The surrogacy process can sometimes feel like an out-of-body experience for intended parents. You walk through all the steps of a pregnancy, witness the ups and downs of the trimesters, follow along with prenatal care, prepare for delivery and everything else — except it’s not your body.

Yet, intended parents can still feel the emotions as if it is their pregnancy, or something close to it. Along with this, there’s a confusing mix of emotions that are distinct to this unique position as an intended parent in the surrogacy process.

Perhaps no step of the journey will illustrate this emotional cocktail better than the ultrasound appointments. A big moment in any pregnancy and in your surrogacy process, these appointments can usher in a confusing wave of emotions.

If you are considering surrogacy as an intended parent or already part of the process, here’s what you need to know about ultrasound appointments, as well as a few tips for enjoying this beautiful part of your journey.

Preparing for Ultrasound Appointments

There are plenty of steps in the process before you get to the ultrasound — too many to cover in-depth here. Instead, we’ll skip to the beginning of the medical process.

As an intended parent, you’ll work together with the surrogate (according to the parameters in your surrogacy contract) to pick a medical provider for these steps of the process.

The surrogate will go through intensive screening, a mock cycle, preparation for the embryonic transfer, the embryonic transfer and a confirmation of pregnancy before the six-week ultrasound. If that sounds like a lot, well, it is! Don’t worry; your surrogacy specialist will be working as hard as possible to make sure everything goes according to plan.

Once the pregnancy is confirmed, it’ll be time to schedule the six-week ultrasound with the fertility clinic. Depending on your fertility clinic, there may be a second ultrasound appointment at 12 weeks before prenatal care fully transfers to the OBGYN. Once in the care of the OBGYN, there will be several more ultrasound appointments.

It will be up to you how many of the ultrasound appointments to attend. If your surrogate lives close by, this will be easier to plan. If you have to travel, then you will need to decide what the cost and time is worth.

What to Expect During Ultrasound Appointments

The practical preparation for ultrasound appointments is relatively straightforward. The emotional work you’ll need to do before, during and after can be more challenging.

When you’re an intended parent, these are some of the strong emotions you should expect to feel when you’re present at ultrasound appointments:

Joy

That’s your child! Take this moment in. You’re getting a glimpse at the future of your family thanks to the wonders of modern medical technology. It’s a beautiful sight.

Jealousy

That’s quite a swing, isn’t it? We hate the feeling of jealousy. It makes us uncomfortable. But it’s actually a fairly common emotion for intended parents who, in many cases, spent years dreaming of this moment for themselves. Be aware that this feeling may come on unexpectedly and with force during the ultrasound appointments.

Confusion

Medical professionals are not always sure how to address a room with both the surrogate and intended parents present. Who to look at and speak to can be confusing, and it can create a tense dynamic. The doctor may address the surrogate when you feel they should be addressing you, or vice versa.

Ways to Get the Most Out of Your Ultrasound Appointments

These emotions and more are common. Not only that — they are normal and should be expected. Nothing you feel during the ultrasound appointments is inherently bad. The good or bad of the situation depends on your response.

It won’t be easy to process all of that on the fly. Here are a few things you can do to prepare yourself and get the most out of the ultrasound appointments:

Stay in close contact with your surrogacy specialist.

Your specialist is there to guide you through the process. From practical help preparing for appointments to emotional counseling during difficult times, call your specialist.

Have honest conversations with your partner (if applicable).

If you have a spouse or partner, are you on the same page with them? Unity and an understanding of the other’s mental state make it easier to support each other. Don’t hide some of the more uncomfortable emotions from your partner. Speak openly and often about how you’re feeling, especially before and after ultrasound appointments.

Prepare for uncomfortable feelings.

You are, in a sense, already doing this. By reading this article, you’re becoming aware of some of the challenging things to expect at ultrasound appointments. That means you can be prepared rather than caught off guard. Develop plans for how you’ll respond to feeling of sadness or jealousy to minimize the impact those emotions have on your experience.

Find ways to focus on the good feelings.

This is not to say that you should ignore or deny the more frustrating emotions. Instead, find ways to focus on the good ones that are also present in the moment.

Some people find practices like daily journaling or mindfulness practices helpful, or you can find breathing exercises to bring your emotions back under control in the moment. Anything that helps you is a good practice to develop.

Speak With Your Specialist

Your surrogacy specialist should be your most trusted resource during your process, and a complex step like the ultrasound appointments is a perfect example of why. Our specialists have experience guiding other intended parents through these challenging emotions, and they can help you, too.

Feeling nervous about your ultrasound appointments as an intended parent? Call your specialist today. Still considering surrogacy as a family-building option? Contact us online now to learn more, or call 1-800-875-BABY(2229).

Babies don’t come on a schedule. As much as we would all like our babies to be healthy, full-term infants, this isn’t always the case. Premature labor and delivery are always scary situations – but it’s even more so when you add in the complicated details of surrogacy.

Every year, about 15 million babies are born premature around the world. And, because many surrogacy journeys involve twins, the rate can be high in gestational surrogacy. While your surrogate and her doctor will do all they can to reduce the likelihood of a premature birth, it will still be a possibility.

If your baby is born premature and ends up in the neonatal intensive care unit (NICU), you probably won’t know what to expect. Rest assured that your specialist will support you through this step, although most of the information will come from your child’s doctors.

Here are just a few things you might expect when your baby goes into the NICU after birth via surrogacy.

1. You’ll need to stay in the surrogate’s state a lot longer.

Most surrogacies take place across state borders. So, if your surrogate went into labor early, you were probably already trying to get to her quickly, with little time to prepare. Now that you’re here and your child is in the NICU, you will likely face a long stay in her state with no plan.

How long you stay in a surrogate’s state will depend on how long your child remains in the NICU. You’ll need to speak with your child’s doctor for guidance. Use whatever information you have to create a plan with your spouse or support person during this time.

Here are a few tips:

• If you have older children, consider sending one spouse home to care for them and set up long-term care with a friend or relative.
• Look at long-term, furnished apartment rentals to give yourself a “home base” during this uncertain time.
• Look at your finances and make a budget for this stay. Your hospital costs will likely balloon during your child’s stint in the NICU, so save where you can. Consider reaching out to a financial advisor to stay one step ahead.
• Ask your surrogate for suggestions on where to eat and stay in the area (more on that below).

2. Your child won’t look like you expect.

All intended parents dream of the time they first meet their children. None of those visions involve the scary sights associated with the NICU.

Your child will likely look impossibly small and fragile among all the wires and monitors required in the NICU. It’s a shock for any parent, but preparing yourself ahead of time can minimize those staggering emotions and help you jump right in to supporting your child. Remember that this is normal for a child in the NICU, although it may not be a “normal” sight for you.

Your child may not look how you imagined, but they are still your child – and they still deserve bravery and strength from their parents.

3. There will be strict NICU rules.

Babies in the NICU are dealing with a variety of health concerns, so a safe, sterile environment is critical in keeping them safe. Hospitals have strict policies on NICU visitation, and your child’s doctor will give you the information you need.

Visiting hours may be shortened, and hospitals may prohibit extended family members from visiting. You may be required to wear a hospital gown, mask or gloves when in the NICU, and you will be required to wash your hands diligently and frequently.

Depending on your child’s health, you may or may not be able to hold them right away. Even if you can’t hold your child, you may still be able to hold your baby’s hand, stroke their head and talk to them. Defer to your doctor’s advice about what is best for your child at this time, and be patient. Every recommendation from the hospital is designed to give your child the best start at life possible.

4. Your surrogate may be a greater support than you think.

Your surrogacy partnership doesn’t end after your baby is born. Most intended parents and surrogates create a genuine friendship during pregnancy, and that relationship often continues after birth, too.

Your surrogate will be just as worried about your baby as you, and she may even feel guilty that she couldn’t carry your child to term like she expected. Remind her that it’s not her fault and, if you feel comfortable, invite her to spend time with the baby in the NICU. This may help her emotional and physical recovery after birth.

Don’t forget that you are on the surrogate’s home turf. She will likely have many suggestions for places to eat and places to stay in the area, and she may even offer to go grocery shopping or run other errands for you during your NICU stay. Don’t be afraid to accept the support she gives; she will be trying to help however she can.

As always, if you ever have questions about your relationship with your surrogate, your specialist is only a phone call away.

5. You’ll need to look out for yourself, too.

When your baby is admitted into the NICU, it’s tempting to focus all of your energy on them. You’ll likely spend all the time you can by their side, going through the same motions of feeding, rocking, holding and just being there. But, as any caregiver will tell you, sitting by a hospital bed for 12 hours straight every day will get exhausting – and it will wear you down.

As tough as it can be, remember your own health during this time. Make sure you’re getting the rest you need, and don’t forget to keep a healthy intake of food and drink, even when you don’t feel like it. During a NICU stay, you will be grieving your original plans for bringing your child home, and that will impact your mental health. Lean on your partner, if you have one, and make a plan, so each of you can get a break. It can be hard to step away from your little one’s bedside, but remember that the doctors and nurses in the NICU are taking good care of your baby.

—

As you navigate the NICU stay, remember that your specialist at American Surrogacy will always be there for you. They will be just as invested as you in your child’s health, so don’t be afraid to check in with updates and for support. We know how tough this time will be, which is why we will do our best to coordinate with your attorney and other surrogacy professionals and let you focus on your child’s health.

You’ll come across many new things when starting a family through surrogacy. It’s a complicated process.

One of the least understood steps of the surrogacy process is embryo grading. And for good reason — it can be confusing and intimidating.

We’ve created this article to answer several of the biggest questions about embryo grading. We hope that, by the end, you have a better understanding of this medical process, as well as a release from any pressure it is causing you to feel.

While we are not medical professionals and cannot fulfill the required steps for IVF, American Surrogacy is a national surrogacy agency, and our specialists know all about the process. Contact us any time with additional questions about becoming intended parents or a surrogate.

What Is Embryo Grading?

Scientific advances in recent years have unlocked valuable information that would’ve been unimaginable even 10 or 20 years ago. The process in which an egg and sperm join together to form an embryo was previously unobservable. Today, we have great insight into how this takes place and can watch it happen. Embryo grading is an evaluation used by embryologists to analyze this process.

How Do Clinics Perform Embryo Grading?

Embryo grading takes place post-fertilization. Once the eggs have been extracted from the intended mother or donor and the sperm has been injected into the eggs, the period of embryo grading can begin.

While the embryo waits in an incubator, clinicians will observe it and look for specific cellular developments, particularly from days 3-5 of fertilization. Based on what they see (or don’t see), they will assign an embryo grade, which will factor into whether or not the embryo is used in the IVF process or is frozen.

What Gives an Embryo a Good Grade?

Embryologists are typically looking for several things from days 3-5 of the incubation process:

• Cell Count and Multiplication: Between days 3-5, the observed number of cells should move from around eight to as many as 150 or more. This growth is a positive sign that an embryo is developing properly.
• Stabilization: Embryos that show stable structure, including symmetrical growth, are believed by some clinics to be more likely to result in successful pregnancies. However, clinics differ on this point. For some, simply seeing sustained growth is all that’s required, while others want to see symmetrical growth.
• Fragmentation: Haphazard development, on the other hand, is a negative sign. An embryo growing without clear structure and organization will likely be graded lower.

The caveat here, as we have already noted, is that embryo grading is still new to the medical community. Common standards are not always agreed upon. Each clinic uses its own system to score results, while some clinics do not take part in the practice at all. One may place a very high emphasis on symmetry, while another’s grading metric might prioritize cell count.

This means the same embryo could receive very different grades from two different clinics. We’ll explore what this means about your embryo grade below.

What Impact Does Embryo Grading Have on Success Rate?

Due to the complicated nature of grading and the different procedures used from clinic to clinic, it is nearly impossible to say what effect the grade an embryo receives has on the success rate of the transfer.

Generally speaking, embryos with an abundance of desired qualities — exponential cell growth, stable structures, etc. — will receive higher grades and are believed to have a better chance in resulting in a successful pregnancy.

However, the science is not exact. Embryos with high grades can still result in failed pregnancies, and vice-versa for embryos that receive lower grades.

So, Why Does Embryo Grading Matter?

While even highly graded embryos can result in a failed pregnancy, this practice can be very useful at catching a failing embryo before the IVF process. There are some embryos that, by day five, are clearly heading down the wrong path.

Embryo grading can be a useful tool for embryologists to determine the best candidates for IVF. But, it is only one tool in the toolbox. There are other factors to determine the likely success rate of embryo transfers.

When you’re an intended parent, it can be disappointing to hear that your embryo has received a low grade from the clinic. But, this shouldn’t be taken as devastating news. Grades are not final says. And, even if the grade is too low to move forward with that embryo, there will be alternative routes as you continue to pursue your dreams of parenthood.

—

Where does that leave you?

You’ll want to use all available medical technologies at your disposal during this process, but you shouldn’t stake your hopes on a single grade. Trust the professionals leading you on your journey, and take heart. Challenges will arise during this process, but the end of the road is the beginning of your family.

If you have more questions about the surrogacy process, or are interested in starting the process with our agency, let’s talk. You can contact us online at any time or call us at 1-800-875-BABY (2229).