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Journey of surrogacy

Joanne Carwardine
Chief Executive of National Fertility Society , National Fertility Society
Sandra Bateman
CEO of National Fertility Society, National Fertility Society

Emotions and Support, Surrogacy

The Journey of Surrogacy
From this video you will find out:
  • What is gestational surrogacy?
  • What is traditional surrogacy?
  • What are the pre- and post-pregnancy expenses?
  • What is the legal process of surrogacy? Do I need to sign a surrogacy agreement? Do I need a pre-birth order?
  • Can the intended parents be in touch with their surrogate?

Journey of surrogacy

How to start your journey to parenthood through surrogacy?

In this webinar, Sandra Bateman and Joanne Carwardine are talking about the journey of surrogacy, from the moment of decision-making until the happy outcome – taking your baby home. There are two types of surrogacy, gestational surrogacy and traditional surrogacy. In gestational surrogacy, the surrogate has no biological link to the baby, while in traditional surrogacy, the surrogate’s eggs are used, making her the biological mother of the child she carries. Traditional surrogacy is very easy to do, it can be done at home, and the embryos are created using sperm from the intended father or a donor through intrauterine insemination (IUI). Gestational surrogacy, also called “host surrogacy” is done at a clinic, a host surrogate would have to be at a clinic because it may be that you’re using donor eggs or you’ve already created embryos, etc. A surrogacy agreement has to be also discussed, and signed so that when you get to know your surrogate, everybody knows where you stand throughout the journey. The intended parents must be sure and be 100% prepared for a surrogacy journey. You need to do your research and know exactly what to expect, especially, with the finances.


Before starting your surrogacy journey, you’ve got to think about the cost of creating your embryos at the clinic and there will be I can’t give you that quote because all clinics are different costs, all clinics have different costs. If you’re using donor eggs that is going to be one thing, if you’re creating embryos with your partner’s sperm or donor sperm, that’s another thing you need to take into account. You’ve got to know exactly what it is that you’re paying for. If you’re going, for example, for cancer treatment or you’re not feeling well yourself, it’s best to prepare yourself for surrogacy and have your embryos screened for surrogacy.
I’ve met so many people that have gone down this route, and then, unfortunately, after their cancer treatment has been complete and then they’re fit and healthy, they needed a surrogate because they didn’t have the embryo screened, they could not use them. That’s an important thing to remember as you don’t want to complete all your cancer treatments, but unfortunately, not being able to carry a child because of the drugs you could be on afterwards, as could affect your pregnancy.
Pre-pregnancy expenses are all the clinic fees and the surrogate to go to and from the clinic, to have all the screening done, and all the appointments. Pregnancy expenses depend on your situation, whether the surrogate will have time off work, or perhaps you don’t want her to work, or whether she will get maternity leave or not and so on. Post-birth depends on what kind of birth you do have, if the surrogate has an unexpected C-section that could accumulate a few more costs. The only thing after that you need to think about is life insurance for your surrogate, wills, in case something happened to you or your partner or the surrogate during this time, and then the parental order fee in the UK, it hasn’t changed for years, it is £215. When your child reaches 6 weeks old, you have to pay that and submit it to the courts.

The legal process of surrogacy

If you’re using a fertility clinic, you’ve got to do all the testing, find a surrogate, and also complete psychological testing. Then the surrogacy agreement has to be signed, this is not a law-abiding agreement, there is no such thing, all it does is helps to determine from the start where you all stand. The fee you’ll need to pay to the surrogate, how you’re paying her because the courts will not want any sums or things like that. It’s always best to discuss it with a surrogate over 10 months and divide the payments up. What happens when you give birth? In the UK, if your surrogate is married, by law, her husband has to go on the birth certificate. If your surrogate is not married, you can list your partner, as long as she’s not married, then the biological father can go on the birth certificate. From the moment your child is born, everything is handed over to you, the responsibility of your child, the surrogate will not want to be there to care for your child, she’ll give birth, and she’ll want to see you all happy, and you should also have a birthing plan, who’s in the birthing room when she gives birth who’s going to have the first hold. When a baby is discharged, it goes home with its parents, the surrogate will go home to her family. You always put your own surname on the birth certificate. The only thing that changes is the parental order, so when the baby is 6 weeks old, you apply to the courts for this. You will show the agreement that was set out between yourselves as documentation, they will ask about expenses, and the parental order will be then changed. It will state the parental order will be in the intended mother’s and the intended father’s name, and that would be your surrogacy journey complete.

How to start your journey to parenthood through surrogacy? - Questions and Answers

Do we have to keep in touch with the surrogate for whole of our child’s life?

No, absolutely not. Not if you don’t want to and a lot of our surrogates don’t want that. We have got some surrogates, I have got a couple of surrogates that do say “I’d like at least a birthday card and a Christmas card” to know that everyone’s okay. But they most certainly aren’t going to best of friends unless you want to be or choose to be. Some of them build such a good relationship throughout the surrogacy journey and some say “she’s a special lady” or “we’ll give her a phone call once a month.” So that’s entirely up to you and your surrogate. You don’t have to keep in contact at all if you don’t want to but if you’ve talked about this right at the beginning then everyone knows what to expect when you get to the end. It’s about being honest and it’s not a bad thing saying that you don’t want to keep in touch. Honesty is the best policy through all of this. Honesty and communication. I’ve got intended parents at the moment whom I’ve just matched with a surrogate. They are based in the UK now but they’re not from the UK and in 3-4 years they are moving back home. There is no way that the surrogate will have regular contact or be involved with in their lives and that’s OK. It’s all about that matching process to get it right from the beginning.

Are the expenses mentioned £15,000-25,000 in addition to the fertility clinic’s fee? If yes, how much will it be for the fertility clinic?

This totally depends on what it is that you want from the fertility clinic. Do you need donor eggs? Do you need donor sperm? Is it a case that you’re using your own material to create embryos? Do you already have embryos? Have you already created the embryos? It depends on your treatment and it depends on the clinic. We like to encourage our same-sex couples to already create their embryos so that when they are matched with the surrogate they’re fairly ready to start the process. Our ladies are very good at deciding whether they’re happy. The key thing is that if you need to create the embryos, then you go and do that first because as the surrogate is ready to go, she will want to start this journey as quickly as possible. She will not want to be waiting 6-8 months for them to be able to find a sperm donor, do all the matching process, etc.

Are single parents allowed to have surrogates as well? What is the age limit?

No, there is no age limit for the intended parents. Obviously, it is a case that some clinics may refuse you if you’re in your 70s because they’ve got to make sure the welfare of the child. It makes perfect sense: you’ve got to be alive long enough to look after the child. At the clinic they will ask you difficult questions, for example, if something was to happen to you, is there someone that’s going to step into and take care of your child. As sad as it is something tragic may happen to a single parent, at least with two parents you’ve got a bit of a 50/50 chance. I think the clinic would need to know that there is a support network around the single person so that they could establish the fact that if anything did happen, then the child would not go into care. All clinics are working very hard to make sure the welfare of child is adhered to and no fertility children end up in care. That’s the ideal.

Do you have a list of suitable clinics for creating the embryos?

Yes, we work with clinics in the UK and a lot abroad. It’s cheaper going abroad. They’ve got excellent care. If you send us an email, we can tailor our answer to you specifically and give you all the information that we can. I do a lot of free Skypes with a lot of intended parents to actually go through everything that is relevant to them. People are asking all different types of questions and needing different types of treatment and going through different journeys. If you contact us, then we will happily give you all the information that you need because each country is slightly different. You have to remember that certain countries won’t do surrogacy, some will, some won’t treat same-sex couples, some will. Please get in touch with us and tell us a little bit about your background. Then we can tailor the response to you. We work with clinics and we have one very good clinic in the UK and then we work with clinics in Spain, Greece, Cyprus, Prague [the Czech Republic] but Prague doesn’t do surrogacy. Everywhere is slightly different – the rules and IVF laws are very different. Some countries don’t have any laws about it so it depends on how it’s interpreted, a bit like in the UK. So there isn’t any legislation per se but it is able to be done here.

Do the clinics you work with have any age limits for intended parents?

A lot of people who are going through surrogacy are of different ages (unless there is a health condition that actually shows that both of the intended parents are not going to live for the next five years, for example, for whatever reason) there’s no actual age limits to anything, even the surrogates. The HFEA guidelines state the age limits for having IVF treatments. You’ll go to an X clinic, they’ll say it’s 50 and then you’ll go to a Y clinic and they’ll say “that if you’re a 52 year-old-woman and you’re fit and healthy, then we’ll treat you.” It depends on the clinic but I’ve had a couple rejected because of the age of the lady and they really struggled. No one in the UK would treat her and she was in her 50s. Even though the surrogate obviously wasn’t in her 50s, they ended up going abroad for surrogacy. That was the only way they could actually get a child.

Can you please advise how you coordinate the surrogacy to make sure everything is going according to plan? Is the surrogate appropriately supported all the way through?

We are both psychotherapists by trade. Sandra [Bateman] has been doing surrogacy psychotherapy for a very long time and it’s something that a lot of people won’t actually touch. A lot of counsellors and psychotherapists are frightened of it because of the legalities and the lack of legalities of it, as well as the gray area. Sandra knows absolutely everything there is to know about it. When I have any questions, I’ll turn to her and straight off the top of her head she’ll just go off into the HFEA code and will cite various different points at me. Sandra is really good at supporting people. She is always contactable. I do nag her about the fact that she constantly has her phone on in the evening when she should be taking a break. At 11 o’clock at night I’ve known her to be communicating with a surrogate or IPs. We did quite a lot of Skypes in the office during the day which is nice because I get to participate as well. I learn more every single time I listen to her and every time she’s advising people. It’s nice to be part of it. We do have some lovely reviews from our surrogates and our intended parents. One of the biggest one that’s ours is going to hit the news because there’s a Channel 4 documentary which is Jake and Anna Graff that we helped through their journey. In the midst of lockdown, they were able to be there with their surrogate and have their child born. It was a very happy story which is being released on air Channel 4 in the next couple of weeks [July 2020] so if you watch that it will show how much I’m part of your journey and how much I’m there for not just the surrogate but for the intended parents as well. During the surrogacy process it’s really important that emotionally and psychologically everyone involved is supported, that financially everyone understands where they stand and it’s all set out right from the very beginning. And once the baby has been born then everybody is happy and can carry on with their lives and their journey that they’ve already pre-agreed. Nobody likes talking about money. Nobody likes talking about having a child that could have a disability. It’s important to do everything in a very safe environment where people can be absolutely honest. Let’s take an example of a child with a cleft palate, a disability that can be easily and quickly fixed. You should understand what kind of disability, from the parents point of view, is where you would say that you want to terminate the pregnancy or is it a case that regardless of what disability your child has that you still would want that child. Having all these difficult conversations right at the beginning is easier than the feeling in the middle of the process that this journey doesn’t feel right for you. Then you would have to start the process again, go back on the waiting list and find another surrogate. Doing it right at the beginning has ended very nice for every journey that I’ve been involved in. There have been some sticky points where people have fallen out, etc. but we want this to be as enjoyable and a beautiful experience for everyone involved.

How long is your waiting list?

To be honest, before COVID-19, it was only three months. Due to COVID-19, we have got surrogates available on our books at the moment, however, they are waiting for things like their children to go back to school, etc. as there are lots of things that’s going around at the moment. As long as we’re easing up the way that we’re doing and if we go to plan then the children are being returned back to school, you will probably be matched by the end of the year. We’ve got surrogates available. We matched one only the other day because she’s gone back to work and it was a good time. They’re doing the introduction period now. How does it work? First, you come on our waiting list. At the moment our surrogates outweigh our intended parents list. But not all of them are available at the moment. In all honesty, we have to be very careful because we’ve had some of our surrogates affected by Covid-19, not personally, but they have lost family members. We are holding them back while Sandra works with them psychologically and emotionally to help them grieve and work through that bereavement period before they step forward to go back into doing surrogacy. That’s vitally important and we did stop introducing for a little moment because the clinics have been shut and nobody didn’t know what was happening, us neither. However, I give regular updates at least every 2-3 weeks, giving you updates on what’s going on, where you are on the list and all sorts of things. We’re talking to those surrogates far more frequently than normal. We’re Whatsapping them all the time. It has been slightly difficult because at the beginning we thought that it was a really good opportunity for our ladies to get to know the IPs and build a relationship which was a little bit naïve, I suppose, because we didn’t understand right at the very beginning how much serious Covid-19 would be and how much it would impact people and their families. For our surrogates, having their children off school and home schooling them meant that some of them were really busy and didn’t have time for communicating. A lot of them have taken a break because children are quite exhausting. They’ve got to look after their own children as well psychologically. This has had a big impact on children not going to school, not seeing their friends, etc. Hopefully, if the way that we’re going on and if it does go to plan as it is, I’d would say by the end of the year. So as long as we don’t have a second wave of Covid-19 and certain areas locked down, etc. it should be the end of the year. Our surrogates are nationals, they are from all over the country as well just like our intended parents. It depends in which area they’re in but, hopefully, if everyone’s sensible and we all take care and look after ourselves then everything should get back to some form of normality and Sandra can get everything moving again.

What is the role you provide with the surrogate? Is it only psychological support or do you also manage the payment to make sure everything is transparent?

No, we don’t manage payments. All we do is when you set up the agreement, I’ll know exactly what you’ve agreed with your surrogate. For example, your surrogate is asking £15,000. All expenses until pregnancy is that you do as you go along. Once confirmed pregnant then £15,000 work out ten monthly payments of £1,500 so once the surrogate is pregnant, you’ll go for your first scan. From the first scan onwards you can start the monthly payments. We always suggest that you do it via a bank transfer so that you can show the payments have been made to your surrogate. Everything is then very transparent. Keeping it simple. There’s no need to complicate it.

Do you help with arranging the agreement? Do you have mediation/negotiation role?

We have a template of an agreement which I can send. What you do then is you’ll sit with your surrogate and you will go through it together and then all three of us go through it and we will all sign it and everyone will have a copy. It’s as simple as that. If your surrogate said that she wanted £15,000 for all of the surrogacy journey, you’ve agreed to ten payments of £1,500 and then, all of a sudden, at your 20-week scan the surrogate says that she had changed her mind and she wants £20,000. That’s not how it works. She’s signed this agreement. She knows exactly where she stands and if that was the case then I would step in and intervene. However, we haven’t had that yet. Also, at the beginning of the journey, Sandra will have a surrogacy counselling session with the intended parents and, separately, with the surrogate where she can explain the wants and needs of the intended parents just to see if they’re compatible. Then the third session will be the three of them together so you’re all having a session together to talk about everything, any hopes, fears, any problems, etc. A lot of our surrogates have done a surrogacy journey before so they know what is expected of them.

Is it legally enforceable?

Nothing’s legally enforceable. Let’s say, for example, that your surrogate decided right at the end she’s keeping your child. You would then have to apply to the high courts. You would have our backing on that. I document every conversation that I have with everybody so then all of that information would be used in the court case. This is why it’s so important to have an agreement set out and this is why it’s also very important to use an agency because it gives you that little bit more security. The dodgy journeys are the ones where you’ve used a friend or a family member and it’s gone wrong, you’ve fallen out and there’s been problems. There have been some really messy court cases that have gone through the high courts. I met a young lady, a potential surrogate, in McDonald’s and I didn’t question why she wanted a happy meal. She actually had learning difficulties and the intended parents did not pick up on this. When she gave birth to a child, she actually thought it was her child. To her eyes it was her baby and because of the issues that she had, they had to take her to high court and fight for their child. They did win the case. But it goes to show when you’re using social media to find a surrogate, you should be aware of these issues.

Have you been involved in any court case?

Not me, personally. I’m very interested in watching surrogacy court cases. Natalie Gamble is one of the leading solicitors in surrogacy law. If you go on her website, there are quite a few court cases on there that she’s been involved with as a solicitor. In all my time that actually I’ve been involved with surrogacy, intended parents and surrogates, there have been hiccups but never ever to the extent of where someone has kept that child.
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Sandra Bateman

Sandra Bateman

Sandra Bateman is a Senior Accredited Fertility Counsellor, the CEO of the National Fertility Society (UK) and the Manager to Louise Brown (The World's First IVF Baby).
Joanne Carwardine

Joanne Carwardine

Joanne Carwardine is the Chief Executive Officer of the National Fertility Society (UK) and BACP Reg. MBACP (Accred) Counsellor Supervisor.
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
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