Surrogacy 101: Medical process

This article continues our series on informational articles about surrogacy.

Cycling

Once the contracts are complete and testing has finished, the Surrogate and the Egg Donor (who can be the Intended Mother or a donor) synchronize their cycles. This is usually with birth control pills. About 14 days into the birth control pills, both Surrogate and Egg Donor will start Lupron.  Lupron is a subcutaneous (just under the skin) injection to shut down the body’s normal hormone production used to control the cycle and ensure the Surrogate’s uterus is ready to receive the embryos at the exact time for the best chance of success.

The Surrogate is usually about a week or so ahead of the Egg Donor to ensure her uterus will be ready when the eggs are retrieved and fertilized, and because they can keep the SM in a holding pattern for up to 2 weeks once her uterine lining is at optimum.

When the menstrual cycle starts while on Lupron, the Lupron dose is usually decreased by half and the Surrogate will start adding Estrogen replacement to the mix (in the form of pills, patches, or shots depending on the doctor). Some doctors have you take other medications as well (Dexamethasone to suppress male hormones to increase implantation, antibiotics to guard against any infection that might have gone undiagnosed, etc.)

The Egg Donor starts on injectable fertility hormones on her cycle day 3 to stimulate her ovaries to produce several eggs as opposed to just 1 or 2. Fertility hormones continue anywhere from 7 to 12 days depending on the Egg Donor’s response to the hormones. The Egg Donor is checked about 3 times a week via ultrasound and blood tests to determine her response to the drugs.

Once the follicles are the right size (about 18-20mm) she is given an HCG shot which induces an LH surge which also matures the eggs. Thirty-six hours after the HCG shot the egg retrieval is performed. Up until this time, the date/time of the transfer is flexible.

The eggs retrieved are fertilized with sperm from either the Intended Father or a sperm donor and incubated for 2-5 days. Lupron usually stops the day before egg retrieval in the Surrogate. Progesterone replacement (most often in the form of intramuscular injections, but sometimes with suppositories or Crinone gel) starts the day of the retrieval and continues until the 12th week of pregnancy or a negative pregnancy test. Estrogen replacement also continues until the 7^th-12^th week of pregnancy (when the placenta takes over hormone production). Because the Surrogate was on Lupron and had natural hormones were suppressed, The Surrogate will need to take external sources of these very important hormones in order to maintain any pregnancy that occurs.

Surrogacy 101: Legal process- Validation, Court, or Post-Birth Legal

The legal process does not end with the finalization of the legal contract. The remainder of the process will differ the most, depending on weather the Intended Parents are a gay couple, a single parent, a married couple, an international couple, and it also varies depending on the state.

We will highlight some common legal processes here, depending on some frequent states for Surrogacy.

Texas

In Texas, if a Married couple decided to enter into a surrogacy, they are the most protected by the laws of the state. There is a clear legal process for a Married couple in Texas to use Surrogacy, and it is the easiest to accomplish. After completion of the contract, the Intended Parent’s attorney will file a petition to Validate with the court.  The Court will validate the gestational agreement, and the Intended Parents or Agency will testify to the validity of the agreement in court. Once validated, the court will issue a pre-birth order, which will be given to the delivery hospital. The hospital will use the pre-birth order to put the Intended Parent’s names directly on the birth certificate.

This process is the same for validation weather the couple is International, or if they have used an egg or sperm donor, so long as they area legally married heterosexual couple.

In Texas, if you do not fall into the category of married hetero couple, you can still have an easy successful surrogacy in Texas.  While your contract cannot be validated in the courts, the rights of the biological parent to the child are still well protected. The process would be a post-birth termination of the Gestational Surrogate’s assumed rights and there would be genetic testing done, if necessary to determine the biological father.

The Biological Father’s name would be put on the birth certificate, and the other Father, if any, would get rights later under various processes such as a joint conservatorship.

Arkansas

Arkansas is a great state for Single parents, as they enjoy the rights to the full protection of the laws there. They can be granted a pre-birth order, similar to Texas.

California, Florida, Chicago, Areas of Pennsylvania

The above are all great states for gay couples to pursue surrogacy in, as their names can be put directly on the birth certificate in most areas. While attorneys should be consulted to explain the rights in a case by case basis, these are usually very favorable states to gay couples. Of course, Married couples can use these states as well.

Other States

There are other states that are favorable to surrogacy, as well as many states where surrogacy is either illegal, or has major complications. If you are considering surrogacy, be sure to consult Simple Surrogacy or an attorney in your state who can help you determine the laws there before you consider surrogacy.

One of our wonderful Intended fathers, Peter Gordon, is about to be come a Father. His Surrogate is currently in labor right now with his twins, and he’ll be a dad any moment! Here is a post on his blog about us. Thanks, Peter, we feel the same way about you!

Peter’s story will be featured on 20/20 on ABC

Archive for the ‘Published’ Category

Simple Surrogacy

Surrogacy 101: Legal process- Reviews and Negotiation

Once the Attorney receives the referral and Match sheet, they will contact the Intended Parents to have them sign their retainer. If the Intended Parents are in Texas, or have chosen a Texas Surrogate to take advantage of our Legal Included Surrogacy program, then they will have their drafting and review, as well as the Surrogate’s review already paid for under their retainer with us.

If the Intended Parents do not reside in TX or have not chosen a Texas Surrogate, then they would pay the attorney directly for their retainer fee and services for post-birth work if any. After the contract is drafted, the Intended Parents will review the contract with their attorney first to be sure they fully understand it. If they have changes, these will be requested to the Surrogate’s attorney, who is working independently for the Surrogate. In the case of using our Match sheet, it is our goal to have as few change requests as possible to speed the process and reduce attorney costs if they are charging hourly. After making any requested changes, the IP’s attorney will forward the contract to the Surrogate’s attorney for their review.

The Surrogate and her attorney will also review the contract and have the opportunity to make any change requests. Again, the use of the match sheet and general fee terms usually eliminates any major changes. While all parties are of course free to have changes, we have found the more the parties try to deviate from the match sheet or make last minute changes, the greater the chance of the other party not agreeing or backing down. Therefore, we try to make the process as smooth as possible to avoid any excessive back and forth or unusual change requests.

The Surrogate’s attorney fees are paid by the Intended Parents, even though the Surrogate’s attorney only works for her. Once all parties are satisfied with the contract, it will be signed by all parties, and notarized, and returned to the attorney to file as necessary with the courts, and for the Agency, Simple Surrogacy, to send to the clinic for legal clearance.

Surrogacy 101: Legal process- Match sheet and Drafting

This article continues our series on informational articles about surrogacy.

After all parties have passed screening they are ready to begin the Legal process. No surrogacy can take place without a valid legal contract; it is the single most important part of the process as it lays the groundwork for the entire surrogacy and all parties’ behaviors and obligations throughout.

The legal process will differ depending on many factors. These factors include the state that the Surrogacy will take place in, whether or not the Intended Parents are a legally married couple, and if there is an Egg Donor involved. The legal process, as a generalization, typically takes 6 weeks from start to finish.

Although Simple Surrogacy in no way will dispense Legal advice, we will refer all parties to dedicated Attorneys who are experts in Reproductive law to help them best determine how and under what laws their contract will be drafted.

If there is an Egg Donor involved, then a separate Egg Donation contract must be drafted and reviewed with all parties. We’ll cover the Egg Donation legal in a future post.

To begin the legal process, the Intended Parent’s attorney will receive a copy of their Match sheet, which contains all the information on the parties to the contract. Simple Surrogacy uses a Match sheet to expedite the process of negotiation of the contract, and it is one of the ways that we work to keep the costs of Surrogacy down. As everyone knows, Attorneys are expensive, and charge by the hour! If the average client were to walk directly into an attorney’s office and ask for a surrogacy contract, they would be asking that attorney to draft and negotiate the entire contract from scratch on their behalf.

With using Simple Surrogacy to guide the drafting and negotiation, the parties agree to most fees and terms beforehand. The Surrogacy fees are generally set and agreed to by the surrogate when they enter our program, if they are a first time surrogate. Experienced surrogates can ask for changes to the general terms, and the Intended Parents are made aware of their requests before they agree to match.

Once this match is agreed upon, the Match sheet will be presented to the Intended Parents for further review. It will contain information on compensation terms and schedules, expenses and fees, and other important material related to the Surrogacy match, such as Insurance information, timing periods,  base compensation and fees for bed rest, childcare, and lost wages. By having all parties agree to the terms of the match sheet before attorneys are brought in, we can save our clients substantial attorney costs and time spent in negotiating.

After all parties agree to the general terms laid out in the match sheet, then they are referred to attorneys to draft the contract.

It is always unfortunate when innocent victims are taken advantage of, and even more so, when the people taking advantage of them could just as easily be helping them. Such is the case of Theresa Erickson, previous owner of Conceptual Options and an attorney specializing in reproductive law, who has pleaded guilty to baby selling in a ring also involving attorney Hilary Neiman of Maryland. We are so saddened by the actions of those in power who have taken advantage of Intended Parents, surrogates and the unfortunate babies themselves. Ms. Erickson and her co-conspirators sold babies of Surrogates to Intended Parents for sums of at least $100,000, after sending the surrogates overseas to be impregnated with donor eggs and donor sperm. It is sad to see what was assumed to be a prestigious agency owner fall so hard, and we hope this leads to greater regulation and oversight of Surrogacy Agencies in general. Our sympathies lie with the Intended Parents and Surrogates who were taken advantage of not only emotionally by preying on their emotions and desire for a baby at any cost, but also were defrauded financially, as we all know a successful surrogacy with a reputable agency can be had for $65,000-$95,000, and not at the exorbitant sums that Ms. Erickson and Hilary Neiman were charging while breaking the law. We are sure there will be more to come from this sad story, and we hope that Intended Parents are not turned off from Surrogacy as a whole, as there are still reputable Agencies such as Simple Surrogacy to help Intended Parents and Surrogates at reasonable, legal costs.

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Attorney admits guilt in baby-selling ring

An internationally known Poway attorney who specialized in reproductive law pleaded guilty Tuesday to a key role in what federal authorities said was a baby-selling ring.

Theresa Erickson, 43, admitted that she and her co-conspirators used women to create an inventory of unborn babies that they would sell for over $100,000 each, according to the San Diego offices of the U.S. attorney.

Federal prosecutors said three women —- Erickson, along with Hilary Neiman, an attorney from Maryland, and Carla Chambers, a surrogate mother —- admitted guilt in the scheme. Assistant U.S. Attorney Michael Merriman said that Erickson agreed to pay restitution of $120,000 —- $10,000 each to 12 couples victimized in the scheme, which started as far back as 2005.

The parents in the scheme did receive children, however, they are considered victims and “we are certainly not taking steps” that would see the parents lose custody of the children, Merriman said.

Under the conspiracy, women would go to overseas clinics and have embryos implanted, becoming pregnant.

Once the pregnancy entered the second trimester, Erickson and co-conspirators would solicit prospective parents willing to pay the high fees to buy the parental rights for an unborn baby, the charges state.

The timing of when a deal is struck matters. Before conception, a woman can agree to become pregnant for profit, under California law. After conception, however, the woman cannot profit from being pregnant and supplying a child to prospective parents. The first instance is considered surrogacy, the second instance is adoption.

Under the baby-selling scheme, prospective parents were duped into believing that the pregnancies were the result of legitimate surrogacy agreements gone awry because the first set of intended parents backed out, federal prosecutors alleged. The replacement parents paid fees of more than $100,000 to take over what they believed were legitimate surrogacy agreements.

Prosecutors said the baby-selling scheme created “a steady flow of newborns with the promise that they (the pregnant women) would be paid between $38,000 to $45,000 for each successful pregnancy that resulted in a birth,” according to charges the U.S. attorney’s office in San Diego filed against Erickson on Tuesday, the same day she pleaded guilty to a charge of conspiracy to commit wire fraud.

Federal prosecutors say Erickson admitted that she faked surrogacy agreements to look like they were struck prior to conception of the baby, and then filed those false documents in court.

What’s more, the scheme enabled the pregnant women to get state insurance they were not otherwise eligible to receive, prosecutors said.

On a cached version of her website — which has since been removed —- Erickson was described as “one of the few attorneys in the United States who specializes exclusively in the area of Family Formation Law.”

The site stated that Erickson herself long ago became an egg donor for several couples seeking children.

Erickson is slated to be sentenced Oct. 28. She faces up to five years in custody.