Gift of life -- surrogates help couples become parents
By Amanda Cuda, Connecticut Post, CT, September 28, 2005

Miguel and Luis were tired of being disappointed. The Bridgeport couple, who asked that their last names not be used, had been foster parents for many years. Time after time, they would take in a child, become attached to him or her, then watch the child leave.

Their pain over the constant loss was evident, particularly to Miguel's sister-in-law, Jessica. "She saw how distraught we were," Miguel said.

So Jessica, who also didn't want her last name used, decided to help out by carrying a child for them. "I saw that they were suffering," she said. "I just told them 'If I could, I would give you a baby.' And they said, 'Are you sure?' "

She was. And she's one of many women who have chosen to act as surrogates for couples who, for one reason or another, can't carry the baby themselves. That includes gay couples, such as Miguel and Luis, and also straight couples with health or fertility issues.

According to the Organization of Parents Through Surrogacy, an Illinois-based nonprofit support and advocacy group, there are more than 1,000 surrogate births a year in the United States, and there have been about 10,000 births to surrogate mothers since 1976.

Many couples today are choosing gestational surrogates as opposed to classic or traditional surrogates, said Dorothy Greenfeld, director of psychological services at Yale Fertility Center in New Haven, which will facilitate Jessica's surrogacy.

Gestational surrogacy occurs when the carrier contributes no genetic material. The egg comes from the intended mother or from an outside donor, which is what Miguel and Luis will use in their arrangement with Jessica.

This is in contrast to traditional surrogacy, in which the surrogate is inseminated with the intended father's sperm. In that case, the surrogate is the baby's birth mother.

Greenfeld said that, although most traditional surrogacy arrangements go smoothly, couples have increasingly been more comfortable opting for a gestational surrogate.

"[Gestational surrogacy] may be more complicated medically, but it's less complicated legally and emotionally," she said.

Though prices vary, the average medical cost for facilitating a gestational surrogacy is roughly $20,000, said Dr. Andrew Levi, a reproductive endocrinologist and fertility specialist in Trumbull. That includes in vitro fertilization of the egg, the implantation and medical care. "It's a long process," Levi said.

What makes the process tricky is the precise timing required. Levi said that, in a gestational carrier arrangement, the menstrual cycle of the carrier and the intended mother must be synchronized so that both are in the middle of their cycles.

If the timing is off by as much as a day, the fertilized egg will not be able to be implanted in the carrier.

Levi's office sees about six surrogate cases a year, nearly all of them with gestational carriers. He said the only traditional surrogates he sees now are women carrying for gay male couples. Even some of them are using donor eggs instead of the carrier's, which is the case with Miguel and his sister-in-law.

Jessica said the only way she would carry Miguel and Luis's child was if she didn't have to use one of her own eggs. That way, she said, the baby wouldn't be hers at all, which would make her more comfortable. Jessica will be implanted with the fertilized egg in October. When the baby arrives, he or she will be entering an already full house. Miguel and Luis have adopted two children, and may soon be adopting a third. But Jessica said that their love of children was the reason she's decided to carry a baby for Miguel and Luis. "I think they'll be great parents," she said.

Jessica has already started preparing for the procedure, which has included a psychological screening through Greenfeld's office. Greenfeld said one of the major things she considers when screening a surrogate is whether she already has given birth (Jessica has).

Though there are special circumstances where she would find it appropriate for a childless woman to be a carrier — as in a recent case she handled in which a woman was carrying for her sister — most clinics prefer that the surrogate has children, Greenfeld said.

One reason is to make sure that the prospective carrier is medically able to carry a child to term, and to give birth. Another reason is to ensure that the carrier will give the child to the intended parents when he or she is born and not take the child for herself.

"We want to make sure that she understands that she has her kids, and this child she's carrying is for someone else."

However, she said, most surrogate arrangements — even traditional ones — tend to go smoothly. "The typical story is a good one," she said.

Many doctors refer couples considering surrogacy to an attorney who can help coordinate the legal aspects of the arrangement, and, in many cases, help the couple locate a surrogate.

Melissa Brisman, a New Jersey attorney specializing in reproductive law, has facilitated arrangements for a number of couples and surrogates in the state. She works with a number of local fertility agencies, including Levi and the Yale Clinic. Brisman, herself the parent of twin boys and a daughter through a gestational carrier, is a national expert on reproductive law, whose credits include serving as legal editor of the e-zine "Infertility Digest" and on the advisory of Conceive Magazine.  

Connecticut's laws on surrogacy are fairly lenient, pegging it as a surrogate friendly state, Brisman said. For instance, Connecticut, unlike nearby New York, allows couples to pay their gestational carrier. Brisman said that carriers can be paid anywhere from $15,000 to $25,000 for their services. The state also allows the genetic parents' names to go directly on their child's birth certificate for gestational carrier arrangements, so the parents don't have to adopt the child.  

New Haven attorney Maureen Murphy, who primarily handles adoptions, has drawn up some gestational carrier agreements, mainly for same sex couples. Even in her somewhat limited experience on the topic, she confirms that Connecticut is good about preserving the rights of the intended parents in gestational carrier arrangements.

"I do know that the state [and the courts] are very friendly to this," she said. Because Connecticut has fairly lenient policies, many parents from other states connect with carriers here. Andrea Sanzo, 38, of Farmington carried for a couple from New York, with whom she was connected through Brisman's office.  

Sanzo approached Brisman after deciding she wanted to play a larger part in helping a couple become parents. She was already mom to a 9-year-old daughter, and had donated her eggs to a friend who was having fertility problems. That donation didn't lead to her friend getting pregnant, but Sanzo enjoyed the experience and wanted to do more.  

"I wanted to help a couple achieve their dream of having a child," she said.

She did some research, which led her to Brisman, who then connected her with the New York couple. "They looked really sweet and nice," Sanzo said.  

So, she carried the child — a girl, who will turn 1 next month. She is still friendly with the family. Throughout the entire process, Sanzo saw and talked to the parents frequently. "It was just really fun," she said. "I had a great time."

Some carriers and couples choose to keep their arrangement simply business, Sanzo said, but many don't. To her, it just didn't seem right to be distant from people to whom she had such a powerful and intimate connection.

"A friend of mine [who was a surrogate], after the baby was born, she and the couple went their separate way," she said. "But to me, it was only natural to want to be friends."