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Gestational Surrogacy

The Surrogate will be put on birth control pills to coordinate her cycle with that of the Prospective Mother or Egg Donor. She will take a medication called Lupron, which is used to manipulate her ovaries and prevent them from releasing any eggs. The Prospective Mother/Egg Donor will generally commence the use of Lupron or equivalent medication to manipulate the timing of the release of eggs. At the appropriate time, the Surrogate will begin taking supplemental estrogen to influence the development of her endometrial lining and the Prospective Mother/Egg Donor will commence administration of ovarian stimulation medications. The clinic will monitor the development of the Surrogate's lining via internal ultrasounds and the Prospective Mother/Egg Donor's follicle development; both parties will have periodic blood tests to monitor hormone levels. Approximately three days prior to the embryo transfer, the Surrogate will commence taking supplemental progesterone to nourish the anticipated pregnancy. At the appropriate time, the Prospective Mother/Egg Donor will be told when to administer an hCG (Human Chorionic Gonadotropin) injection, which must be given at the precise time instructed, triggering ovulation. The egg retrieval procedure will take place 35-36 hours after the hCG injection is given. The eggs are harvested under a "light" general anesthesia. The eggs will then be fertilized with the Prospective Father's sperm (or donor sperm). Generally, three to five days later, a specified number of embryos (typically two) will be transferred into the Surrogate's uterus. After clinical confirmation of pregnancy by blood test (beta hCG) and another test two days later to confirm the number is going up appropriately, the Surrogate will be scheduled for a pregnancy confirmation ultrasound (approximately 4 weeks from the date of the embryo transfer) to see the fetal heartbeat. She will have two more ultrasounds to confirm fetal development until she is 9-12 weeks pregnant, when she will be weaned off the supplemental hormones and "graduate" from the clinic and begin obstetrical care.

Traditional Surrogacy
The Surrogate will meet with the physician to monitor her cycle, and will typically have one or more ultrasounds to monitor follicle development and her uterine lining. Medications may be used (although typically for the first few cycles they are not), based upon the physician’s protocol and recommendations as well as the parties’ agreement. An ovulation predictor kit will be used to determine when a LH (luteinizing hormone) surge has occurred. Ovulation will generally occur 25-35 hours after the surge. When the ovulation predictor test is positive, the Surrogate will return to the fertility clinic for the inseminations. Most often, the clinic will perform an intrauterine insemination (IUI), depositing the semen directly into the uterus, thus bypassing potentially hostile vaginal secretions. Frequently, more than one insemination will be performed. Approximately two weeks later, a blood test or urine test will determine whether the Surrogate is pregnant. Traditional Surrogates will generally commence obstetrical care around 8-9 weeks of pregnancy.

All expenses relating to the Surrogate's medical screening, IVF and fertility specialist fees, and any other charges by your clinic or the monitoring clinic, if any, are paid by you directly, with the exception of some screening labs, cycle labs, and medications, which are paid out of the Escrow Account (if not included in the clinic's cycle fee). Once your Surrogate is pregnant and released from the care of the fertility clinic, her health insurance policy will be utilized (see "Health Insurance", below). You will pay any charges not covered by the Surrogate's insurance through the Escrow Account, such as co-payments and deductibles, as well as health insurance premiums if a policy is procured to cover the Surrogate's pregnancy. The Case Coordinator will monitor these expenses to ensure their timely payment. Any expenses paid directly by the Surrogate (i.e. doctor visit or prescription co-pays) will be reimbursed to her upon presentation of receipts, and will generally be included with her monthly allowance check.

Surrogate' Health Insurance

If the Surrogate has a health insurance policy, we will review the Evidence of Coverage booklet and make a determination as to whether there is a provision specific to a surrogacy-related pregnancy. If there is specific language indicating surrogacy coverage, you may elect to have the surrogate utilize her insurance for the anticipated pregnancy and delivery (provided she agrees). If the policy does not address surrogacy or contains a specific exclusion, an individual policy must be purchased that specifically includes surrogacy. If you elect to utilize the Surrogate's own policy, you would be responsible for any co-pays and deductibles associated with the pregnancy, delivery and post-partum follow-up care. If an individual policy is required, we will help your Surrogate obtain an individual policy that will cover the pregnancy and for three months following delivery for which you will be responsible for the monthly premiums in addition to co-pays and deductibles associated with the pregnancy and delivery. The health insurance policy must be in place prior to an Embryo Transfer or Intrauterine Insemination procedure.

Intended Parents' Health Insurance
The costs associated with the baby's medical care are the legal and contractual responsibility of the Intended Parents from the moment the baby is born. The type of coverage will depend upon your residency and citizenship.
 
Domestic Couples: A policy of health insurance that will cover the baby(ies) must be in place prior to your Surrogate becoming pregnant and maintained for the duration of the pregnancy and following delivery while the baby is in the hospital.

International Couples: While some international couples may have travel insurance that includes dependents born abroad (typically where international travel is required for their jobs), health care coverage options for babies born to non-U.S. residents are limited. Information regarding these options will be provided at the time you contact us.