Here’s Exactly What to Expect
At Brownstone, we believe in complete transparency. It is important that an agency be entirely upfront about what you should expect from start to finish. While the details may seem overwhelming at first, we’ll be with you every step of the way.
Below you will find additional details about key topics such as Brownstone’s screening process and matching process, and what to expect from the doctors, lawyers, accountants, and other professionals who will be involved along the way. As always, we’re happy to answer any questions you may have. Drop us a line!
Get into the nitty-gritty below 
The Screening Process
Brownstone’s screening process entails many steps—even more than other agencies—all designed to make sure that we minimize risks to your health, to the health of the baby, and to everyone’s emotional well-being. We have summarized the steps below, but for full details, please see our two blog posts on this topic (1 and 2).
In addition to the initial application and interview with Brownstone, the key steps include:
Show More Information +Shortly after you complete your application, we will ask you to sign medical records release forms so that Brownstone can obtain and review your complete prenatal and delivery records. We also ask your OB/GYN to verify that, in their medical opinion, you are healthy to carry a pregnancy again.
Brownstone will conduct a criminal and civil background check on you and everyone over 18 living in your home. We also ask that you retrieve your own credit report and share the results with us.
Once you have been medically cleared for surrogacy based on your paper records, you and your spouse, partner, or other primary support person will meet with a mental health professional experienced in surrogacy arrangements for a clinical interview and psychological assessment. The session is helpful to everyone because it is another step to ensure that you know what you are signing up for and are truly ready.
If you have insurance, we ask that you share with us the policy booklet from your insurance provider. Brownstone uses an insurance brokerage company specializing in surrogacy arrangements to review your insurance and give us a clear picture of what the policy will and will not cover and what additional insurance may be necessary.
After you have met with and matched with your intended parents (as described below), you will travel to their IVF clinic for a screening with their reproductive endocrinologist. This screening generally a uterine evaluation (a saline sonogram or HSG), blood work to test for communicable infectious diseases like STIs, a urine screen, and a consultation with the doctor on the risks of pregnancy via IVF and what to expect medically. The clinic’s screening process may also include a “mock cycle” of IVF injections to allow the doctor to evaluate your specific reaction to the medications. Around this time, you, your partner, spouse, or support person, and your intended parents will all meet together with a social worker or therapist for a group counseling session.
We do offer the intended parents the option to have Brownstone conduct reference checks or conduct an in-person or virtual home visit. While not common, you should be aware that this can occur and the selection of these options by the parents is not a reflection on you or your fitness as a surrogate. With reference checks, we ask you to provide us with the contact information for two to three individuals with whom you have discussed your plan to pursue surrogacy—family, friend, and/or colleague. With the home visit, we’re not applying any “white glove” test to your home—so don’t worry about disorganized closets—but rather forming a general opinion of the place the baby will be “living in utero.” It also gives us a chance to chat further about the whole process with you and your support person.
You may be wondering: I go through all of these screening steps, what do the intended parents have to do by way of screening? Unsurprisingly a lot less, since they are not preparing for pregnancy. That said, Brownstone requires more of its intended parents than most agencies, not to judge who should be parents but to make sure you are informed at match about who you will be helping through this unique and intense journey.
We run the same criminal and civil background checks on the intended parents that we do on you and the adults in your household. A mental health professional will also conduct a psychological consult with the parents in order to help us understand upfront any special considerations about the parents’ personal history and mental health that should be considered. Your relationship with your intended parents, and theirs with you, really matters, and the more information we all have about everyone’s previous experiences, feelings and expectations, the better the match we can make and the better the relationship will be!
The Matching Process
As soon as you start the screening process, we are already beginning to consider you for all of our waiting intended parents and them for you. 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 parents and surrogates 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 Rubella, some of which may be recommended or required by an obstetrician
- Your preferences (if any) for a surrogate/intended parent local to you
- Whether your state’s parentage laws are appropriate for certain intended parents
- Your desired levels of communication
- Your preferences (if any) for an intended parent with a particular profile (single vs. partnered/married; straight vs. LGBTQ+; domestic vs. international; younger vs. older)
- 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 intended parents tell us otherwise. Once we have identified intended parents we believe are a perfect match for you, we show you their profile. It will include some photos, background information, and a “Dear Surrogate” letter we ask them to draft. If you want to move forward with them, only then will we send them your profile for their review. This profile will also include photos, background information, and a “Dear Parent” letter (written with our guidance), plus details about your compensation expectations and insurance coverage. If there is anything from the background checks, psychological evaluations, or medical histories that we can and should disclose, we always will. In both directions, surrogates and parents are not presented with a “pool” of potential matches; the match is individualized and customized.
If the intended parents also show interest in pursuing the match, we will schedule a video chat between you and the parents. 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 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!
Compensation and Schedules
The various compensations, supports, benefits, and reimbursements that Brownstone surrogates can expect to receive are detailed here. But we think it is also important that you understand when and how you are paid throughout the process. Everything is handled professionally and you’ll never be stuck with an unpaid bill.
Show More Information +At the very minimum, nothing you require throughout the process should come out of your pocket. Everything Brownstone does to screen you prior to the match, we pay for. And once you are matched, your intended parents are paying for your travel expenses (and those of your support person), your medical screening, your attorney, and your medical, life, and disability insurance.
The intended parents are required to fund an escrow account managed by a professional escrow agent. Once the main contract—the gestational surrogacy agreement (GSA)—is in place, the escrow agent follows the terms of your contract to disburse your compensation and reimburse you for any out-of-pocket expenses. Typically, you can expect:
- Base compensation paid out in equal monthly installments starting at the heartbeat confirmation.
- For example, if your base compensation is $50,000, you would receive $6,250 per month over 8 months starting at heartbeat confirmation (around the six-week mark) with any balance paid out in a lump sum post-birth.
- Additional compensation paid out at the appropriate time
- For example, while your monthly allowance will be paid, well…monthly, the embryo transfer fee would be paid out shortly after the transfer, the maternity clothing allowance would be paid at the end of the first trimester, and child care and lost wages would be paid if and when you incur that cost (e.g., when you are put on bed rest or have to travel out-of-state for an appointment).
- Expenses or reimbursements paid out when you provide receipts
- For example, after an appointment was run through your insurance plan, whatever co-pay, deductible, or other out-of-pocket charge remains is submitted to the escrow agent and promptly paid from the funds in your intended parents’ account.
- Gifts and goodies sent throughout the process (pre-transfer to postpartum)
As a surrogate, you will be able to login and see a real-time accounting of payments made to you. If your intended parents’ escrow account were to dip below a set amount, Brownstone would prompt them to add additional funds. We require that the parents keep the escrow account open for many months after your delivery to cover any outstanding bills from the hospital. At the end of the day, you will never be stuck with a bill. That’s our promise.
Third Party Professionals (Lawyers, Psychologists, 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.
Brownstone works the leading insurance agencies for the ART community. In a nutshell, if you have your own insurance, we will send your policy booklet to the experts for review. They will advise as to whether it is likely to be usable for a surrogacy and, if usable, will potentially recommend a backup policy. If your insurance is not usable (or you do not have insurance at all), the experts will make a recommendation on a private insurance policy your intended parents can purchase to cover the pregnancy, whether through the Affordable Care Act (ACA) exchanges during open enrollment, or through policies designed to cover surrogacy pregnancies.
Brownstone works exclusively with independent escrow managers so that you and your intended parents can both be assured that disbursements are handled professionally according to the terms of 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 a NY-licensed attorney, we prefer to give you and your intended parents the added peace of mind and transparency of the professional and user-friendly services of these experts.
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 expertise in infertility, donor conception, and surrogacy. For our surrogates, we also offer individualized attention from a former surrogate and monthly support groups. We require that our intended parents provide you at least $1,000 specifically for mental health support expenses as part of our program.
Sometimes our surrogates prefer to work with a doula, midwife, dietician, chiropractor, or other medical professional as part of their pregnancy experience. Sometimes our intended parents have that desire. In either case, so long as the other party is on board, Brownstone can help you locate those individuals or practices. We consider these preferences as part of our matching process as well.
The Medical Process
You’ve been pregnant and delivered before, but you might be wondering: What does the medical process look like for surrogacy? Take a look at our blog post on the medical process for even more detail, but here is a brief overview of what you can expect from a medical perspective:
Show More Information +Once you have passed the in-person screening, the IVF doctor will create a medical protocol and schedule to prepare you for transfer. This month-long protocol will include about 2-4 monitoring appointments at a clinic local to you (if you don’t live near your intended parents’ clinic), a few medications, and some ultrasounds and blood draws. Each case and clinic varies in its approach, but the medications typically include various pills, injections, suppositories, and/or patches:
- Birth Control – to regulate the timing of your menstrual cycle
- Estrogen – to build your uterine lining
- Lupron – to suppress your ability to ovulate short term
- Progesterone – to help the embryo stick to the uterine wall
- Antibiotics – to fight off any infection that could interfere with implantation
- Steroids – to prevent inflammation of the uterine lining and rejection of the embryo
- Low-dose aspirin – to improve uterine blood flow
- Vitamins and supplements
As most surrogates will attest, the annoying parts of this process are the intramuscular progesterone in oil (PiO) injections which can leave your hips or butt quite sore, and just keeping track of all of the medications and appointments.
The embryo transfer itself is quick and relatively painless. The IVF doctor inserts the embryo into your uterus through a small catheter and with the guidance of an ultrasound. No anesthesia or recovery time is needed. Most surrogates report that the worst part is having an uncomfortably full bladder and not being allowed to pee until after the transfer. You will have a few restrictions on your movement that same day, but are not likely to be on bed rest, and you can usually travel home shortly thereafter.
After the transfer, you will continue to be monitored by your local clinic. Post-transfer monitoring involves blood tests and ultrasound scans, including, at about 10 days post-transfer, a pregnancy test! If you’re pregnant (!), you remain on the 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 weeks gestation), you will be weaned off medications (hooray—no more shots!) and released to your own OB/GYN for prenatal care and regular checkups. From here on out, it should be pregnancy as you already know (and love?) it. We just ask that you sign a HIPAA release form at your OB/GYN practice so that parents can receive medical updates from your OB/GYN during the pregnancy.
For more information, please visit our Resources page, which includes links to authoritative medical information on the IVF process.
The Legal Process
For surrogates, there are three different legal steps to this surrogacy process. We know that sucks. Our founder and director is a lawyer, and even he knows that’s not so fun. But they are all absolutely essential. Please see our blog post on the legal nitty-gritty, but here’s an overview:
Show More Information +The GSA, sometimes called a carrier agreement or contract, is an agreement between the 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 a few things to be incorporated into the intended parents’ will, including that they designate a guardian for all children born from the surrogacy process and that they designate an executor to fulfill their duties under the contract with you. We also suggest that the intended parents pay for an attorney for you to help you express your wishes as to medical treatment in terminal illness or injury situations and to specify an agent to make medical decisions for you should you become incapacitated.
Finally, we need to make sure that the intended parents have the rights to and obligations of any children resulting from the surrogacy arrangement and, correspondingly, that you are never obligated to support this baby after birth. The process for establishing the parental rights of your intended parents can vary widely by state and based on the parents’ identities. Brownstone ensures their rights by considering their identity and your state’s laws at the matching stage and by insisting that all parties have experienced attorneys who will work with you during the second trimester of pregnancy to get all of the legal ducks in order.
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