Surrogacy / Gestational Carrier

Surrogacy involves a couple contracting with a third party who will use her oocytes (eggs) and uterus to conceive a child for them. The surrogate is the biological mother of the child. Typically the male in the relationship will supply a sperm specimen to fertilize the eggs through Invitro Fertilization (IVF), although donor sperm may be used. 

Gestational Carrier is a more common option for couples and less legally complicated.  This involves the female using her eggs, her partner using his sperm, and a third party carrying an embryo created from the egg and sperm.

The information in this packet will help you to understand the process of undergoing an IVF cycle with a Gestational Carrier at The Fertility Center. There are many required steps and FDA regulations with which we must comply. Please review this packet thoroughly and call our office at any time to review the steps or ask questions. The Donor Coordinator RN, physicians, and billing department are here to help. 

Selecting a Gestational Carrier
The first step in the process is to select your Gestational Carrier. We cannot help you find a Carrier, as Michigan law does not allow Gestational Carriers to be paid. Carriers can be reimbursed for typical expenses, but cannot receive a “fee” for doing this. We cannot participate in any procedure if we are aware of a Carrier being paid fees. Therefore, you cannot use a Carrier or Surrogate through an agency and have the procedures done at our facility. The decision making process regarding who to use for this important role should not be taken lightly. Many issues need to be discussed thoroughly with the Carrier and her family. This volunteer will be responsible for up to 10 months of pregnancy with your biological child and delivery of your child. She must also release the baby to you through an adoption procedure because Michigan law states that whoever delivers a baby is the legal mother (and father if married). 

This is not a decision to be made quickly or without much consideration of the person and their lifestyle. Some courts are now recognizing the advancement of fertility procedures and are allowing pre-birth orders stating that the child is the biological child of the IVF couple and therefore, your names would be on the birth certificate. Due to the detailed legal issues, you will need to hire an attorney that is very familiar with family and adoption laws to write a contract prior to procedures, stating the intentions of all parties involved. This attorney will also continue with the adoption process, if the Carrier becomes pregnant. If you need a referral to an attorney, we can provide you with names and contact information for attornies experienced in this process. 

FDA Requirements
Female and male IVF patients are required to have their personal medical records reviewed for communicable disease and a physical exam with the physician. We are also required to ask specific screening questions, perform blood tests, and collect cervical or urine specimens for Chlamydia and Gonorrhea. We will discuss requirements with you on a per case basis.

In fresh cycles, female testing must occur within 30 days of the egg retrieval. In frozen cycles, testing of the male and female must occur more than 6 months after embryo cryopreservation.

For fresh IVF cycles, the FDA prefers males to be initially screened and tested for communicable diseases and then to freeze a semen specimen for 6 full months. The male patient will be rescreened for these communicable diseases risk before the sperm would be used in an IVF cycle. Please consider preparing for this requirement as soon as possible. 

NOTE: A second option for the male is to be tested within 7 days of the egg retrieval. Please be aware, however, that with this option there are risks that the testing will not be completed in time or may need to be repeated if the egg retrieval is occurs more than 7 days after the initial tests. In these cases, a fresh embryo transfer cannot occur and the embryos will be frozen until the FDA requirements are completed. 

Procedure for using a Gestational Carrier
Once you have chosen a Carrier and they are willing to begin this process with you, the next step is to begin the screening process to ensure everyone is a good candidate for this program. The IVF couple and gestational carrier couple (if female is married) need to meet with our infertility counselor separately (both husband and wife) for a consultation regarding using a Gestational Carrier and all the potential issues that can arise. There is no charge for this appointment. If the IVF couple is not a current patient of ours, the first step is to schedule a new patient appointment with one of our physicians. The appointment with the physician and the counselor can be combined in one visit, if desired. 

The next step is to have your Gestational Carrier (and husband if she is married) meet with our infertility counselor. The counselor will talk about the process and the Carrier will take the Minnesota Multiphasic Personality Inventory (MMPI), which is a psychological screening test. There is a $150 charge for this appointment to cover the MMPI interpretation fee. 

If there are no concerns with either couple after meeting with our counselor, the next step is to have your Gestational Carrier meet with our physician for a new patient appointment. He will take her complete history and do a physical exam. We will need her medical records from her primary care physician or OB/GYN prior to this appointment. 

Testing will need to be done to ensure the Carrier’s uterus is a normal shape and she will be able to carry a pregnancy to full term. This test is a Sonohystogram (SHG) and will need to be done during cycle days 5-14. The second test is a mock ET (practice embryo transfer) and can be done the same day as the SHG. This test helps the physician to know how best to transfer the embryos procedure time. The doctor will insert a tiny catheter into the uterus and measure the depth of the Carrier’s uterine cavity. The new patient appointment can be scheduled during one of these testing times in her cycle to coordinate more than one appointment at time, if desired.

The next step is to have both the IVF patient and Carrier meet with a nurse to review the process of the cycle, medications, consents and any further testing that needs to be done (e.g. lab work). 

Lastly, there are consents that will need to be signed by all parties involved. All consents need to be witnessed by a Fertility Center staff member or a Notary Public. 

We advise that your gestational carrier does not use her personal insurance for medications, medical appointments, procedures, and/or obstetrical appointments related to being a gestational carrier or she will be at risk of losing her current and future insurance coverage. You should anticipate the need to pay out of pocket for all fees she incurs as a gestational carrier.

Thank you for taking the time to read this information. We realize it can be quite complicated. We will do our best to simplify and guide you through this process. Once again, please call our office with any questions you may have.

This information will help you understand the steps involved in being a Gestational Carrier or Surrogate. Please review this information thoroughly and call us with any questions.

There are many steps involved in being a gestational carrier or surrogate (a gestational carrier carries a pregnancy for another person; a surrogate provides her eggs and carries a pregnancy for another person).  Please review this information thoroughly and call us with any questions.  Note that patients may proceed through these steps in a slightly different order, depending on each person’s situation.

 To initiate the process, we will need a copy of your medical records.  If you have more than one doctor (e.g. an OB/GYN & primary physician), we will need a medical release for each.  We also need you and the intended parents to complete a “Donor History Questionnaire.”  Although you are not actually “donors,” it provides medical and social history which will be exchanged between both parties to be sure you have a better background and understanding of one another.

 You are also required to meet in person with our fertility counselor to discuss the vast emotional, psychological, and physical demands that you will go through.  If you have a partner, he/she may also attend—otherwise a phone consult will suffice for them.  After meeting with the counselor, you will take the Minnesota Multiphasic Personality Inventory (MMPI), which is a psychological screening test. This test takes about an hour to complete. Once results of the MMPI are back and the Infertility Counselor feels all parties involved are ready to proceed, you will need to schedule an appointment with one of our physicians to proceed.

 Our physician will review the procedure with you, discuss the number of embryos to be transferred, and help answer any medical questions you may have. You may choose to do a required uterine test at this time:  A sonohystogram (SHG) to check the shape of the uterine cavity and rule out any defects; and a mock ET (practice embryo transfer) to measure the depth of the uterine cavity. 

 When you get closer to proceeding, you will meet with one of our Donor Coordinator nurses to review the medications, injections, blood testing, consents, and timing.  Whether you are transferring fresh or frozen embryos, when you are ready to proceed, it normally takes 2 menstrual cycles for the transfer to occur. 

 Consents are required by all parties involved, as well as legal contracts. In the state of Michigan, whoever delivers a baby is the legal mother (if she is married, her husband is the legal father). If you achieve a pregnancy, the legal contract will help avoid the intended parents from having to adopt their biological child—this “pre-birth” order can usually legally name them the parents at the time of birth.  Legal contracts have to be signed and copies sent to our office prior to any procedure. Michigan law does not allow payment for being a carrier or surrogate. Money can be paid for medical costs, clothing allowances, work loss, transportation to office visits, etc. but an outright “payment” for the act of being a gestational carrier or surrogate cannot be paid to you from the biological parents.

 We advise you to check with your personal insurance carrier regarding coverage of any medications, medical appointments, procedures, and/or obstetrical appointments related to being a gestational carrier.  If you do not follow your insurance carrier’s guidelines, you may be at risk of losing your current and future insurance coverage. 

 If at any time, you have conflicting feelings about proceeding, please call our office and ask to make an appointment with our counselor at no charge. This is a major decision and we want to be sure that you have fully considered every aspect of this process before beginning. If you have medical questions, please contact one of our donor coordinators nurses:  Christine Dixon or Kim Helm at 616-988-2229, ext. 131.  For billing questions, call Amy or Robin in billing at 616-988-2229.

This information will help you to understand the process of utilizing a gestational carrier at The Fertility Center. There are many required steps and FDA regulations with which we must comply. Please review this information thoroughly and call our office at any time to review the steps or ask questions. The Donor Coordinator RN, physicians, and billing department are here to help.

Selecting a Gestational Carrier
The first step in the process is to select your Gestational Carrier. We cannot help you find a Carrier, as Michigan law does not allow Gestational Carrier’s to be paid. Carrier’s can be reimbursed for typical expenses, but cannot receive a “fee” for doing this. We cannot participate in any procedure if we are aware of a Carrier being paid a fee. Therefore, you cannot use a Carrier or Surrogate through an agency and have the procedures done here. The decision making process regarding who to use for this important role should not be taken lightly. Many issues need to be discussed thoroughly with the Carrier and her family. This volunteer will be responsible for 10 months of pregnancy with your biological child, delivery of your child. She must also release the baby to you through an adoption procedure because Michigan law states that whoever delivers a baby is the legal mother (and father if she is married). 

This is not a decision to be made quickly or without much consideration of the person and their lifestyle. Some courts are now recognizing the advancement of fertility procedures and are allowing pre-birth orders stating that the child is the biological child of the IVF couple and therefore, your names would be on the birth certificate. Due to the detailed legal issues, you will need to hire an attorney that is very familiar with family and adoption laws to write a contract prior to procedures, stating the intentions of all parties involved. This attorney will also continue with the adoption process, if the Carrier becomes pregnant. If you need a referral to an attorney, we can provide you with names and contact information for some that are experienced in this process. 

Your Requirements for using a Gestational Carrier
Once you have chosen a Carrier and they are willing to enter into this process with you, the next step is to begin the screening process with our office to ensure everyone is a good candidate for this program. 

We initially request a copy of you and your husband’s medical records from your primary physician. The Food and Drug Administration (FDA) requires that we review your records to reduce the likelihood of disease transmission from you to your gestational carrier. 

Next, if you are a current Fertility Center patient, you will need to meet with our infertility counselor (both husband and wife) for a consultation regarding using a Gestational Carrier and all the potential issues that can arise. There is no charge for this appointment. 

If you are not a current Fertility Center patient, you first need to schedule a new patient appointment with one of our physicians. The appointment with the physician and the counselor can be combined in one visit, if desired. 

You will need screening and lab testing to reduce the risk of disease transmission to the gestational carrier. These are required by the FDA. 

A deposit will need to be paid to the billing supervisor for the frozen embryo transfer procedure to the Carrier, once you have been approved. We have enclosed an estimation of costs for the procedures and testing. We advise that your gestational carrier does not use her personal insurance for any medications, medical appointments, procedures, and/or obstetrical appointments related to being a gestational carrier or she will be at risk of losing her current and future insurance coverage. You should anticipate the need to pay out of pocket for all fees she incurs as a gestational carrier.

Your Gestational Carrier’s Requirements
We initially request a copy of your potential Gestational Carrier’s medical and OB/GYN records and a medical clearance letter from the individual’s primary physician. We will review this information to assure she will be a good medical candidate for this procedure. 

Once her records are reviewed, she can schedule an appointments with our infertility counselor—it is required that, if married, her husband also attend this appointment. The gestational carrier must take the Minnesota Multiphasic Personality Inventory (MMPI), which is a psychological screening test. There is a $150 charge for this appointment to cover the MMPI interpretation fee. This fee is applicable even if the gestational carrier is not accepted into the program. 

Our infertility counselor will need to approve both the gestational carrier and IVF couple. In addition, the MMPI test results will need to acceptable BEFORE anything further can be scheduled with us. 

The gestational carrier will need to schedule an appointment with one of our physicians to be approved, medically, for this procedure. Once the gestational carrier has been approved by the counselor and our physician, you can then move on to the next steps.

Requirements for Both Parties
Both parties will have the opportunity to meet with the Donor Coordinator to review the process of the cycle, medications and required screening/testing. 

Legal contracts must be established before the procedure will be performed. 

Consents need to be signed by all parties involved. All consents need to be witnessed by a Fertility Center staff member or a Notary Public. 

Thank you for taking the time to read this information. We realize it can be quite complicated. We will do our best to simplify and guide you through this process. Once again, please call our office with any questions you may have.