Friday, April 12, 2013

How To Go About Doing A Surrogacy in Puerto Rico

Firstly, I am what is known in the online surrogacy community as a Gestational Surrogate x 1 (GSx1). Currently 20 weeks pregnant carrying my 2nd pregnancy as a Gestational Surrogate. First Gestational Surrogacy was twins, this one is a singleton. I have been through 3 IVF’s, 3 IUI’s (one cancelled), a miscarriage previous to conceiving my own last child, another miscarriage after my first IVF (first surrogacy), had my first cesarean with the surro twins, and have birthed 3 children of my own vaginally. Two were home births. So it’s safe to say, I am not only an experienced surrogate, but experienced in general.

This post is in response to an anonymous comment/question left at my blog entry titled:  
Officially An Experienced Gestational Surrogate

The comment says …

"hey :) i live in Puerto Rico have a baby boy and would love to be a surrogate do i do that? my email is … "

As I told the poster, I would post my reply as a separate blog entry because it could help someone else with the same question.

So here is my answer …

First and foremost, you only have one child, and if I am not wrong you now have a profile at SurrogateMother (recently noticed this site does NOT exist anymore) and I can see you are 18, so before doing a surrogacy you have to be sure that in the event you lose your uterus from any sort of complications at birth, you would be ok with not being able to have any more children.

That is why many experienced surrogates advise surrogate hopefuls to wait until their family is complete to do a surrogacy. At least for me that was the case. I had completed mine before I did this.

Doing a Traditional Surrogacy you can also lose a fallopian tube if you suffer an ectopic pregnancy.

Regardless, Traditional Surrogacies are not advised in Puerto Rico, since it is too risky for the Intended Parents because the surrogate can change her mind, and you being as young as you are and only having one child thus far, I wouldn't advise it either.  It can be emotionally confusing if the person has not completed their family. There can always be an unconscious maternal need if the woman is young, and again, hasn't completed her family.

Going the Gestational Surrogacy route ensures it is a more mechanical/medical process for the surrogate, and maybe aid in her feeling less attached to the pregnancy in general. AND, it will ensure that if she changes her mind, she can be taken to court and the baby given to the rightful parents, since she is not the biological mother anyway.

How do you do a surrogacy? You do lots of research first. Ask lots of questions on online forums from experienced surrogates. Don't get into a surrogacy until you understand the medical process you'll go through and until you have a Word Document containing your terms/conditions and your fees. You need to have this handy at all times so you can email it to prospective Intended Parent's (IP's), or be able to take a photocopy with you when you are meeting any couple in person for the first time.

Then, you find Intended Parents (IP's). They mostly take over from there in finding the Reproductive Endocrinologist, lawyers, and Psychologist they want to work with.

You all then draft a contract to give to the Reproductive Endocrinologist (RE), and both you, maybe your partner, and the IP's, need to get a psychological evaluation (lasts from 4 to 5 hours) to give to the Reproductive Endocrinologist (RE) as well.

Once both these documents are given to the RE, the fertility drugs and injections can be started by both you and the egg donor/Intended Mother (for Gestational Surrogacy, which is the only one recommended in P.R.).

Might I add that the medication protocol/routine is a mentally and physically challenging one. YOU MUST take these medications/injections as instructed, at the correct times and dates, or YOU will have made the Intended Parents waste thousands of dollars and ruin the whole cycle (a cycle is usually a month or two).

The drugs will then control your hormones, while they will make the egg donor or the Intended Mother (IM) produce more eggs than normal. Once everything is ready, the eggs will be extracted from the donor/Intended Mother and transferred to your uterus 3 to 5 days later. All of this is called an IVF (In Vitro Fertilization) cycle.

You then go on a 2 week wait (2ww) until the official pregnancy test, which is ordered by the RE and is not the regular pregnancy test one might get personally at a laboratory. It is a test that measures hCG in numbers. If the results are more than 50, you are considered pregnant. You will not pick up these results yourself. They will be faxed to your RE directly and he/she will contact you/the IP's later in the day.

When it comes to compensation (Comp), you should divide that by 9 or 10 installments, and that should only start AFTER pregnancy has been confirmed by the Reproductive Endocrinologist (RE). Many Surrogates will only take their first comp payment after the heartbeat is first confirmed, which is at about 6 wks gestation, others at the moment pregnancy is confirmed via blood test.

Intended Parents SHOULD NOT give those 9/10 installments before an achieved pregnancy as this is frowned upon. Most surrogates will have added fees in place for procedures/doctor's visits before the embryo transfer, and that is ok. There is nothing wrong, for example, in asking for a "transfer fee" since after transfer you have to rest for 24 hours and that fee can help you pay for child care and take-out food for your family so you can concentrate on getting the rest required. Plus, it can pay for your gas and maybe for you to give something to the person who drives you to/from the RE on the day of the transfer, since you shouldn't drive yourself afterwards anyway.

Also, if your partner needs to take off from work, this can compensate for his missed wages. Many people think some surrogate fees are silly until you break it down for them like this. Then, it makes more sense to them. Many Intended Parents (IP's) are strapped financially because they have maybe already done IVF (In-Vitro Fertilization) many times themselves, and they will question any and all of your fees, so you MUST be able to understand and explain why you ask for the things you do in your terms.

Explain to them you need to have for gas, tolls, parking, food on the road, child care, your time, etc.

Surrogacy is an emotionally and physically draining experience. Just because our personal pregnancies were easy does not mean a surrogacy will be the same. This is especially true if it was via In Vitro Fertilization. You can end up carrying twins, triplets, and IVF is known for a higher incidence of high blood pressure, preeclampsia and miscarriage.

You must also research the side effects (short-term, and long term) the drugs you will take can give you. Most women are not prepared for this. I know I wasn't. I still shudder thinking of all the Progesterone in Oil intramuscular injections I had to take. I am 20 weeks pregnant from my 2nd surrogacy right now and I still have pain/tingles/itchiness on my left buttock muscle from all those injections. Those are daily injections that will last 10-12 weeks after pregnancy is achieved. That is the medication that will keep that baby glued to your uterine wall. If you stop using this, the baby will start detaching.

Lupron is another drug used during IVF, it has to be administered daily in the abdomen. It’s most notable side effects are headache, hot flashes and mood swings. During this surrogacy I had to use it for 40+ days. So that in itself is food for thought!!! And I don’t mean to scare anyone. It’s just that the RE might not explain this to you, and when time starts passing, you might get impatient. I know it happened to me every time, and I still can’t believe I got through it! Going into this with some knowledge might help.

Surrogacy is one of the things I am most proud of having done. I have brought a set of boy/girl twins into this world already, and this family is ever so grateful and reminds me all the time. BUT, it will be the hardest thing you'll ever do and YOU MUST BE SURE you are ready to go through it. I went into this because in my heart I knew I could carry a child, and give birth to it, and not get attached. And I knew I could do it for people I had never met before, and that I wouldn’t require any updates from the parents after birth OR any contact whatsoever with the children I carried. You must be too, and you must not be coerced by anyone into doing this for whatever reason. You must want to do this.

Many times you will also have to think about your Intended Parents (IP’s) and the struggles they have gone through trying to become parents, and compromise on terms because you really want to help them. It's just something that'll evolve over time for you. The outcome of your compromise can make you feel very proud afterwards. I know from experience.

After you give birth, you will sign a contract before leaving the hospital. You must not feel bad about this. Even though the IP’s will hopefully hold you in high regard for what you have done for them, they still have fears in place and their lawyer will advice them to do this to protect themselves. Then, the lawyer will start requesting the court hearing for the final relinquishment of custody and parental rights, as this is how this is done in P.R. At least for my first surrogacy, this whole process took 8 months before we finally went to court, and we only had to do that one hearing.

I might have forgotten somethings, so feel free to ask away if you feel so inclined. That's the best thing you can do, make as many questions as necessary.  Mostly ask experienced surrogates though. They know what they are talking about. They have been there, and done that. Even though many are catty and like to put many surrogates down when they find out you have unconventional fees, etc. The surrogacy community is unfortunately filled with lots of drama queens and disrespectful people, so steer clear of that and you’ll be fine.

You can also read this previous post where I talk more about beginning a journey:

Best wishes,