Your surrogacy journey will begin with an in-depth screening process. Growing Generations is committed to thoroughly screening potential surrogates, and we're proud of the process we have developed. Although richly rewarding, surrogacy should not be entered into lightly.

STEP 1: THE APPLICATION

The first step is to fill out our online surrogate application. Your replies will be used to help us determine if you meet the minimum qualifications to be a Growing Generations surrogate. We consider a number of specific criteria, including age, state of residence, height, and body mass index. Other determining factors include tobacco use, U.S. citizenship, green card, or visa status and if you or your partner have been convicted of a felony. We ask other questions to gather information about gastric surgery for weight loss, diabetes, and other pregnancy-related diagnoses you may have had in the past.

STEP 2: FOLLOW-UP QUESTIONS

If you meet our minimum requirements, you will progress to several follow-up questions. These questions are asked to uncover your current relationship status, preferences on the types of intended parents you’d be willing to work with, medical history, reproductive history/preferences, as well as personal and social history. You’ll also field questions about your psychological history. Finally, we’ll need to know about your travel and child care availability and health insurance.

STEP 3: ONLINE ACCOUNT & FINAL APPLICATION

Once this is submitted and the application is accepted, a Growing Generations’ admissions specialist will contact you within one business day. At that time you’ll be given access to an online portal to complete the final part of your online application. You’ll also be granted access to an online account with Growing Generations where you can read answers to our most frequently asked questions.

The second portion of the application will ask you more in-depth questions. Topics include birth control history, pregnancy, and birth history, your employment and insurance information, and personal health history.

STEP 4: CONSULTATION

Finally, after this leg of your application is approved, your Admissions Specialist will invite you to schedule a phone consultation. During this phone call, you’ll be able to ask questions and we’ll chat a bit about the process.

We will talk more about the phone consultation, as well as about the second half of your surrogate application process, in our next blog post, Surrogate Screening Process: Part 2.

Key takeaways from this article:

• The surrogacy journey begins with a thorough screening process.

• The initial application includes basic info, medical history, and lifestyle habits.

• Criteria include age, BMI, citizenship status, felony convictions, and health diagnoses.

• If minimum requirements are met, follow-up questions focus on personal history, preferences, and availability.

• After acceptance, an admissions specialist will contact the applicant within a business day.

• Access to an online portal is granted to complete the final application parts.

• The next part of the application asks about birth control, employment, and health history.

• Post-approval, an admissions specialist schedules a phone consultation for further queries.

To get started on your own surrogacy journey, contact us online or call us at 323.965.7500.

Updated 2/29/24

If you miscarry or have an otherwise abnormal pregnancy, your doctor may recommend a dilation and curettage (D&C) procedure (as opposed to a natural miscarriage). A D&C can be a first-line treatment option for clearing the uterus or for instances where your body does not expel all tissue on its own. In this case, the procedure is necessary to stop bleeding and prevent hemorrhage. Like any surgical procedure, however, a D&C carries some risks. As a surrogate, it's essential that you understand the risks and benefits of this option.

 

WHAT IS A D&C PROCEDURE?

A D&C procedure usually takes just 10 to 15 minutes, but you may stay at the clinic or medical site for up to 5 hours. During the procedure, you’ll either be sedated using either a general anesthetic or given an epidural or local anesthetic. Your cervix will be dilated to allow a scalpel or vacuum into the uterus to remove tissue associated with pregnancy. This outpatient surgical procedure is generally routine and free of complications. However, as with all medical procedures, there can be risks. 

WHAT ARE COMMON D&C RISKS & COMPLICATIONS?

The most common complication of a D&C, according to the Mayo Clinic, is the perforation of the uterus. In this instance, a cutting object would inadvertently poke a hole in the wall of the uterus during the clearing of the pregnancy tissue. These perforations will usually heal on their own and only represent real concern if a blood vessel or secondary organ is damaged. 

Other potential D&C complications include:

• Damage to the cervix: It is possible for the cervix to be torn during the procedure. If this were to happen, your doctor would apply pressure to the cervix and then use stitches to repair the tear.

• Scar tissue or adhesions inside of the uterus: Known as Asherman’s syndrome, the development of scar tissue in the uterus happens in roughly 30 percent of D&C patients. This condition, which becomes more likely with each subsequent D&C, can lead to painful, absent or otherwise abnormal menstrual cycles. Additionally, it can lead to difficulty with future fertility, occasionally resulting in increased miscarriages or total infertility.

• Infection: While incredibly rare, infection can occur following the procedure. Infections are often detected by a fever or odorous vaginal discharge.

WHAT TO DO DURING D&C RECOVERY

You’ll want to pay close attention to your body after the D&C to ensure that you’re healing properly. You can usually return to your regular activities after a few days, but you may experience mild cramping and light spotting. You should wear a sanitary pad and take pain relievers if necessary. 

Your next menstrual cycle also might come early or late after the procedure. Be sure to call your doctor right away if you experience any of the following symptoms:

• Heavy bleeding

• Bleeding lasting longer than 2 weeks

• Fever

• Cramping lasting more than 48 hours

• Foul smelling discharge

• Pain that gets worse as the days progress

At Growing Generations, we understand that a miscarriage is a challenging and emotional event for both surrogates and the intended parents. We're here to support you through this difficult time. Reach out to us online at any time. 

All pregnant women are tested for gestational diabetes during their pregnancy, and it is no cause for alarm. Even if they’ve had no prior issues with blood sugar levels in their day-to-day life or in previous pregnancies, they will still have a glucose test during pregnancy as a surrogate.

While being a surrogate does not raise the odds of developing gestational diabetes, factors such as excessive weight, age, and carrying multiples may contribute to a more significant insulin resistance and the development of this condition.

GESTATIONAL DIABETES TEST

Glucose tolerance tests monitor the body’s ability to turn sugar into energy. During pregnancy, the additional hormones can confuse the pancreas, rendering it unable to break down glucose properly. When this happens, blood glucose rises and, on occasion, the woman will develop gestational diabetes. Unlike type 2 diabetes, gestational diabetes is purely hormonal. If a diagnosis of gestational diabetes is given, it is not the result of your surrogate’s food and exercise choices. This is not a diagnosis that could have been avoided with different behaviors.

GLUCOSE TOLERANCE TEST RESULTS

Learning that your surrogate’s initial glucose tolerance test came back elevated is a conversation that no intended parent hopes to have during their journey. Your initial reaction will likely be surprise, which then ignites questions and concerns: “She’s never had THAT in her history! What does this mean for the pregnancy? What did she do to ‘fail’ this test when she’s never failed it before?”

Let’s start by establishing a baseline. Having an elevated one-hour glucose test result is not a “failure.” If the test result is elevated (a “fail”), then there is nothing that could have been done differently by your surrogate to “pass.”. Also, many women will have elevated levels in a one-hour standard test and go on to pass a three-hour screening and have no problems. However, an elevated result on a one-hour glucose screening can also be the first indicator that your surrogate has developed gestational diabetes. In either event, it’s important to note that this test result is not the result of any action or inaction on the part of your surrogate.

Understand that your surrogate is likely having an emotional reaction to these results as well. Despite not being able to control the results, she likely feels guilty and perhaps even a bit scared. The kindest thing that you can do for her is to reassure her that she hasn’t lost your trust and that you’re in this together.

WHAT DOES IT MEAN FOR THE BABY?

If left unidentified or untreated, gestational diabetes can affect the baby. Here's how: With a buildup of sugar in the bloodstream, a pancreas will work harder than it should, often to no avail. This means that the glucose buildup can, and often will, cross the placenta and work its way into the developing baby’s blood. That will cause the newborn’s pancreas to work overtime and create more energy than it needs. As a result, that fetus will store the extra energy as fat. This can lead to a variety of complications, including high birth weight, damage to the shoulders as they exit the birth canal, and an increased risk of obesity or type 2 diabetes later in life.

GESTATIONAL DIABETES TREATMENT

In most cases, gestational diabetes can be managed by closely monitoring diet and adding a bit of additional exercise. Your surrogate will be asked to monitor her glucose levels with a home testing kit and keep a strict log of her food intake and sugar levels, but she may not need to change much about her lifestyle.

Women who are unable to control their blood sugar levels, even with strict adherence to diet and exercise, may be asked to begin taking oral medication or injected insulin. For most women, gestational diabetes will go away once the child is born. The American Diabetes Association advises women who develop gestational diabetes to have a 2-hour glucose tolerance test at 6 weeks postpartum in order to ensure that the diabetes has cleared up.

UNDERSTANDING GESTATIONAL DIABETES DURING SURROGACY

It’s important to understand what gestational diabetes is (a hormone-driven resistance to insulin) and what it is not (poor dietary choices or the inability to follow a diet). Your surrogate will likely feel some level of guilt in the case of a gestational diabetes diagnosis, even though it was induced by pregnancy. This is a great time to show her that you support her and will stand by her side moving forward.

Growing Generations is always here to answer your questions as intended parents and support you throughout your family-building journey. 

Embryos are tiny, delicate things. Following the embryo transfer process, surrogates concerned about how to protect the embryo they're carrying may worry about how secure the embryo is once it's placed in the uterus. Is it possible for the embryo to "fall out" after it has been transferred?

IS IT POSSIBLE FOR AN EMBRYO TO FALL OUT AFTER TRANSFER?

The overwhelming fear is that walking, jumping, or even urinating could cause the embryo to simply slip out of the uterus. Doctors often prescribe bed rest following the transfer to allow the embryo time to “get settled” and implant, so it makes sense that undue movement could cause the embryo to become dislodged and slip out, right? Rest assured that this is highly unlikely. The idea has merit, in theory, but it is not plausible in reality. The uterus is a muscular organ. This means that it stays contracted and tight in its natural state. While the area inside of the uterus is called a “cavity,” it is not a literal empty space. The transferred embryo does not have open space in which to move freely or roll around. 

WHY EMBRYOS DON'T FALL OUT

Your body is prepared well for the embryo transfer with IVF medications. Nearly all IVF doctors will require your uterine lining to be thick enough for the walls to touch in the middle before proceeding with a transfer. This creates an environment in which the thick, sticky endometrial lining leaves no empty space. When the embryo is placed between the uterine walls and the muscle contracts, it will create a secure place for the embryo to bury itself deep within that thick lining and begin to grow. Visualize placing a poppy seed in the crease of your elbow and then folding your arm shut tightly by using your muscle. Now wiggle that arm as hard as you can. No matter how hard you try, that poppy seed will not fly out. 

An implanted embryo inside of a flexed uterus is much the same. No reasonable external physical activity—be it jumping, rolling over in bed, walking, or running—can cause a healthy receptive embryo to become dislodged once it has implanted into the endometrial lining. The bed rest period is meant to help you relax and encourage the embryo to implant and bury itself within the endometrial lining. 

While you should always follow doctor’s orders regarding bed rest, do not be afraid to get out of bed to use the restroom or stretch your legs. If you have questions about what activities are approved, both during bed rest and once you’re cleared to return to daily life, do not be afraid to ask your nurse or doctor.

READY TO LEARN MORE?

Please contact Growing Generations for more information about being a surrogate in our program.  

Intended parents and surrogates often have questions about the types of insurance coverages used during the surrogacy process. Growing Generations (GG) is here to help intended parents understand how they can limit financial exposure and to help surrogates understand how insurance is used to provide them with safety and security. GG will be with you to provide guidance and connect you with top insurance providers as needed.

Here are the different types of insurance that will be discussed.

HEALTH INSURANCE FOR PREGNANCY AND DELIVERY

What is it?

This insurance is designed to cover routine pregnancy and delivery care as well as any complications that may arise.

How Does it Work?

Pregnancy and delivery are covered in the following ways:

• A surrogate’s existing health insurance policy

• The Affordable Care Act (ACA)

• A specialty surrogate maternity product underwritten by Lloyd’s of London.

During a surrogate’s admissions process, GG will review her personal insurance to determine whether it is acceptable to use. If it is not, we may ask the surrogate to apply for an ACA insurance policy. ACA insurance policies are only available during an “open enrollment” period that most commonly occurs in December of each year. If we cannot use a surrogate’s existing insurance or an ACA policy, Lloyd’s of London’s specialty surrogate insurance will be used.

Once we’ve determined the method of coverage, we will create an insurance coverage plan outlining the type of insurance which will be used for maternity care along with cost information for intended parents.

Why it’s Important?

Medical care in the United States is known for being top notch but very costly. Health insurance is designed to offer financial security no matter the level of care a surrogate may need during pregnancy and delivery.

HEALTH INSURANCE FOR NEWBORN BABY CARE

What is it?

This insurance is designed to cover medical care for baby once born.

How Does it Work?

For intended parents living withing the United States, they will simply add their child as a legal dependent to their own insurance policy within 30 days of birth. For intended parents living outside of the United States, policies are offered through Allianz and Lloyd’ s of London.

Why it’s Important?

Again, medical care in the United States is known for top notch but very costly. Health insurance for the newborn is designed to offer financial security in the event the baby needs care beyond what is considered “well baby care.”  Babies that are born prematurely or born with other health conditions will often result in medical bills in the hundreds of thousands to millions of dollars and health insurance  helps to mitigate this financial risk for the intended parents.

Cycle Insurance

What is it?

Cycle insurance is designed to cover complications arising from IVF protocols and procedures.

How does it Work?

Your case specialist will request cycle insurance as soon as an IVF calendar is received.

Why it’s Important?

While complications are rare, we want to ensure that should a complication arise, there is no delay in obtaining medical care, and there are no surprise costs for intended parents.

LIFE INSURANCE, TOTAL DISABILITY, AND LOSS OF REPRODUCTIVE ORGANS

What is it?

This policy pays a benefit to the surrogate or the surrogate’s named beneficiary should she lose a reproductive organ, experience complete disability, or lose her life because of pregnancy or childbirth.

How Does it Work?

Upon confirmation of pregnancy, your case specialist will request that the policy be placed.

Why it’s Important?

As unpleasant as it is to think of an extreme outcome, like most things in life, pregnancy is not without risk. The health and safety of our surrogates is a top priority, and as a result, surrogates are specifically screened to make sure they are ideal candidates for pregnancy. Despite best efforts, no one can completely remove risk, so we require that all surrogates be provided this policy.

We know insurance can be complex but remember that we are here to help guide you along the way.  Our insurance specialist will work with and connect you with respected insurance professionals as needed.

Many surrogates find themselves wondering why their intended mother needs their help. One potential cause stems from prolonged or advanced polycystic ovary syndrome, PCOS for short. PCOS is often associated with pregnancy difficulties and infertility, leading many women to turn to surrogacy to build their families. 

WHO GETS PCOS AND WHY?

PCOS is actually quite common. Doctors estimate that as many as 8% to 13% of all women in childbearing years suffer from PCOS, and suggest that as many as half of those women may not even know they have it. 

Women suffering with PCOS produce too much of a typically male hormone called androgen. When it is too abundant, androgen prohibits the body from allowing a healthy egg to be released from the ovary into the fallopian tubes, sometimes leaving the woman unable to conceive a child.  Instead, the immature eggs turn into small cysts and are retained inside of the ovaries. These retained cysts will continue to contribute to steadily elevated levels of androgen in the body, serving only to fuel the cycle of PCOS further. 

PCOS Symptoms

PCOS is often characterized by missed or irregular periods, excess body hair, weight gain, and acne. Given that these are symptoms that are incredibly common for most women, many don’t mention them to their doctors for many years. The diagnosis itself can often take quite a while to attain, given that PCOS is only diagnosed as an “exclusionary diagnosis,” meaning it is only diagnosed after every other possible diagnosis has been ruled out. 

PCOS: PREGNANCY, MISCARRIAGE & SOLUTIONS

For women living with a PCOS diagnosis, the answers to their fertility can run the line from very hopeful to very grim. While some women may need minor hormone therapy to regulate their cycles and work to correct the abundance of androgen, others may experience infertility or miscarriage. Often, this latter group of women is left considering reproductive technologies and even surrogacy as the best way to create their families.

Helping these women build their families through surrogacy is deeply rewarding. (You can learn about other reasons to become a surrogate in our related blog post.)  Reach out to us online to learn more.