What You Can Expect:
The Fine Print
As you likely have noticed, the process of having a child through surrogacy can be complicated. Nonetheless, it is important that an agency be entirely upfront about what you should expect. At Brownstone, we believe in complete transparency.
Below you’ll find additional information about key topics like the requirements for surrogates and how we screen them, how Brownstone matches you with your surrogate, when your payments are due during the process, and what you can expect medically, legally, and otherwise from the third-party professionals supporting you throughout your journey. The details can be overwhelming at times, but we would be happy to talk through it all with you during our free consultation.
Delve into the details below 
Basic Criteria
Brownstone’s screening process is rigorous so that we can reduce risks to the health of your surrogate and your future child and ensure a successful emotional and legal outcome.
All of the surrogates accepted into the Brownstone program share these basic qualifying characteristics:
Show More Information +- ︎Between the ages of 21 and 42
- Healthy height/weight ratio—a BMI between 18 and 32
- Free of sexually transmitted diseases
- ︎Has had only full-term, uncomplicated pregnancies and deliveries
- Has had at least one delivery but not more than five, and not more than three c-sections
- ︎Resides in a state where surrogacy is legal and where our clients’ parental rights are protected (i.e. not Nebraska, Louisiana or Michigan)
- Is a citizen or legal permanent resident of the U.S.
- Does not smoke, has no history of drug or alcohol abuse, has not had tattoos or piercings within the last year
- Is not being treated for or on medication for serious depression or anxiety, or another psychological disorder
- Is financially stable
- Is mature, dependable, and has a good support system
Even before prospective surrogates formally enter our screening process, we take time to talk to them about their path to surrogacy, their motivations, their hopes, and their worries, to make sure they seem ready for the lengthy and intense journey.
The Screening Process
Brownstone’s screening process entails many steps—more than most other agencies—all designed to make sure that by the time the surrogate is presented to you for a potential match, we would trust them to carry our own child. Please check out our two blog posts (1 and 2) for even more detail, but overall these steps include:
Show More Information +The full Brownstone application goes into great detail about the candidate’s family, education, and employment history, their medical history, and their views on pregnancy and motivations for surrogacy.
If the application contains no obvious disqualifiers, our team then follows up with the surrogate candidate to discuss the whole process, from what the rest of the screening entails to how we match to what their relationship with the parents might look like. We probe their ability to manage all of the medical aspects—from medications to appointments—and talk through some of the risks. We also discuss any restrictions the surrogate has for matching, including their thoughts on termination or selective reduction, willingness to carry multiples, and desired level of closeness with their intended parent(s).
Brownstone obtains prenatal and delivery records from all of the surrogate candidate’s previous pregnancies. The surrogate must have had a normal pap smear within the past year and undergo blood screening for infectious diseases. Unlike many other agencies, we use an OB or other medical professional specialized in pregnancy to review these records even before you are matched and your surrogate is reviewed by your own reproductive endocrinologist. This additional internal step helps reduce the risk that your matched surrogate may be disqualified by your doctor later on, saving you time and money.
Brownstone conducts background checks on the surrogate and anyone over 18 living in their home, including review of a nationwide criminal database, sex offender registry, social security number trace, motor vehicle records check, and bankruptcy history. We also review the surrogate and their spouse/partner’s credit reports to make sure that the surrogate is financially stable. Any issues raised by these checks would be disclosed to you during the matching process so that you can make that decision with full information.
Brownstone partners with mental health professionals with surrogacy-specific experience to conduct psychosocial evaluation of all of our surrogates and their spouse, partner, or other primary support person. Our partner mental health professionals are typically affiliated with ASRM-Mental Health Professional Group or SEEDS Ethics and abide by their standards. Your surrogate will also undergo psychological testing (usually the Personality Assessment Inventory (PAI)) to assess major mental illness and social/personal maladjustment.
Brownstone collects the potential surrogate’s insurance policy booklet and shares it with insurance experts specializing in assisted reproductive technology so that they can give us a clear picture of what it will and will not cover, what additional insurance coverage is advisable, and what the various options might be. You will likely use this team of experts to secure life insurance, short term disability insurance, or newborn insurance (as needed). Based on this insurance review, a surrogate’s expected base compensation may be adjusted (i.e. their compensation may be lowered if their insurance does not cover surrogate pregnancies).
While Brownstone does not as a matter of course conduct reference checks or visit the surrogate’s home, we are happy to do so at your request for an additional fee. With reference checks, we ask the surrogate to provide us with the contact information for two to three individuals with whom the surrogate has discussed their plan to pursue surrogacy—family, friend, and/or colleague. With the home visit—which is typically conducted virtually—we make a general assessment of the place the baby will be “living in utero,” and send you a report. We are happy to discuss these optional steps further during our consultation.
Finally, after you have met with and matched with your surrogate, your surrogate will travel to your clinic for an in-person screening with your reproductive endocrinologist. This screening generally includes ultrasounds to detect any uterine abnormalities, blood work to test for communicable infectious diseases like STIs, a urine screen, and a consultation with the doctor. The clinic’s screening process may also include a “mock cycle” of IVF injections to allow your doctor to evaluate the surrogate’s specific reaction to the medications. Around this time, you, your surrogate, and their partner will undergo a group counseling session together.
Although this all technically happens “post-match,” should your reproductive endocrinologist disqualify the surrogate from continuing based on the results of their screening, we will rematch you free of charge. We wait to start the legal contracts process until after your doctor has given you medical clearance.
The Matching Process
As soon as you sign the agency agreement and pay the initial retainer, we begin considering you for all of our viable surrogate candidates. For more information on our thoughtful matching process, check out our blog post on this topic.
But here’s some of what we consider when determining whether you are the right fit for each other:
Show More Information +- The number of embryos to be transferred with each attempt
- Your stances on termination or selective reduction in numerous scenarios
- Your stances on vaccines, including COVID-19, TDAP, Flu, and MMR, some of which may be recommended or required by an obstetrician
- Your preference (if any) for a surrogate willing to pump and ship breast milk after delivery
- Your preference (if any) for a surrogate with insurance that will cover their pregnancy
- Your preferences (if any) for a surrogate with a particular profile or location
- Whether the surrogate’s state of residence provides an appropriate legal regime for your profile as intended parents
- Your desired levels of communication
- A general personality meld
- Any other wants or needs during or after the pregnancy
Matching on some of these elements is a “must have” while others are treated more as “nice to have” unless you or the surrogate candidate indicates otherwise.
Once we have identified a potential surrogate we believe is a perfect match for you, we first present your profile to her. Your profile includes some photos, basic information, and a “Dear Surrogate” letter we ask you to draft (with some guidance from Brownstone). If the surrogate wants to move forward with you, then we will send you their profile for your review. This profile includes photos, basic information, and a “Dear Parent” letter, plus details about their compensation expectations, insurance coverage, written psychological evaluation (if completed), and any issues raised by the background and credit checks. In both directions, surrogates and parents are not presented with a “pool” of potential matches; the match is individualized and customized.
If you also show interest in pursuing the match, we will schedule a video call between you and the surrogate and their partner/spouse/support person. We will join the call to facilitate as needed, but generally fade to the background and allow you to get to know each other organically. After the call, we will check in with each side to discuss how they felt it went. If you both would like to move forward, we will exchange information so that you can be in touch with each other directly. Congratulations!
Payments and Schedules
The anticipated costs associated with our program are set out in detail here, but you might also be wondering—when do I owe payments and how is my surrogate paid?
For information on the major invoicing events during the journey, please see our blog post on the subject.
Show More Information +For information on how your surrogate is compensated, see the “Compensation and Schedules” section here.
Third Party Professionals (Doctors, Lawyers, etc.)
While the core of what Brownstone does is recruit, screen, match, and support surrogates and intended parents, we also help you find numerous, competent third-party professionals to help you along the way. In all cases, we try to find lawyers, doctors, escrow agents, insurance experts, and other medical professionals at the top of their game. What does that mean in practice?
Show More Information +For both the parents and the surrogate, you have free choice in choosing your own representation. Brownstone will make referrals to attorneys who specialize in gestational surrogacy arrangements and parentage proceedings in the proper jurisdiction and who are familiar with the particular issues of LGBTQ+ family formation.
If you have not already found a reproductive endocrinologist you like, Brownstone will help refer you to doctors and clinics. At a minimum, we ensure that the doctor and clinic is familiar with the medical and interpersonal issues that arise with surrogacy pregnancies in particular. Moreover, we analyze clinic reports from the Society for Assisted Reproductive Technology (SART) to evaluate the clinic’s relevant results. Finally, Brownstone recommends using clinics committed to following ASRM guidance for screening egg, sperm, or embryo donation. Brownstone will help educate you about these relevant factors so that you can make an informed decision.
Brownstone works with one of the leading insurance agencies for the ART community. They will evaluate your surrogate’s policy booklet, offer advice about your specific situation, educate you about your insurance options, and help you secure appropriate medical, life, short term disability, and/or newborn insurance.
Brownstone partners with an independent, licensed, and bonded escrow manager so that you and your surrogate can both have peace of mind that disbursements are handled professionally and in accordance with your contract. While Brownstone is one of the only surrogacy agencies operating in New York that legally can hold your money because we are owned and operated by an attorney licensed to practice in New York, we prefer to give you and your surrogate the added peace of mind and transparency of the professional and user-friendly services of this third party.
Brownstone believes that all parties can benefit from compassionate and professional support. We are prepared to make referrals for both parents and surrogates to mental health professionals with particular experience and expertise in infertility and surrogacy. For our surrogates, we also offer the option of individualized attention from a former surrogate and professionally-led support groups and webinars.
If you want your surrogate to work with a doula, midwife, dietician, chiropractor, or other health professional and your surrogate is amenable, Brownstone can help you locate those individuals or practices as well. This individualized support is part of our all-inclusive agency approach.
Finding Egg or Sperm Donors (If Applicable)
While Brownstone is not an egg donor agency, we are willing and able to support parents every step of the way during their process of creating embryos.
Show More Information +And, of course, we are happy to provide you with referrals to quality egg donor databases run by ethical providers who follow the ASRM guidelines and will ensure that you’ll receive any vital medical information throughout your child’s life. While less common for our clients, we are able to provide similar advice and referrals for sperm providers.
For more information on finding an egg donor, please see our detailed blog posts on the topic (1 and 2).
Once you select a donor, Brownstone will help coordinate as needed between agencies and clinics. We can refer you to attorneys with experience crafting donor agreements and to mental health professionals experienced in donor conception, the issues it can raise, and the ways you might handle these issues with your future donor-conceived child.
The Medical Process
Depending on the personal circumstances that bring you to surrogacy, you may be less familiar with in vitro fertilization (IVF) and the medical process surrounding gamete donation, embryo creation, surrogate preparation, and surrogate pregnancies.
While additional information is available in our blog post(s) on related topics, in a nutshell, the medical process for you and your surrogate looks like:
Show More Information +What this entails depends on your particular circumstances. Some parents can create their own embryos, some need egg donors, some need sperm donors, and some need both. If you are creating embryos from your own genetic material (egg and/or sperm), this is what that process might look like:
- The sperm contributor, be it a parent, two parents, or donor, undergoes a “retrieval” that is exactly what you expect it to be. Per FDA guidelines, the clinic will also conduct certain infectious disease screenings through a blood draw and urine sample collection. The sperm sample is often cryopreserved.
- The egg contributor, be it a parent or donor, undergoes an egg retrieval. This may begin with using birth control pills to regulate the cycle. For ten days, the parent or donor takes hormone injections. At some point, the doctor will add another hormone to prevent premature ovulation. Finally, as the retrieval date approaches, the doctor will use a “trigger shot” to stimulate the final maturation of the eggs prior to retrieval and to decrease the risk of Ovarian Hyperstimulation Syndrome (OHSS).
- Your IVF clinic’s laboratory will take the sperm and eggs, cryopreserved or not, and create embryos. More likely than not, your laboratory will grow them to the blastocyst stage (around day 5) to help weed out less promising embryos before transfer. If you want to conduct pre-implantation genetic testing, the embryos will have to be grown to the blastocyst stage. To wait for the results of such tests before selecting and transferring an embryo, the blastocysts need to be cryopreserved.
Once the surrogate has passed the in-person screening, your IVF doctor will create protocol and schedule to prepare your surrogate for transfer. This protocol will include about 2-4 monitoring appointments at a clinic local to your surrogate, a few medications, and some ultrasounds and blood draws. Each case and clinic varies in its approach, but the medications typically include Estrogen, Lupron, and Progesterone, and other injections, pills, suppositories, or patches. Some of the injections will happen daily for more than 10 weeks.
The embryo transfer is quick and relatively painless. The IVF doctor inserts the embryo(s) into a surrogate’s uterus through a small catheter and with the guidance of an ultrasound. No anesthesia or recovery time is typically needed. Your surrogate will have a few restrictions on their movement that same day, but will not be on bed rest, and can travel home shortly thereafter.
While success rates depend on many factors, transfer of a chromosomally-normal blastocyst typically results in a live birth around 60% of the time. However, with three attempts, that success rate exceeds 90%.
If your surrogate does not live near your IVF clinic, they will be monitored after transfer by a clinic local to them. Monitoring involves regular blood tests and ultrasounds. About 10 days post-transfer, the local clinic will draw the surrogate’s blood to conduct a pregnancy test. The test measures the level of hCG (human chorionic gonadotropin) present, or the “beta number.” If you’re pregnant (!), the surrogate remains on their medications to ensure the pregnancy continues to grow. Around two to three weeks later, a heartbeat is confirmed via ultrasound. Near the end of the first trimester (10-11 weeks gestation), your surrogate will be weaned off medications and released to their own OB for prenatal care and regular checkups. The surrogate should sign a HIPAA release form so that you can receive medical updates from their OB throughout the pregnancy.
For more information, please visit our Resources page, which includes links to authoritative medical information on the IVF process.
The Legal Process
There are at least four different legal steps to this surrogacy process. We know that sucks. Our founder and director is an attorney, and even he knows that is not so fun. But they are all absolutely essential. For more detail, check out our blog post on the legal process.
Show More Information +To officially sign up with Brownstone, the intended parent(s) must sign an agreement with our agency. It essentially outlines the same process and mutual obligations stated on this website and we have done our best not to draft it in “legalese.” You are welcome to consult with an attorney prior to signing.
If you are using an egg or sperm donor, you will work with attorneys to form a donor agreement that, first and foremost, clearly states the intentions of the parties at the time of donation. A well-written contract will often exceed 20 pages and address, among other things, the expectation of both the donor and recipient that no rights be retained by the donor to the eggs/sperm, the embryos, and/or to the child or children resulting from the cycle.
The GSA, sometimes called a carrier agreement or contract, is an agreement between intended parent(s) and a gestational surrogate and their partner/spouse, if any. Both parties have independent counsel and are afforded sufficient time to draft, review, discuss, negotiate, and edit the agreement.
The contract addresses many issues, including but not limited to: (i) parental rights; (ii) control over medical decisions; (iii) conception and any genetic testing; (iv) payment of medical bills; (v) the carrier’s compensation and expenses; (vi) insurance; (vii) mental health counseling; (viii) delivery, travel, and medical instructions; (ix) termination or selective reduction; (x) the birth plan; and (xi) confidentiality.
The final contract is typically between 30 and 75 pages long! The process of drafting and negotiating is yet another check—the most important one—to ensure that all parties’ expectations and desires are aligned.
Brownstone (and New York law) requires that the intended parents execute a will that designates a guardian for all children born of the implanted embryos and names and authorizes an executor to perform the obligations of the intended parents under the agency agreement, the GSA, and the donor agreement (if applicable). Brownstone also requires that any international parents execute a power of attorney naming a local guardian for their newborn in the event they are unable to attend the birth.
As for your surrogate, our program requires that a surrogate execute a health care proxy and living will to specify an agent to make medical decisions for them if they become incapacitated, including instructions regarding whether they should be kept alive on life support for the benefit of the unborn baby if they suffer brain death while pregnant.
This is the most crucial step of the whole legal process—ensuring that your future children are, indeed, yours. The unfortunate thing is that the process for establishing your parentage varies by state, and even within one state may vary based on the sexual orientation, marital status, citizenship of the intended parent(s) or their genetic relationship to the child. Brownstone works to ensure your parental rights by considering these laws during the matching process and by referring you to attorneys with extensive experience in the relevant state. Your attorney will work with you during the second trimester of pregnancy to get all of your legal ducks in a row.
Typically, in the 47 states in which compensated gestational surrogacy may be practiced legally, the parentage process entails one or more of the following:
- Pre-Birth Orders (PBOs): In some states, parents can get a court order establishing them as the legal parents of the baby to be born.
- Post-Birth Orders: As the name implies, a post-birth order is similar to a pre-birth order, but is not issued until after the child is born. Although there is a gap in time between birth and legal parentage, the intended parents still take custody of the child immediately from birth and are responsible for the child.
- Second Parent Adoption: In some cases, certain intended parents will need to complete an adoption process to attain full parental rights.
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Brownstone Surrogacy is licensed as a surrogacy matching program by the New York State Department of Health. Our license number is GS221023. We are proud to be among the few agencies licensed by a governmental regulator.
“Gestation is a marvel, no matter how it is accomplished. But gestation isn’t the real magic. Love is the magic. Love is the only magic.” – Early: An Intimate History of Premature Birth and What It Teaches Us About Being Human by Sarah DiGregorio