How to Choose a Surrogate (or Gestational Carrier)

Eran Amir

CEO and Founder of GoStork

As you start the surrogacy process, one crucial decision to make is choosing a surrogate mother (also knows as the Carrier) who will assist you in building your family.

There are many factors to consider when choosing who will play that role in the process. It may be a close friend or a family member or you can always seek the assistance of a surrogacy agency who can help you match with a surrogate. 

Read more about “How to Choose a Surrogacy Agency?” here

Your Involvement in the Selection Process

Choosing a surrogate through an agency is the most common way. Depending on the country in which the subrogation takes place, the choice of the surrogate is made in one way or another:

  • Intended Parents are involved in the selection process
  • Intended Parents do not play a role in selecting the surrogate. Thus the responsibility falls on the surrogacy agency to do so.

Jurisdiction is not the only factor to decide whether Intended Parents participate in this process. Some Intended Parents choose not to do so and leave the agency to be the intermediary.

The preferences of each of the surrogates are also considered, as there are some who prefer that the future parents do not intervene in the adjudication and others who want to get involved themselves.

Participate in the search for the surrogate

Assuming that the country allows you to choose the surrogate mother, there are two main ways to proceed:

  • Matching: The agency looks for a candidate based on the personality, values, and lifestyle of the intended parents. Only if both parties, surrogate and future parents, agree, will the candidate be finally selected as the surrogate.
  • Database: When surrogate mothers apply to become a part of the agency’s database, a profile is created for them that provides a lot of information about them. The agency offers intended parents a list of candidates and they themselves select the woman who best suits their preferences. If the selected surrogate accepts, she will be the one who will carry the future baby.

Although there are slight variations between countries, this is the general way of choosing the surrogate when the process is carried out through a surrogacy agency.

Usually, it is a double direction selection, that is to say, the future parents choose the surrogate but this one has to accept them to be able to initiate the process.

Factors to Consider Before Making the Decision

The following is a list of factors you should consider thoroughly before making your decision:

  1. Age – It is highly recommended that the surrogate’s age is less than 40 years old.
  2. BMI – Surrogate must have a healthy Body Mass Index (BMI) below 35.
  3. Medical History – This includes the surrogate genetic profile and blood tests. It is important that the surrogate is free of any major illnesses that could complicate pregnancy, such as hypertension or diabetes.
  4. Pregnancy History – An ideal surrogate is someone who has been pregnant before and has delivered healthy infants through an uneventful gestation. You should verify that the surrogate has no more than 2 consecutive pregnancy losses, no more than 2 Cesarean sections, 
  5. Lifestyle – The surrogate’s lifestyle choices including their history of drinking and substance abuse and diet.
  6. Cost – This includes the surrogate compensation, health and life insurance, legal fees, agency fees, psychological screening and monitoring, travel costs and medical expenses. Experienced surrogates are more expensive than first-time surrogates. Also, her location will also affect her compensation as in the United States the west coast surrogates compensated way more ($50,000-$60,000) than east coast surrogates ($30,000-$40,000). In Canada surrogates are not being compensated, you only pay for other expenses. 
  7. Surrogate Health Insurance – Most of the health insurance companies in the United States are not surrogacy friendly and will not cover the surrogate’s health costs. So you as an intended parent can decide whether you wait longer till you are matched with a surrogate that has a friendly surrogacy health insurance or you can decide to be matched with a surrogate that you will have to purchase her a separate friendly health insurance (that will add around $25,000 in the United States).
  8. Surrogate Location – The laws on surrogacy vary from state to state, so the location of your surrogate is an important issue to consider. The laws regarding establishing parental rights vary even within counties so it’s essential that you work with a qualified family formation attorney to assess your particular situation. California has the most permissible surrogacy laws, allowing intended parents to be listed on the birth certificate even before the birth of the baby. Oregon, Idaho, Illinois, and Maryland are among many states where surrogacy is allowed with few restrictions. States such as Texas and Florida have restrictions based on marital status. New York & Michigan, for example, are states where surrogacy is illegal.
  9. Number of Cycles – How many transfers does she agree to do in order to get pregnant. Unfortunately, sometimes the first transfer doesn’t catch and then you need to do another transfer and another one till it catches and she becomes pregnant, so you want to make sure that she is ok with doing multiple cycles.
  10. Relationship – What kind of relationship you wish to have with the surrogate during the process and after the child is born: you may wish the surrogate to remain an integral part of your child’s life, or have the relationship complete upon delivery.
  11. Support System – The support system the surrogate will have during the surrogacy (her partner or husband).
  12. Multiple Births – Whether you and she agree on issues such as having twins pregnancy.
  13. Pregnancy Terminations – Whether you and she agree on issues such as reductions or pregnancy terminations.

In addition to the many questions you may have, surrogate mothers go through a thorough screening and vetting by the agency they are involved with. Each agency should share the results of that screening with you so you are better informed when making this crucial decision.