Surrogacy 101

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Surrogacy 101

  1. 1. Surrogacy 101 Men Having Babies NYC Conference November 2014
  2. 2. 2 Surrogacy 101 • The purpose of this workshop is to prepare you to make decisions regarding your surrogacy journey, particularly picking an agency and clinic. • In order to move through the presentation effectively we will stop for questions at the end of each slide. But if the table of contents indicates that your question will most likely be addressed later in the presentation, please keep your question for later. • If you have questions that have not been answered, you may find that they will be answered by the end of today. After today you can always post your question to the Men Having Babies Facebook’s group or email me at Aasaf@MenHavingBabies.org
  3. 3. 3 What is surrogacy Definition: The act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give said child to the intended parents at birth. Traditional Surrogacy Gestational Surrogacy Independent Agency
  4. 4. 4 Gestational Surrogacy Independent Agency What is surrogacy Definition: The act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give said child to the intended parents at birth. Traditional Surrogacy •The surrogate is both the egg donor and carrier of the baby conceived. •The child is usually the biological child of the intended father, and of the surrogate. •The child will be conceived with the surrogate carrier's eggs and the sperm of the intended father. •The surrogate will go through Artificial Insemination with the sperm of the intended father in order to become pregnant. •Traditional surrogacy can be done either through basic home insemination or a clinic intrauterine insemination (IUI).
  5. 5. 5 What is surrogacy Definition: The act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give said child to the intended parents at birth. Independent •Intended Parents will search and find a surrogate through various means (friends, message boards, newspaper adds). •IPs will assemble the professional team to help them: •A clinic for medical screening and process. •An agency or clinic for donor matching •Attorneys for the surrogacy agreement and the parentage hearing and/or adoption. •Psycho-social screening and support is often overlooked Traditional Surrogacy Gestational Surrogacy Agency
  6. 6. 6 Traditional Surrogacy Independent Agency What is surrogacy Definition: The act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give said child to the intended parents at birth. Gestational Surrogacy •A gestational surrogate mother is not the biological mother of the baby conceived. •The child is either the biological child of the intended mother, or of an egg donor and the intended father (or one of the intended fathers). •A gestational carrier will go through IVF, In-Vitro Fertilization, to become pregnant. This is where the intended mother's or donor’s eggs, and the intended father’/s sperm, are combined in a laboratory to create viable embryos. •Then, one or more of these embryos are implanted into the surrogate's womb in order to become pregnant.
  7. 7. 7 Traditional Surrogacy Gestational Surrogacy Independent What is surrogacy Definition: The act of a woman, altruistic by nature, gestating a child for another individual or couple, with the intent to give said child to the intended parents at birth. Agency •An agency screens surrogates, matches them with the Intended Parents, and supports them throughout. •Act as a liaison between the IPs and the carrier. •Some agencies also provide egg donor matching. •The agency works with the clinic to coordinate the parties, at least until pregnancy is achieved. •The agency’s lawyer, or one it suggests, will draft the surrogacy agreement. •The agency may also arrange the parentage hearing.
  8. 8. 8 Gestational Surrogacy •A gestational surrogate mother is not the biological mother of the baby conceived. •The child is either the biological child of the intended mother, or of an egg donor and the intended father (or one of the intended fathers). •A gestational carrier will go through IVF, In-Vitro Fertilization, to become pregnant. This is where the intended mother's or donor’s eggs, and the intended father’/s sperm, are mixed in a laboratory to create viable embryos. •Then, one or more of these embryos are implanted into the surrogate's womb in order to become pregnant. Traditional Surrogacy Independent Today we will focus on Gestational Surrogacy using an Agency. But the information in the presentation can benefit intended parents who choose other routes as well Agency •An agency screens surrogates, matches them with the Intended Parents, and supports them throughout. •Act as a liaison between the IPs and the carrier. •Some agencies also provide egg donor matching. •The agency works with the clinic to coordinate the parties, at least until pregnancy is achieved. •The agency’s lawyer, or one it suggests, will draft the surrogacy agreement. •The agency may also arrange the parentage hearing.
  9. 9. 9 Traditional versus Gestational Traditional Gestational Legal reasons Less ambiguity about role of GC GC and ED Can each be best fit for role May be less difficult for surrogate Known bio mom No need for ED More affordable No IVF Traditional Gestational Your reasons Your reasons
  10. 10. 10 Known Anonymous Your reasons Legal reasons Less complicated Easier to find / wider selection Your reasons May agree to meet children Long term medical history Personal impression Known vs. Anonymous Donations
  11. 11. 11 How does it work: a short description of the medical process For gestational surrogacy Meds and monitoring ED: Fertility drugs to stimulate egg production ED: Blood tests to monitor hormone levels ED: Ultrasounds to monitor follicle development GC: hormones to suppress menstrual cycle Monitoring to keep GC and ED in sync Retrieval Eggs are harvested from ED through a transvaginal ultrasound-guided procedure Egg retrieval is performed outpatient with monitored sedation Well screened donors may provide as many as 20 or more eggs. Fertilization The semen is specially prepared in order to select the most viable sperm The sperm are placed together with the eggs in an incubator for 12-18 hours for fertilization Embryonic development is closely observed on a daily basis The ED is no longer part of the process Transfer Within 3-5 days about half of the eggs have developed into embryos The best embryo, or two, are transferred into the uterus through a thin tube This is a non-surgical ultrasound guided procedure with no need of sedation 10-12 days following the transfer, the GC’s blood is tested to determine if pregnancy has occurred
  12. 12. 12 Adapted from http://rba-online.com/ivf/index.php?IVF-Program-17 with the assistance of Georges Sylvestre, MD How does it work: a longer description of the medical process For gestational surrogacy In IVF, fertilization occurs outside the woman's body, both egg donor and surrogate. The donor’s eggs and the man’s (men’s) sperm are united in the laboratory. Once fertilization occurs, the early embryo(s) are transferred to the surrogate’s uterus. In gestational surrogacy there are 3 (or 4) parties with no infertility problems: egg donor, gestational carrier and father(s) Cycle Monitoring: To begin the process of IVF, the egg donor is given fertility drugs to stimulate egg production and control the timing of ovulation. This helps maximize the number of eggs produced (target 10-25). Frequent blood tests to monitor hormone levels and ultrasounds to monitor follicle development are required. Meanwhile hormones are given to the GS to suppress her menstrual cycle and make he uterus suitable to receive an embryo (or embryos). Egg Retrieval: The eggs are harvested from the egg donor primarily through a transvaginal ultrasound-guided procedure. The ultrasound-guided egg retrieval is performed on an outpatient basis with monitored I.V. sedation. Recovery from the sedation requires thirty minutes. Fertilizations: Once the eggs are retrieved and the sperm sample collected from the IP(s), they are immediately given to the embryology laboratory for incubation. The man's semen is specially prepared in order to select the most viable sperm. In conventional IVF, the sperm are then placed together with the eggs in an incubator for 12-18 hours to allow for fertilization. Following normal fertilization, early embryonic development is closely observed on a daily basis. The egg donor is no longer part of the process. Embryo Transfer: Within 72 hours (and up to 5 days) after egg retrieval, about half of the eggs have developed into embryos and are generally ready to be transferred into the woman's uterus through a thin tube, or catheter, gently inserted through the cervix. This is a non-surgical procedure performed under ultrasound guidance with no need of sedation. About ten to twelve days following the embryo transfer, the GS’s blood is drawn and tested to determine if pregnancy has occurred
  13. 13. 13 Fresh / Shared / Frozen Full fresh donation will yield more eggs, but be more expensive Shared donation will cost less but may not leave enough for a sibling journey Frozen eggs are immediately available but selection is limited Single or multiple Embryos Transferring one embryo will reduce risks associated with multiples Transferring two embryos will increase likelihood of pregnancy Transferring more than two is not recommended Genetic Screening of Embryos PGS / CCS can help avoid transferring chromosomally imperfect embryos Can increase pregnancy rates of first transfer, but Costly Some protocols can produce false negatives or require freezing of embryos Typical Medical Choices
  14. 14. 14 Legal Considerations How can we establish parentage? • Birth certificate v. legal parentage Will the agreement by enforceable? Significant legal differences between Traditional v. Gestational Surrogacy Ultimately, your level of risk adverseness will factor in to decisions
  15. 15. 15 Parental Establishment • Each State and sometimes counties within a state are different • Make sure you understand the process and the length post birth legal process as it will help you plan your return home. • Depending on State law and a court’s protocols, the surrogate and sometimes her husband will relinquish their parental rights to the (unborn or born) child • Sometimes only one father will be put on the birth certificate at this time, and the second father will either do a second or step parent adoption in the state of birth or back in the home State • In many cases, a pre birth order will be granted without the name of the surrogate ever going on the birth certificate. However, it may not create the legal relationship between a non-biological parent and the child necessary to secure the relationship in every state or country. • Second or Step Parent Adoptions create a legal and portable relationship between a non-biological parent and the child. A Pre-Birth Order to terminate the rights of a gestational carrier can still be utilized. Contract with agency • Will cover parties responsibility and costs • Attorney can review of agreement IPs. Some agencies open to changes Contract with surrogate •The agreement between the surrogate and the parents must be signed before cycle begins. •Will cover base compensation, reimbursement and other monetary obligations •Will discuss relationship between IP’s and surrogate •Risks and responsibilities of both parties •Some contract points rely on meeting of the minds and not court intervention: pregnancy termination reduction •Should cover cycling, transfer, pregnancy, delivery, and relationship post delivery •Termination of the surrogate’s parental rights •Expenses and health insurance for the carrier •IP’s will pay surrogate's attorney fee •Rarely there may also be a need for a contract with the egg donor The Legal Processes
  16. 16. 16 Where can I do it? A review of Countries and US States Overseas • Two major considerations, parentage in delivering and home country and citizenship. • Very few counties where gay men seek surrogacy overseas. • Recent popular destinations such as India and Thailand are no longer viable. • New destinations such as Nepal and Mexico still have no clear record of medical and legal outcomes. US: Bans or Voids & Penalizes • New York (compassionate surrogacy only and with restrictions) • DC, MI, AZ, NE US: Allows But With Some Restrictions: • Sometimes allows only gestational but not traditional, or only allows uncompensated • New Jersey • North Dakota US: Allows and/but Regulates (either by Statue or Published Case) • FL, NH, TX, UT, VA, WA, OH, MA, PA, SC US: Vacuum: Most expansive Protections (No Statue/No published case) • CA, IL, NV • PBO routinely granted • PBO unpredicted • Post birth adoption http://www.creativefamilyconnections.com/state-map-surrogacy-law-practices http://www.americanprogress.org/issues/women/news/2007/12/17/3758/guide-to-state-surrogacy-laws/
  17. 17. 17 Parental Establishment Pre-Birth Order Granted (it is not definitive whether a PBO actually creates a universally recognizable legal relationship between a non-bio parent and the child born through surrogacy. It can, however, make the second or step parent adoption process easier if there is a PBO, although an experienced attorney can successfully process the adoption without one depending on the state where the adoption takes place. The adoption is the one assured way of creating a fully transportable legal right between the non- bio dad and the child.) Post Birth Order or Second Parent Adoption at Place of Birth Second Parent Adoption completed in IP’s Home State
  18. 18. 18 Same Sex Parents Favorable Unfavorable
  19. 19. 19 Intended parents The surrogacy agency and the surrogate The egg donor agency and the egg donor The fertility clinic The attorneys: surrogacy contract & parental establishment* Who are the involved parties
  20. 20. 20 Most IP’s will start with one of these The surrogacy agency The fertility clinic Who to pick first?
  21. 21. 21 Some will start with one of these The egg donor agency The attorneys Who to pick first?
  22. 22. 22 Research and selection process Research • MenHavingBabies.org/events • Workshops, conferences, breakout sessions • MenHavingBabies.org/directory • Profiles, contact info, videos • MenHavingBabies.org/ratings • Ratings and reviews of agencies and clinics • Facebook.com/groups/menhavingbabies • Ask questions, network Interview • MenHavingBabies.org/consults • Universal consultation request form • Free in-person or Skype consults (at least 3-4 agencies and clinics) • May start with agency or clinic, and ask them who they typically partner with • Ask for references, but recognize they may not be representative
  23. 23. 23 Limited Service • GC Matching • Fees per screened GC • Some coordinating • Service providers like attorney Clinic and Egg donor agency recommended but not included in agency fee Full service • GC Matching • Full screening • All coordinating • Attorney and psychological fees included or facilitated • May include escrow services Possible Extras (VIP) • Like Full Service but with a lot of hand holding • Many times surrogates are prescreened and the cost of the prescreening is included • Insurance review • Guarantee / refund plans • Close affiliation with a clinic(s) Level of service: correlated to agency fee Picking a surrogacy Agency
  24. 24. 24 Experience •How long have then been in business •How many families have they helped •How much experience do they have working with: same-sex couples/international IP’s and can demonstrate experience •Have experience with working with attorneys that can do both the surrogacy agreement and the parental agreement for same sex couples Background •Reputations, personal connection and recommendations •Men Having Babies Surveys http://menhavingbabies.org/surrogacy- resources/directory/agencyratings/ Cost •Do they provide discounts through the Gay Parenting Assistance Program? •Variables that may contribute to cost ranges •Compare with MHB’s generic budget checklist •Rematching process and cost •Sibling journey cost (same surrogate, other surrogate) Surrogates • Pre screened: low risk • Basic pre-screening: IP’s pay for medical, background check and psychological screening with risk • The process of sourcing the surrogates • Typical surrogate comp and expense package • Geographical locations of surrogates • Will use surrogates insurance Availability / Waiting time • Short to Long • Long for surrogate with insurance • In general can take 3-12 months to match and start the process Relationship with service providers like attorney, clinic and egg donor agency • In-house and must use them • In-house but can use anyone • Must pick from list • Recommended only Other considerations when picking an agency and questions to ask
  25. 25. 25 Agencies are the only participants in ART that are wholly unregulated. But you can take some steps to obtain the reassurance of some meaningful regulation by working with agencies run by professionals, such as attorneys, who are already regulated for other reasons not related to the agency. When this is accomplished, together with a professional liability insurance and criminal bond, the client is protected as completely as possible during this difficult and expensive process. •Attorneys, in general, have a detailed set of practice and ethical rules that govern their behavior, if they violate these rules, they risk losing their license to practice law and their occupation. •Attorneys are encouraged (but not necessarily required in every state) to carry malpractice insurance to protect their clients from their negligence in performing their legal duties to their clients. This is an important protection to cover proper legal work, but it only covers their work as a lawyer, not as an agency. It is important to ask every prospective attorney (agency-related or not) whether they carry such insurance. •For every agency that performs any matching or other administrative duties for third-party reproduction programs (surrogacy, egg donation, embryo donation, etc.) the administrative activities in this role will not be covered by an attorney's legal malpractice policy; therefore, a different kind of business insurance is required. This would be professional liability insurance of the kind every business can obtain to protect its clients against the agency's negligence or malfeasance in its administrative duties. •That being said, anyone can break the law and steal, even attorneys. Therefore, it is recommended the every agency has applied for and been granted a criminal bond by a reliable bonding company to protect the agency's clients against the theft of their funds. Agencies handle thousands of dollars of client funds throughout surrogacy and other programs, and if this money is under the control of the agency, it is susceptible to criminal activity such as theft or embezzlement. A criminal bond insures that a reliable company has assessed the agency's manner of handling their clients' money and found it to be acceptable and reliable enough to grant the company a bond to protect its clients against the company's theft of client funds. This has happened with past agencies, and it is a protection all agencies should offer.
  26. 26. 26 Using and Agency or going Independent? Using an Agency • Agencies are experts in surrogacy laws and medical standards, many of which change state to state. • Agencies have long experience working with gestational carriers. • Agencies find gestational carriers and manage all the required psychological and medical screening to find a good match for you. Independent • Agencies can be expensive, with total costs for agency, legal, gestational carrier, donor and IVF clinic well above $100,000 (less if you have eggs donated by a family member or use an egg bank). • Agencies do not coordinate everything; you still have to be a very active participant.
  27. 27. 27 The Clinic and it’s Experience •Staff size and experience, turnover: doctors, laboratory, nurses, case managers / coordinators •How long have they been in business? •Have they worked with surrogates/same- sex couples/international IP’s and can demonstrate experience •Do they have in-house genetic counselor? Psychological support? Relationship with outside providers? •Reputations, connection and recommendations •Men Having Babies Surveys http://menhavingbabies.org/surrogacy- resources/directory/clinicratings/ Medical fees and what they include: •Are typical services such as ICSI, assisted hatching, first year embryo storage included? Costs of non-typical extras such as PGS •Do they provide discounts through the Gay Parenting Assistance Program? •Cost of diagnostics (like FDA screening), medications (actual or flat) •If they do not have donors: estimates of total cost of outside donors •Cost of monitoring donor and surrogate – and estimated costs if they are not local •Cost of frozen embryo transfer (if the first transfer fails) •Compare with MHB’s generic budget checklist Statistics & Medical •Success rates: Specifically with surrogates, and specifically with frozen eggs and/or embryos •Check http sart.org •Is their lab experienced in advanced procedures such as vitrification (rapid freeze) of embryos? Are they experienced in freezing eggs? Performing embryo biopsy (PGD / CCS)? •Prefer to freeze eggs or embryos •Medical fees and what they include •Are typical services such as ICSI, assisted hatching, first year embryo storage included? •Costs of non-typical extras such as PGS •Do they provide discounts through the Gay Parenting Assistance Program? •Cost of diagnostics (like FDA screening), medications (actual or flat) •If they do not have donors: estimates of total cost of outside donors •Cost of monitoring donor and surrogate – and estimated costs if they are not local •Cost of frozen embryo transfer (if the first transfer fails) •Compare with MHB’s generic budget checklist Picking a fertility clinic Relationship with surrogacy / egg donors agencies • In house and must use them • In house but can use anyone • Must pick from list • Recommended only • Have their own Egg & Embryos banks Treatment Option Plans • Minimum egg guarantee • Known non-anonymous donations • Unlimited IVF package • Automatic progressive discounts • Money-back option Location • Close to your home • Close to egg donor: most screening and monitoring • Close to your surrogate: some screening and monitoring. Many clinics will allow surrogates to screen and monitor close to her home and will only see her for the transfer. Some wont.
  28. 28. 28 The agency •Reputations, personal connection and recommendations •Level of support in the process •Relationship with surrogacy agencies and clinics (some are exclusives, this may be a good sign!) •Experience with surrogacy, same-sex couples and international IP’s •Compensated donors via IVF clinic, surrogacy agency, or an egg donation agency •Sources vary by: •list size, and the extent donors on it are exclusive •Screening quality and timing: some do not screen the candidates until after they are selected •Selection process: available information, advice Donors Variables •Geographical locations (proximity to clinic a plus) •Age (the younger, the better) •Experience and proven fertility •Medical history and genetic screening •Known or anonymous - openness to meeting or sharing future medical records with IPs •Availability and waiting time (some only available during college vacations) Picking an egg donor & egg donor agency Costs • Registration fee to see database? • Agency / matching fee • Donor’s compensation (ASRM guidelines) • Travel and monitoring costs (depends on proximity) • Rematching cost (if donor doesn't work out) • Sibling journey cost (same egg donor, other egg donor) • Unshared or Shared cycles • Frozen eggs from donor egg banks? • Minimum egg guarantee? • Unlimited IVF package (money back guarantee?) • Automatic progressive discounts? Information and presentation • On-line database or individual files/ suggestions • Type of information regarding donor: • Profile: health, ethnicity, education, appearance, religion, etc. • Personal statements / essays • Photos - adult/childhood/family photos • Videos – studio or home made • Meeting the donor in person • Level of genetic screening • Openness to donating to gay men • Anonymous / non-anonymous donations
  29. 29. 29 Picking an attorney • The attorney for the surrogacy agreement and the attorney for the parental establishment may or may not be the same person. • The attorney for the surrogacy agreement should be licensed in the state of where the surrogates lives and will deliver. • The attorney for the parental establishment MUST be licensed in the state of where the surrogates lives and will deliver. • She must be experienced, and able to demonstrate this experience, in surrogacy law. • You should ask the parental establishment attorney if she has been able to establish parental rights through pre birth order or second parent adoption in the county where the surrogate will live or deliver or in the county where birth certificates are issued for the State. This is not always available, but should be considered.
  30. 30. 30 Variances based on rates, level of service, experience of surrogate, number of cycles, number of children and location. MHB’s survey indicates a wide range of $80-$170k Surrogacy Agency & Program • Agency Fee for Surrogacy Program/Coordination Fee • Legal Counsel representation for Intended Parent/s • Escrow Account Management • Review of Surrogate Insurance Policy • Surrogate's Attorney's Fee to Review Contract Screening Fees & Medical Expenses • Surrogate/IP Psychological Evaluation • Surrogate Criminal Background Check • Surrogate and her partner's Infectious Disease Testing • IP’s FDA testing (one or two sperm sources) • Surrogate Medical Evaluation • Monitoring of donor and surrogate • Fresh/Frozen IVF Cycle Fee & Medication • Pregnancy test &post transfer meds Surrogate Expenses and Compensation • Surrogate Base Compensation • Transfer Fee • Transfer Expenses and travel • Monthly Allowance • Maternity Clothing Allowance • Lost Wages for Surrogate and Spouse • Travel Expenses / Local Travel • Bed Rest Compensation • Child Care • Extras for twins, invasive procedures, C-section, etc. Legal Fees for Parentage Proceedings • Representation of IP's (court pleading and/or Pre-Birth Order) • Representation of Surrogate • Birth Document Insurance • Medical Insurance for Surrogate • Co-pays and deductibles • Surrogate Life Insurance Policy • Disability Insurance • Health Insurance for born children • Surrogate's Estate Planning Egg Donation and Egg Donor Agency • Donor matching / agency fees • Egg donation contract (rare) • Donor compensation • Donor screening • Donor monitoring (if not close to clinic) Estimated Costs
  31. 31. 31 Cost Saving Best Practices The three C’s • Choice: • agency and clinic with competitive rates • Egg sharing or frozen eggs from a bank • Number of embryos transferred. • Number of sperm sources. • Circumstances: residence, age, HIV status, etc. • Chance: number of tries, twins, bed rest, etc. Geographical locations • Donor – clinic: proximity can save thousands in travel and monitoring costs. • Surrogate – clinic: more rare, but proximity can save thousands in travel, childcare, lost wages, etc. • IPs – Surrogate: proximity can save much in travel (and enhance relationship!). Compensation levels • Donor: up to ASRM level ($8k, less in some regions), but it is worth it to pay extra for experienced donor (higher success rates). • Surrogate: no sense to pay extra for experienced surrogate (unless going indie). • It may be worth it to pay extra (and wait longer) for a surrogate with applicable insurance.
  32. 32. 32 Family and journey vision • Makeup: How many children would you like? How many surrogacy journeys would you be willing / able to go through? • Paternity: If a couple, is it equally important for both of you to be the bio dad? • Relationships: How do you envision the relationship with the surrogate during and after the journey? How about the donor? • Risk tolerance: Would you be willing to pay a premium upfront in order to reduce cost uncertainties? • Time / cost priorities: Will you be willing to prolong the process to achieve cost savings? Will you have the time to take a more active role in planning and execution?
  33. 33. 33 Ethical and Social Considerations: Relationships and communication • Remember that to create your family you need the help of a surrogate and her family! • While surrogates are typically compensated, this does not mean that they are mere service providers. What makes the difference are meaningful relationships. • The motivation of the surrogate depends on her original drive, but also on the support and appreciation she will receive throughout the journey – from you and her family. • Visit the surrogate and her family. Remember that all of them, especially her children, are affected by this journey. • Adjusting expectations, curbing the need to control, and maintaining good communication are key, and a professional can help facilitate this and mediate when needed. • Your surrogate and you are going through this journey for the first time, and there is no hand book. Speak with your surrogate, by phone or Skype and not just email and text message, as much as you can. • Every journey to parenthood, especially gestational surrogacy is accompanied by the feeling of loss. Accept them, they are normal and part of the process. • The loss of your freedom • Large expenses • Being depended on so many people you hardly know • Accepting that you need one or two women to carry out your dream of parenthood • Failed cycles, lost pregnancies • Harsh and unfair reactions from strangers or friends and family • The disappointment when there is a lack of thrill when you meet your surrogate or egg donor
  34. 34. 34 Ethical and Social Considerations: Stress and support • Surrogacy is a process that requires patience, compassion and a positive attitude (as well as a good sense of humor) • Surrogacy pregnancy requires a village. Accept it, and be grateful for the people who chose to accompany you on this journey • Uncertainty, financial strain and lack of control are bound to cause substantial stress. • Tension is also likely between partners as they reconcile differences in vision, coping mechanisms, and motivation levels. It is a good idea to nourish your relationship. • While family and friends often provide valuable support, for some the need to deal with their expectations may be an additional source of stress. Choose with whom and when you share news about your parenting journey. • Professional support is available and often invaluable – do not hesitate to reach out. • Pick good advisors that are outside your network of paid service providers. You also need a good friend to lean on. • Remember, you decided to become a parent, you will! It is just a matter of time (ok, and money)
  35. 35. Gay Parenting Assistance Program
  36. 36. 36 Stage I / Journey Booster • Access to discounts from clinics, agencies, and law firms to provide modest help to boost the efforts of those who start the surrogacy process. • There is a $20 / per person non-refundable administrative fee. • If you have already signed with a clinic or agency and then apply for Stage I support, you will not be able to apply discounts offered through our program to your current plan / contract. • Applications are accepted year round. Stage II / Direct Assistance • Reviewed by a grant committee for direct financial assistance or to be matched with a partner clinic and / or agency who will provide services free of charge. • No charge to apply. • Direct financial assistance funds are generated through event sponsorship fees paid by providers. • This program does not provide retroactive expense reimbursement for anyone who has already gone through or currently going through the surrogacy process. • Those who pass Stage I are invited to apply for Stage II on an annual basis. Gay Parenting Assistance Program (GPAP) The program consists of two tiers of assistance:
  37. 37. 37 For Stage I / Journey Booster • All applicants must be homosexual males. • Single and Joint applications are accepted. • Annual income of each applicant must be less than or equal to the income eligibility level determined by our board of directors in consultation with the providers we work with, and adjusted by cost of living index and age. • Applicants must be between 25 – 50 years of age in order to apply. • No existing children. • If applying as a couple, you must be living together in the same residence for at least the last 2 years. • Each applicant must pass a criminal background check. Program Eligibility / Requirements
  38. 38. 38 For Stage II / Direct Assistance • Remember, only those who passed Stage I will be invited to apply for Stage II. • Each applicant must submit a health statement from a physician detailing any chronic, terminal or debilitating conditions. • Each application must submit their current Credit Score and sometimes full details of their current credit report. • A listing of current assets and liabilities is required. • Applicants must agree to submit to a psycho-social evaluation to provide the Grant Committee with state of readiness, commitment and contemplation, past journey hardships, and other relevant observations. Program Eligibility / Requirements

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