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How Surrogacy Works

Why Choose Surrogacy?

There are many reasons for people to consider surrogacy to start or expand their families. Perhaps a woman has found it relatively easy to get pregnant, but then suffered repeated miscarriages. Or she has endured a number of costly in vitro fertilization cycles without success. Maybe a gay male couple longs to have children of their own.

The missing piece in all these scenarios is a viable womb to carry a baby to term. This is what surrogacy provides. And unlike adoption, surrogacy allows the intended parents to have some or even total genetic relationship to their child, to be fully informed of the child's entire prenatal care and health, and to take their newborn home from the hospital without any anxious waiting or conditions. [See FAQs for a more detailed contrast between surrogacy and adoption.]

What Does NAFG Do?

NAFG will find you a qualified and compassionate surrogate, source an egg and sperm donor (if necessary), guide you through the complex legal, medical, and psychological components, and provide 24-hour support and counseling throughout.

Surrogacy is a complicated and sensitive process that is very difficult to accomplish successfully without expert help. At NAFG, we expend resources to find excellent carriers, and have them screened medically, psychologically, criminally, and financially. They are interviewed extensively by our surrogate coordinator, an expert in the field, and by a psychologist. The laws on surrogacy vary from state to state, and require experienced navigation. Although NAFG itself does not perform legal or medical services, our counsel and our president are experienced assisted reproduction and adoption attorneys who can assemble the appropriate legal structure for you. Medical procedures take place at a qualified facility of your choosing. If it is necessary to include donor egg and/or donor sperm in your plan, our coordinator will guide you wisely and carefully.

How Do I Start?

Everyone has a unique and special situation. We at NAFG need to hear your story in great detail so we can discuss the options available to you. This consultation may take place in-person in Boston or New York, or by phone or video conference. Your schedule and plan will be customized to fit your needs. We believe in everyone's right to have a family, and welcome people of any age, marital status, or sexual orientation.

The First Step: Finding a Carrier

Working with our surrogate coordinator, clients will be presented with profiles of appropriate gestational carrier candidates, found through NAFG's extensive advertising and contacts. How long it takes to find a carrier depends on the pool available at the time you start. It could be right away, or take a few weeks. When you are preliminarily matched with a carrier, we will arrange first a conference call, then an in-person meeting supervised by one of our staff. Depending on the residences of the parties, some travel may be required for this step. The logistics (where the IVF and births take place) depend on the primary residence of the intended parents as well as the residence of the carrier who will be chosen.

NAFG offers an online surrogacy application for women interested in becoming gestational carriers.

Egg Donation (if required)

If an egg donor is required, you will have the resource of NAFG's egg donor coordinator for direction and assistance through this process. Clients may work with NAFG’s own donor program, one of our recommended outside egg donor facilities or a donor program of their choosing, according to the policy of the specific IVF participating facility. Clients select donors by reviewing profiles of candidates. Donor profiles are complete dossiers that include full medical history, religious and ethnic background, education and basic biographical information, while typically remaining anonymous. Each donor is screened medically to make sure that she and her eggs are healthy and free of potential disease (family history of hereditary disorders is also investigated). Donors are screened psychologically by a licensed counselor to ensure that they have the mental competence and maturity required for the task. [See also Donor Egg]

Egg Retrieval and IVF

In order to increase the chances for a successful pregnancy, the intended mother or donor is administered fertility drugs daily by injection to increase the number of eggs she produces in her cycle. She is also monitored daily through blood tests and ultrasound exams. The embryo carrier will also take medications to prepare her for gestation.

The eggs are retrieved through a routine surgical procedure using a needle and anesthesia (which does not require an overnight stay in the hospital). The eggs are then fertilized with the intended father's or donor's sperm, then incubated and observed for three to four days. An average of seven to twenty eggs are retrieved. Sperm is then introduced and embryos are formed for observation and evaluation. Typically, two to three embryos are transferred to the gestational surrogate or intended mother. The rest, if also viable, are frozen for later use.

Embryo Transfer

The embryos are transferred through a painless, in-patient procedure. A pregnancy test is administered approximately fourteen days after the embryo transfer. If the result is negative, then the transfer may be repeated at another cycle with the frozen embryos. If necessary, the process may start again from the beginning.

Pregnancy and Birth

The NAFG relationship manager/social worker acts as liaison between carrier and intended parents throughout this stage. She makes sure that the carrier is going to her regular appointments and is following other conditions of her agreement while informing the intended parents of her progress. Intended parents may review all medical records pertaining to prenatal care and delivery. [The carrier provides a HIPAA-compliant general medical release.] The relationship manager oversees the day-to-day health and well-being of the carrier (both physical and psychological), and serves as a resource for intended parents to prepare for the new arrival. The relationship manager is the primary contact for this phase, but all parties can be assured that the full staff of NAFG is always available to them at any time, should any particular needs arise.

After the baby is born, the intended parent(s) take their newborn from the hospital. In some states, the intended parents will appear on the birth certificate, and no additional legal work is required. In others, a step-parent adoption will be necessary. Either way, the baby stays with you from the moment he or she leaves the hospital. Congratulations!

How Surrogacy works

How Surrogacy works



29 Commonwealth Avenue
Boston MA 02116
Tel: 800-710-1677; 617-557-4300
Fax: 617-557-4301

New York *

148 East 74th Street
New York NY 10021
Tel: 212-207-1900
Fax: 212-207-3099

Washington DC

717 D Street, NW
Suite 300
Washington DC 20004
Tel: 202-388-7575
Fax: 202-388-1772


3379 Peachtree Road NE
Suite 555
Atlanta GA 30326
Fax: 404-467-4485


2650 Biscayne Boulevard
Miami FL 33137
Tel: 305 674-8989
Fax: 305-674-8979


9319 LBJ Freeway
Suite 100
Dallas TX 75243
Tel: 214-350-5200
Fax: 214-350-5202

* New York state residents may work with NAFG as intended parents, but state law currently restricts New York residents from serving as surrogates (carriers).

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How Surrogacy works
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