It’s important during this phase of your process to establish the foundation of your relationship with your surrogate.  Here’s what I hear from surrogates about what they are looking for.

Surrogates are not looking for a new best friend. Their goal is to help you create your family and the pay-off for them is seeing you gazing at your newborn for the first time. During the process, however there are things that can help make your relationship smooth and pleasant. I always tell surrogates and intended parents that there are four things that make a surrogacy relationship work. They are trust, communication, appropriate boundaries and flexibility.

The most important ingredient in any surrogacy relationship is trust. Trust is the foundation of surrogacy and should be at the core of your relationship with your surrogate. This is not total, unconditional, blind trust, but trust as a mutual gift that you give one another. Surrogates want to feel that you trust them and that you know that your baby is in good hands. They don't want or need to be managed by you (although of course it's understandable that you want lots of details). If you have a solid foundation of trust in your surrogate and she in you, you will be able to relax and enjoy your surrogacy journey.

The next important ingredient in your surrogacy relationship is communication. While you and your surrogate will have a team of professionals that you can talk to throughout your journey being able to communicate with each other about your relationship and about the pregnancy will help you feel that you are really participating and it will help your surrogate feel that you really care. At the core of good communication is having clear and articulated expectations. It is totally appropriate to ask your surrogate how much and what kind of communication she wants. It is also important for you to be clear about how much communication you want. The best way to keep open lines of communication with your surrogate is to be interested in her and her life, but you can keep it light and let the relationship develop naturally.

Boundaries are an essential part of any relationship and the surrogacy relationship is no different. You can always open a boundary as the process progresses, but once you open a boundary up it is very hard to close it again. Be careful not to make promises that you can't keep--remember your surrogacy relationship exists for one goal: to help you create your family. Intended parents sometimes make the mistake of "falling in love at first sight" with their surrogate when they meet her and realize that she is the woman who will help them fulfill their dream of parenthood. In that honeymoon phase they may reveal things or promise things that they later regret. The rule of thumb is: take it slow, be warm and authentic and have good boundaries.

The final ingredient in the surrogacy relationship is flexibility. Surrogacy is not a linear process and there are many points in the journey where flexibility will be essential. Remember that your surrogate probably has a very full life outside of the surrogacy and although your journey to parenthood may be first and foremost on your mind, she also has to think about her kids, her partner, and her job, and the surrogacy may not always be first in line for her attention. So, be flexible in your expectations of her. She doesn't need to return your call instantly to be taking good care of her body and your baby!

Overall, your surrogate's primary goal is to succeed at having your baby--the relationship that you have along the way is the backdrop for that unfolding story and the beginning chapter in your child's life. When you trust each other, have good, open communication, live inside of appropriate and fluid boundaries and bring flexibility to all of your expectations you set the stage for a wonderful journey together!

Stories have always been a powerful communication tool, and that’s no different when we’re talking to little ones about about how they were created. Whether you’re an egg donor, surrogate, or intended parent, you likely will be excited and proud to tell your current and future children about your decision. However, finding a way to explain something so scientific to young minds can feel challenging. Children are full of curiosity, even at a young age. 

As a parent, you can educate your child on the subject of their birth story or the birth story of another child without it being an uncomfortable topic of conversation. One way to broach the subject, especially with younger children, is through topical books. As assisted reproduction grows in popularity, more and more authors are penning books for children about egg donation that explore the topics in an age-appropriate way. 

Here are a few books to consider, including those that can open the door to discussion with slightly older kids. 

EXPLAINING EGG DONATION TO YOUR CHILDREN

Stories to Share

• You Began as a Wish by Dr. Kim Bergman: This wonderful children's book written by Dr. Kim Bergman, author of Your Future Family: The Essential Guide to Assisted Reproduction, and beautifully illustrated by Irit Pollack, answers those questions in simple, easy-to-understand language. Use this book to help your children understand all the parts that came together to make them who they are, beginning with a wish!

• “A Tiny Itsy Bitsy Gift of Life, An Egg Donor Story for Boys” by Carmen Martinez Jover: Egg donation is explained through the context of a family of rabbits in this touching story.

• “One Little Egg” by Kimberly F. DeMeo: Readers follow the journey of an egg all the way from the “Donor Egg Academy.”

• “The Pea That Was Me: An Egg-Donation Story” by Kimberly Kluger-Bell: This is one of many books in a series that helps parents explain birth stories.

• “A Very Special Lady: A Story about IVF, an Egg Donor and a Little Girl” by Nell Carswell: Discover a beautifully illustrated story about “a very special lady.”

• “Mommy, Was Your Tummy Big?” by Caroline Nadel: Great for small children, this book explains egg donation through a mom and baby elephant.

• “A Part Was Given and an Angel was Born” by Rozanne Nathalie: With phrases that lift the heaviness of the topic, this is a sweet story about egg donation.

• “How We Became a Family” (Version Egg Donor — Twins) by Teresa Villegas: Find a combination of science and a love story in this helpful book for parents.

• “Hope & Will Have A Baby: The Gift of Egg Donation” by Irene Celcer: This is part of a series addressing various topics with subtitles such as “The Gift of Sperm Donation” and “The Gift of Surrogacy.”

If you want to keep the conversation going with your kids, we also list helpful children's books about surrogacy in a related blog post.

Our Growing Generations team delights in helping you navigate the wonders of egg donation and surrogacy. If you're considering becoming an egg donor or surrogate or you want to build your family through surrogacy, get started by completing our online application form.

By the time an egg donor or IM reaches her retrieval day she very fertile and ready to have upwards of 30 eggs extracted! The idea of something coded as a minor surgical procedure can sound a little scary, but the truth is that this is a very routine in office process that is generally pain free. The donor or IM will be typically scheduled for a morning appointment at the clinic. It is usually a good idea to arrive a bit early in order to fill out any paperwork and have time to ask any questions you may have. As you will be placed under light sedation for the procedure, you should not consume food after midnight on the day of the retrieval. When it is time for the procedure you will be put under light sedation for comfort. The doctor will then use a very small needle, guided by an ultrasound, to retrieve the eggs. The needle is inserted through the vagina where it will pass into the follicles and ovaries. The needle then extracts the eggs with a gentle suction action. The fluid surrounding the eggs is also extracted. After the eggs have been safely captured the needle and ultrasound wand are removed. The entire procedure takes between 15-30 minutes to complete. 

Despite the quick procedure you should plan on spending another two to three hours at the office. The doctor will want you to come out of the light sedation state and monitor you for a while before releasing you. Plan on having someone at the clinic with you in order to drive you home. Once you’re home you are encouraged to spend the rest of the day resting and recovering. You can expect to feel menstrual cramping and to see some light blood spotting when you wipe. If the pain or bleeding become extreme you should call your nurse to let her know what you’re experiencing.  Painful urination, a temperature above 101.0 degrees, fainting or vomiting are all highly unlikely but should also be reported if experienced. Normal activities can typically resume the day following the retrieval. Occasionally the doctor will ask to see you in office one final time following your next period. This is just a precaution to make sure you’ve healed properly.

Another bit of jargon you may encounter on your way to transfer day includes the terms “mock cycle” and “dropped cycle.” Both are IVF terms used when a surrogate takes medications as directed but does not transfer an embryo at the end of the cycle. Here’s a look at what each term means and how they differ.

WHAT IS A MOCK CYCLE?

A mock cycle is when a doctor puts a surrogate on full or partial medicines and monitors her as if she was planning to transfer with the clear intent that she will not transfer an embryo. This can be ordered for a number of reasons with the most common being that the doctor wants to observe how the surrogate’s body responds to a certain medication. 

An IVF mock cycle allows the doctor to ensure that the surrogate's body, most specifically the endometrium lining, is capable of reaching levels that will support pregnancy and make implantation likely—without the cost of preparing an egg that could potentially be lost to unfavorable conditions. At the conclusion of the mock cycle, medicines or dosages may be changed or fine-tuned in order to create optimum results in the real cycle.

You can learn more about embryo transfer preparation on our Surrogacy Process page. 

WHAT IS A DROPPPED CYCLE?

A dropped cycle is when a surrogate is taking all prescribed IVF medications with the intent of transferring an embryo at the end of the med-cycle, but the transfer is canceled. This can be ordered because of many factors, including:.

• The egg donor or intended mother’s response to medicines

• A mistake in properly following protocol

• The quality of the eggs retrieved

• Having eggs lost to the thawing process 

However, a surrogate with a thin lining can also cause a transfer to be canceled or “dropped.” If you experience a dropped cycle in your journey, you will most likely consult with your IVF doctor, make changes to the medical plan and try again in the next month.

Growing Generations is here to support surrogates throughout the process. If you or someone you know is interested in becoming a surrogate, you can fill out an application or contact us online for questions or more information.

The labor and delivery process is the most emotional, nerve wracking, exciting, overwhelming and, more than anything, confusing day of your journey as an intended parent. After all, your entire life is about to change forever! Here’s a look at a few of the labor and deliver terms and abbreviations that you may hear flying around during the hours that lead up to the birth of your child. 

SHOW

Also referred to as the “bloody show” is when the softened cervix begins to open, thus rupturing tiny blood vessels and leading to blood tinged mucus. This is also known as the mucus plug. This is usually indicative on the onset of early labor. 

DILATION

A term used to measure the opening of the cervix. Through the process of labor the cervix will go from 1cm (the size of a Cheerio) to 10cm (The size of a sliced bagel). 

EFFACEMENT

A term used to measure the softness of the cervix. Usually measured in percentage from 10-100% effaced. 

EPIDURAL

A popular form of pain management used in childbirth. A form of regional anesthesia, an epidural is administered through a small tube inserted into the back. The goal is to decrease sensation in the lower half of the body by blocking nerve impulses. More than 50% of laboring women will request this form of pain management. 

STATION

This refers to how far into the birth canal your baby’s head is located. The scale ranges from a -5 to a +5. Generally speaking, a -5 station is a baby that is not engaged at all, and a +5 station very engaged and preparing for delivery. 

MECONIUM

The fetal waste that accumulates in a baby’s intestine during gestation. It is expelled during or shortly after birth and is greenish in color. If it is present at the time of birth members from the NICU may be called in for observation. 

NICU

Short for neonatal intensive care unit. This is a hospital inside of the hospital for babies born either very premature or with serious health conditions. You can learn more about what to expect if your baby needs to stay in the NICU in our related blog post. 

BREECH

The term given to the position of the baby when the buttocks or the feet are positioned to exit the vagina before the head. 

EPISIOTOMY

The procedure of cutting the thin skin (the perineum) between the vagina and the anus. The doctor may perform this procedure in the final stages of labor in order to enlarge the vaginal opening in preparation for delivery. This can help prevent excessive tearing. 

Learn more about Growing Generations and building your family with surrogacy on our Surrogacy Program page. If you're ready to get started, complete your intended parent application.

If you're entering surrogacy, you will typically be placed on a regimen of hormone IVF surrogacy therapies to prepare the uterus for the embryo transfer and aid in maintaining the pregnancy. Some of the surrogacy medications you can expect to be on during your medical cycle may include:

• Estrogen- You are likely to be on at least one form of estrogen supplement. This is to build the uterine lining. Common forms include Estrace (pill) and/or Delestrogen (intramuscular injection).

• Lupron- This medication (subcutaneous injection) is given primarily to women who are planning on transferring a fresh embryo as opposed to a frozen one. It is used to help suppress the ovaries while waiting for the transfer.

• Progesterone- Most surrogates will be on progesterone for many weeks. Progesterone is used to mimic pregnancy in the body and sustain a viable early pregnancy. Common forms are vaginal suppositories (Endometrin), patches, and intramuscular injections compounded with oil (Ethyl Oleate, Sesame Oil, or Olive Oil are common.)

• Medrol- This is a short term steroid administered orally prior to transfer. It is given to suppress the surrogate’s immune system in hopes of encouraging embryo implantation and potential pregnancy.

• Prednisone- This is another steroid form, administered (pill) for the same purpose of immune system suppression, but given over a prolonged period of time.

• Baby Aspirin- Given as a blood thinner as a precautionary measure due to the high levels of hormones the surrogate is taking.

• Doxycycline- Some surrogates are given this antibiotic (pill) before their embryo transfer to help fight infection in the body, including possible low-grade pelvic infections.

• Prenatal Vitamins, Folate & DHA- Just as with all pregnant women, most surrogates are asked to take daily supplements to aid in their overall health and the development of the fetus.

The list above is purely a sample of frequently used medications in IVF. Your medical cycle may vary. Just as with all medications, an individual’s response to each medication can vary widely from one patient to the next. What works well for one patient may not work at all for another. 

Ensuring you're a good fit for the surrogacy process is one of the reasons for our in-depth medical screening during the initial surrogacy process.

MONITORING MEDICATIONS

Your hormone medications will be monitored closely through the entire process. Your doctor may order changes to the drugs you take as well as the dosage of your medications many times in order to ensure continued success of your journey. This is normal and is not a cause for concern.

SURROGACY MEDICATION TIMELINE 

You'll likely begin IVF medications a month or two before the embryo transfer. Some surrogates undergo a mock cycle beforehand so the doctor can see how your endometrium lining responds to the medication. 

Typically, you'll be released from medication between 10 to 12 weeks of pregnancy. That time estimate is just a guideline and actual release may come earlier or later. When you're released from medication, it is a weaning process that generally takes several days.

Any questions or concerns you experience during your medical cycle can and should be discussed with your case specialist and/or nurse right away.

BECOMING A SURROGATE

If you're considering becoming a surrogate, we're happy to walk you through the process and answer all your questions about surrogacy and its medical protocol. Growing Generations is a premier surrogacy agency known for its attentive team. You can reach us online or call us at 323.965.7500.

*Revised 2/29/24