BEST AIRLINES FOR INTERNATIONAL NEWBORNS PREVIOUS ITEM NEXT ITEM When it comes to your newborns first flight, we understand that you’re bound to be a little anxious! Especially for parents whose journey home includes an overseas flight, it is important to consider which airlines are able to make your trip home as comfortable as possible. We’ve done a bit of web crawling for you, and here’s what we’ve learned about international vs US domestic carriers. According to travel expert blogs and articles published on The Huffington Post and Travelsort.com, your best bet is always to book with an international carrier as opposed to an American based carrier. American based carriers have had to focus on cutting their costs to guard their profits over recent years, and don’t have the capital to offer as many amenities as their international counterparts. While most airlines will still allow passengers with small children to pre-board, often times ahead of even first class passengers, many airlines also offer additional considerations to help make your flight more enjoyable. Many International airlines are still able to offer perks and convenience features to parents of newborns including bassinets for sleeping, free on board diapers, wipes, and formula, as well as complimentary formula warming. Only a handful of American based carriers can brag these features, and most can’t guarantee these features will be available ahead of time. Many of the same carriers were applauded time and time again for their attention to your smallest passenger. These airlines include: Singapore Airlines, Japan Airlines, Cathay Pacific, Etihad, Virgin Atlantic, Emirate, Lufthansa and British Airways. When pricing and booking your tickets to the USA for the birth of your child, keep in mind that you’ll be traveling home with a newborn and look into what each airline offers. When in doubt if certain features or amenities will be available on your flight or in your cabin (will you be flying coach or first class), it’s always best to call ahead and ask.

9 REASONS TO BECOME A SURROGATE PREVIOUS ITEM NEXT ITEM The reasons a woman chooses to become a surrogate can be endless. Chances are, if you’re considering making this life changing choice, you’ve already compiled a list of reasons and benefits. Even so, here are nine more benefits to consider; one for each month you’ll be carrying a child. 1. Giving Life. Surrogates are given the chance to give a gift that no one else can. Intended parents turn to surrogacy because they need help conceiving a child. You’ll be chosen to help that couple become a family. You’re the one person who can turn an only child into a brother or a sister. It’s a selfless gift unlike any other, and the sense of accomplishment is a benefit all its own. 2. Financial. Yes, you get paid. While our surrogates agree that financial compensation is not the only reason they choose to become a surrogate, it is indeed a benefit worthy of consideration. Many women use the compensation to put a down payment on a new house, buy a new car, send themselves back to school, or pay off college loans. Others use the funds as the nest egg that allows them to open their own business or even stop working in order to stay at home with their own children. 3. One More Time. Our surrogates tell us they love being pregnant. If you’re like them, you had uncomplicated pregnancies and loved every minute. Even so, your own family might be complete. Becoming a surrogate gives you the benefit of being pregnant one more time. 4. Be a Role Model. Choosing to be a surrogate makes you a stand out figure, not only in your home but also in your community. Earning the respect of your own children and of your peers is indeed a benefit. 5. Global Perspective. Becoming a surrogate will open eyes, both your own and those of people around you. Choosing to walk this road will give you the benefit of perspective. The ability to see life from walks of life very different to your own can be humbling and empowering at the same time. 6. Self Confidence. On delivery day, in the 12th hour, when you hurt and when you just want to go to sleep, something amazing happens. You give birth to a child with no relation to you. You make a family. You change the world. In this moment, your self-confidence soars to heights you never knew possible. You swell with pride and receive a benefit you cannot comprehend until you’ve lived it. 7. A Different Kind of Family. Many intended parents seek to have an emotional bond with their surrogate. Quite a few surrogates report having long lasting bonds with the families they help create. Think of it as an extended family that you get to choose. 8. Health Care. During our surrogate application process and beyond, you receive access to valuable healthcare screenings at no cost to you. In addition, all of your pregnancy care will be covered either through a surrogacy-specific plan or by your own current health care plan. 9. Community. Becoming a Growing Generations surrogate gives you a VIP pass to join the ranks of many other like-minded women. You’ll be given the opportunity to connect with other past and present surrogates through your journey. It starts as a support group, and quickly turns into a group of sisters you’ve never met. Whatever reasons you have that have brought you to consider becoming a surrogate, know that you’re already an extraordinary woman. We look forward to having you complete our online initial application and speaking with you about the many tangible and intangible benefits of choosing to become a surrogate.

YOUR VISION FOR YOU FAMILY'S FUTURE IS THE DRIVING FORCE BEHIND EVERYTHING WE DO. As we help you on your path to parenthood, your comfort is paramount. We take care to keep your goals at the center of our work as we guide you and your surrogate through the journey. Rest assured, our team pays close attention and is always working in the background to give you the experience of a lifetime. DELIVERING WHAT MATTERS EVERY MOMENT MATTERS. WE'RE HERE FOR THEM ALL. GESTATIONAL SURROGACY Growing your family with the help of a gestational surrogate relies on a special kind of relationship. Whether using your own eggs, or that of your intended co-parent or an egg donor, the gestational surrogate is the person you form a close partnership with throughout the pregnancy, who plays a role in your goals as a parent and ultimately gives birth to the baby you will welcome into your growing family. One of our core strengths as an agency is not only ensuring you connect with the right surrogate to go on this journey with, but also following you closely through every step together. The Growing Generations surrogate admissions process is highly selective, keeping safety and quality as our top priorities. At every step of the surrogacy journey, our team is skilled in managing and anticipating the variety of needs and negotiations that may arise, so that you can feel fully supported. BECOME A PARENT EGG DONATION OVERVIEW STARTING YOUR FAMILY WITH THE HELP OF AN EGG DONOR BEGINS WITH A SEARCH We’ve facilitated close to 1,500 egg donations, communicating between intended parents, donors and clinics. From finding the right donor based on your personal preferences and key criteria, to finalizing medical clearance and legal agreements, to guiding you through the egg donation cycle, our team is here to make sure you get the strongest start to growing your family. Growing Generations egg donors come from the top 1% of our applicant pool, which makes your choice easier. You can focus on exactly what you’re looking for in a donor, knowing that we’ve taken care of gathering the best candidates for you to select from. FIND A DONOR Our Intended Parents Have Access to the Very Best Egg Donors Available Trust Us To Find the Right Egg Donor for You

YEAST INFECTIONS IN SURROGATE PREGNANCY PREVIOUS ITEM NEXT ITEM Yeast infections are common and impact millions of women every year. Even so, many women will experience their first yeast infection, or potentially her first outbreak of several yeast infections, in her surrogate pregnancy . WHY ARE YEAST INFECTIONS MORE COMMON IN SURROGATE PREGNANCY? According to the American Pregnancy Association , the second trimester of pregnancy represents the time in a woman’s life where she is most likely to experience a yeast infection. So why is there an increased likelihood of a yeast infection in surrogacy if you never experienced one during your own pregnancies? The link could be because several potential causes of a yeast infection occur all at once as a woman prepares to become a surrogate. For example, some common causes of yeast infections include: Hormonal changes related to pregnancy Starting hormone therapy treatments (including birth control pills, estrogen, or progesterone treatments) Taking antibiotics or steroids (a common component of your pre-transfer medical protocol ) An increase of sugar in the diet (sweets are a common craving for pregnant women) An influx of vaginal intercourse (potentially before or after doctor ordered pelvic rest) Blood or semen in the vagina Often characterized by an increase and change in appearance of your normal vaginal discharge and a persistent, insatiable itch, yeast infections are caused when the levels of yeast and acid in the vagina are out of balance. Both elements are present in your body normally, so the presence of bacteria is not the problem; it is the unbalance that presents the issue. YEAST INFECTION TREATMENT DURING SURROGATE PREGNANCY While yeast infections have no major risks or implications to the pregnancy, they can still be uncomfortable and problematic for you, especially if left untreated. Yeast infections during pregnancy can be difficult to control, so it’s best to get early treatment. Additionally, and unlike traditional pregnancies, yeast infections in IVF pregnancies and surrogacy may require a different form of treatment than your standard over the counter creams. This is because many IVF doctors do not want the creams or their plastic applicators introduced to your vagina in the early stages of your pregnancy. While some doctors may be OK with the creams with hand application only, other doctors may choose to call in a prescription to treat the infection orally. We understand that it can feel embarrassing and invasive to tell your nurse about a potential yeast infection before simply self-treating with over the counter medications, but in the case of surrogacy, you should absolutely mention symptoms to your nurse, even if this is a multi-occurrence infection. Treatment is key, because if it is left untreated, the yeast infection can be transferred to the child you are carrying during birth, leading to a condition of the mouth called thrush. Once you begin treatment you can expect to experience relief from the symptoms within 10 to 14 days, although most treatments will begin to offer relief from many of the symptoms within 48 hours. STEPS TO PREVENTING YEAST INFECTIONS DURING PREGNANCY If you find that you are experiencing repeated yeast infections during your journey, you may opt to introduce the following natural prevention measures in order to try and stave off any future infections. Wear loose clothing Wear cotton underwear Always wipe from front to back after using the restroom Limit sugar intake, as vaginal yeast feeds on sugar If you have additional questions or concerns, try to focus on feeling comfortable mentioning this to your nurse or case specialist. Sending an email to approach the subject may offer you a bit more comfort than mentioning it in a call, but understand that both your case specialist and your nurse manage these sorts of issues every day, and they’re nothing to be embarrassed by. Growing Generations is a premier surrogacy agency that provides intended parents, surrogates, and egg donors with exceptionaly attentive service. If you are interested in becoming a surrogate, contact us online or complete our surrogate application .

WHAT ARE MOSAIC EMBRYOS? PREVIOUS ITEM NEXT ITEM As science continues to advance and doctors learn more about embryos and IVF technology, we continue to see new terminology and practices in the field. Recent studies conducted by the world’s largest genetic laboratory, Reprogenetics, have introduced the IVF community to a new term and potential game changer in the assisted reproductive technologies world: mosaic embryos. Mosaic is the term now assigned to embryos found to possess both normal and abnormal cells during preimplantation genetic screening (PGS) testing. The testing, typically completed on day five of embryo development, is completed by taking a tiny biopsy of the embryo and examining the genetic makeup of the cell. During the examination, embryologists are able to detect, and often diagnose, potential chromosomal abnormalities. These abnormalities, including things like the presence of Downs Syndrome, have traditionally been used to help determine which embryos are chosen as the most likely to implant once transferred. Until very recently, any cell with noted abnormalities was discarded and not considered for transfer. However, recent developments have led doctors to suspect that these abnormal cells may be viable for transfer after all. Doctors have noted some level of success in transfer of the mixed quality embryos, and many of the births have gone on to produce healthy babies. The belief is that the abnormal cells will be segregated to a part of the pregnancy tissue that is non-vital to chromosomal development. However, if the abnormal cells are not rendered harmless, the embryo will either fail to implant or force early miscarriage as the pregnancy progresses. Clearly, the evidence is far from conclusive and the use of a mosaic embryo could still result in the birth of a child with abnormalities or life-altering conditions. As such, the use of mosaic embryos should be very carefully considered with full consideration given to each potential outcome. Despite the risks, some IVF doctors and their clients are beginning to consider the use of these mosaic embryos; especially in instances where the gender of the fetus is especially important to the parents. In the instance that an IVF cycle results in a small number of a specific gender, and of the small sample, there are few suitable embryos for transfer, the use of mosaic embryos allows parents to hold out hope for a successful pregnancy in the desired sex. While research remains inconclusive about the long-term impacts of babies born of mosaic embryos, the initial implication could provide additional hope to couples struggling with infertility.

THE EGG DONOR PROCESS HOW TO BECOME AN EGG DONOR At Growing Generations, we make it as simple as possible to become an egg donor. Each step of the way our specialists will support you and ensure you have a safe, comfortable experience. 5 STEPS TO BECOME AN EGG DONOR You will begin by completing an online application that will ask you to share basic information about yourself as well as ensure you meet all the basic requirements to be an egg donor. Once your application is approved, one of our donor specialists will schedule a video consultation with you. The entire conversation usually lasts about 30 minutes. In that time, we’ll give you an overview of the entire process, and you’ll have time to ask us any questions you may have. Upon completion of your egg donation consultation, we will provide you with a few documents to sign electronically and ask you to provide photos, GPA and test score verification, and photo ID verification. We will also set you up with instructions to complete fertility testing. These tests will measure hormone levels to ensure your body will produce an ideal number of good-quality eggs. There will be no cost to you. The test is a great way to learn about your own fertility and assures prospective intended parents looking for an egg donor that they are selecting the best egg donor for their family. After receiving the requested items, we’ll be able to make your egg donor profile available for intended parents to view online. The most unpredictable aspect of egg donation is the time it takes to be selected by intended parents. Every intended parent is looking for a unique set of characteristics in their egg donor, and it may take time for them to find the right one. This phase could take a few days or months, but your admissions specialist will be with you the whole time. When you’re selected by intended parents, you’ll know they have spent all that time looking for the perfect donor, which happens to be you! You will complete a screening process designed to make sure that the egg donation will be a safe and healthy process for you. Some IVF physicians will require testing on day three of your menstrual cycle. You will also complete a psychological and medical screening. At the same time, you’ll complete a legal agreement with the intended parents to outline the terms of the egg donation. We will connect you with an attorney who specializes in this area of law, and they will walk you through the contract. After we receive your screening clearance and signed contract, you’ll begin the IVF cycle for your egg retrieval. The IVF clinic will put together a calendar with the dates of your appointments and a list of your medications. This usually depends on the start of your next period, and you may first need to begin a round of birth control pills. If you have any questions before applying to become an egg donor, please contact us at family@growinggenerations.com , and a member of our donor team will contact you directly. Growing Generations is always here to help and support you through your egg donation experience from the very first step to the last stage of your journey. STEP 1 APPLY STEP 2 ATTEND A VIDEO CONSULTATION STEP 3 INTENDED PARENTS VIEW YOUR PROFILE STEP 4 COMPLETE YOUR SCREENING AND CONTRACT STEP 5 BEGIN EGG RETRIEVAL BECOME A DONOR TIMELINE AND OVERVIEW The egg donation process is a little different for every donor. The two most significant factors are how long it takes an intended parent to choose you and your menstrual cycle. But overall, the entire process takes an average of THE EGG DONOR PROCESS TWO TO FIVE MONTHS TO COMPLETE AN EGG RETRIEVAL AFTER BEING SELECTED BY INTENDED PARENTS. This general overview provides a more in-depth explanation of what to expect when you decide to become an egg donor with Growing Generations. 1. PRE-QUALIFICATION You will first fill out a simple online questionnaire before completing the egg donor application in its entirety. This form allows us to screen for various preliminary qualifications including questions we are required to ask you by the Food and Drug Administration (FDA). 2. APPLICATION PROCESS After you submit your egg donor application, a member of our admissions team will review your information within one business day, and your next step is a video consultation. 3.NEW EGG DONOR CONSULTATION The video consultation will last approximately 30 minutes. You’ll be able to utilize our easy online calendaring system through your online account to schedule your consultation. During your consultation, we’ll discuss how the egg donation process works, answer your questions, and address your concerns. 4. IMPORTANT DOCUMENTATION SUBMISSION Once your egg donation consult is complete, we will provide you with a small to do list which includes reading over and electronically signing some documents. You will also receive instructions to complete fertility testing that will measure your hormone levels. Some of the items we need are: ​ A copy of your photo ID. Pictures and a video for your online profile. GPA and test score verification. 5. PUBLISHING YOUR EGG DONOR PROFILE We’ll be able to make your egg donor profile available for intended parents to view in our online database after receiving all requested items. Once matched with intended parents, a case specialist will be assigned to you who will support and guide you throughout your egg donation cycle. 6. SCREENING PROCESS Prior to beginning your egg donation cycle, you will need to meet with a mental health specialist who will evaluate your psychological understanding of egg donation. You will also meet with an IVF physician to complete your medical screening where you will undergo blood tests and an ultrasound. The purpose of these tests is to look for anything unusual and make the best medical plan for you. It will take about two weeks to receive your medical screening results. 7. LEGAL PROCESS While waiting for your medical screening results, you’ll complete your legal contracts with the intended parents that outline the terms of the egg donation. You’ll have an attorney assigned to you, and they’ll help walk you through the egg donation contract. The legal contracts may take four to six weeks to complete. Your case specialist will notify your IVF physician once legal clearance has been issued. Legal clearance must be in place before you can begin injectable medications. 8. EGG RETRIEVAL PREPARATION You will be issued an egg donation cycle calendar after completion of your screening process and legal contracts. The cycle calendar will include information on taking your fertility medications, which increase the number of eggs that will be released at the time of the retrieval, and the estimated date the egg retrieval will take place. The IVF clinic will review the medications and appointments with you to make sure you understand the instructions they provide. Cycle medications will be shipped to you. 9. EGG RETRIEVAL At the beginning of the egg donation cycle you’ll go in for cycle monitoring appointments. Your monitoring appointments will take place at a clinic near you. These appointments will confirm your body is ready to begin the cycle and track your progress on the medications. As we are near the time of the egg retrieval, you’ll be required to attend appointments at the IVF clinic directly until your procedure takes place, which may be up to 5-12 days. From the time you start the injectable medications to the time of your egg retrieval, the IVF cycle is about 2 weeks long. The IVF clinic and your case specialist will be there for you every step of the way. The egg retrieval itself takes about 15-20 minutes. You’ll be required to stay in town for 24-48 hours after the egg retrieval procedure to give your body time to rest. You’ll usually have one final monitoring appointment after the retrieval. Once your egg retrieval is complete, your specialist will follow up with you, obtain your egg donation records, and see if you’d be interested in donating again. Our goal is to make sure the donation process is enjoyable for you, and we love when egg donors return to our program. You’ll be able to take pride in knowing you have helped someone continue their dream of becoming a parent, which could not have been done without you. BECOME A DONOR DISCLAIMER Egg donation involves a screening process. Not all potential egg donors are selected. Not all selected egg donors receive the monetary amounts or compensation advertised. As with any medical procedure, there may be risks associated with human egg donation. Before an egg donor agrees to begin the egg donation process, and signs a legally binding contract, she is required to receive specific information on the known risks of egg donation. Consultation with your doctor prior to entering into a donor contract is advised.

WHY EGG DONORS SHOULD TAKE THEIR TIME ON THEIR PROFILES PREVIOUS ITEM NEXT ITEM THE IMPORTANCE OF YOUR EGG DONOR PROFILE During your admissions process, you’ll be asked to complete your donor profile and video. This is the information that is posted on our database for prospective parents to review and select their perfect donor. Your profile consists of your educational history, medical history (mental health, reproductive health, etc.), family/genetic history, and most importantly, photos, and personal essay questions. Some parents are looking for specific qualities in an egg donor, like a higher education level or certain ethnicity, but most parents are hoping to find a donor they can relate to, whether it’s through appearances, personalities, or similar interests. Your profile and video give parents an opportunity to get to know the “real” you. It’s important to take your time creating your profile and not rush through it. Parents are also looking for an egg donor they can trust. Using proper grammar and providing well thought-out responses gives parents confidence that you are serious about this process. KEY ELEMENTS OF YOUR PROFILE Medical Most of your profile consists of listing your medical history. It’s helpful to consult with trusted family members about your family health history, so you can give honest and precise answers. The more details you can provide the better. Parents are looking at this information to ensure they have a compatible health history (i.e., not having a history of diabetes in both families). This is also information the parents will use in the future when providing their child’s health history. Personal The more fun aspect of your profile are the personal essay questions and photos/video. Are you adventurous and love to travel? Do you love animals and volunteer work? Are you a great cook? These questions are designed to really let your personality shine. When parents read your answers, they are hoping to find a connection with you, so it’s important to be honest and true to yourself. MATCHING WITH INTENDED PARENTS Once your profile is published on our database, intended parents will begin reviewing your information. There is no set time frame on when you’ll be selected, but we find that donors who take the time to create a great profile are usually selected sooner. After you’re selected by intended parents, you’ll begin the egg donation process, which consists of medical/psychological screenings, a legal contract, and the IVF cycle for the egg retrieval.

TELLING YOUR BOSS ABOUT SURROGACY PREVIOUS ITEM NEXT ITEM Telling your boss that you’re pregnant can be stressful. When the baby you’ll be carrying isn't your own, telling the boss your big news can seem overwhelming. Depending on your relationship with your boss and the workplace atmosphere, you’ll first need to decide if you’re an early sharer or a late sharer. If you have an open relationship with your boss and you don’t feel as though the news would be ill received or put you in jeopardy, then sharing news of your surrogacy hopes early may be beneficial. Early sharing inspires open communications and trust while allowing you to be honest with your boss over the upcoming absences you’ll be taking for the transfer and monitoring appointments. Your boss will also be clued in to any tiredness or moodiness that tends to come with early pregnancy. Many women do not feel comfortable sharing their goals until much later in the process. Some wait until a positive pregnancy test, and others wait until the end of the first trimester. Delayed sharing allows you to keep their secret a bit longer in the sad possibility of an early miscarriage. Some women also feel as though their bosses would not authorize time away from work for these important medical procedures. If this is your situation, feel confident knowing you are not required to tell your boss why you’re missing work for medically related absences. Whenever you choose to tell your boss about your surrogate pregnancy, it is probably best to schedule a time for the conversation in advance. A good call would be a time when this can be a one-on-one discussion without many distractions. A lunch break or other time when you’re off the clock is probably best. Be sure to ensure your boss of any intentions you have for time off following the birth, and if you intend to return to work following the birth, ensuring your boss of this intention can help create calm. Finally, ask if he/she has any questions. Giving your boss the opportunity to ask questions about the process and what it means to your job performance is important. Revised on 4/17/18

SURROGATE REQUIREMENTS: 4 THINGS THAT CAN DELAY YOUR SURROGACY PREVIOUS ITEM NEXT ITEM Making the choice to become a surrogate can take a lot of time and thought. We know that by the time you make that choice you’re probably ready to move forward quickly. You should note that there are several surrogate requirements that can cause us to have to press pause on your journey. Here are a few of the most common circumstances. BREASTFEEDING AND SURROGACY We encourage you to take your time nursing your child, and enjoy those very special moments. However, potential surrogates are not able to progress through screening while currently breastfeeding. We will be here for you when you’re done breastfeeding. MEDICATIONS AND SCREENING From time to time, certain medications can cause a delay in your screening . Most commonly we see women who are on implanted birth control methods having to delay their screening process. In some cases we need to wait for a set amount of time once you’re off the medications before we can proceed. SURROGATE HAS PENDING COURT PROCEEDINGS In some instances, we are unable to move forward with screening a potential surrogate due to open court proceedings. We will need all proceedings to be closed and final before moving forward. This is to ensure that you are in a stable legal position before you begin to carry a child for someone else. Surrogacy can have legal implications of its own. FRESH TATTOOS It’s OK to have tattoos and be a surrogate. but fresh ink can cause a delay in your journey. If you’ve had a tattoo within the past 3 months, we’ll need you to wait until that ink is at least 90 days old before we can move forward. This is for your health , as well as the health of the child you’ll be carrying. Occasionally there are other circumstances that may cause a delay in your journey as well. It is important to us that you are in a stable place in all areas of your life before we get started. Following these guidelines will allow you to have the best overall experience. If you're considering becoming a surrogate, we're happy to guide you through this process. Contact us online or complete an application to get started.

ASK AN EXPERT: DR. KATHY SALARI ANSWERS MEDICAL QUESTIONS ON SURROGACY PREVIOUS ITEM NEXT ITEM In 2021, Growing Generations announced its partnership with Mitera, a group of California-based maternal-fetal subspecialist and reproductive health counselors operating via telehealth. Dr. Kathy Salari, co-founder and Chief Medical Officer of Mitera, kindly answered some commonly asked questions on surrogacy. She is a maternal-fetal medicine subspecialist, specializing in caring for high-risk pregnancies. Reproductive genetics and fetal imaging are the primary focus of her clinical work. WHAT IS MATERNAL-FETAL MEDICINE (MFM)? HOW DOES IT HELP WITH THE SURROGACY PROCESS? Maternal-Fetal Medicine is a subspecialty of Obstetrics & Gynecology that focuses on the complications of pregnancy. As the expert in conditions that can negatively affect the fetus and the pregnant individual, an MFM physician is uniquely qualified to assess the medical profile of a surrogacy candidate. Furthermore, involvement of an MFM in the surrogacy process allows for a more robust dialogue and an educational opportunity for all those involved in third party reproduction. AS A FIRST-TIME INTENDED PARENT, WHAT SHOULD I LOOK FOR IN A SURROGACY AGENCY? WHAT QUESTIONS SHOULD I ASK WHEN TALKING TO EACH AGENCY? First-time intended parents are likely to feel overwhelmed when searching for a surrogacy agency. An agency that is transparent and forthcoming about their surrogacy selection and matching process is more likely to exercise prudence in ensuring appropriate candidates are selected to serve as surrogates. Intended parents should inquire about specifics regarding the medical and psychological clearance process and what type of healthcare professionals are involved in determining a candidate’s health profile. Furthermore, intended parents should inquire as to the nature of medical oversight provided for their pregnancy and to what medical experts, they will have access should complications arise. WHAT ARE SOME OF THE MOST COMMON MISCONCEPTIONS ABOUT SURROGACY? When starting their surrogacy journey, many intended parents assume that surrogates have undergone extensive medical and obstetrical screening and are considered good candidates with a low risk for pregnancy complications. WHAT RECOMMENDATIONS CAN YOU SHARE WITH FIRST TIME SURROGATES? As advocates of women’s health, we generally encourage surrogates to ask questions about pregnancy, the IVF process, and to have any concerns about their own medical history addressed. We also encourage surrogates to have open discussions with their intended family regarding their expectation for the surrogacy journey. WHAT ARE FACTORS THAT CAN DISQUALIFY YOU FROM BEING A SURROGATE? Factors that can disqualify an individual from surrogacy are varied but may include current or past health conditions that may impact the health of the pregnancy as well as a prior history of obstetrical complications. HOW DOES EARLY GENETIC SCREENING HELP IN THE SURROGACY PROCESS? Early genetic screening, either at the time of embryo formation or early in the pregnancy provides early information regarding the health of the fetus. Genetic screening of embryos (also known as preimplantation genetic testing) allows for identification of chromosomally normal embryos; therefore, ensures that the healthiest embryos are transferred to the surrogate. However, genetic screening of embryos is not universally recommended, and it is best for intended parents to discuss pros/cons with their fertility specialist. It is recommended that intended parents have a discussion regarding genetic screening and testing early in their pregnancy. Genetic testing modalities have significantly evolved over the last decade and intended parents should consider what information they value knowing early in their pregnancy. WHAT ARE SOME CHALLENGES SURROGATES AND INTENDED PARENTS FACE DURING THE SURROGACY PROCESS? Meeting expectations of both parties in third party reproduction can be challenging. A transparent matching process that promotes open dialogue and discussion among surrogate candidates, intended parents, and healthcare providers helps ensure that a relationship based on mutual trust and respect continues to build as the pregnancy progresses. Unforeseen challenges including medical complications and changes to delivery planning may cause frustration or anxiety for either or both parties involved. In such circumstances, it is best for both surrogates and intended parents to turn to their medical experts for guidance.. WHAT SUCCESSES HAVE YOU SEEN? The most successful surrogacy journeys we have seen are among well-screened and prepared surrogates who are matched with well-informed intended parents where the mutual goal is to achieve a healthy singleton pregnancy. Agencies with dedicated case workers that are available and attendant to the concerns of both parties usually ensure that the surrogacy journey meets the medical and emotional expectations of all those involved. WHAT ARE SOME COMMON MISCONCEPTIONS ABOUT EGG DONATION? Many intended parents believe that because egg donors are young, there is no risk for a genetic abnormality in the fetus and that egg donors have all undergone extensive medical and genetic screening. Prior to an egg retrieval cycle, egg donors undergo intensive medical screening. WHAT ARE THE RISKS INVOLVED IN BECOMING AN EGG DONOR? Egg donation is generally considered very safe. However, it does have small procedure-related risks for the egg donor including a small risk of infection, bleeding, and ovarian hyperstimulation. Risks of using an egg donor are largely related to inheriting the genetic health burden of another individual. HOW DOES A SURROGACY AGENCY GET CERTIFIED BY MITERA? WHAT ARE THE REQUIREMENTS? Certification by Mitera is a commitment to medical transparency and responsibility in third-party reproduction. Becoming a Mitera certified agency provides intended parents with the assurance that their surrogate has undergone a comprehensive medical evaluation by a Mitera Maternal-Fetal Medicine subspecialist and that the pregnancy will continue to be under Mitera’s obstetrical surveillance as it progresses. Mitera certification requires that an agency commit to pre-match medical screening of all surrogate candidates with Mitera and that Mitera’s determination of suitability for surrogacy or stipulations for surrogacy be acknowledged and upheld by the agency.