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Why Does the Surrogacy Process Take So Long? – An Explanation of the Timelines

The surrogacy process is a complex and intricate journey that involves numerous legal, medical, and logistical considerations. While surrogacy offers a ray of hope for individuals or couples struggling with infertility, same sex couples or single men, the process itself can be lengthy.

From initial preparations and screening to legal contracts, IVF medical procedures, and then pregnancy, surrogacy requires careful navigation of multiple steps. Understanding the various factors that influence the duration of surrogacy can shed light on why it often takes a considerable amount of time before a successful surrogacy baby is born.

How Long Does the Average Surrogacy Journey Last?

The duration of an average surrogacy journey can vary significantly based on several factors and circumstances. While it is challenging to provide an exact timeline, as each surrogacy arrangement is unique, it is generally safe to expect that the process can take between 18 months to two years from the initial steps to the birth of the baby.

This timeline includes the very beginning of the process when the intended parents need to research a fertility clinic, make the embryos, and find a surrogacy agency. If the journey has failed embryo transfers, or any other major delays, the two year timeframe is the most common scenario.

All the Surrogacy Process Steps That Make the Timeline Longer

Looking from the very beginning of the process, all the way to end at labor and delivery, there are a few particular moments that tend to cause bottlenecks and add time to your journey. Below I will explain the details involved in those moments, and also include tips and advice on how to move through them quicker.

Deciding to Pursue Surrogacy to Have a Baby

The decision to pursue surrogacy as a means to have a baby is deeply personal. This choice often comes after a long and emotional journey of exploring various fertility options or possibly adoption. While many do take their time to throughly think through all the scenarios and options for third part reproduction and family building, my advice is don’t wait too long before you take action.

The waitlists for surrogates are very long, and parents often wait over a year before they are matched with a surrogate. I highly suggest meeting with surrogacy agencies and putting your name on at least one waitlist as soon as possible.

About Surrogacy Agency Waitlist Fees

*Note – I have recently updated this section after to speaking to agency owners. I had originally said that intended parents should never pay to be on a waitlist, but there are some circumstances where it may be applicable. The deposit should be a smaller amount (in the hundreds range and not thousands), and should be applied to your agency fee upon match.

While there are many agencies that do take large fees to be on their waitlist, this is considered an unethical practice to take a deposit and never ultimately provide a good match with a surrogate. I have worked in the surrogacy industry for years and I know many agencies who do not charge parents until they are matched with a surrogate of their choice, or they charge a very nominal fee that is refundable. Non-refundable deposits with no guarantee of a surrogate match is unethical.

Applying to Be a Surrogate

If you are applying to be a surrogate and you’ve confirmed that you meet all the surrogate requirements, then the agency will start gathering all your medical records for review. The process of the agency contacting your previous medical providers and requesting your ONGYN records from previous pregnancies can be a bit tricky. Sometimes it takes weeks to get the records mailed, and other times the doctors offices don’t want to release them to an agency.

The best way to speed along the medical records process is for the surrogate to request them herself, and then have them delivered directly to the agency from the doctor. The OBGYN is much more likely to release the records to the surrogate, and in a much more timely manner.

For my own surrogacy journey, I requested most of the medical records myself and had them either faxed, emailed or mailed to the intake team at my agency. It only took me 2 weeks to get all my records, versus the 4 – 6 weeks I’ve seen for other surrogates.

OBGYN Annual Exams and Pap Smear

When a surrogate is going through the application process, she will need to be current on her OBGYN check-ups. First thing that should be done is scheduling an annual exam at your OBGYN, including getting an updated pap smear.

Most surrogates are also required to get an OB clearance form completed by either their current OB doctor, or the doctor who delivered their last baby.

These types of appointments can be booked out for weeks, so it’s important to be proactive and get your appointments scheduled as promptly as possible. A surrogate could be looking at a delay as long as 8 weeks just waiting for her OB to have an opening for an office visit.

Making Embryos at the Fertility Clinic

There’s two types of IVF treatments that happen with a surrogacy journey. The first one is the intended parents making the embryos. This usually involves egg retrieval from either the mother or an egg donor. Next comes sperm retrieval, and finally the embryos are created and tested.

The delays in this process are usually with the egg retrieval, often when multiple rounds of retrieval are required to get enough viable eggs. Also there could be delays with finding an available egg donor, especially because there’s a shortage of qualified egg donors.

The only way to possibly move forward through this process a little faster is to be very proactive when it comes to scheduling the appointments and submitting paperwork. While you can’t control how many egg retrieval cycles you’ll have to complete, staying engaged in the process and being very responsive the clinic is vital for movement forward.

Matching with Your Surrogate

The Match Call with the surrogate and intended parents is a momentous occasion, but there’s so many things to be done before this moment happens. When both the surrogate and parents are thinking about who they want to work with on their journey, they need to be realistic and compromising. There’s no such thing as a perfect person, we all come with our baggage and characteristics. Communicate with your agency about what you’re looking for in a surrogate or intended parents, and also be open to seeing profiles that don’t meet 100% of your expectations.

The truth is you’ll be waiting a very long time to be matched if you’re not willing to compromise at least a little bit on who you are matched with. In my opinion, at the end of the day you want to be matched with someone who has a good heart and will be supportive during the journey. Those are the two major things that will make or break your journey experience.

Medical Screening at the Fertility Clinic

When the time comes for the surrogate to head into the fertility clinic for medical screening, the scheduling is done around her period cycle and there’s a very limited window of time for the appointment. She will basically have to drop everything with very little notice and travel to the clinic. For my own journey, I had to travel from Sacramento to Las Vegas and I only had about 1o days notice beforehand.

In order to avoid having to wait until the next month of her cycle, the surrogate needs to be proactive in finding last minute childcare so she can travel. Childcare should always be paid for by the intended parents if she needs to hire someone, or a family member can be reimbursed lost wages if they have to take time off work to watch the kids.

If the surrogate is employed, she will have to have an agreement and flexible schedule with her employer to allow for the last minute travel. Having those conversations with her job at the beginning of the journey can possibly help to avoid delays.

The Legal Clearance Process

Both the surrogate and intended parents enter into legal contracts to formalize the surrogacy agreement. This process is assisted by ART attorneys (Academy of Adoption and Assisted Reproduction Attorney). The surrogate is assigned her own legal representation (which is paid for by the parents), and the intended parents also have their own attorney.

Both parties need to read the very long contract (mine was about 65 pages long with small type). Any requested changes are referred to as “red lines,” and they go back and forth between the two parties until everyone has agreed to all the terms.

To keep the legal contract process moving along swiftly, make sure to be very responsive to emails and calls from your lawyer. Be vocal from the very beginning regarding the requested changes, and make sure to ask as many questions as you can early on in the process.

IVF Cycles and Embryo Transfer

After the legal contracts are signed, the surrogate is ready to move forward with starting the IVF medication. It’s very important to pay close attention to the medication calendar and protocols. Making a mistake in the medication process can cause a month delay, because you may have to start a new cycle. Stay in close communication with your clinic and case manager, and make sure to ask any questions if you are not sure how to follow the instructions.

When it comes to scheduling the embryo transfer, it’s very similar to medical screening in that the surrogate will have to travel fairly last minute. Having as much flexibility as possible is important to try and make the limited timeframe work for travel plans.

Delays at the Fertility Clinic

I want to take a second to address a reality that is currently happening at the fertility clinics. A significant challenge facing fertility clinics across the United States is a shortage of staff. The demand for fertility treatments and assisted reproductive technologies has been steadily increasing, while the number of trained professionals in the field has not kept pace. This shortage affects various areas of fertility clinics, and can cause delays in several areas of the process.

The complexity of the procedures, the need for personalized care, and the delicate nature of fertility treatments require a skilled and dedicated team. However, the limited availability of trained professionals has led to longer wait times for appointments, delays in treatment cycles, and increased stress for individuals and couples seeking fertility services.

Pregnancy and Delivery

Once the surrogate is confirmed pregnant after heartbeat confirmation, there shouldn’t be anymore delays in the process. She will hopefully remain pregnant until labor and delivery happens, and then of course the baby arrives!

In Conclusion, Patience is Key

In the world of surrogacy, nothing moves fast. All parties involved must do their due diligence to make sure the surrogate, the intended parents and the baby are fully protected. The intricate and time-consuming nature of the surrogacy process requires a steadfast commitment to waiting and understanding that delays and unexpected hurdles are not uncommon. From finding the right surrogate, to medical evaluations and legal procedures, patience becomes paramount, but the reward of parenthood is always worth it in the end.

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