Whether it is due to fertility problems or other reasons, surrogacy is a practical option for so many people. Being a surrogate is an exciting and life-changing experience that can have many valuable impacts on the life of an infertile couple. For every woman who considers being a surrogate, learning about the process and its requirements is essential. Here is an outline to know all about surrogates and the process of a surrogate mother and how to become one of them.
Who is a surrogate mother?
Surrogate mother is a woman who goes through pregnancy process, then deliver the baby for another couple.
As we have two types of surrogacy, there are two kinds of surrogates:
Traditional surrogate is a woman who gets inseminated artificially by the sperms of the intended father. She is the biological mother of the baby because her eggs are used for making the embryo.
Gestational surrogate is a woman who gets inseminated by an embryo made with intended parents’ (or donor’s) sperms and eggs using one of the infertility treatments (IVF or ICSI). In this type, the surrogate is just the carrier of the baby through pregnancy period.

Who need to use surrogate mother?
There are several reasons why people use surrogates, such as:
- Medical uterus problems
- Lack of uterus because of hysterectomy
- Health conditions which prevent pregnancy like cancer, diabetes, cardiovascular disease, etc.
- Having a genetic disease which can be transmitted to the embryo
- Recurrent miscarriages
- abnormalities in the structure of the uterus, etc
How to choose surrogate mother?
Commonly, there are two major ways for finding a surrogate.
- Friends or relatives: some people find a surrogate among their friends or family members. They discuss that this way is simpler by a trusted person because of the high cost of surrogacy and the complex legal issues.
- A surrogacy agency: the agencies are mostly used for gestational type of surrogacy because they have experts to manage the whole arrangements between both surrogate and intended parents.
Required features for becoming a surrogate
The qualification features vary among different agencies but the most important ones are explained here.
Age: The preferred age for being a surrogate is between 21 to 45. This range can be a bit different based on the location and destination country’s principles.
Reproductive background: Surrogates need to give birth to a baby at least once before becoming the surrogate candidate. Their reproductive background must not exceed five vaginal deliveries or two cesarean sections.
Physical and emotional tests: The surrogates must have passed a psychological screening by a mental health expert as well as their physical tests.
Lifestyle: They must have a comfortable and supportive environment during the pregnancy period and also do not have any kind of alcohol and drug problems.
Signing necessary contracts: a surrogate must understand her role and responsibilities and sign the related contracts which the attorneys prepare.

What is the process of a surrogate mother?
To be a surrogate has a lot of merits. It can change the lives of so many couples which is priceless. If you are considering being a surrogate, you may wonder what the process would be like from the beginning to the end. Here we talk about the pregnancy process for gestational surrogate mothers to guide you through this journey. the pregnancy process for gestational surrogate mothers is explained below.
Step 1: initial screening
It all begins by completing a surrogate application form. The questions of this form are all about you that allows the agency gather some information about topics like your personal information, health and pregnancy details, financial condition and your supporting network. After your application is approved, you need to submit your medical record for evaluation. If everything goes well, you will be in touch with a surrogate advisor until you find a match with an intended couple. This process can take 1-2 weeks
Step 2: Consultation
Before starting embryo transfer, it is necessary to have psychological consultation to be sure you are emotionally ready to be a surrogate. During this phase, you will have in-depth interview(s) with a social worker to evaluate your motivation for becoming a surrogate, your supporting people, family members and the interpersonal relationships, your interests and also your pregnancy history.
In consultation session(s), you can ask all of your questions about this process to know what your position in surrogacy process is and what is expected from you.
Step 3: Matching with intended parents
In this phase, profiles are exchanged with intended parents to examine if there is an interest. A surrogate advisor from the agency will help you through this period to find the best match. You may choose to text or call the intended parents before meeting them. There can be in-person meetings if both parties are comfortable. An agency staff can also accompany them to mediate the sessions.
Step 4: Medical screening and Legal contracts
After matching happened, you have to pass medical screening at an IVF clinic which includes physical exam, sonogram and blood test. Also, the surrogates learn about medications which must be taken to get prepared for the pregnancy process.
By receiving a confirmation from the physician that proves you have completed the necessary tests and you are ready to proceed with the process, now it is time to sign the contract provided with the intended parents’ lawyer. You need to have your own lawyer to protect your rights and make sure the contract fulfills your needs. Things like risks, each parties’ responsibilities, compensation, monthly allowance and other costs of surrogacy must be negotiated in the contract. They may also discuss about probable scenarios like having twins, triplets or even abortion. This step can take approximately 2-3 months.
Step 5: Physician’s monitoring and embryo transfer
During this step you start your prescribed medications under the monitoring of your physician. Monitoring appointments include bloodwork and ultrasounds to make sure everything goes in the right direction.
For embryo transfer, you have to go to the IVF clinic. This process is done fairly quickly. Doctor gives your needed instructions and probably asks you to rest after the procedure. Intended parents can also attend in the embryo transfer session, so you can use this chance to spend more time with them. This period can take 3-4 weeks.
Step 6: Pregnancy
After embryo transfer, you need to have your routine appointments with your local doctor for blood tests to ensure pregnancy is progressing as it is expected. After usually 10 days the first blood test is done and if you have positive beta test, around 6-7 weeks you will have an ultrasound test to check if there are heartbeats. Around week 10th of the pregnancy, you will be allowed to have your routine appointments. Meanwhile, you can try to develop your relationship with the intended parents and get to know each other better.
Step 7: Delivery day and saying goodbye to the newborn
Delivery day is one of the most special and emotional days for both intended parents and surrogates. During the last months, you can have a birth plan to make sure everything happens according to both parties’ wishes. This plan can include matters like taking photographs during delivery, holding the baby for the first time, etc. intended parents may even bring this document to the hospital to inform the hospital staff about the agreements.
The delivery day can be very emotional day for you as the surrogate because you spent almost a year of your life to carry and nourish the baby in your body. What you do would be priceless and amazing and the intended parents will be grateful for good. However, you have to know that at this stage saying goodbye to the baby and wishing him/her happiness is very important. This stage of surrogacy process for surrogates could be hard but necessary. Although it cannot be an eternal goodbye as many surrogates continue their relationship with the intended parents even after delivery.
Short Questions & Answers
How does Surrogate Mother get Pregnant?
Gestational surrogacy is the most common type of surrogacy. In this type, the embryo is made through the fertilization of the mother’s egg and the father’s sperm. These gametes can be taken from donors. Then the embryo is transferred to the surrogate’s uterus using a catheter. The surrogate mother does not have any genetic relationship with the embryo and she is only the carrier of the baby. In the traditional type of surrogacy, the surrogate is also the egg donor and as a result, the baby has a genetic relationship with her. In this type, the intrauterine insemination (IUI) process is used to fertilize the surrogate. The doctor takes the sperm from the intended father and transfers it to the uterus of the surrogate mother so that the natural pregnancy happens.
How is a Surrogate Baby Made?
The answer to this question depends on the type of surrogacy process that has been chosen. In traditional surrogacy, the surrogate gets pregnant by simply transferring the sperm to her uterus using the IUI technique. Then she waits for natural fertilization to occur. However, gestational surrogacy needs the IVF process since the eggs are taken from the intended mother or an egg donor. Therefore, the embryologist fertilizes the eggs with the sperm of the father or a sperm donor through In Vitro Fertilization process inside a laboratory.
for more information: Surrogacy in Iran
Author: Leila Nazari
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