Surrogacy in Times of COVID-19

The COVID-19 pandemic is hitting most of our countries, from different levels of isolation and lock downs, including traveling bans and limitations, health providers, and more it is a very stressful time for surrogates and IP’s who are obviously very concerned. For this reason, we decided to ask the top agencies, lawyers and service providers for some insights regarding surrogacy processes and its different stages at this uncertain times.

Healing Infertility’s counselor Amira Posner helps us put words to these feelings: “The COVID-19 pandemic is showing us how to live with uncertainty. The good news is that those struggling with infertility are familiar with uncertainty and may in fact be experts at it. They deal with it every single month. There is the possibility of a pregnancy and then there is no more possibility. When will it happen? Why is this happening to me? But infertility compounded with the pandemic is like uncertainty on top of more uncertainty and well, it wasn’t on anyone’s radar.

You have been considering surrogacy for a long time and decided this is the best way for you to start a family. What to do now? Should we even start with a surrogacy journey? For most experts the answer is yes.

Gail Sexton Anderson from Donor Concierge thinks you may have a better chance to matching, quicker than before: “This is actually a good time to start looking for a GC. Though many agencies have had to slow down and are working from home they have surrogates who are either in the process of being interviewed or are ready to be matched but since transfers and in-person medical screenings are on hold some intended parents are waiting.”

Since trying to conceive/pregnancy is not advised at this time all intended parents and surrogates should expect delays with the process. All medical screenings/cycles are currently on hold due to COVID-19, explains Sally Rhoads-Heinrich from Surrogacy in Canada Online, “but you can definitely move forward with the matching process and have a video/phone consult with the IVF clinic doctor.”

There are many steps that can be taken during this time, Donor Concierge team suggests, so when restrictions are lifted your surrogate will be ready for transfer before you know it. (You can click here for more detailed recommendations from Donor Concierge)

Kim Bergman from Growing Generations points out “3rd party ART is a collaboration so now is the time to put your team together”. This is the time to interview agencies if you decided to use one, search and choose your egg/sperm donor, interview a reproductive attorney who will help you with the contracts and a reproductive endocrinologist who will help your surrogate get pregnant. There is a whole lot of leg work that you can do ahead of time to get all the parts lined up for when clinics are open again. Your goal should be to have everything completely lined up so that when the clinics “unpause” you are at the starting gate and ready to go.

We are encouraging all IP’s to start preparing their documentation and have legal consultations with their lawyers so they can have all information possible, says Susan Kibler from Delivering Dreams, this is an excellent time to get basic fertility testing done and, if necessary, consult with out doctors and get treatment so you will be in the best possible position to move quickly and succeed. We are providing virtual meetings with doctors, specialty fertility doctors and coordinators.

You should not forget, patience is key. As Bergman reminds us “this process takes time even when we are not in the middle of a pandemic.”

As for the legal aspects of the process and how it’s been affected by COVID-19 you can see Amy Demma’s article for Mysurrogatemom and Stephanie Caballero’s specific recommendations to our members.

So we are at the egg retrieval stage, what are we supposed to do? Dr. Alex Sunshine, from Sunshine Egg Donation Agency, recommends to wait for egg retrieval or embryo transfer. “I suggest you postpone it. Most of the clinics have stopped initiating treatments because their primary priority is your health and success of the procedures. However, this doesn’t mean the cancellation of the process, just a delay for your health and undertaking success.” He continues, “[don’t] panic and listen to your coordinators’ instructions. All agencies have their lawyers and consultants who monitor the situation 24/7; they always get the first-hand information.”

But what happens if we were ready for transfer? Dr. Mark Trolice, from the IVF Center, explains that very little is known about COVID-19, particularly regarding its effects on pregnant women and infants. As a result, there are no recommendations specific to a women’s desire to conceive or how to evaluate and manage a pregnant woman if she develops COVID-19 Pandemic. There is no convincing evidence pregnant women are more susceptible to becoming infected and developing COVID-19. We also do not know if pregnant women are more at risk of serious complications from the virus, although do they do experience more respiratory infections so, the American College of Ob/Gyn (ACOG) does consider all pregnant women, at this time, as high-risk. While neither ACOG nor the CDC have advised against pregnancy, the American Society for Reproductive Medicine has release guidance to its members to discontinue fertility treatment cycles.

You are pregnant! Congratulations! But what happens if your surrogate is pregnant during the pandemic? How do we make sure she is staying healthy without being overbearing? Communication, communication, communication. Surrogates and IP’s are in the same situation and must respect that they are each taking all measures to shelter in place. If you have concerns that your surrogate is not taking restrictions that we are all being faced with seriously you may want to first contact the agency who is representing your surrogate, suggest the team at Donor Concierge. They continue: “If you have an open relationship with your surrogate you should be able to share your concerns without having to worry about stepping on toes. Surrogates want to please you and bring you joy so this should not be difficult provided they don’t feel micromanaged”.

Communication is key, Intended Parents and Surrogates have usually built up a relationship with trust and good communication. “I think everyone is doing the best they can to stay home and keep safe” says Sally.

According to Emilee Gehling from Dakota Surrogacy, the most important discussion point when Intended Parents and gestational carriers are considering whether to move forward at this time of uncertainty is for each of them to be fully up front and honest about expectations. Once all clinics reopen, there will be a rush of people scheduling appointments, causing a slight delay even beyond the social distancing period. The number of people losing jobs and, as a result, insurance coverage, will also be unprecedented. Intended Parents’ financials may be affected and their ability to pay surrogacy expenses may also change. Staying in communication is so vital to keep all of the parties on the same page.

“Be transparent and crystal clear in your communication” – recommends Dr. Simmons from Partners (in)fertility – if you are IP’s, express your appreciation to your GC and her family frequently. Be honest about your fears, without jacking up fear. If you are a surrogate, be aware of your IPs’ fears; their previous traumas or other experiences may be front and center. Keep in mind that you all want the best for one another. “You are all on Team Baby!” she finishes.

Due date is approaching fast! What are we going to do?! In general the weeks before birth are really stressful both for IP’s and gestational surrogates, but there is now an extra level of anxiety as a result of the situation. Dr. Simmons sheds some light on what to expect: “In the context of Covid-19, anxiety and uncertainty may be the primary emotion. How will the birth go? The dream of being in the delivery room will not be possible now. This will be a huge loss for many IPs and GCs. How can everyone reframe the situation? For example, ‘We have all worked on this beautiful project together and we are near its completion. It is different than we imagined, but we rock! We all can’t wait to meet this baby.’ Be together on Zoom, Skype, or FaceTime during the birth and celebrate the same way after the birth. Virtual hugs to all!”

There is no one way to go about surrogacy, not in normal times, let alone during a pandemic, but you must keep your eyes in the finish line, building your family!

As Amira reminds us “For many individuals and couples around the world, fertility treatment may be put on hold during this period of time, changing the projected timeline once again. As human beings, there is a very natural inclination to push against a new plan. We thought things would be different; we created a story in our mind. By consciously bringing acceptance to the new plan, we create space to process the uncertainty more easily and peacefully.
Remember that this is just temporary. The expectation of impermanence can sometimes provide comfort. “(…)Feel all the feelings and then allow yourself to let it go.”

“Strap in. Hold on. Believe in one another and the beauty of the journey you have all been on. Things may be different than you imagined, but there are a lot of ways that things can go right” encourages us Dr. Simmons.