We received an email last week from a lovely couple, Jamie and Luke, who are dying to start family as soon as possible through surrogacy. But, with so many unanswered questions about the process, their heads were beginning to spin, so we put them in touch with Carole Gilling-Smith, Consultant Gynaecologist and Medical Director of the Agora Fertility Clinic.
“Hello, we are two gay men desperate to start a family!!! We have looked into all of the different options and have decided that for us, having a biological connection to the child is key, so we have ruled out adoption. We have so many questions and fears though that we would love your help with. Thank you. Jamie and Luke.”
Q: Our main problem at the moment is trying to work out whose sperm we are going to use, mine or my partners. We are worried what the psychological effect will be for both of us afterwards – will the partner whose sperm hasn’t been used feel left out? This is something that we know we need to discuss with a counsellor perhaps before we go forward. Do you offer this support and guidance? Is this a common fear?
A: Yes this is a common question and does lead to a great deal of anxiety. We do believe that counselling is a very helpful part of the initial discussions as you try to work things out. I also suggest that you start thinking right from the start about your plans for a ‘family’, not just a child. So you could both be biological fathers, but not at the same time of course. I often find that for two gay men starting out on this journey, it is so daunting and there are so many unknowns that just having one child seems like an amazing milestone to achieve. So having a second child seems very hard to imagine, despite it being an underlying wish. But as gay parenting is becoming more feasible, especially in the UK, it is not unreasonable to imagine your ideal family right from the outset.
Also, as finding a surrogate is often the most difficult step, I often suggest that you plan your parenting journey in two stages.
Firstly find your egg donor and create some embryos which can be frozen. Then focus on finding your surrogate. When you are ready, one of the embryos you have created will be thawed out and transferred into her womb. The beauty about doing it this way is that in the first stage you can ask for half of the donor eggs to be fertilized with Jamie’s sperm and half with Luke’s sperm. Needless to say, you could not put back two embryos, one created from each biological father, into the surrogate’s womb at the same time!
Q: Our other dilemma is the choice of surrogate. We have heard stories of surrogates changing their minds, which fills us with fear. We think we would rather accept the incredible offer from a friend of ours who has said she would carry the baby for us. If we do decide that this is what we want to do, do you offer her support and counseling too?
A: We certainly do offer all the necessary guidance and support she will need, including independent counselling. She will have many questions and this is why using a clinic is so important as you will get proper expert advice. However we are not legal experts and we do ask you and your surrogate to get independent expert legal advice before you embark on your parenting journey, as the law surrounding surrogacy is complex. What you need is for both yourselves and your surrogate to have talked through every possible eventuality so that you agree the action you would take. One of these might be what would happen if you discovered she was carrying a baby with a serious abnormality? Not something you would really even consider at this early stage but one you need to be prepared for. This is where organisations like Surrogacy UK can be very helpful as they have a detailed checklist of areas you and your surrogate should cover in your discussions.
Q: We don’t want our friend to be biologically connected to the child, so we need an egg donor. How do we choose our donor? Can we choose a donor that looks like us?
A: This is something we can help you with. Egg donors are rigorously screened. They have to be 35 years or younger, have a completely healthy medical profile and excellent ovarian reserve. They should also pose no risk of passing on a hereditary condition so we take a very detailed family history. They have to have a number of screening tests, including a chromosome check, and they have to be clear of any infectious diseases including HIV and Hepatitis B and C. We use characteristic matching to help you choose your egg donor so when you are ready to choose, you have to decide which physical characteristics are most important to you. Things like eye colour, hair colour, ethnicity and body stature are key features to consider.
Q: Is it true that our child will be able to track down its ‘biological’ mother when it is 18?
A: Yes it is. Egg and sperm donation in the UK is highly regulated by the Human Fertilisation and Embryology Authority (HFEA) which means that all donors have to be identifiable by the child when they reach 18. All details of every cycle of treatment that involves an egg or sperm donor are securely held by the HFEA and your child can find out at the age of 16, with you, if there are any other children conceived using the same egg donor. At 18 they can independently find out more information about their egg donor by contacting the HFEA.
Q: Does your clinic take care of everything in terms of helping us source an egg donor?
A: Yes, we have both an egg donation scheme and an egg sharing scheme. Egg sharers are people who are having treatment themselves at the clinic and donate half of their eggs to those who need donor eggs. We generally recommend our gay couples planning surrogacy to consider a full egg donor so that they can create more embryos to freeze.
Q: Does your clinic help us with the legal aspects?
A: No, we can only point you towards reputable legal firms that are highly experienced in dealing with surrogacy arrangements.
Q: Can you give us a rough idea of the cost of the whole process, how long it will take, and when we could start?
A: We cannot advice you of the legal costs involved nor of the costs required to support your surrogate (known as surrogate expenses).
At the Agora we do have very clear pricing for all our initial screening and subsequent surrogacy packages. Initial screening depends on whether only one or both of you wish to be screened. We would recommend an enhanced male fertility assessment which includes an initial consultation and then you will need further screening tests if your sperm is to be used in a surrogacy arrangement. For the initial assessment stage, to include all your consultations and screening tests, I would allow up to £2000.
Moving onto treatment, in your case you would either need a full surrogacy cycle with donor eggs, where donor eggs are collected and treated with your sperm and an embryo is replaced in the same cycle or alternatively embryos could be created with donor eggs and frozen first and then you would have a separate cycle involving embryo thawing and transfer into the surrogate. Whichever way you choose to do things, I think you should allow a budget of between £10,500 to £13,000 for one cycle of treatment, including the transfer of an embryo into your surrogate. If there are sperm quality issues and the sperm has to be injected into the donor eggs (ICSI) then there is an additional charge of £ 1200.
We have an Egg Donation and Surrogacy Nurse Coordinator as well as an LGBT Coordinator. We offer a free 15 minute ‘find out more’ telephone consultation to anyone wishing to explore surrogacy so that they can get a clearer idea of their options and what to do next. These are either with one of our Medical Consultants or our Surrogacy Nurse Coordinator. We also have monthly Same Sex Open evenings which start with a presentation by one of our Consultants followed by some Q & A time with different members of our team as well as a clinic visit.
Thank you so much to Carole Gilling-Smith for this guidance. If you have any further questions, do get in touch with the Agora team who are always ready to help.