency or independently. Yes, there are such things as agencies for surrogacy. That was one thing that was surprising to me when I first began learning. Through an agency, there is a third party between the surrogates and the IP's to begin the process.

Hopeful surrogates apply to the agencies and are pre-screened. Accepted surrogates create extensive profiles about themselves and their families and are usually placed on a list for IP's (who themselves have been screened and accepted by the agency).

A profile of the couple is sent to the surrogate. If a couple and surrogate are interested in each other based on their profiles, the agency usually arranges a phone call first, then if things are still going well, a face-to-face meeting next.

The agency handles almost all things related to the surrogacy, leaving the couple and the surrogate free to develop their relationship without too many of the worries of finances or legal aspects.

Many first-time surrogates opt to go the agency route, as usually it frees them from the worries of being financially "burned" by IP's, where irresponsible IP's leave their surrogates with medical bills or unpaid fees.

Agencies are also reassuring for the IP's, as the surrogates have been pre-screened and are already dedicated to the process.

The alternate option is an independent journey, which is where both the IP's and surrogates do everything by themselves without the use of a third party. Some websites, such as SMO, have classified ads, where both surrogates and IPs can outline the type of person they're looking for and the type of journey they want to have. Surros and potential IP's (PIP's) can scan the ads, and if one begins to tug at their heartstrings, they can send an email and begin learning about one another.

The pros to an independent journey are that both parties have complete freedom from start to finish in learning about each other and there is more of a sense of control over what happens through the process. Cons to an independent journey are that it leaves both the PIP's and the surrogates more open to scammers who are not true to the heart of the matter- having a baby and respecting all parties involved in the process.

With an independent journey, there also is no third party there to handle uncomfortable situations between the IP's and surrogates, so they have to handle any problems that may arise by themselves.

In all surrogacy situations, GS or TS, independent or agency, potential surrogates have many other things to consider before even attempting to find an IP. How much (or how little) will you feel comfortable asking for in fees? How much contact do you want to have with the parents after the birth of the child? How do you feel about selective reduction? How close of a relationship do you want to have with your IP's through the pregnancy?

The PIP's have to consider the same issues, but from the IP perspective. In all situations, there should also be legal consult finalizing everything agreed upon by both parties in a signed contract.

After taking in as much as I could and coming to many decisions within myself, I initially decided to go the agency route. I had phone consults with a couple of agencies and submitted a few applications, but eventually, I came to the realization that I got tired of always waiting for someone else to get back to me; I wanted more of an active hand in what I was doing. I felt that I would be happier seeking an independent arrangement, and I focused my energies there.

I scanned the ads and responded to a couple of them, but for whatever reason, none "clicked" the way I wanted them to. Then suddenly, all the talk about babies got Frank ready for another of our own, and I readily put my surrogacy plans on the backburner.

About a year later Jordan was born, and when he was nine months old, I again felt encouraged to restart my efforts to be a surrogate.

To read Week 5, part 3, click here.


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