The most important question faced by intended parents starting out their surrogacy journey is how to find the best suited candidate for carrying and delivering their baby.
Surrogacy comes in two broad categories: Gestational & Traditional.
In traditional surrogacy, the woman uses her own egg to carry a baby for another couple, as a result of which she has a genetic link with the unborn child. Traditional surrogacy dates back to pre-historic times where infertile couples would often seek the help of another woman to bear a child for them.
Gestational surrogacy is the more modern form of third-party reproduction where a woman is impregnated using an embryo formed by the intended parents, and hence has no genetic connection with the fetus. The IPs have the option of using donor eggs or donor sperms as well in cases where the woman has poor egg quality or if the male partner has poor sperm count/quality.
Once a couple decides to use a surrogate, or gestational carrier, the next important step in the process is to identify a candidate who would be willing to bear their child for them. Surrogacy is an extremely compassionate and selfless act and those willing to take up this responsibility know how demanding it can be. Hence, it is extremely important for the IPs to take all the necessary steps in order to find a surrogate they can be comfortable enough with. After all, they would be working very closely with her for at least 9 months and at times, even beyond that.
Picking a surrogate can be a very extensive and time-consuming process, especially if you are choosing one independently. Independent surrogacy requires the IPs to take matters in their own hands which includes, searching for potential gestational candidates, conducting pre-screening, medical and mental screening, liaising with family attorneys and insurance providers, finding a fertility clinic and an Ob/Gyn as well as a whole lot of ad-hoc requirements in between.
It's a ton of work and something you should not ideally be handling on your own singlehandedly. Independent surrogacy can be cheaper as opposed to hiring a surrogacy agency to handle the whole process for you however, the premium you pay for a surrogacy agency's services is well more than worth it.
A surrogacy agency usually has a pool of pre-screened, ASRM-qualified gestation carriers along with connections with reproductive attorneys, insurance providers, fertility clinics, as well as mental health experts. All these players play a fundamental role in your family building journey and an agency not only helps take the administrative burden off of you but it also makes sure you're getting the best of the best.
However, even if you're working with a surrogacy agency, the onus of choosing the right surrogate more or less still lies on you and your partner. You are normally required to interview potential candidates before being asked to make a pick according to your personal criteria and beliefs.
It can be a very intimidating and taxing decision to make but, narrowing down your requirements can greatly help you make the right choice. Know what's a deal breaker and what are things you greatly appreciate and encourage. For instance maybe a healthy, fitness-oriented lifestyle for some IPs can be a huge plus. Similarly, for some, a record of previous problematic pregnancies can be a hard-no.
To make things a tad simpler, we've put together a list of things you should definitely consider while making this incredibly important decision.
Health & Lifestyle
This is probably one of the first few things that IPs are concerned about when interviewing candidates. Ideally, a woman with a healthy medical history with no prior problematic pregnancies is preferred. Although, how each pregnancy is unique and there's no guarantee that the surrogate pregnancy would follow the textbook pregnancy route however, knowing that the GC has had a healthy, uneventful reproductive track record is definitely comforting and important to consider. Mostly IPs are also stringent about the lifestyle of a surrogate. Does she smoke? Does she have a drinking problem? Has she used drugs in the past? Does she exercise? All these questions are important in determining how well you would be able to work together.
Most surrogates are responsible, devoted mothers with families of their own including their partners/husbands. She could also be a single mom with support from her parents and siblings for pursuing her fertility journey. It is up to the IPs to decide if they are comfortable with the familial structure of the surrogate.
Surrogates can be anywhere between the ages of 21-42 in general as long as they have a healthy, clean medical record. It's important to understand that the surrogate will not be using her own eggs so maternal age is a non-issue.
A healthy body-mass index is critical for sustaining a normal pregnancy and the ideal BMI for any woman preparing to carry a baby should be between 19-33. This is an important indicator since an abnormally high BMI is associated with pregnancy and post-birth complications. Similarly a below-average BMI is also attributed to preterm births in some cases which is why having a healthy BMI is an important determinant in surrogacy.
Most IPs would want to be in close geographic proximity with their chosen surrogate in order to be able to be there for doctor visits and provide support in general. However, in some cases the IPs reside in a different state or a different country altogether. This is true for international surrogacy where the IPs cannot pursue surrogacy within their own country due to varying laws and regulations. Fortunately, technology bridges the gap very effectively as you can be in close contact with your surrogate at all times via phone calls, video conferencing and text messaging.
Lastly, one very important factor to consider while choosing your surrogate is the natural bond and connection you feel towards her. At times, you just seem to click more with a particular candidate possibly because of how they are as a person, what their beliefs and motivation to pursue surrogacy are. Never underestimate the importance of these non-tangible indicators and your gut feeling.