Advice from old-timers

Competition between candidates.

You and your husband must look through and interview at least 3-5 candidates.  Find out about their psychological type, their life story, their body build, educational status, the true reasons that lead them to seek this type of income, and other aspects of their life that might help you build a better dialogue with them and maybe even a better relationship during the entire pregnancy.

Maria: "A surrogate mother does not have to be married.  I think that having a husband in that case merely creates an additional problem.  The absence of a husband does not mean that a woman is not self-sufficient and will want to keep your child.  As a general rule, women who agree to become surrogate mothers do so to fix their financial situation (most often their living conditions or medical care for their own children).  They already have children of their own that they need to feed and clothe.  Therefore, as a rule, they do not need another woman's child.  When I was interviewing candidates, I would usually ask about the following:
* the woman's age (generally, younger than 35, the younger the better),
* how many children she has and what are their ages,
* family status. If she is married, does her husband agree to her participation in the surrogacy programme,
* her blood type, Rh factor (it should be positive, but not necessarily). A woman with a negative Rh factor will be suitable for couples who both have negative Rh factor,
* the regularity and length of her menstrual cycle,
* how far along the woman was when she gave birth, and whether or not she had any problems during pregnancy and delivery,
* the amount of compensation, monthly allowance for food, transportation costs, place of residence are then agreed upon".

The most unpleasant and unsettling possibility is the subsequent blackmail on the part of your surrogate mother.  Maybe you can't read people well, you got unlucky, and you didn't choose the best candidate for your  surrogate mother.   She might be too greedy, deceitful, or, what's even worse, has dangerous connections (a partner, brother or husband, who is an ex-convict).

If your surrogate mother is married, you need to be prepared for a possibility that she must fulfill her marital duties, which could indirectly lead to pregnancy termination.

If a surrogate mother has no one to leave her children with, it will also interfere with the programme, because you will be forced to accommodate her (you are not a monster, after all, to keep a mother from going to her sick child).

It is essential to agree on the method of childbirth: C-section or regular birth.  This is entirely up to you, but some believe that C-section delays the awakening of mothers' maternal instincts.  Taking that into account, you might want to  mentally prepare the surrogate mother for a C-section.  That will be psychologically easier on both you and her.

You need to cover all these aspects when interviewing your candidate, do not hesitate to ask these questions.  It would be a good idea to inspect your chosen mother, and you might have to take the time to look at her actual living conditions or give that task to the company.

Choosing your candidate

It is best to have at least two candidates as a reserve in the event of unforeseen circumstances. In choosing one candidate or another, you must immediately determine your behavioral strategy as well.  No friendships.  Strictly a business relationship.

Medical examination of your chosen candidates.

It is better to spend more money and have her be examined at the centres, where they do a good job of checking for infections and the like, rather than trusting the certificates from local clinics, because provincial laboratories are quite possibly working with outdated technology and equipment.  Nevertheless, your chosen candidate must have documentation certifying her healthy status, which you will, no doubt, have to recheck.  Let us go over the more important ones: a pelvic ultrasound on day 4-5 or 15-17 of the menstrual cycle.  A transvaginal ultrasound should be performed (if  the overall tests are normal).

If the doctor expresses no concern about the results of the ultrasound, we can move on to the next stage of the examination - checking for sexually transmitted infections.  Normally, they just do a pap smear, but it is better to be on the safe side and do a blood test as well.  If they don't find anything, congratulations to you.   If the results of the tests are not comforting, you need to decide for yourself the following: do you now go on to have your candidate undergo treatment for the infections or do you resume your search for a new surrogate mother and, consequently, go through all the examination stages again.  

Reference. As of 2009, the AVERAGE cost of examination for one surrogate mother (if you take the surrogate mother to different laboratories) amounts to 15-25 thousand rubles.  These same examinations will average anywhere from 25 to 60 thousand rubles, if you have them done at a reproductive clinic. 

Keep in mind that a surrogate mother can ONLY obtain a certificate from a mental health clinic and a drug treatment centre at her permanent place of residence. 

Negotiation of the "contract" terms and conditions and the signing of the contract

What should the contract definitely include? The devil, as they say, is in the details: the more thoroughly you describe your mutual obligations, the better.  Do not forget that you are entering into a LONGTERM relationship, and that verbal agreements tend to become forgotten and lead to mutual grudges. In sum:

* determining the price or cost of the service in the event of successful outcome of the programme;
* the place of residence of the surrogate mother during her examination and the protocol procedure, her pregnancy and childbirth;
* the procedure for payment;
* compliance with the treatment regimen by both parties;
* the place and procedure for labor and delivery;
* payment for cell phone communication;
* daily allowance (food+transport) during her residence for the period of examination and the protocol procedure, if she is not going to be staying with you;
* payment for her transportation home and back;
* etc.

Reference.  It is, of course, better to turn to professionals even for a contract. The "SweetChild" company provides this service for free, but all the participants will have to be present for it.

Maria: "I had a not so pleasant experience with having a surrogate mother live with me (during the protocol procedure).  I want to advise you against living together.  If the surrogate mother can go back home, that's great.  If not, look into the possibility of renting a place for her for the duration of the procedure.  This will preserve your sanity and, most importantly, your relationship with this woman.  I am not even going to go into the difficulties of cohabitation of two very different adult individuals, who need to communicate 24/7."  

Starting the protocol procedure (synchronizing your menstrual cycle with that of the surrogate mother)

The essence of the protocol procedure with surrogate mothers: you undergo the stimulation of superovulation and simultaneously the surrogate mother (her endometrium) undergoes preparations for transfer of your fertilized embryos.  The process of fitting or synchronizing a surrogate mother's cycle to yours begins well before the start of your protocol procedure.  In the meantime you go through all the stages of a standard IVF procedure, including follicular aspiration.   Women, who have their reproductive organs intact,  undergo a regular medical protocol for IVF.  Only they are not prescribed anything for luteal phase support following oocyte aspiration (or whatever they are given is mild to maintain hormonal balance).  Difficulties for women with hysterectomy arise only at the very first stage, when it is necessary to determine the starting date for the superovulation stimulation. 

You might have some fears regarding the surrogate mother's own ovulation.  You do not need to worry.  The doctors monitor the situation with medication and examine the surrogate mother's ovaries on ultrasound. 

An important indicator of the surrogate mother's readiness is normal thickness and structure of her endometrium.  If there were no problems with fertilization, and the embryos turned out normal, the embryos are transferred into the surrogate mother's uterine cavity. The chances of success are rather high in the surrogacy programme, which increases its popularity with clients, who have gone through numerous unsuccessful IVF attempts.

Following the embryo transfer, you will need to provide the surrogate mother with all the necessary medications in the required amount (based on a doctor's prescription) and detail for her a clear timetable for taking the medication, its route of administration, and dosage.

Pregnancy check

If your result is negative, you pay the surrogate mother in accordance with the arrangements for such an eventuality and, following a consultation with your doctor, decide on your plans for the next protocol procedure, and agree on a new candidate for a surrogate mother. Quite often, following an unsuccessful embryo transfer into a surrogate mother, the doctors recommend using another candidate, and then, unfortunately, everything gets repeated, starting from the selection of a new surrogate mother (see above).

If you have positive results, then you can allow yourself a small victory celebration.  Afterwards, you will have the difficult task of waiting for the birth of your baby for 9 long months.

Tatyana: "We went through this process ourselves and are now raising our two sons.  They are already 6 years old, and when we were starting out, there, unfortunately, were no reliable  companies out there that specialized in surrogacy programmes.  Now I know that everything that I did on my own, I could have handed over to professionals.  Of course, the more things you do  yourself, the lower the overall cost of the programme.  HOWEVER, I already advised two families to go to a company.  The "SweetChild" company takes the load off of you, helps you feel ten times lighter and increases your peace of mind. The decision is entirely up to you."

Maria: "You might get scared off after reading all of the above. Nevertheless, the chances of a successful pregnancy following an IVF procedure with an embryo transfer into a surrogate mother is much higher than with a regular IVF, since the transfer is performed on a virtually healthy woman. The happiness you gain by becoming a mother fully compensates all the expenses (financial and psychological) that you incurred at the beginning stages of your path toward parenthood."