Often, one of the disappointments upon discovery that one is gay is the loss of the opportunity to create a biologically connected family.  As recently as ten years ago, “having a baby” for two gay men, or two lesbians facing fertility challenges, was next to impossible.  Today, thanks to medical technology and the willing hearts of surrogates and egg donors, the dream of having a biological family is not only possible, it is, happening with increasing frequency.

There are two types of surrogacy:  traditional and gestational. Traditional surrogacy is a process in which, through artificial insemination, the surrogate is impregnated using her own egg and the sperm of the intended father or a donor.  Gestational surrogacy is a process in which eggs are extracted from an egg donor, fertilized by a doctor using the intended father’s sperm or donor sperm, and some or all of the resulting embryos implanted into the gestational carrier or surrogate. Gestational surrogacy is by far the more popular option, accounting for more than 90 percent of all cases in the gay, lesbian, bisexual and transgender (LGBT) community.

SOUND EASY? THINK AGAIN!

The surrogacy process is complex at best.  While being a part of the pregnancy process is an extraordinary experience (and the result is the creation of your family), surrogacy is not for the faint of heart. Surrogacy is a process involving an array of individuals, all with unique personalities and all working to fulfill your dreams of parenthood. In addition, just like any couple attempting pregnancy, medical issues can involve unsuccessful attempts, miscarriage and fetal abnormalities.

Success rates for gestational surrogacy have improved greatly with advances in technology; 60 percent of first attempts and 90 percent of second or third attempts result in a positive pregnancy.

There are three primary approaches to surrogacy. While they differ greatly in how the process will work, all approaches include the following components: a gestational or traditional carrier, doctor, lawyer, intended parents and, more often than not, an egg donor. It is important to remember that no approach is without pros and cons and all require some level of your personal involvement. Surrogacy is, more than anything, a process in which all the parties play a special and unique role.

THE “BIG” AGENCY APPROACH

There are several large agencies that offer a full service approach to the surrogacy process, including identifying and screening your surrogate, providing case management support throughout the process and assisting with legal, medical, insurance and financial matters. A psychologist is also usually involved to assist with emotional and relationship issues. Most large agencies have close working relationships with the clinics and other professionals they work with and are there to “hold your hand” throughout the process—even through delivery of your child by working with the hospital staff for a smooth birth process. While the large agencies have the highest fees, the big advantage is that you’ll do less work and have a comprehensive support network to rely on.

THE “SMALL” AGENCY APPROACH

As surrogacy has become more widespread, a growing number of smaller surrogacy agencies have come into being.  These include agencies run by former surrogates as well as attorneys. The general approach of smaller agencies is to provide you with introductions to surrogate candidates, provide referrals to clinics and other professionals, and provide support services that often include legal and financial administration.  While the fees of these agencies are usually less than those of the large agencies, you will do more of the work yourself and will not have a full service, case-managed approach to the process.

THE “INDEPENDENT” APPROACH

Often called the “home-grown” or “do-it-yourself” approach, independent cases often involve using a friend or family member as the surrogate or locating gestational carrier candidates by advertising. This approach will require you to manage all the financial, administrative, legal and medical issues yourself and for this reason may be overwhelming at times. However, an independent approach also can save a great deal of money, making surrogacy more affordable and a possibility for more members of the LGBT community.

WHERE DO I START?

The first thing you need to do is your research. Many agencies offer free or lowcost consultations in which they will explain how the process works in their program. You can also use the internet.  Search for “gay surrogacy” in Google.  You’ll be amazed at the number of resources available. As you research the options, the goal is to find the approach that feels the most comfortable for you.

You also want to evaluate the important issues including:

• Legal status of surrogacy in the state your surrogate resides
• Success rates of potential IVF clinics
• Availability of healthcare insurance for your surrogate during the pregnancy (many policies have surrogacy exclusions)
• How you and your partner will be named parents of the baby in the state where the delivery occurs or in your home state after delivery
• Your surrogate’s medical background including previous pregnancies and deliveries
• Success rates and business history of the agency you will be working with

BRING HOME BABY

Typically, you should plan on the entire surrogacy process taking between 14 and 18 months from the time you begin until you go home with a baby. While costs vary depending on your approach, you should be prepared to spend at least $50,000 on an independent case and up to $120,000 for an agency-managed case that includes private insurance for your surrogate. Also be prepared for the potential of a larger family than you may have imagined. Approximately 40 percent of all gestational surrogacy cases result in multiple births.  While the surrogacy process, like adoption, has its ups and downs, the end result is that you will have your baby (or babies) and all the memories of how you created your family.