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Everyone’s path to parenthood is unique. For some, becoming a parent can take a month while for others, it can take years. Some go through many rounds of IVF to carry a baby to term, while others find themselves pursuing surrogacy to grow their families. No matter how someone’s journey may unfold, there’s power in understanding the who, what, where, when, and how of each potential family-building option so you’re well-prepared for what’s to come.
Emily Sonier, LICSW and Vice President of Culture and Program Support at Circle Surrogacy, has worked with families for the last 13 years to make individuals and couples feel as supported as possible on their surrogacy journeys.
“We are an agency that manages all the parts of a surrogacy or egg donation journey, except the medical process, so we have an in-house staff made up of social workers, attorneys, case managers, and financial trust accountants,” explains Sonier.
While surrogacy is legal in some form in most U.S. states, the specific laws and regulations vary. Some states have very permissive laws that allow both traditional surrogacy (where the surrogate uses her own egg) and gestational surrogacy (where the surrogate carries an embryo created using someone else's egg and sperm), while other states may have more restrictive laws that only allow one or the other, or impose additional requirements or restrictions.
Circle Surrogacy specifically supports gestational surrogacy and those with a medical need for surrogacy, and their support team helps intended parents navigate the entire process, as well as any questions or concerns that may arise along the way.
“Gestational surrogacy [means] the surrogate is not genetically related to the baby (she does not share DNA with the baby),” explains Sonier. “Either because the biology being used is the intended parents’ or an intended parent/egg donor combination.”
A medical need for surrogacy refers to the intended parents having a medical diagnosis (either physical or psychological) that makes it difficult or impossible for them to start a family through other means.
Behind the Scenes at Circle Surrogacy
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According to Sonier, the first step in the matching process includes making sure both the intended parents and the potential surrogate are aligned ahead of time on important decisions that may need to be made. For example, they review the intended parents' and surrogates' views on selective reduction and pregnancy termination, should either scenario present itself. After establishing legal and ideological alignment, the intended parents and potential surrogate participate in a matching call that, if successful, would officially match them and kickstart their journey.
Their next steps would include a checklist of items:
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A full medical screening at the intended parent's fertility clinic
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Legal clearance, including a completed carrier agreement
“Once medical and legal clearance is in place, the surrogate can start medications for the IVF cycle and will travel to the IVF clinic for the embryo transfer,” explains Sonier. “If the transfer is successful, the surrogate is transitioned to an OB in her home community for the remainder of the pregnancy after the IVF clinic releases her for care. If she is not pregnant, the surrogate will usually proceed to a new IVF cycle for an additional transfer.”
Common Reasons Intended Parents Choose Surrogacy
According to the California Center of Reproductive Medicine, menstrual conditions like PCOS, endometriosis, or not having a uterus are some of the reasons why people turn to surrogacy.
Sonier adds that those who turn to surrogacy come from all different starting points:
“Some of our clients are gay individuals or couples who want to have a biological connection with their child or who believe this is their best path forward to grow their family for other reasons. Some of our intended parents are heterosexual individuals or couples who have a medical need for surrogacy, meaning the intended mother cannot carry a pregnancy due to a medical diagnosis.”
While the surrogacy process is mostly the same for both heterosexual and LGBTQIA+ couples, some key differences (both legal in nature and on the medical side) are unique to LGBTQIA+ couples.
In order to close gaps for couples who identify as LGBTQIA+, Sonier and their Circle Surrogacy team do the following:
“First, Circle will always look at finding the best legal match first, so knowing whose biology is being used to create the embryos, citizenship requirements, [and more], will be important. Surrogates get to choose with whom they match, so we are always sure to check that not only the surrogate and her support person/partner are comfortable working with a gay individual or couple but that her larger support system is as well. We are an organization started by a man who has two children, now adults, via surrogacy. At the time he and his husband created their family, they wanted to expand access for others, believing that everyone deserves the opportunity to be a parent.”
How to Advocate For Yourself When Exploring Surrogacy
Surrogacy is a complicated — yet beautiful — way to grow your family, which is why knowing what questions to ask and key things to look out for is incredibly important.
Sonier shared a few questions intended parents should ask themselves, as well as any potential surrogacy agencies when considering gestational surrogacy:
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What level of support do I hope to have going through a surrogacy process?
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Knowing that surrogacy can be a profound experience for everyone involved, how open might I be to building a relationship with the surrogate during the process?
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Does experience matter when choosing a surrogacy agency, knowing how many unknowns there might be ahead?
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How thorough is the screening and matching process for the surrogate we end up working with?
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What types of things can go wrong during surrogacy?
While it may feel like starting a family through surrogacy is full of decisions, it is not a path you need to walk on your own. You can find power and support in turning to your own community or working with an organization like Circle Surrogacy.
Vivian Nunez is a writer, content creator, and Happy To Be Here podcast host. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.