Selecting the Surrogate

Many of the clinics will allow you to select a surrugate, usually from profiles emailed to you.  If you are at the clinic, you may get a small book of profiles to review.  The information in the profiles themselves are rather limited and include age, religion, education, number of children and a photo.

Everyone will have different criteria, but below is a list of some of the criteria you may choose to include when selecting a surrogate:

1) Successful pregnancies.  In general, more is better.  Both the surrogate's own children and surrogate children.  Successful pregnancies show that the surrogate can carry a baby to term and also has experience doing so.

2) No unsuccessful pregnancies or complications in pregnancies.  On the one hand, successful previous pregnancies are a good sign.  On the other hand, they don't guarantee pregnancies were trouble free or that there weren't previous difficulties.  Unfortunately, it is almost impossible to get good information on whether there were complications in previous pregnancies - one possibility is to speak with the gynecologist that handled previous surrogate pregnancies to understand if there were any complications with those pregnancies.

3) Diet/Vegetarian.  India has a high percentage of vegetarians.  This can sometimes lead to low iodine levels which can also cause low T4 levels during pregnancy.  While this can be easily overcome with vitamins, one may consider a non-vegetarian surrogate.

4) Education level.  On the one hand, the education level one attains is really based on how one did in the lottery of birth.  If you're born in the U.S., you probably got an education.  If you are a woman born in the Indian countryside, you may not have had the good fortune of access to formal education.  From that perspective, education is irrelevant.  On the other hand, a higher education level may impart more knowledge that would help ensure a safe and successful pregnancy.  But trumping that is whether the surrogate has had past successful pregnancies. 

5) Previous transfers.  Some of the surrogates have had multiple previous unsuccessful transfer attempts.  It's valuable to ask how many unsuccessful transfer attempts a particular surrogate has had.  Medical science doesn't understand everything, and certainly doesn't understand what does and doesn't cause a successful transfer.

6) Religion.  Aside from any diet restrictions that religion may impose, religion is a non-issue for most people.

7) Age.  Age is most important for the eggs (if there is an egg donor), but not as important for the womb.  For many, age is secondary to successful pregnancies and limited unsuccessful transfers.  However, age in the mid to late 20s is probably in the sweet spot. 

8) Medical tests.  Clearly, standard medical tests to check for any infections or diseases should be undertaken.  Most of the reputable clinics seem to do this.

9) Height/weight/etc.  Some Indian women are more petite and some IPs may have genes that could result in bigger babies.  Some couples may want to pursue a "bigger" surrogate.  It would seem that a big baby in a little woman could increase risks during delivery, much as the larger babies caused by gestational diabetes can increase risks during delivery.

10) Choice of surrogates.  Even with the above, if the clinic has very limited choice, you're going to get what is available.  When choosing a clinic, you may try to understand the choice of surrogates (and possibly egg donors) they will provide.     

11) Colostrum/Breast Milk.  Colostrum is the initial milk produced for newborns and helps jump-start the baby's immune system.  If you would like the surogate to express colostrum or breast milk for some period of time, consider including this as part of the selection process and also include it in the contract with the surrogate.  Asking any time after the transfer leaves you at greater risk of the surrogate declining. 

12) Surrogate's living conditions.  This crosses over the issue of clinic selection and surrogate selection.  Some clinics (Rotunda, for example) have maternity houses for their surrogates where the surrogates can be more closely monitored during the pregnancy.  Others allow them to live with family or at home with periodic visits by a case worker and/or periodic visits to visit the gynecologist.

Of course, you have to trust that the clinic and surrogate are giving you accurate information.  While at Rotunda, Peter heard a conversation among the doctors about "no longer working with a surrogate that had complications in a transfer".  From that, it would appear that Rotunda has a high enough supply of surrogate candidates that it can be selective about which it offers for intended parents to work with. 

(This article was taken largely from Peter's blog post on Selecting a Surrogate)