You’ve reached the point in your family-building journey where you’re excited to hit the ground running. You want to find the perfect egg donor for you, and you may believe that starts with finding an egg donor  who lives within a 5- to 15-mile radius of your home.    We meet many intended parents who believe that the closer the egg donor lives, the better. Thankfully, the country is your oyster, and location doesn’t have to limit who you choose as your egg donor.    Instead, you get to focus on your preferred egg donor criteria—from your preferred religion to your preferred education level—and let us worry about the rest. Still wondering why location doesn’t matter? Here’s a quick breakdown of the egg donor search  and why your egg donor does not need to live near you.  Do I need to find an egg donor near me?  For those who live in larger cities, Googling “egg donation near me” may lead to a lot of results, but the same may not be true for those who live in smaller cities or towns. Thankfully, egg donation  can occur in a few different ways to maximize the number of intended parents who can benefit from egg donation.    Donated eggs come in two different forms—fresh and frozen. The two types get their names from the manner in which they are stored or processed.   ·         Frozen eggs are donor eggs that have been frozen, stored, and later shipped to your fertility clinic. They allow extra flexibility because you do not have to time an egg retrieval with implantation. ·         Fresh donor eggs, on the other hand, are donated at your clinic at the time they will be used to create an embryo for implantation. This type of egg donation requires a bit more logistical legwork but is still doable if this is what you’re looking for.   No matter which path you choose for your donor egg—whether fresh or frozen—you won’t have to worry about finding an egg donor near you because your egg donor can travel to your fertility clinic or your frozen egg will be shipped. When helping you narrow down the best egg donor option for you, our goal is to make this journey as peaceful and frictionless as possible.  What should I focus on during my egg donor search?  Since location is not a barrier to finding the best egg donor for your growing family, you can focus on other aspects of your egg donor journey instead.    During your egg donor search, a Donor Concierge case manager will meet with you to discuss what you’re looking for in an egg donor. They will use those traits to pull together a customized plan that reflects your family’s wants and needs. Before your meeting, you may sit down and ask yourself key questions about who you hope your egg donor may be.   When you start answering those questions, don’t shy away from being as specific as possible. Your donor search criteria  can include traits like a donor’s: Religion Ethnicity Location Education level Physical attributes Egg donation history Your preferences help set the stage for a donor search journey that is right for you.    And since proximity is not an issue, Donor Concierge can cast your net as wide as possible to present you with a list of vetted donors that will bring a smile to your face!    Getting started You have already started to pave your path to growing your family with bricks only you can lay down. Your donor search does not have to be any different. You get to decide what matters most to you in your donor egg search without limiting yourself to what is available to you in nearby towns or cities. If you're ready for Donor Concierge to help you find the perfect egg donor for your family, contact us  using our online form; we can't wait to help you build your family.

If you are curious about how much an egg donor costs , you’re in the right place. Starting your search for an egg donor and coordinating your finances can be a daunting process, but know that you have more egg donor options than ever. Donor Concierge has helped thousands of hopeful parents build their families. We want to make sure that every hopeful parent starts the egg donation process feeling confident and prepared for this family-building path and its cost. Read on for the information you need to know to begin your egg donation journey. Find an Egg Donor As you begin your search to find an egg donor, our advice is to make sure you are prepared and know your priorities. Don’t be afraid to act fast. Many hopeful parents are trying to find an egg donor, so egg donor candidates that you like might be chosen by someone else if you wait too long. Knowing your priorities and feeling confident will help you find your egg donor and move forward quickly. Donor Concierge searches more than 250 egg donor and surrogacy agencies to give you the best possible options to build your family. If you are struggling to find the best egg donor candidate for your family, we can help. Our team searches thousands of egg donors so you can find your top egg donor candidate. Egg Donor Cost The overall cost of egg donation can range from about $22,000 for a small cohort of donor eggs from in-house egg donor programs to over $40,000 for private egg donation through an egg donor agency. Egg donation is typically more expensive than a “traditional” IVF journey because more parties are involved in the process. The total donor egg cost includes associated expenses like: Agency fees Insurance costs Fertility lawyer costs Egg donor compensation Any travel fees Other various egg bank expenses Why does the total cost of egg donation vary so widely? Many variables are at play in your egg donation journey, including the type of donor eggs you choose, your fertility clinic, and your insurance options—all influence the total financial impact. If you are wondering about egg donor costs and how to afford egg donation, read on! How To Afford the Cost of Egg Donation One of the biggest challenges for hopeful parents considering egg donation is financing the egg donor journey . As we mentioned above, the total cost of egg donation varies based on a number of factors. You might save money on the egg donor journey by: Choosing an egg donor with lower compensation Choosing an egg donor from a fertility clinic’s egg donor program Choosing a local egg donor Applying for fertility grants Our expert team at Donor Concierge can walk you through some of the financial considerations of egg donation. Even before your free consultation with our team, be sure to check out financing options and fertility grants that can ease the total cost of egg donation. Between fertility grants, financing options, and different egg donor costs, there are ways you can save on your egg donation journey. And when you work with Donor Concierge, we can help ensure your fertility journey is as efficient as possible so you don’t lose money or time. Preparing for Your Fertility Journey As mentioned earlier, the key to a successful egg donor search is to feel prepared and confident. We highly recommend that you do your research, assemble your fertility team, and speak to a specialized fertility therapist or fertility support practitioner. Seeking out as much information as you can will help you understand the egg donation process and know what to look for when you find your egg donor. If you want to speak with other parents who have been through the egg donation process, there are many supportive communities online and in person for sharing experiences and advice. The Donor Concierge team can also refer you to past clients who are open to sharing about their egg donation journey. Over the last few years, we have seen more and more people open up about their experiences with donor conception. There are many DEIVF (donor egg in vitro fertilization) parents sharing their experiences, donor-conceived people advocating for changes in the field, and public figures sharing about the egg donation process. Taking That First Step Is Simple If you are considering egg donation, our team is here to help. Interested in building your family with Donor Concierge? Contact us to schedule your free consultation today .

Egg donor profiles usually contain a full health history of the egg donor and her immediate family. ADHD, whether medicated or not, is something we may see on a donor profile, and it may raise questions for intended parents during their egg donor search. “ That’s something we talk about with our intended parents before we start a search,” says Krystal Lemcke, Director of Private Client Services . “ Some people don’t mind, but others are rightly nervous and want to know more about the condition. We might ask the agency about it, whether the donor has had a formal diagnosis or takes medication. Some people see it as an asset in that people with ADHD may be hyper-focused and ambitious. ” Is ADHD a Genetic Condition That Can Be Inherited? Will an egg donor's ADHD be passed on to the baby? We asked some of our Donor Concierge  genetic experts to find out. Emily Mounts and Gena Shepherd, of ORM Fertility : ADHD (attention-deficit/hyperactivity disorder) is characterized by impulsivity, inattention, and hyperactivity. Individuals with ADHD may have difficulty following instructions and focusing on a task. Other symptoms include impatience, and talking excessively.( 1 ) ADHD can cause behavioral difficulties that can affect relationships and harm performance at school and, later, work. ADHD often occurs with other conditions, such as anxiety, depression, substance abuse, learning disorders, and oppositional defiant disorder.( 2 ) Some children grow out of ADHD symptoms; however, in over 30% of cases, symptoms persist into adulthood.( 3 ) ADHD is typically treated with a combination of behavior therapy and medication. With treatment, many people with ADHD can be successful in school and lead productive lives. There are many successful individuals with ADHD, and some people report that their ADHD helped them in certain ways, such as by increasing creativity and multitasking.( 4 ) Genetic testing cannot accurately predict whether someone will develop ADHD, as there is no one “ADHD gene.” ADHD is a multifactorial condition, which means that it is caused by a combination of multiple genetic and environmental risk factors. Studies have shown that relatives of someone with ADHD have an increased risk to have ADHD.( 1 , 5 ) The severity of ADHD symptoms can vary significantly, even between members of the same family. The risk for relatives of someone with ADHD is likely increased regardless of the severity of symptoms for the affected individual. Studies have found that the chance that a first-degree relative (child, sibling) of someone with ADHD will have this condition is 15-60%.(5) Relatives also have an increased chance to develop genetically related conditions such as personality disorders, substance abuse, depression, anxiety, and learning disabilities.( 1 ) It is estimated that 2-10% of the general population has ADHD.( 5 ) Even if there is no family history of ADHD, a child may still be diagnosed with this condition. Amy Vance, of Bay Area Genetic Counseling : ADHD/ADD is a relatively common condition in children (5-10%) and adults (3-5%). ADHD is a complex trait from a genetic perspective. Most researchers have suggested that ADHD is polygenic meaning it is caused by a large number of genes, each of relatively small effect, rather than a single gene. There may be environmental influences which interact with these genes, such as prenatal exposure to alcohol, as well as gene-environment interaction leading to ADHD. Twin studies provide evidence of heritability. The concordance (heritability) in identical twins is reported as 82% compared with 38% in fraternal twins. The higher number of identical twins affected indicates the genetic component. The fact that identical twins were not 100% concordant signifies that the condition is not purely genetic. For polygenic conditions, the risk to close relatives is often increased above the population risk, but the risk to more distant relatives is not. The recurrence risk for first-degree relatives of affected individuals is 20-65%. Males have a higher risk. Continuation of illness into adulthood has been found to be associated with increased risks to relatives. Finding the Right Egg Donor for You Our goal at Donor Concierge, is to help you make the right decision for your family. Sometimes, these are tough calls; that’s why our searches include connecting you with the fertility experts who can help. If you’d like to know more about finding an egg donor read our related blog post and then contact us to get started. References: Faraone, S.V., Larsson, H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry 24, 562–575, 2019; DOI: https://doi.org/10.1038/s41380-018-0070- 0 Mayo Clinic. Created June 2019. Accessed June 2020. https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889 . Margaret H. Sibley, James M. Swanson, L. Eugene Arnold, Lily T. Hechtman, Elizabeth B. Owens, Annamarie Stehli, Howard Abikoff, Stephen P. Hinshaw, Brooke S. G. Molina, John T. Mitchell, Peter S. Jensen, Andrea L. Howard, Kimberley D. Lakes, William E. Pelham. Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity. Journal of Child Psychology and Psychiatry, 2016; DOI: 10.1111/jcpp.12620 Jennifer Lea Reynolds. 2017. ‘Good Habits of Successful People With ADHD’. US News. Accessed June 2020. Schachar R. Genetics of Attention Deficit Hyperactivity Disorder (ADHD): Recent Updates and Future Prospects. Curr Dev Disord Rep 1, 41–49, 2014; DOI: https://doi.org/10.1007/s40474-013-0004-0

Any couple considering using an egg donor as an option for growing their family has to make a leap in their understanding of family building. It’s not uncommon for one partner to be more ready for this transition than the other. While the focus of adjusting to the egg donation process is often focused on the woman, men have their own struggles when considering this path. Men Want to Support Their Wives I often say that no one grows up saying, “I can’t wait to pick my egg donor.” It is as true as for men as it is for women. Men fall in love with their mate and picture a child that is theirs together. It can be a difficult emotional transition for the husband or male partner even if he will be genetically related to their child. I reached out to some of my friends in the mental health community who work with couples grappling with fertility issues to see what their experience has been with the future dads. Dr. Piave Pitisci Lake of Mount Pleasant, South Carolina: “The things I have noticed is that they are very supportive of their wives and they seem to understand their wives’ grief without being critical of it. They all want to do what is right for their wives and help them feel better. They don't like to see them hurting. They do not seem to be as concerned about the lack of their wife's genetic connection in how the child will belong to them and are able to say that because she is carrying the child it will be hers. They also seem to agree with their wives that they would rather maintain some genetic connection and control over the in-utero environment through egg donation rather than adoption.” How Do Future Dads Adjust to the Egg Donation Process? Although most of the men we work with are quite supportive, some do have reservations. One of the clinics I work with has mentioned that some of the husbands/fathers are hesitant to review donor profiles and may overly focus on the cost of an egg donor cycle. There can be many reasons for this, and if you interviewed 20 of these men, you would probably uncover 20 different issues at the core of their reserve. So let’s look at a few common issues that may arise. Grief : Men need time to mourn the child they had imagined they would have with the woman they love. This is a normal part of coming to a place of acceptance for both husband and wife. It is a necessary step toward becoming comfortable with what may still seem like a new and unusual way to create one’s family. Guilt : Men may feel that choosing an egg donor is the wife’s decision since they will be genetically related to the child being created. The dad may even feel guilty that he can be biologically related to their future child while his wife can’t share in that connection. He may feel guilty because it may feel like he is having a baby with another woman. Hands-off: If the father is the type of man who likes to leave certain decisions to his wife, whether it where they will go on vacation or who will be the egg donor, he may simply feel confident in his wife’s judgment and not want to be involved in the details. Often the wife has already done significant homework before she starts looking at egg donor profiles. Orwellian: The process of reviewing profiles of young women who will provide eggs to create their family may feel Orwellian. Donor databases can look like dating sites, and that can feel odd. Although choosing an egg donor is not choosing a new mate, it may feel like a competition between the intended mother and the donor. Transference : Men may experience transference and feel guilt if they find the donor attractive. It is a normal reaction, just as women sometimes have transference with their doctor. We all have thoughts or temporary crushes that can arise; it’s acting on those thoughts that would be a problem. Both the man and his partner may be feeling sensitive and vulnerable during this emotionally charged time in their relationship. Analytic: Some men may be used to taking an analytical approach to solving problems. He may not realize how important it is to his partner that he take an active role in choosing the egg donor. Or, through his analysis, he may have strong feelings about who should be their donor by who ‘measures up’ to his assessment of the pros and cons. Control: Both men and women want to feel that they have some control when they are creating their family via egg donation. I often hear, “If it can’t be my wife, I want to find the best possible donor to give my children the best chance in life”. When one falls in love, we rarely take the time to look at our partner’s genetics. Nonetheless, when we have the chance to have a say we want someone who is as perfect as possible. Embracing Your Options Most of us haven’t grown up thinking about egg donation as part of our future. I’ve written this with input from several mental health professionals who specialize in assisting infertile couples to come to terms with family-building struggles. My fertility industry colleague Elaine Gordon, Ph.D. sums it up very well when she says, “The child will be the teacher of the parent.” When it comes down to it, your child will be who they are; we are not in control. Be gracious with yourself and your mate as you make the often-slow evolution to embracing egg donation as a miraculous family-building choice. *Other thought contributors to this blog are: Carrie Eichberg, Psy.D. , Macy Schoenthaler, M.Arts of RSC Bay Area If you're ready to explore the egg donation process to build your family, Donor Concierge is here to help. Contact us today  to learn more about your options.

What is epigenetics? How does it all work? How much influence does a gestational carrier have on the embryo they are carrying? How do epigenetics work in egg donation? When one is creating their family via third-party fertility, these questions often come up. Epigenetics gives some insight into how to answer these questions, though the answers are not simple, and there is much that we still don’t know. According to the NIH , “epigenetics is very much like a switch on the outside of the genetic circuits and genome that influences the behaviors of a gene.” The woman who is carrying the embryo, be that the intended mother who has used an egg donor or a gestational carrier who is also not genetically related to the embryo, can influence the development of the child. How she eats and cares for herself throughout the pregnancy is important and may influence the child's future health. Epigenetics continues long beyond in-utero throughout our lifespan; our health will be influenced by how we eat, manage stress, and exercise, and more. If you are creating your family via egg donation, you may be struggling with the fact that you can’t contribute genetically to your child. However, you will be able to contribute significantly to your child’s development “Thanks to the role of epigenetics, your nurturing womb can help your baby lead their healthiest life, well into adulthood,” says Jaime Shamonki , MD is the Chief Medical Officer at Generate Life Sciences, who is also a physician with unique expertise in regenerative medicine, reproductive medicine, genetics, and clinical laboratory management. “It turns out molecules known as MicroRNAs that are secreted in the mother’s womb act as a communication system between the mother (or surrogate) and the growing fetus… this is really the beginning of every influence that a mother (or surrogate) can have, including the onset of diseases.” Dr. Carlos Simon , a researcher who started his career at Stanford University in 1996, has presented more information about the effects of epigenetics. I share his findings below. “Think of the MicroRNAs as little spaceships that shuttle information through the endometrial milk from a mother’s genes to the developing embryo and regulate the expression of its genes. “This epigenetic effect begins to happen at the moment of conception,” says. Dr. Simon. “If you take out the micro RNA, this regulation disappears.” But it’s about more than how your baby will look. Dr. Simon says that this is really the beginning of every influence that a mother (or surrogate) can have, including the onset of diseases. For example, if a mother has Type 2 Diabetes at the moment of conception, it can directly affect her growing fetus. “The condition of the mothers at the time of pregnancy makes a huge difference, says Dr. Simon. “There are many things a mother can change regardless of whether her baby comes from her own eggs or not, and by the same token a surrogate can modify her lifestyle for the baby.” Over the years, I have worked with thousands of future parents and often heard back from them telling me how much their children share certain qualities with them. In some cases they seemed to have the mother's eyes and in many cases, they have the same mannerisms as the parents. There is really no guarantee that any child, regardless of how they are conceived, will look like his or her parents. But I love this note I received from a former client years ago: “Almost 2 years ago, I contacted you to help us locate a donor. I was hesitant to even consider using a donor and, of course, very sad that in our fertility journey, we were at this junction. Over the course of 8 years, we had experienced 14 IUI’s, 8 IVF egg retrievals and transfers, and 4 miscarriages. You helped us locate a donor and now we are the glowing parents of an amazing 8-month-old daughter. I wanted to share with you something I’ve learned from our “Topsy Turvey” tomato plant hanger and our daughter. When our miracle baby was born, it was amazing how much she looked like me. In fact, my mother drug out my baby book and compared pictures of how much we looked alike. She even had the same birthmark on the back of her head and mole on her rear end that I have. We love garden fresh tomatoes. Sadly, our Topsy Turvey tomatoes tasted terrible compared to my mother-in-law's tomatoes. What I learned is that it really doesn’t matter where the tomato seed came from. The secret ingredient was the soil that grew the tomatoes. I can with 200% certainty tell anyone hesitant about using a donor that once your baby is born, that baby is ALL yours. We are so grateful for our miracle baby and I regularly say prayers and offer thanks to our egg donor. I may never meet our donor, but I will forever be eternally grateful for her gift to us. She gave us the seed to grow our daughter, and allowed my soil to grow her. She’s our daughter in every way. Thanks so much for helping us find the 'special seed' we needed.” Often, epigenetics is a source of confusion for parents beginning the egg donation, sperm donation, or surrogacy process. It is one of many considerations, and a piece that can often feel overwhelming as you make your decision to pursue third-party fertility. Having knowledge about these concepts is just one part of what will help you to feel prepared. We strongly recommend working with a specialized fertility therapist who can help walk you through the fears, concerns, or trauma that you may have after a fertility battle. My suggestion to all intended parents who may be struggling with the decision to pursue a donor egg cycle and/or surrogacy - your fears are valid, and talking through them is the first step. But there is light on the other side. Interested in building your family with Donor Concierge? Schedule your free consultation today .

Exciting news: we've partnered with Carrot Fertility ! We're working together to bridge gaps in fertility access by bringing third-party fertility coverage to more hopeful parents. If fertility benefits feel out of reach, Carrot Fertility is here to help. To kick things off, they're sharing their expert advice to help YOU advocate for fertility coverage. Read on! If you’ve had to take out a loan or ask family for support funding your egg donor search or gestational carrier (commonly known as surrogacy) journey, you’re not alone. Donor-assisted reproduction is expensive and rarely covered by insurance. To help close the gap, some employers offer fertility and family-forming benefits. These benefits provide financial and logistical support for fertility care and other family-building services. Want to get your employer on board? Asking for fertility benefits can be daunting but with a bit of preparation about how they work — and how they can benefit your company — you can make a strong case for yourself and your colleagues. Step 1: Know that your HR team wants to hear from you If you’re feeling nervous, it’s helpful to remember that many benefits programs get off the ground because of employee demand. Especially in a competitive job market, HR teams want to create employee benefits packages that meet the needs of their existing employees and make the company more attractive to job seekers. In other words, assuming your HR team is committed to creating the best benefits package they can, they want to hear from you. Step 2: Gather your evidence Data is important to HR teams. They might ask questions like, how many people would use a potential new benefit? How much will it cost? How does it impact their bottom line? While you don’t need to go into your meeting with a PowerPoint deck and spreadsheet prepared, having a few numbers in your back pocket can help support your request. Here are some powerful stats to consider sharing: Infertility is common. One in eight couples are affected by infertility in the United States. Medical infertility isn’t the only reason people seek out fertility and family-forming care and services. 63% of LGBTQ+ couples and individuals plan to use donor-assisted reproduction such as donor-assisted reproduction and gestational carrier (GC) services to grow their families. Offering fertility benefits can help improve employee recruitment and retention . 88% of respondents in Carrot’s Fertility at Work survey would change jobs for fertility benefits — and 77% would stay at a company longer if they had access to fertility benefits. Just 24% of companies offer fertility benefits and even fewer include coverage beyond in vitro fertilization (IVF). Offering an inclusive fertility benefit that covers donor-assisted reproduction and adoption can help your employer stand out even more. Many employees don’t feel comfortable discussing fertility and family forming at work. If you’re the only person approaching HR about this topic, that doesn’t mean you’re the only one going through it. Nearly a third of respondents wouldn’t feel comfortable asking for fertility benefits at work. Besides data, personal stories are powerful, too, but it’s understandable if you don’t feel comfortable getting into the details of your own. Instead, you can share examples of parenthood journeys a fertility benefit can support. For example, Carrot Fertility shared a series of personal stories for National Infertility Awareness Week that highlight some of the ways fertility benefits impact employees. Step 3: Get specific about the support you want — but let your HR team know there are flexible options Though fertility benefits are growing in popularity, your HR team may not necessarily be familiar with them. They may also associate fertility benefits with egg freezing or IVF support, leaving out services like sperm freezing, donor-assisted reproduction, and GC services. When discussing fertility benefits with your company, share that to be truly inclusive of all paths to parenthood, their fertility benefit should include support for IVF, IUI, donor-assisted reproduction, GC services, and adoption. Your HR team may also be under the impression that fertility benefits are too expensive, especially if your company is on the smaller side. While some large companies do make a significant investment in fertility benefits, solutions like Carrot Fertility also offer flexible options that can expand as a company grows. Step 4: Consider finding allies. There’s power in numbers, so if you can, consider enlisting other employees when you make your request. If your company has employee resource groups (ERGs), they can be a great liaison between employees and HR teams. ERGs are employee-led groups of individuals with a shared identity or experience. Some common ERGs include: Culture, race, and ethnicity People with disabilities Women Religion or faith Gender identity Sexual orientation Parenting If your company doesn’t have ERGs, another option is to join forces with a co-worker who agrees that fertility and family-forming benefits are important — even if they’re personally not going through a family-forming journey. Surveys show that when companies offer fertility benefits, just knowing they’re available boosts morale even for those who aren’t planning to grow their families. Finding an egg donor or GC takes time, money, and patience. Employers can help by providing fertility benefits that are inclusive of all paths to parenthood. It can be intimidating to start the conversation, but advocating for fertility benefits at your company could mean that both you and your colleagues can access the family-forming care and services you need. About Carrot Fertility: Carrot Fertility is the leading global fertility benefits provider for employers and health plans, built to support people through their entire family-forming fertility journey. If your employer offers Carrot Fertility, you have access to discounts with Donor Concierge/Tulip. Want to request Carrot at your company? Fill out our request form and we’ll be happy to reach out to your HR team on your behalf.

August marks National Breastfeeding Awareness month, a month dedicated to celebrating breastfeeding and the health benefits that go along with it. We absolutely support breastfeeding and condemn the stigma that mothers and fathers get for simply feeding their children. However, not everyone has the ability to breastfeed, and we have received many questions about feeding over the years from our clients. What happens if your baby was born via surrogacy? Can you breastfeed a surrogacy baby? What are the feeding options for parents using a surrogate? What formula is best for a surrogacy baby? At Donor Concierge, we are committed to supporting all parents through their family building journey, and our team walks clients through each of these considerations. Our Private Client team provides bespoke journey management, supporting clients through pregnancy, birth and beyond. All in all, we have quite a bit of experience finding the best feeding options for our clients. Want to know how to feed your surrogacy baby? Let’s go over your options. What are the options? There are several options for feeding your baby: donated breast milk, and formula. Believe it or not, all of these options are possible for parents via surrogacy. Surrogacy may complicate your feeding options, but you do have options. Many parents don’t consider feeding during their surrogacy journey – and that’s okay! We know there are much more pressing concerns through the process, but we also don’t want parents to reach the feeding stage and regret not planning ahead. So let’s get into the options. Many parents actually end up choosing breast milk for their baby, through an outlined agreement with their surrogate. Contractual provisions in the gestational carrier agreement can outline the terms for pumping and shipping breast milk. Donor milk is another option that parents unable to breastfeed often turn to. There are accredited milk banks where parents with excess milk can donate after passing strict screenings. Parents unable to breastfeed can then sign up on a list to receive breast milk as it becomes available. This is a great option for many parents, but we urge you to do your research and to choose an HMBANA accredited bank to avoid scams or poorly screened milk. Last is baby formula. Many babies in this day and age are formula fed, and it is a great option for parents of all kinds. This is another good option for surrogacy parents, since it is much more readily available and reliable. Which is best for my baby? We can’t answer that for you. Only you can! Every family is different, and every family has different needs. The best option for you will be the one that best fits your specific needs. To figure out what those are, we recommend doing your research and talking through some important questions. Is your surrogate open to pumping breast milk? What is your budget? Are you able to find donated sources that you trust and get on their lists? Do you have any concerns about formula? Knowing your own priorities and individual situation will help you decide. If you have the budget and your surrogate is happy to pump, then breast milk might be a great option for you. If you can find a great baby formula brand that fits your budget, then that might be your best option. And we will be clear – it is not necessarily an “either/or” situation! Many parents take a hybrid approach and use multiple sources to feed their babies. Preparation is key As with any important decision, preparation is important! As we discussed before, receiving breast milk from your surrogate is an option, but it needs to be outlined in a contractual provision in your gestational carrier agreement. This provision will establish the flat fee for pumping (your surrogate’s compensation), shipping costs, and more. If you strongly prefer breast milk for your baby, it is important to discuss the issue early to ensure your gestational carrier is on board. Talk it through and come to an agreement that is right for everyone. If you are looking into donor milk, there are a few considerations. Milk banks require a prescription from your doctor, and it is a good idea to look into several accredited milk banks to get on their lists. These lists are prioritized by infant health, so high-risk babies will be first in line. It is definitely possible for healthy parents and babies to receive donor milk, but milk banks often have high demand and low supply. There are also for-profit milk banks to consider, but commercial milk banks’ screening protocols often don’t meet HMBANA’s requirements. You will also want to do your due diligence when choosing formula. Whether you choose one of the above options or not, you may use baby formula to supplement your feeding. Or you may go straight to formula. Regardless, you will want to seek out a high quality formula option that fits your price point. (Pssst - we will have more to share on this soon!) There’s no wrong answer Here’s the thing - there’s no wrong feeding option. As long as you do your research and choose a safe, high-quality feeding option for your baby, you have chosen correctly. We know this topic can be scary, and there is undue pressure and stigma around all types of feeding that is absolutely undeserved. We support feeding of all kinds, as long as everyone involved is happy and healthy. Pick the right option for you, and remember that how your baby is fed does not equal how much you love your child. Good luck!

By Julia J. Tate, Esq. Julia@TNBabyLaw.com When Intended Parents and potential Surrogates find each other, it can be a little like falling in love. Everyone seems so perfect. You seem to have so much in common with one another. Your hopes and dreams seem to mesh so well. You can’t imagine that there would ever be a disagreement that you couldn’t work out by just sitting down and talking. The process of negotiating your Surrogacy Agreement should burst that idealistic bubble so that you get an Agreement that can serve as a firm foundation for your relationship. After all, it’s hard to build on a bubble! A new relationship between Intended Parents and a potential Surrogate (and possibly her husband) is also like other relationships in that we are often hesitant to ask important questions of one another. There are things that we think we’d just really rather not ask – hoping instead that these topics will just arise in the course of the relationship. Parties to a surrogacy relationship usually wait for a lawyer to raise these hard issues. This is a less-than-optimal choice because, in addition to the danger that the attorney simply won’t think of a particular topic, it deprives the parties of the relationship-building experience of hashing out a difficult discussion. These conversations and the way they are initiated and conducted give the parties a chance to get to know one another on a deeper level. Trust in one another is built when the parties talk things through. It is much better to have this sort of trust-building experience in the low-risk environment of contract negotiation than in the stress-filled environment of a conflict which arises once the pregnancy has begun. Having the parties actually negotiate the Agreement themselves may help reduce the chances of the Agreement being broken during the pregnancy. Studies on mediation (particularly divorce mediation) have shown that parties are much more likely to comply with terms to which they have agreed than terms which have been imposed on them. Such parties have a “buy-in” in the terms, whether it’s a surrogacy agreement or a negotiated marital dissolution agreement. Further, when parties have negotiated their agreement themselves they are more likely to understand each other’s values and the importance of certain terms of the agreement to one another. Knowing why something is very important to the other person makes it more likely that we’ll actually do that thing since we all have empathy for one another, to some degree. So, with the understanding I’ve set out above, I have proposed a list of Talking Points which parties considering entering into a Surrogacy Agreement may want to discuss. I would like to use stronger language and say “should” or even “must” discuss, because the topics which prompt some hesitancy are probably the ones that are most important to discuss. However, being committed to parties doing this negotiation without the compulsion of the supposed experts, I will simply suggest that these topics be discussed. Traditional Surrogacy or Gestational Surrogacy By traditional surrogacy, we mean an arrangement in which the surrogate receives artificial insemination and becomes pregnant with a baby which is the result of the union of her own egg and the sperm in the artificial insemination. Gestational Surrogacy is an arrangement in which the surrogate receives the transfer of one or more embryos into her uterus and gestates the baby on behalf of the Intended Parents. The embryos transferred to her uterus may come from the union of the Intended Father’s sperm and the Intended Mother’s egg or the union of egg or sperm donated to the Intended Parents. The key factor is that the Gestational Surrogate is not the genetic mother of the baby she carries. The distinction is very important. In a gestational surrogacy, in Tennessee, we can get a Court order prior to the birth, declaring that the Intended Parents are the legal parents of the baby and ordering the hospital to name them on the birth certificate. We can’t do that in a traditional surrogacy. The risks Intended Parents take when they decide to do traditional surrogacy are too numerous to list here. In nearly all situations when I explain all the risks, the Intended Parents decide against traditional surrogacy. If you are seriously considering traditional surrogacy, please consult with your attorney about the risks. Money is a part of every surrogacy negotiation, even if the gestational carrier seeks to serve as a compassionate carrier and does not want to be compensated for her time and trouble. Even then the parties should discuss compensation so that all the parties are clear on the decisions being made and the basis of those decisions. In many respects parties can craft their surrogacy agreement in whatever way they want. One big exception is money. Every State in the Nation – and probably every nation in the world – has a statute on the books making it a crime to pay money or anything of value in exchange for a parent surrendering his or her parental rights to a child and making it a crime to receive anything of value in exchange for surrendering parental rights to a child. So you can not draft a contract which says, in essence, the Intended Parents will pay the Gestational Carrier so much money and she’ll surrender her parental rights to them. You can not make these two events contingent on one another. To do so would be a felony – at least in Tennessee. Short of the above, on what basis do Intended Parents transfer funds to the Gestational Carrier? Many contracts include provisions that state that the Gestational Carrier is being compensated for her time and trouble, for the pain and inconvenience that pregnancy and childbirth entails and for the risks to her own health and future reproductive capacity which she’s taking by carrying and giving birth to a child. While these may play into the funds transferred to the gestational carrier, it’s useful to make it clear that these are not the only things for which the Intended Parents are compensating her. Most recently, contracts have been designating percentages of the funds or even specific amounts as support to cover the Gestational Carrier’s housing expenses, clothing expenses, reduced earning capacity, food allowance and other specific items. One reason for being so specific about the allocation of the funds is to prevent the Gestational Carrier’s insurance company from claiming that the funds that the Intended Parents pay to the Surrogate constitute “other insurance” from which the health insurance company should be reimbursed for amounts they’ve paid for her maternity care and for the delivery of the baby. If we are clear as to the reasons behind the support payments, insurance companies are substantially less likely to be able to recover their payments. Clients often ask how much is a reasonable amount for the gestational surrogate. While I do draft a number of these contracts, I can not make an estimate on this topic. It’s completely a matter for the parties to determine. Health Insurance It is very important that the Gestational Carrier have health insurance that will cover her pregnancy. There are very few health insurance policies which provide for maternity coverage but do not provide coverage if the pregnant woman is carrying a child for someone else. The coverage is for her health care and, if she’s pregnant, she needs health care, regardless of how she came to be pregnant. Most policies do, however, have a provision in their terms relating to infertility treatment which says that the insurer will not provide benefits for surrogacy. Usually this means that if the insured person has infertility issues and needs a surrogate to help the insured person have a baby, the insurance company will not provide benefits to cover the surrogacy. If this provision is in the gestational carrier’s policy this does not mean that the insurance company will not cover her care, it means that Often Intended Parents decide that they’d like to purchase health insurance coverage for their surrogate. This is usually quite difficult, if not impossible without such a long waiting period that the arrangement just becomes impractical. If the parties opt to work together, in Tennessee, and the surrogate does not have health insurance, she might be able to get coverage through TennCare which is Tennessee’s version of Medicare. Getting this coverage is not a matter of certainty, however. Further, even if the surrogate does get this coverage, she will be limited to the providers who have agreed to accept TennCare patients. Relying on TennCare to provide the prenatal care and to cover the delivery is not the optimal choice by any means. Life Insurance Most agreements include a provision under which the Intended Parents pay the premiums for a term life policy for about ten months from the date of the positive pregnancy test (or from the positive pregnancy test through a date which is about a month after the termination of the pregnancy). Term life insurance premiums are fairly affordable now so the Intended Parents can easily provide a substantial amount of protection against the economic impact on the Gestational Carrier’s family of her untimely death. Few insurers will write a term life policy for such a short period of time. The shortest period of coverage which I have obtained is a two year policy. Given these circumstances, the burden falls on the Gestational Carrier to get the coverage and pay the premiums for which the Intended Parents reimburse her. Recently, some parties have decided to increase the amount of coverage beyond what would go to the Gestational Carrier’s family to provide for an amount of insurance which would go to the Intended Parents in the event of her death during while they are engaged in the surrogacy arrangement. The Intended Parents invest quite a bit of money in their efforts to bring a baby into the world. If tragedy strikes and the Gestational Carrier dies while carrying the Intended Parents’ baby, the Gestational Carrier’s family is not the only family to suffer economic loss. The Intended Parents also suffer a loss. Increasing the Gestational Carrier’s coverage by an amount which would go to the Intended Parents provides the Intended Parents with some compensation for the funds they’ve expended. This insurance payment may be the difference between the Intended Parents being able to recommence their efforts to add to their family by surrogacy or having to adjust to not having this baby enter their family. Lost wages If the Gestational Carrier works outside the home, the contract will usually provide that the Intended Parents will compensate the Gestational carrier for her lost wages if she has to miss work. This compensation is calculated based on the net wages, not the gross wages. Net wages are the wages less the federal withholding which would have been taken from the wages had the wages been earned. Other withholdings such as health insurance premiums, retirement contributions or other deductions are not deducted from gross wages in the calculation of net wages for purposes of reimbursement. The idea is that the Gestational Carrier’s household should not sacrifice anything as a consequence of work missed because of the surrogacy arrangement. Contracts usually also provide for reimbursement for the Gestational Carrier’s Husband’s lost wages, if he has to be off work to assist his wife during the meetings before commencing the surrogacy or during the pregnancy or child birth. Compensation for lost wages usually includes caps on the amount of the Intended Parents’ reimbursement for the Gestational Carrier’s lost wages and a separate cap on her husband’s lost wages. Values about abortion Parties considering a surrogacy arrangement should thoroughly discuss their values about abortion. One of the most difficult decisions which can arise in any pregnancy involves selective reduction. This is the procedure by which the number of fetuses growing within a woman’s uterus is reduced in order to increase the likelihood of the birth of healthy babies. Selective reduction terminates the lives of the embryos which are removed from the uterus. All the parties need to understand the termination of life involved in selective reduction and thoroughly discuss how they feel about this. It can be hard to discuss this because the parties are afraid of finding that their values differ on this topic. They fear that this topic may be the deal breaker. I urge people to completely discuss this, despite their fears. It is much better to find out that your values differ before the pregnancy happens than when the need for a decision about selective reduction arises. The worst scenario is that the need for a decision arises and the parties realize there is a conflict and one side ends up having to do something in conflict with their values. If you do find that your values differ in this area, it is not necessarily the end of the agreement you’d hoped to reach. You may be able to reach a compromise and make a plan which will work for everyone. Even if you can’t reach this Agreement, surrogacy does remain open for you. Another Gestational Carrier can be found and other Intended Parents can be identified for this surrogate. The key is in getting a good match. Values about children in broken homes and single parents Although some attorneys do not cover this topic, I think it is important for the parties to consider. I request that parties to contracts which I am drafting determine whether they want to continue the efforts to try to conceive if the Intended Parents’ marriage becomes troubled or breaks up prior to the pregnancy beginning or if one or the other of the Intended Parents dies before the pregnancy commences. Some Gestational Carriers may find that they feel strongly that they only want to help a two-parent couple become parents and that, if the pregnancy will bring a child into a one parent home, they do not want to do it. Again, this is best discussed before the issue arises. A Gestational Carrier’s decision to terminate the Agreement at this point would result in the loss of all the funds which the Intended Parents have already invested in their efforts to conceive with her. Attendance during embryo transfer As much effort as Intended Parents put into their efforts to conceive, it is somewhat ironic that using assisted reproduction means that the parents of a child do not actually have to be present at the time of conception. Embryo transfer, while a miraculous event, is a medical procedure from which the Intended Parents are likely to be excluded. The Gestational Carrier may want them to be present as she commences to give them this tremendous gift. Their presence or absence may seem to be an indicator to her of their commitment to parenthood and to this process. This seems a reasonable way to look at it from her perspective as this is her only exposure to the long path the Intended Parents have been down in trying to form their family. Gestational Carriers almost never have had problems with fertility themselves. The Gestational Carrier doesn’t see the months of fertility drugs the Intended Mother has taken, the shots she’s given herself, the miscarriages she may have had, the grief she’s gone through when she’d started her period and found out, over and over again, that she’s not pregnant. The fact that the Intended Parents are willing to enter into a surrogacy arrangement, having gone through all those experiences, is the indicator of their commitment to parenthood. I suggest that the parties talk about all these experiences, despite the painful memories, so that the Gestational Carrier and her husband can know how dedicated they are to this endeavor. Expenses can stand in the way of the Intended Parents being present at the embryo transfer. Usually Intended Parents have already spent quite a lot before they decide to pursue surrogacy. Then they are committing to even more expenditures throughout the surrogacy. The travel expenses and the time off work to be present at the embryo transfer may be considerable. The Gestational Carrier needs to take this into account if the Intended Parents are hesitant to commit to being present at the embryo transfer. Attendance during the birth The Intended Parents’ attendance at the time of birth is an entirely different matter than their attendance at the embryo transfer. Prior to the birth, the Gestational Carrier has the right and responsibility to make all the decisions about the management of the pregnancy and the birth process. After the birth, however, the Intended Parents have important legal obligations. Usually they fulfill these obligations by being present and making the decisions themselves. In situations in which the Surrogate and the Intended Parents live at considerable distances from one another, however, attendance at the birth could be a problem. This is usually handled by phone contact with the medical staff. Some situations may require more in-depth planning. For instance, in international arrangements Intended Parents may be requested to designate an agent to act on their behalf and to make decisions for their baby if they are not able to do so. This agent’s obligations usually extend even to take custody of the baby upon discharge from the hospital if the Intended Parents are delayed in getting there. In this age of managed care, hospitalizations are remarkably short for healthy births so an insurer urging discharge before an international parent can arrive is quite conceivable. As the pregnancy draws to a close, the parties will prepare a Birth Plan which they will share with the delivering hospital prior to the onset of labor. This plan will usually set forth agreements such as who is to be in the delivery room and who will have bracelets allowing them access to the baby. Those items do not have to be spelled out in the Gestational Surrogacy Agreement but I still suggest that the parties share their thoughts on the birth experience at this point. This discussion lets them envision the process together and bond in their efforts to create this child’s entry into the world. It lets them get to know what is important to one another as well as how they will each respond to one another when they do bring up matters of importance. This builds trust between the parties. So when topics arise such as who holds the baby first and who holds the Gestational Carrier’s hand while she’s in labor, please don’t dismiss them as premature since there is not even a pregnancy yet. This is a chance to dream together. Such chances are rare and should be handled as precious gifts. Post-birth contact Parties have different feelings about the amount of contact they want to have with one another after the birth. Of course, emotions change as relationships are built throughout trying to conceive and throughout the pregnancy. Arrangements for post-birth contact are as varied as are the people engaging in surrogacy arrangements and, so long as the parties are in agreement, contact which varies from the initial agreement is just fine. So why would the parties need to include this in the negotiation if they can change their arrangements after the birth? One reason is that talking about this lets you get to know the values of the people with whom you are about to get involved. It’s part of the process of getting to know each other. Another reason is that it sets a foundation that the parties can go back to if disagreements do arise. Further, negotiating this provision helps put the parties in a place of thinking ahead about the pregnancy and the birth. This can be useful in moving everyone into thinking about these other aspects of the Agreement. There are really no norms on what people tend to put in this provision of the Agreement. I suggest that people think of this provision as describing what they want from one another if they’re not getting along. You may decide that, even if the adults in this arrangement have nothing in common and don’t want to spend any time together, everyone still wants to know where each other lives so that, when the child grows up, if he or she wants to meet the Gestational Carrier, such a meeting can be scheduled. Maintaining some degree of contact can make that possible. Whatever your Agreement provides about contact after the birth, I will be in touch with the Intended Parents shortly after the birth and again a few weeks after the birth, to remind them to express their gratitude to the surrogate. This is simply a recognition that, once the Parents get home with their child, their minds will be completely on their baby and not on the Surrogate. For better than nine months, the Surrogate has been the center of attention, sometimes even uncomfortably so. This shift in attention, coming at a time when her body is adjusting to a different hormonal state, can leave a Surrogate feeling abandoned. After having done such a miraculous thing, the last thing anyone wants is for the Surrogate to come away from this feel any way other than completely appreciated. For this reason, I believe it’s almost always in everyone’s best interest for the parties to talk at least a little after the birth. Privacy concerns Parties on the different sides of surrogacy arrangements have different needs around privacy. Infertility treatment is daunting path which exposes couples’ most vulnerable sides. For many people this makes using Surrogacy to form their families something that they want to keep very private. Surrogates, on the other hand, have not gone through such a difficult path to get to the point of engaging in surrogacy. Surrogates are performing a wonderful act of which they are rightfully proud. They may want to talk about the experience and even describe it to various media outlets. Articles and news stories about surrogacy help make it more accessible and understandable to the general population so, these disclosures, do have their place. When they expose private matters, however, they are a problem. Nearly all contracts include a provision which says that the parties will not disclose the identity of the other parties. I would suggest that the parties think beyond not disclosing the other parties’ names. Disclosing that a Gestational Surrogate lives in a particular State and is carrying or has carried a baby for a parent who lives in a different particular State can be a breach of that parent’s privacy. Her friends and co-workers, who know she’s been trying to have a baby, may know that she’s been traveling to that State quite often. It doesn’t take much for them to put the pieces together and then these people know all about her Surrogate. These are the kinds of situations which the parties should discuss thoroughly. Again, the process of negotiating the Agreement sets up the parties to think about what’s important to each other as situations come up. The goal of the Agreement is not merely to set out the rules of what shall and shall not be done, but also to help you establish the relationships upon which you’ll make decisions throughout the pregnancy and after the birth. Conclusion These are some of the topics you’ll want to discuss in your negotiations. Of course, each side may think of things that are important to them. This is your Agreement. The lawyer may write the document but Agreement in it and the behavior you’re setting out in it is all yours. You have the right – indeed the responsibility – to bring up what matters to you and make sure it’s covered to your satisfaction. Whether I draft your Agreement or you have another lawyer do this work, please make sure your Agreement meets your needs by speaking up.

Most of our clients are first timers in the world of pregnancy. After the exhausting search for the right surrogate, it’s not always clear what the next steps may be after transfer or how to plan your life for the next 9 months if (fingers crossed) everything goes as carefully planned. So here at Donor Concierge, we thought it might be handy to have the top 5 moments not to miss with your surrogate after transfer but before the big birthday. Confirmation hCG Beta or “Beta” lab : Your embryo has been transferred, when will you know you are pregnant? Most fertility clinics will test your surrogate’s serum beta hCG approximately 14 days post transfer (this may fluctuate some depending on whether your clinic did a 3 day or 5 day embryo transfer . The quantitative hCG Beta serum lab is a blood test that measures the level of beta-human chorionic gonadotrophin (the hormone generated from the cell development of the placenta) in your surrogate’s blood stream. An hCG Beta value can vary but generally your RE will confirm that the lab value you received is in fact within range for what is expected post transfer. YOU’RE PREGNANT! A more in depth explanation on hCG Beta hormone can be found here . First Transvaginal Ultrasound: A Transvaginal Ultrasound otherwise known, as a Transvaginal Sonogram (TVS) is performed anywhere from 4 to 6 weeks post transfer . You’ll need to check with your particular fertility clinic to see what their recommendation is and when exactly this will be scheduled. The Early Transvaginal Ultrasound is used to detect your baby’s yolk sac, gestational sac, and early detection of your baby’s heartbeat. The first Transvaginal Ultrasound can be very reassuring and may in fact be the start of transfer to care to a regular Ob/Gyn provider. You are likely to get the first glimpse of your baby and pictures to share with your loved ones. First OBGYN appointment : You are now almost a best friend with your RE and her staff, but don’t get too comfy. At anywhere from 10 weeks to 12 weeks , your RE will lovingly (and professionally) hand you off to an Ob/Gyn. Congratulations! The hand off is a remarkable milestone. Whether you and your surrogate have chosen an Ob/Gyn to work with together or have chosen the doctor she has worked with for the birth of all of her natural children, there is very important information at this very first appointment: Do go , if time permits. Things that are normally accomplished during the first appointment include: Your first trimester screening Establishment of your due date (if not already determined by your RE) Your chance to hear your baby’s heartbeat via Doptones (hyperlink) and a potential second Transvaginal Ultrasound should your doctor recommend (although this is not standard coarse for most non-IVF pregnancies). A chance for you to get know your baby’s doctor and their team; and to sign important HIPPA  consents so as to expedite communication and sharing of information and keep you update to date on the latest and greatest of your pregnancy. 20 Week Ultrasound:  You’re half-way home to parenthood! At around 20 weeks, your Ob/Gyn will schedule what is known as the 20-week ultrasound or full anatomy scans. DO GO!  Your baby will be looked at from head to toe including looking at their intricate heart, brain, internal organs and bones. The most important anatomy for parents however, is the one between the legs. Are we having a boy or girl? The 20-week ultrasound will give you your definitive answer (if you want it). 20 Week Ultrasound:  You’re half-way home to parenthood! At around 20 weeks, your Ob/Gyn will schedule what is known as the 20-week ultrasound or full anatomy scans. DO GO!  Your baby will be looked at from head to toe including looking at their intricate heart, brain, internal organs and bones. The most important anatomy for parents however, is the one between the legs. Are we having a boy or girl? The 20-week ultrasound will give you your definitive answer (if you want it). But more importantly, the scan is looking for any potential growth issues or placenta issues in advance. Don’t fret too much though; there are many early issues that resolve as the pregnancy continues. If the doctor does detect anything of concern, they will likely schedule further ultrasounds and consults with other professionals as needed. So again, being at this appointment with your surrogate is helpful as you will be able to learn so much and know what is coming down the road. 36 Week Check Up: At the 36th week check up, the physician will now increase clinic visits to weekly. Why the extra appointments? Well, from 36 weeks on, your surrogate is getting ready for delivery. Your physician is likely to perform a Group B Strep test, check cervical lining, and discusses what to expect or plan for at the birth. An additional ultrasounds may be ordered to check on positioning of the baby, recheck the placenta, and any other needs that will help guide your physician on day of delivery. This is also a good time to make sure that the Birthing Center of your choice has a copy of your Birth Plan. Are their any special accommodations they are able to make? For instance, will they be able to give you a separate room (from your surrogate) after delivery for you to welcome and care for your baby? Your surrogacy agency should be able to support you in knowing what to expect and helping you transition from the world of fertility treatment to parenthood. You’ve traveled - literally and emotionally- a long way to get to the birth of your baby. Remember to take care of yourself in the coming days before birth. Your life, like all new parents, is about to be forever richer. So before the richness of parenthood sets in, get in those last few quiet nights at home enjoying a simpler time. Take a deep breath and know that this was all meant to be as it has unfolded and most importantly enjoy every minute of it!

I want to address the biggest anxiety Intended Parents may have, so let’s start today with the end: Is it hard for a surrogate to give up the baby? In my experience: No, absolutely not. However, it is especially important that your surrogate has been properly evaluated and cleared by an educated mental health professional in third party reproduction, to ensure she has the appropriate strength, support, understanding and motivation to be a trustworthy surrogate candidate. When I was a surrogate I did not feel like I was giving the baby up, because she was never mine to begin with, I was just giving her back. We had a visceral connection from nine months nurturing her inside me, but I did not bond with her. In truth I bonded with her parents, in our mutual desire to bring her into the world so they could be a family. Most other surrogates feel the same way. A surrogate may be a little emotional right after the birth, but it will be because she is adjusting to the realization that the surrogacy journey has suddenly ended. That’s natural. The year of focus, excitement and anticipation of delivering a baby to you are over, and it can be hard to let go of that. Here is the key. A surrogate just wants to share in your joy, to have the privilege of watching you become a family, and to feel appreciated for her choice to make that sacrifice and take that journey with you. The baby a surrogate carries is not hers and she knows that. And she is perfectly okay with that. In fact, she can’t wait to deliver that baby into the arms of the intended parents, to see how her gift can bring joy to a couple where there was devastation and longing. That was my reward, and continues to fulfill me to this day: to know that I made it possible for them to wake to the unconditional love of a little girl who brings them joy every time she giggles, or wraps them in a hug or tells a silly story. I have absolutely no regrets, and only a wealth of gratitude for having the privilege of sharing such an intimate journey with another couple. That’s why women choose to be surrogates. *Pamela MacPhee is the author of DELIVERING HOPE: The Extraordinary Journey of a Surrogate Mom . She is a Stanford University graduate, with a degree in Human Biology and a concentration in Physiological Psychology. She successfully delivered a baby girl as a surrogate for her cousin and his wife, who suffered from cancer-related infertility. She has also written columns and articles, spoken at fertility conferences, and interviewed with local, national and international media, including The New York Times, to share insights into her own journey in an effort to educate people about surrogacy.

The first case of egg donation occurred in 1983 . In the early stages of egg donation it was treated much like sperm donation, which, like the early days of adoption, was shrouded in secrecy. No one ever needs to know. Women were told after the insemination to go home and make love to their husband and just forget that this ever happened. The trouble with secrets is they are heavy and burdensome. We can’t forget things that we are vigilantly holding as secrets without feeling a constant undercurrent of stress. Secrets take on a life of their own and create rifts in relationships, whether consciously or unconsciously. Every family has their own decisions and choices to make with regard to telling that their child is a product of egg donation: Who do you tell? When do you tell? What do you say? How do you say it? Do you tell at all? Every family has their reasons for wanting to keep the egg donor a secret: Some feel shame that they could not conceive Fear their child might be rejected by family Fear that their child may reject them Fear their child will feel different Mostly fear is the biggest motivator for keeping secrets If you choose not to tell you should tell no one. Why? Because the more you tell the more likely this secret is to be shared by well-meaning individuals who are sure that the one person they tell will not tell anyone else. The web of who knows and who doesn’t know slowly spreads. There are always dangers in not telling as there can be in telling but holding secrets can have serious repercussions throughout your child’s life. As Carole Lieber Wilkins, MFT points out, “The best interests of children and their families are served by children growing up with the knowledge that they are not genetically or gestationally related to one of their parents ... Children who ‘sense’ there is something wrong in their family usually assume it is about them and assume the worst ... the feeling of betrayal can be overwhelming.” What happens if: Your child develops an allergy that no one else in the family has (allergies are 100% inheritable though they may skip a generation)? Your child in 9th grade biology does a cheek swab and finds that his or her DNA is different from yours? Someone slips and says something and your child thinks that the people (you the parents) who he/she loves and trust the most in all the world have lied about being his/her biological parents? Right now while you are trying to get pregnant this is your story. Once you conceive via egg donation and give birth, the story becomes your child’s story. His or her genetic beginning may be important throughout his or her life. This child is yours but he or she has a genetic link to one other person. You are the parent but the donor is a genetic relative. In most cases, when children are made aware at an early age of their special conception, they are very accepting because it has always been part of the fabric of their lives. Madeline Licker Feingold, PhD, a psychotherapist specializing in infertility says “Current research in collaborative reproduction supports Erikson’s ideas. Children who have been told about their donor origins have not rejected the non-genetic parent or responded negatively to the information. Additionally, when children learn about their donor origins at a young age, they seem to have a more positive experience about their donor conception than those who are told later in life.” They will of course have questions but when they do, you can answer them with age-appropriate answers, and with the information that you have available to you. “Studies also indicate that an offspring’s curiosity about the donor was independent of the parent-child relationship, meaning that children can have positive relationships with their parents and also be curious about their donor origins … from the parents’ perspective, almost no parents regretted their decision to use an open-identity donor.” That may be the donor’s profile, or a scrapbook you have created for your child to tell the story of how they came to be part of your family with all of the players involved. Your child is the star of this story and you the parents are the co-stars. The donor, the RE and nursing staff are all supporting players. You wanted to share your love so much that you went to great lengths to have him/her. There are many great books to help you to tell your child’s story to make it easy straightforward. “What Makes A Baby” is a great one to consider or check out our Resource page for more suggestions. You may find that as you read these books they are not just for your child but also for yourself as you become more comfortable with your child’s special beginnings. More and more of my clients are choosing to tell their children of their special beginnings, realizing that this is an important part of their child’s story. There are many things that you can do to lay the groundwork for keeping avenues open for your child to discover more information should he or she want to as they grown up: Check with the egg donor through her agency to see if she is open to the possibility of future contact (Though many donors may answer no to this question on their application it is worth asking the question. Donor’s often say no to put so that the intended parents don’t feel threatened by the donor intruding on their lives) Include a clause for future contact in the egg donor contract Sign up with the Donor Sibling Registry and request that your donor does the same Most egg donors have a desire to do the right thing. I have found that the vast majority of donors, when specifically asked if they would be willing to be contacted at a later date by either the couple or the child are open to answer questions that you or your child may have in the future. In some cultures telling might be out of the question, or there may be other reasons why you don’t want to tell. Only you can make that determination for your family. However, I strongly feel that openness and honesty are definitely the best policy for building your family via egg donation because in the long run, secrets are dangerous and each child has a right to know where he/she came from. There is no danger in telling, when a child comes from love. Gail Sexton Anderson is the founder of Donor Concierge. She has been working with intended parents, guiding them through egg donation and surrogacy for nearly two decades.

We recently travelled to Sydney, Australia and Brisbane, Australia for the Growing Families: Fulfilling Your Family Building Dream Seminar, and spent an inspiring weekend speaking with past clients and Australian hopeful parents. We have helped many Australian hopeful parents navigate their fertility journey in the U.S., through the surrogate or gestational carrier search , the egg donor search , and the sperm donor search . Can Australians have children in the US? Yes, Australians can have children via surrogacy in the United States, but there are a number of legal, financial, and logistical considerations to keep in mind. Each state in the US has its own laws regarding surrogacy, and some states have more favorable laws and regulations than others. For example, some states have laws that recognize and protect the rights of intended parents in surrogacy arrangements, while others have laws that restrict or ban surrogacy altogether. It is also important to consider the financial costs involved in surrogacy, which can be substantial, and to ensure that all parties involved in the surrogacy arrangement are protected legally and financially. Additionally, it is important to note that the recognition of surrogacy arrangements and the transfer of parentage can be complex, and it is advisable to work with experienced surrogacy attorneys and agencies to ensure that the process goes smoothly. Overall, while surrogacy in the US is an option for Australians, it is important to carefully consider all factors and to seek legal and medical advice before proceeding. Why do Australians come to America for fertility treatments? Australians may travel to the U.S.A. for fertility treatments for a variety of reasons, including: Advanced technologies: The US is known for cutting-edge fertility treatments and technologies. High success rates: US fertility clinics have a reputation for high success rates, which can be a factor for patients seeking treatment. Legislation: Many states in the USA have fertility-friendly legislation, which can make family-building easier for some international hopeful parents. Long waiting lists: There may be long waiting lists for fertility treatments in Australia, leading patients to seek care abroad. Cost: In some cases, fertility treatments in the US may be less expensive than in Australia, especially when factoring in the cost of travel and accommodation. Privacy: Some patients may prefer to undergo fertility treatments in a foreign country for privacy reasons. What are the laws governing third-party fertility in Australia? Third-party fertility, such as the use of donor sperm, eggs, or embryos, is regulated by law in Australia. The use of third-party reproduction is governed by the Commonwealth's Reproductive Technology Accreditation Committee (RTAC) and the state or territory laws where the treatment is provided. In Australia, only licensed clinics and practitioners can provide assisted reproductive technology (ART) services, including third-party reproduction. The use of donor sperm, eggs, or embryos must comply with guidelines and regulations, which include rules around anonymity, record keeping, and consent. Some of the key laws that restrict third-party fertility in Australia include: The Human Reproductive Technology Act 1990 (Cth): This act regulates the provision of assisted reproductive technology (ART) services in Australia, including the use of donor sperm, eggs, or embryos. It requires ART services to be provided by licensed clinics and practitioners and sets out the ethical and technical standards that must be followed. The Surrogacy Act 2010 (NSW): This act regulates surrogacy arrangements in New South Wales, including the use of third-party fertility. It sets out the legal requirements and obligations for surrogates and intended parents, and governs the transfer of parentage after the birth of a child. The Reproductive Technology Accreditation Committee (RTAC): This body is responsible for accrediting ART clinics and practitioners in Australia and ensuring that they comply with ethical and technical standards. State and territory laws: In addition to the above federal laws, each state and territory in Australia has its own laws and regulations regarding third-party fertility. For example, in some states, it is illegal to pay for surrogacy services, while in others it is allowed with certain restrictions. We know how important it is to have a fertility team you can trust during this process, and we are well-versed in the considerations Australian hopeful parents face when coming to the U.S. for fertility assistance. If you are looking to build your family through surrogacy or gamete donation in America, we can help. Interested in building your family with Donor Concierge? Schedule your free consultation today .