There’s no doubt, the COVID-19 pandemic has had huge implications for those who are navigating through infertility care. In the beginning, fertility treatments were being postponed, and then throughout the pandemic, patients have had to weigh the risks of getting pregnant during this time. The complications have been even greater for those patients considering surrogacy.
Who Seeks Out Surrogacy?
Surrogacy is an option considered by women who are unable to carry a child to term because of the absence of or abnormality of the uterus. These challenges include excessive scarring, hysterectomy, cancer history, or other pre-existing medical conditions that make carrying to term in her own uterus impossible or risky. The embryo is created using the eggs of the female intended parent or a donor and her partner’s sperm or donated sperm.
The other common group that considers surrogacy is single or gay male couples. Obviously, they lack the ability to carry to term in a uterus so a surrogate is a way for them to experience pregnancy through a relationship with their chosen carrier. Donor eggs are the only option for men who are seeking surrogacy.
Surrogacy in the US or Abroad?
In the U.S., each individual state governs the contractual relationship between the carrier and intended parents. It’s important to research where the surrogate lives and in what state she will deliver the baby. That is a benefit of working with a reputable agency that has established practices in surrogacy-friendly states.
When American parents travel to other countries to pursue surrogacy, the cost is typically the driving factor. In the U.S. the cost is typically about $100,000 – $150,00. But in some countries where surrogacy is legal, the cost can be almost 50% lower. However, traveling to another country raises other concerns for prospective parents. Issues like medical care and best practices for both carrier and baby must be researched carefully.
Another consideration for those traveling abroad is the surrogates themselves. It’s important to know if the carriers are choosing surrogacy freely or as an act of desperation to better their lives. Ethical practices for surrogate relationships can be attained but require some education and research on the part of the intended parents.
It’s far more common for hopeful parents from other countries to come to a surrogate-friendly state here in the U.S. Surrogacy in American clinics or through U.S. agencies has a high success rate and enjoys a favorable reputation for excellent prenatal and medical care, as well as ethical surrogacy relationships.
How has COVID-19 Impacted Surrogacy?
Gestational surrogacy can still be a viable option to build your family during the pandemic, but here are some of the extra factors to consider if you are looking at surrogacy during the pandemic.
Start by asking yourself whether you should be moving forward with surrogacy right now. Are you willing to take that leap of faith with a carrier who might be living in a hot spot? Are you okay with the fact that she might be putting herself – and thus your child – at risk, knowingly or by accidental exposure? Remember, pregnancy is a “high risk” condition with COVID-19.
If you feel comfortable with the timing of moving forward right now, how do you feel about the stress factor of pandemic living on the carrier’s pregnancy and childbirth experience? Have you done adequate research on the impact of prenatal stress on a developing baby?
If you do proceed, there many issues related to where you live and where your surrogate is located that you should consider.
- How do you feel about the carrier living in a different state with different mobility restrictions than your state?
- Do you have a plan to craft a relationship with the carrier if you live at a great distance from each other? Remember, telecalls carry a different impact on a relationship than in-person meetings to get to know each other.
- Ask your agency if their pandemic protocol is set up to help you in the screening process to choose a carrier and what her access will be for pre-birth and follow-up supports.
- Will the restrictions of your location – or hers – prohibit your presence at important appointments?
- Does the surrogate have easy access to testing and screening sites that are local to her?
- Will traveling to her appointments increase her risk of exposure?
- Consider the ease and access to testing for the process of creating the embryos, including transfer appointments.
- Do the current travel restrictions impact your ability to be present for the birth of your child?
- Are the quarantine restrictions feasible with your current employment and financial ability?
Labor and Delivery Factors
When you get to the end of your carrier’s pregnancy and the baby’s arrival is imminent, the pandemic has other concerns to consider. You’ll need to work with the surrogate, the agency, and the hospital to create a plan around the following things:
- Visitor restrictions at the hospital
- Presence in the labor and delivery room
- Plan B for what will happen if there are sudden changes to the pandemic protocols
- Financial arrangements for both the carrier and the baby
- In the worst-case scenario, Plan B arrangements for who will care for the child upon delivery if the intended parents are delayed and the surrogate’s contracted relationship is fulfilled. In this case, it’s imperative to have a formal plan drawn up for the infant’s safe and legal care.
Factors for Going Abroad or Coming to the US from Abroad
Recognize that all the above-mentioned factors will be magnified in their difficulty to manage if you are traveling abroad. Delays and constantly changing timelines can have a huge impact on the process.
The added challenges of the pandemic have dramatically slowed the international surrogacy experience. Waiting out the worst of the COVID-19 pandemic makes good sense if international travel is involved.
What Are You Going to Do?
The uncertainty of the coming 6-12 months has a huge impact on your next steps. If you have already created the embryos and you are still seeking a suitable surrogate, your time constraints should be less burdensome right now. You don’t have the same urgency now that you know your embryos are waiting and safe.
However, if you are in a race against time because of your age or other health factors, you should consider creating embryos sooner than later with a reputable infertility clinic. These embryos can be frozen, then screened and tested for implantation later in a carrier once COVID-19 slows or the vaccine is released and shown to be effective. While you wait for that day, use your time to research more about parenting after surrogacy and other related parenthood topics you will experience as Mom or Dad.
Image Credits: Mrs. Flinger; Steven Miller; Ministério da Ciência…; Donnie Ray Jones