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Frequently Asked Questions About Surrogacy
Is a consultation required?
Yes. The nature and style of the consultations on surrogacy that we offer is varied. Because in many instances, the need for a surrogate is medically quite obvious, while in other situations, there may be many medical details to be considered before deciding on surrogacy, a variety of consultations are offered. If you have been involved with a fertility specialist that has now recommended surrogacy, a telephone conversation between your physician and ours may allow for a rapid understanding of your medical situation, and your consultation may be planned to prepare you for a surrogate match and plan your treatment details. If you have begun to consider a surrogate based on your personal understanding of your situation, your consultation will include a detailed review of your medical situation as well as a discussion on surrogacy. Prior to deciding upon and beginning surrogacy planning arrangements in these instances, any medical details essential to offering you the optimal chance for success will be gone over and finalized. For out of town or country patients, telephone consultations with our nurse coordinators may, in some instances, allow for the early details of your surrogacy match to be begun. In other instances, you may be asked to speak directly with our physicians prior to the planning stage of your treatment. The availability of physician specialists (reproductive endocrinologists, urologists, embryologists, andrologists) IN the office allows ALL details of your situation to be gone over by the fertility team. With all of your records maintained and treatments carried out in one place, there is no need to travel from location to location to arrange and carry out your treatment cycle. We are one of the ONLY surrogacy centers providing both surrogates and medical care in one, centralized location.
Where do you obtain your surrogates?
Having now been involved with surrogacy for many years, we find that many of the potential surrogates that contact us do so after being referred by a woman who has served as a surrogate in our program or in other programs. We maintain multiple office locations in geographical areas where many potential surrogates live and/or work. The convenience of local care and treatment attracts many surrogates to our facilities. We are active in the surrogate community through lectures we offer to women considering serving as surrogates. We are contacted through internet sources that channel interested potential surrogates our way based upon our excellent reputation for providing quality care to surrogates. This care is offered without placing excessive travel and time demands upon the surrogates as some programs do.
Why should we consider your program before others?
You shouldn't !! We would only ask that you consider our program along with any others that you may have an interest in. Your greatest benefit may be derived from viewing our program last. Unlike some other programs, we do not speak or think ill of competing programs. In fact, it is our feeling that there are many high quality "agency" programs (we are not an agency, but a medical practice), "pure" agencies and independent health care providers in the community offering surrogacy services to couples. We have found that as couples "shop" our competitors, they learn that while high quality surrogacy services may be available with a few good programs, these services by our competitors are offered at double or triple the fees found at our practice. They also learn that this price difference is attributable largely to fees for services termed "Center fees", and surrogate recruitment and surrogate psychological profiling "costs". These fees run into the tens of thousands of dollars. So, we encourage couples considering surrogacy to explore all of the options and resources available to them, while keeping in mind that our state-of-the-art surrogacy program routinely offers a better chance of successful outcome at less than half the cost of most other programs. This cost savings does not arise from ANY compromise of medical care. In fact, we maintain the HIGHEST LEVEL of stringent surrogate screening currently available. Our screening process EXCEEDS ALL mandatory FDA requirements for surrogate screening and we are the world's ONLY program utilizing the revolutionary new screening process that is able to detect TOBACCO use in surrogate and egg donor candidates. While routine blood and urine tests can detect illicit drug and alcohol use, it has been virtually impossible until now to practically and reasonably detect tobacco use. Recently developed technology now allows us to detect tobacco use with near perfect accuracy. ALL of our egg donors and surrogates are routinely screened for tobacco in addition to all other screens. This highly valubale test is provided as a benefit to all of our patients considering an egg donor and/or surrogate and demonstrates our uncompromised dedication to assuring that only the highest quality candidates are made available to our patients. We invite you to question all other programs about their use or non-use of tobacco screening! Our lower discount prices represent no compromise in care. To the contrary, you will find no higher level of care anywhere. The discounts in our program arise from a total absence of descript and nondescript "fees", recruitment charges and surcharges levied upon couples making what we view as great sacrifices in their quest to obtain a successful pregnancy.
What are the legal issues involved, and how are they handled?
The legalities of surrogacy vary from state to state and nation to nation. We have provided a link here to a site that monitors the progress of legal initiatives attempting to establish a standard for surrogacy among states and nations: http://www.surrogacy.com/legals/map.phtml This site also provide outlines of current U.S. laws by State in this regard. California has been and continues to be one of, if not the most tolerant and medicolegally well advised states and jurisdictions related to the rights of parents to their children. Attorneys working with our Center were responsible for many of the original legal arguments and decisions that established a nationwide precedent for the recognition of the rights of parents whose child is delivered by a surrogate in California. When your surrogacy arrangements are being formulated by our experienced staff, legal counselors will become involved with your case, and will oversee the draft of a binding legal contract between you and your chosen surrogate. These efforts are aimed at assuring that the couple, the surrogate and most important, the resulting child are afforded all the protections of the law overseeing the issues involved.
The guidelines below represent a summary interpretation of CALIFORNIA law only. Major differences may exist from State to State. You are advised to seek the assistance of a qualified attorney before considering any of the below options. We are associated with several leading attorneys specializing in the below noted legal arrangements.
Is there an additional (sur)charge for foreign or out of State parents?
No !! While additional expenses may be incurred related to immigration details and the final disposition of the child, these expenses are paid directly to the person(s) providing the services (surrogacy or immigration attorneys, etc.). We do not financially penalize any couple based upon their place of residence. There is never a foreign or out of State surcharge imposed by us. On occasion, where extensive paperwork or consultations were required to allow for a temporary visa to be issued for medical care, we charge only a modest per hour service fee at our cost for those extra efforts made by us on behalf of a patient.
Will insurance cover any of the expenses?
Insurance coverage for surrogacy expenses is usually limited to covered obstetrical expenses of the surrogate. In some instance, if pre-approved by your insurance company, certain fees related to the establishment of your embros (ie; in vitro fertilization) may be covered. Due to the extreme variability in different coverage plans and the scarcity of plans that cover such arrangements, potential patients are advised not to expect any major insurance assistance with surrogacy expenses. Payment for our heavily discounted program is required in advance, regardless of any insurance benefits that may be available. Insurance billing is a patient responsibility. Once your child has been delivered, your obstetrical benefit coverage, if applicable, will cover the expenses of your child while in the newborn nursery.
How often does gestational surrogacy "work"?
68 % of our surrogate cycles result in pregnancy on the first attempt. Following the completion of 2 attempts, 84 % of surrogates have become pregnant. It should be remembered that the structure of the payments in our program allow for repeat cycles at significantly reduced fees. In addition, most of the cost of the first cycle includes the surrogate becoming pregnant and delivering the baby. If conception does not occur on the first attempt, the surrogate compensation is only for that part of the program that she has completed. The remaining money destined for payment to the surrogate covering the term of the pregnancy and the delivery remains in trust for a successful cycle, or is refunded to the couple should they elect not to try a repeat attempt. Nearly every couple that "sticks with it" related to surrogacy attempts ultimately achieves a health pregnancy.
Can we use our own surrogate?
Yes. Couples who have a surrogate interested in working with them may take advantage of our surrogacy "flex" program. This arrangement allows couples that may have a portion of their surrogacy arrangements worked out to integrate into our surrogacy arrangement protocol. There is generally no additional charge for this integration. Surrogates and couples, of course, will need to pass our rigorous medical screening protocols before being allowed entrance to our program. It is important to remember that surrogacy laws vary by State. Some States where surrogacy is legal may not allow a surrogate to be compensated financially. After receiving a request for integration into our program, the couple-surrogate will meet with attorneys experienced in such arrangements to discuss issues vital to the success of such arrangements.
Can we use our own egg donor?
Yes. Those that have chosen an egg donor from an agency or have made arrangements with a family member or other contact, may bring that individual into our program if the donor screening requirements and criteria have been met. We are able to screen potential egg donors for couples, though in most instances, chosen donors not related to the potential recipient mother will be referred to an outside screening agency with whom we will work to assure that all donor qualification requirements have been met. It must be remembered that therew are legal instances in which known, unrelated donors will be required to undertake an adoption arangement even though she will not carry the child. Attorney referrals will be offered to assist couples and egg donors with these arrangement formalities.
Can you work with a physician near our home?
Yes. We have worked with many, many physicians from all parts of the world to assist couples with their treatment cycles. If a physician, ultrasound facility and hormone laboratory are available, in many instances the bulk of the cycle preparation and treatment may be carried out with the couples remaining at or close to home. In some instances a portion of the surrogate monitoring may similarly be carried out near the surrogates home. We have worked with physicians in nearly every State in the U.S., and have worked closely with physicians from countries as diverse as Russia, Poland, Australia, Germany, Britian, Peru, Mexico, Argentina, Venezuela, Chile, China, Spain, Singapore, Japan and many others. Details of these arrangements will be worked out at the time of your initial consultation.
How much time do we need to spend at / with the program?
The amount of time requred to successfully complete a full treatment cycle involving a gestational surrogate is approximately 5 weeks. We have, depending upon predetermined arrangements with out of town patients, completed successful cycles with the mother to be present for as few as three days, and the spouse present for one day. Most out of the area couples are able to comfortably complete the monitoring and egg retrieval portion of their treatment with a ten to twelve day stay. These requirements are only offered as a guide, as circumstances and requirements may vary greatly.
How soon can a match be obtained?
Depending upon the desires of the couple related to specific issues involving their surrogate, matches are usually made in from one to five weeks. Requests for surrogates that live in certain geographical locations, or that are of certain religious or ethnic backgrounds may delay this matching process. In all instances, the couple and the surrogate will meet prior to finalizing a match.
How soon may we begin?
We begin surrogate cycles twice monthly. Once a suitable match has been arranged, the limiting factor becomes completion of all of the appropriate legal formalities. Once a signed surrogacy contract is received, the cycles of the mother to be (or egg donor) and the surrogate will be analyzed, and arrangements will be made to initiate the tretament cycle. We are able to take into account scheduling requirements of all involved. With modern cycle management techniques, we can usually accomodate any scheduling requirements of either the couple or the surrogate.
What happens after the birth?
Prior to an anticipated delivery, depending upon the State where the delivery will occur, and the arrangemnts that have been made, the attorney for the parents to be will usually petition the Court for an order directing the Medical Records Department at the hospital where the delivery will take place to place the names of the legal, genetic parents on the birth certificate of the infant. The surrogate's name generally never appears. The obstetrician then signs the completed, legal birth certificate record which is then forwarded to the city or county recorder of vital statistics. Parents will obtain a validated certificate from the appropriate government agency charged with maintaining birth records. The baby will be seen in the newborn nursery by a pediatrician, and when ready for discharge, will be sent home with his or her new parents. The surrogate will be discharged home when her obstetrician feels she is ready to leave the hospital. At this point, further contact between the parents and the surrogate is by mutual consent and agreement. Please see other sections of this Web site for post-delivery experiences of couples and surrogates. The care of the newborn in the nursery is coordinated with the health insurance company of the new parents. This is important, as multiple births can result in significant newborn infant care charges. Our current multiple birth rate in gestational surrogacy has been reduced thanks to a reduction of the number of emryos placed with the surrogate, but still remains substantial.
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