Your Surrogacy journey: step by step
We understand that deciding to have Surrogacy treatment is a big decision, and before starting treatment, there is a lot you will want to consider. This blog will explain each stage of the Surrogacy journey and hopefully answer any questions you have. At CARE Fertility, we believe that family is for everyone, and we are committed to supporting you on your path to parenthood.
Who might need Surrogacy?
Heterosexual couples may consider Surrogacy because they cannot carry a child for medical reasons. Gay couples who wish to start or grow their family will likely consider Surrogacy. We have also supported single people through a Surrogacy journey.
What are the Surrogacy options at CARE Fertility?
We provide ‘straight’ and ‘host’ Surrogacy at CARE. Straight Surrogacy (also known as genetic, full or traditional Surrogacy) is when the surrogate uses their own eggs and the sperm of an intended parent to achieve a pregnancy. In host Surrogacy (also known as gestational or partial Surrogacy), embryos are created using either the eggs of an intended parent or an egg donor with the sperm of an intended parent or with a donor’s sperm.
We will only provide treatment where the intended parent(s) will be able to obtain a parental order and become the legal parent of any child or children born. In both types of Surrogacy, either the eggs or sperm used to create the embryo must be provided by an intended parent for a parental order to be granted.
Under UK legislation, treatment can only be offered if there is a genetic link to at least one of the intended parents. Unfortunately, we cannot provide Surrogacy with donor embryos or embryos created using donor eggs and sperm.
Do I need legal advice to have Surrogacy treatment?
There are other specific requirements set out in the law about how Surrogacy can be commissioned and who can get a parental order. It’s important that if you are considering surrogacy, you understand the law.
As a starting point, we recommend that you read the advice published by the UK Government, which you can find here. Before we go ahead with any physical treatment, we ask both the intended parent(s) and the surrogate to seek legal advice.
Can you help us find a surrogate?
The law doesn’t allow CARE to help you find a surrogate. However, some agencies in the UK match and support intended parent(s) and surrogates for the duration of their journeys.
We recommend that you consider using one of these organisations to navigate the process of finding a surrogate:
- Brilliant Beginnings: providing support for people considering surrogacy
- COTS - Childlessness Overcome Through Surrogacy: providing support for people considering surrogacy
- Surrogacy UK: providing support for people considering surrogacy
Alternatively, some intended parent(s) come to us with a family member or a friend who has offered to be their surrogate; we can provide treatment with a surrogate via a private arrangement like this or with a surrogate through an agency.
However you have met or sourced your surrogate will not change your treatment pathway.
Do you offer international Surrogacy at CARE?
At CARE, we do offer international Surrogacy; each case is individually assessed before confirming we can provide treatment.
International Surrogacy can be highly complex; therefore, we ask patients to provide us with evidence of legal advice specific to their case before we can confirm that they can proceed with treatment.
What is the Surrogacy process?
You will have an initial call with the Surrogacy team and will be given an individualised pathway and pricing for your treatment. Following your call, you will be asked to complete a couple of forms via our patient portal. If you have a surrogate, their forms are assessed by the consultant before you have a consultation.
In this consultation, your CARE Fertility doctor will discuss the treatment process in Surrogacy either using your own eggs and sperm or with donor eggs or sperm and will answer all the questions you have.
Your surrogate would have an individual consultation where they will discuss all elements of the treatment and discuss the treatment process for an embryo transfer.
- Appointments with the Central Surrogacy Team
We will next arrange for you to have your appointment with one of the members of the Central Surrogacy Team. During this appointment, we will talk you through the Surrogacy journey; this may also coincide with a donation appointment for donor eggs or sperm.
We discuss the legalities surrounding Surrogacy and the process you will go through as an intended parent. We will also closely listen to your preferences and requirements in a donor if using donor eggs or sperm. Your surrogate will also need a donation appointment where we will again discuss the legalities in Surrogacy and all aspects for them and the journey, including screening.
The intended parent(s) will need to be screened in line with the mandatory HFEA requirements. Screening is a method to protect the surrogate from the risk of contracting infectious illnesses and minimise risk to those providing your care. An element of genetic screening will also be undertaken, which includes screening for Cystic Fibrous, Sickle Cell, Thalassemia, and we also screen your chromosomes through karyotyping.
Screening is completed before any embryos are created. Men will have their sperm quarantined for a 3-month period and undergo further screening once the quarantine period has been completed. Women are screened before their treatment and will undergo further screening during their treatment.
Your surrogate will also need some screening. This screening is minimal compared to the intended parent(s) but is completed with any future child and pregnancy in mind.
Your local CARE team will also organise a counselling appointment for you, where you will discuss the implications of Surrogacy. This is also an opportunity for you to talk through any concerns you have about treatment.
The intended parent(s) would have an appointment together, your surrogate and their partner (if they have one) will have a separate session. Once you have both completed these, you will have a joint counselling session. These sessions can be conducted remotely via our online platform, making it easier for couples whose surrogates live a great distance from them or the clinic.
- Creating embryos
To create your embryos, we first need to start stimulating your ovaries or prepare the donor eggs. Following egg collection, our embryologists will fertilise the mature eggs using IVF or ICSI treatment with a specially-prepared sample of your sperm or donor sperm that has been frozen in advance and quarantined.
If you are using frozen eggs, these would have already been collected. Our embryologists would need to gently warm the eggs at your convenience and fertilise them using ICSI. In surrogacy, we can do a freeze all cycle which allows the intended parent(s) to create their embryos even if they do not have a surrogate. This gives the intended parent(s) the flexibility in finding a surrogate, knowing they have precious embryos ready when they are.
- Embryo transfer and beyond
Once your embryos have been created, your treatment will follow the usual IVF pathway. Your surrogate will have her womb lining prepared for an embryo transfer by taking medication. We will check that everything is ready for transfer through ultrasound monitoring and sometimes blood tests.
If we are creating embryos for a fresh transfer, our embryologists will keep a close eye on your embryos as they are developing in our specialist laboratory. If you choose our unique time-lapse imaging embryo selection algorithm, CAREmaps, we then will select the best embryo for transfer using the embryo selection algorithm. If you are not using CAREmaps, our embryologist will select the best embryo for transfer based on the development they have seen using their extensive experience.
If the lining responds to medication as expected, your CARE clinical team will carefully place this embryo into the womb through embryo transfer. Alternatively, if you have precious frozen embryos on the day of the transfer, our embryologists will take great care in thawing the embryo and have it ready for the transfer.
Your surrogate may be asked to take the hormone progesterone during the ‘two-week wait’ before your first pregnancy test, as this helps to support embryo implantation. Between 14 and 15 days after your embryo transfer, we will ask you to take a pregnancy test and later confirm the pregnancy test result with an ultrasound scan.
If your surrogate’s pregnancy test is negative, we will encourage you to take as much time as you need and can support you all with counselling. When you all feel ready, we will organise a follow-up appointment with your CARE consultant to discuss the next steps. This can be a follow up for intended parent(s) or surrogate or, if needed, both; however, these would be separate appointments. If we confirm a foetal heartbeat, we will discharge you into the care of your maternity provider.
If you would like to learn more about Surrogacy treatment with CARE Fertility, please call our enquiry team on 0800 564 2270. The team are here to support you in any way they can.
With love from CARE x