Before Surrogacy

Why it’s done

There are many reasons people choose surrogacy:

. Health issues prevent a woman from getting pregnant or carrying a pregnancy to term.

. Infertility issues prevent couples from either getting or staying pregnant, like recurrent miscarriages.

. Same-sex couples wish to have children. This may be two men, but women also find this option attractive because the egg and resulting embryo from one partner can be transferred and carried by the other partner.

. Single people want to have biological children.

Criteria for becoming a surrogate

The qualifications for being a gestational surrogate vary by agency, but they involve things like:

. Age. Candidates must be between the ages of 21 and 45 years old. Again, the specific range varies by location.

. Reproductive background. They also have to have carried at least one pregnancy — without complications — to term but have fewer than five vaginal deliveries and two cesarean sections.

. Lifestyle. Surrogates must live in a supportive home environment, as confirmed by a home study. Drug and alcohol abuse are other considerations.

. Tests. Additionally, potential surrogates must have a mental health screening, a complete physical — including screening for sexually transmitted infections (STIs).

Intended parents have certain requirements to meet as well. These involve:

. Providing complete health histories

. Having physical exams to ensure they can successfully go through in vitro fertilization retrieval cycles.

. Screening for infectious disease

. Testing for certain genetic diseases that could be passed to a child.

Mental health counseling is also recommended to cover things like expectations from surrogacy, addiction, abuse, and other psychological issues.

Using a Surrogate

A surrogate should get a medical exam to check that she’s likely to have a healthy, full-term pregnancy. The organization suggests she gets tests that check for infectious diseases such as syphilis, gonorrhea, chlamydia, HIV, cytomegalovirus, and hepatitis B and C.

Surrogates should get tests to make sure they have immunity to measles, rubella (German measles), and chickenpox. Also, you may want to ask that she get a medical procedure to visually “map” the uterus, which can help the doctor check her potential to carry a pregnancy. A surrogate mother should have her own doctor during pregnancy rather than use yours.

How to find a surrogate

Some people find a friend or family member who’s willing to serve as a surrogate. Others turn to surrogacy agencies to find a good match. Agencies first screen candidates to ensure they meet the criteria associated with the process. Then they cross-match your own wants/needs to find the best situation for your family.

Does a Surrogate Mother Share DNA with the Baby?

It depends on what type of surrogacy you need. In traditional surrogacy, there is a DNA connection between the child and the surrogate mother, while in gestational surrogacy, there is no genetic or DNA connection between the child and the surrogate mother.

What are the possible risks of using a surrogate mother?

A surrogate mother can experience the same medical complications during pregnancy as other expectant women. Some of these health complications include:

. Gestational diabetes

. Preeclampsia

. Eclampsia

. HELLP syndrome

The surrogate mother will be the only one who can give consent to any medical care decisions that arise during the pregnancy.

There are also potential legal risks, in particular surrounding parental rights when traditional surrogates are used. For gestational surrogacy, you and your partner will be the legal parents after your baby is born, but you’ll need to consult a lawyer in advance to check the laws in your country.

Surrogacy Pros and Cons for Intended Parents

Pros:

Here are just a few of the advantages of surrogacy for intended parents:

. Surrogacy completes families. For those who have struggled with infertility, LGBT couples, and those with medical conditions that make pregnancy unsafe, surrogacy is often the answer to years of unsuccessful attempts to create a family.

. Surrogacy allows for genetic connections. Gestational surrogacy often enables one or both parents to maintain a biological relationship with their child.

. Surrogacy creates relationships. Many intended parents become close with their surrogate and her family during the process, developing meaningful bonds that can last a lifetime.

. Surrogacy involves few surprises. A legally binding contract outlining everyone’s expectations will be negotiated and signed prior to the embryo transfer, so everyone will know exactly what to expect during the surrogacy process. A court order is obtained prior to birth of the child, confirming the intended parents’ legal rights.

. Surrogacy ensures you are involved. Intended parents are often able to be involved in their surrogate’s pregnancy, attending key appointments and being present for important milestones, including the embryo transfer and birth.

. Surrogacy is likely to be successful. Surrogates have a proven track record of carrying healthy pregnancies, which often makes surrogacy more likely to be successful than fertility treatments for intended parents.

Cons:

While there are many surrogacy pros for intended parents, there are also some disadvantages of surrogacy for hopeful parents to consider:

. Surrogacy can be complicated. Gestational surrogacy involves complex medical procedures, and surrogacy laws. Legal processes can be overwhelming at times. It is important to work closely with a trusted professional to ensure the process is completed safely and legally.

. Surrogacy costs can be significant. Because of the number of people and services required to complete a successful surrogacy, surrogacy can be expensive.

. Surrogacy requires you to let go of some control. While intended parents typically enjoy a greater sense of control and involvement than families pursuing adoption, you will need to relinquish some control and trust your surrogate to carry the pregnancy for you.

Legal Requirements for Surrogates

One of the most important requirements in any surrogacy arrangement is the legal contract. Every surrogacy agreement is different depending on your circumstances and your relationship with the intended parents. Your specific legal rights and obligations will be outlined in your contract.

Prior to beginning any medical procedures, you and the intended parents must agree to and sign the contract, which will clearly outline all of the legal aspects of the surrogacy, including:

. Compensation

. Possible risks

. Your responsibilities as the surrogate

. Relinquishment of the child

. And more

In most cases, the intended parents’ attorney will draft the contract. You will then review the contract with you own attorney to ensure that all of your requests have been included. Once all necessary revisions have been made and both parties agree to the terms of the contract, you and the intended parents will sign the paperwork and the contract becomes legally binding. At that point, you can begin receiving payments and prepare for the embryo transfer.

Types of Surrogacy in Iran

The term “surrogacy” is generally used to describe a couple different scenarios.

. A gestational carrier carries a pregnancy for an individual or couple using an egg that is not the carrier’s. The egg may come from either the intended mother or a donor. Likewise, sperm may come from the intended father or a donor. Pregnancy is achieved through in vitro fertilization (IVF).

. A traditional surrogate both donates her own egg and carries a pregnancy for an individual or couple. The pregnancy is usually achieved through intrauterine insemination (IUI) with sperm from the intended father. Donor sperm may also be used.

Gestational carriers are now more common than traditional surrogates. Why is this? Since a traditional surrogate donates her own egg, she is technically also the biological mother of the child.

While this can definitely work out just fine, it can create complex legal and emotional issues.

Surrogacy in Iran Step-by-step

Once you’ve found a surrogate, achieving pregnancy differs depending on what type of surrogate you use.

With gestational carriers, the process looks something like this:

. Choose a surrogate, usually through an agency.

. Create a legal contract and have it reviewed.

. Go through the egg retrieval process (if using intended mother’s eggs) or obtain donor eggs. Create embryos using intended father’s sperm or donor sperm.

. Transfer embryos to the gestational carrier (surrogate) and then — if it sticks — follow the pregnancy. If it doesn’t work out, the intended parents and surrogate may pursue another IVF cycle.

. The child is born, at which time the intended parents obtain full legal custody as outlined in the legal contract.

Traditional surrogates, on the other hand, are also donating their eggs, so IVF is usually not involved in the process.

. Choose a surrogate.

. Create a legal contract and have it reviewed.

. Go through the IUI process using the intended father’s sperm or donor sperm.

. Follow the pregnancy or — if the first cycle doesn’t work out — try again.

. The child is born. The surrogate may need to legally terminate parental rights to the child, and the intended parents may need to complete a stepparent adoption in addition to any legal contract set up in earlier stages of the process.

After Surrogacy in Iran

Unanticipated issues with surrogacy

When planning surrogacy, everything may seem quite straightforward. However, it’s important to note that as with most things in life, there are opportunities for issues to arise and make things tricky.

Some considerations:

. IVF or IUI isn’t a guarantee of pregnancy. Sometimes these procedures don’t work on the first or even subsequent tries. You may need several cycles to achieve pregnancy.

. We don’t mean to be a Debbie Downer here. But another consideration is that even if pregnancy occurs, miscarriages are possible.

. Just as with the traditional pregnancy-to-parenthood path, there is always a chance for health issues with the baby or complications with the surrogate or actual birth.

. Pregnancy with IVF and IUI may result in multiples — twins or triplets.

. While home studies and psychological evaluations are part of the screening process, they can’t guarantee that surrogates won’t engage in behaviors you may consider risky. (On the other hand, most surrogates carry babies out of a desire to bring the joy of parenthood to people who might not experience it otherwise.)

A note to those considering being a surrogate

There are various ways that being a surrogate may make sense in your lifestyle. You may find the money appealing or feel fulfilled giving a couple something they may not be able to achieve without your help.

Still, it’s a big decision. We outline a few things to consider before applying to be a surrogate.

. You’ll need to meet all the minimum requirements — including those regarding age, health status, reproductive history, and psychological status — that may vary by agency.

. You’ll need to be ok with giving up control during the pregnancy. While it’s your body, what happens during the pregnancy isn’t entirely up to you. This involves things like testing that you may not choose for yourself but that the intended parents may wish to undergo.

. You’ll also need to think about the process itself. Getting pregnant via IVF takes a number of procedures and medications. Consider how you’ll feel about taking injectable and oral drugs and hormones.

. You’ll want to consider if your own family is complete. Do you want more children? Understand that with each pregnancy and with advancing age, more risks for complications can arise that might impact your fertility.

. You’ll need to get input from the rest of your family as well. How does your partner feel about surrogacy? What about your children?

There aren’t necessarily right or wrong answers to questions you need to ask yourself — these are just things to consider. Surrogacy can be a wonderful process and gift.

Who is a Good Candidate for Surrogacy in Iran?

. Congenital or acquired absence of uterus: Some women do not congenitally have a uterus. But some people have had their uterus removed due to diseases such as uterine or cervical cancer.

. Abnormal and improper structure of the uterus: Sometimes the uterus is congenitally abnormal and does not allow the fetus to implant. Sometimes the uterus is no longer suitable for pregnancy due to infection, severe adhesions, and large fibroids created during various surgeries.

. Repeated failure of infertility treatments despite proper fetuses: In some cases, couples may fail to conceive after several IVF and ICSI cycles despite good embryo quality.

. Repeated miscarriages for unknown reasons.

. Having diseases that cause high-risk pregnancy: The presence of underlying diseases such as advanced heart failure, diabetes, and kidney failure in the mother makes pregnancy dangerous for her. In addition, some patients, such as those with cancer, need to take medications that can affect the health of the fetus.

What are the Characteristics of a Surrogacy Volunteer?

To increase the chances of a successful pregnancy, a person with a uterus must have certain characteristics and conditions. These conditions are:

. Proper age: The volunteer must be under 35 years old. Because with increasing age, the possibility of embryo implantation in the uterus decreases.

. History of a successful pregnancy: The surrogate mother must have at least one child. This will give you more confidence.

. Physical health: The candidate must be in good physical health. Having diabetes, high blood pressure, heart disease, etc., which can affect the pregnancy process, can remove the volunteer from the list. In addition to addiction, alcohol consumption, sexually transmitted infections also prevent the volunteer from continuing the process.

. Mental health: The surrogate uterus is a psychologically complex issue. Therefore, the candidate should be examined in terms of mental health, marital stability, personality stability, and mental illness. If mental health is not approved, the person will be removed from the list of volunteers.

. Fully familiar with the legal issues of surrogacy: The candidate must be familiar with all aspects and legal issues of this work and read and approve all necessary contracts. One of the most important legal issues in surrogacy is the delivery of the baby to the parents after birth.

What Factors Influence the Success of a Surrogacy Procedure?

The success of an alternative uterine procedure depends more than anything on the quality of the egg. Therefore, the age of the person from whom the eggs are taken is very effective in the success of this method. The rate of miscarriage in 35-year-old mothers is 15%, 35-40 years old 20%, and more than 40 years old up to about 40%.

In addition, the health of the surrogate uterus is critical to the success of the pregnancy. For this reason, a successful pregnancy history is one of the conditions for choosing the right person as a surrogate mother. Another factor that can affect the success of surrogacy is the skill of the treatment center and specialist physician. Therefore, you should be more careful in choosing a medical center and doctor.

Types of Contracts in Surrogacy

In order for the infertile couple and the owner of the uterus to trust each other and to ensure that the parties adhere to their obligations, prior to the transfer of the fetus to the surrogate mother, a contract is made between the infertile couple, the uterus owner, and her spouse. In this contract, the uterus owner undertakes to carry the fetus and give birth to it and deliver it to the couple after birth.

On the other hand, infertile couples have different obligations depending on the type of contract. These obligations depending on the type of contract are:

. Commercial contract: In this type of contract, the infertile couple pays the volunteer an amount of money in exchange for the uterus.

. Friendly contract: In this type of contract, the uterus owner has only an altruistic motive and does not receive any payment from the infertile couple for her obligations. In most cases, the volunteers are close relatives of the infertile couple. In this type of contract, the infertile couple is usually responsible for paying for food and medical care for the person with the uterus. It is recommended to think about all the aspects before concluding the contract and consider a guarantee in the contract for any case you are concerned about.

Types of Surrogacy 

The term “surrogacy” is generally used to describe a couple different scenarios.

. A gestational carrier carries a pregnancy for an individual or couple using an egg that is not the carrier’s. The egg may come from either the intended mother or a donor. Likewise, sperm may come from the intended father or a donor. Pregnancy is achieved through in vitro fertilization (IVF).

. A traditional surrogate both donates her own egg and carries a pregnancy for an individual or couple. The pregnancy is usually achieved through intrauterine insemination (IUI) with sperm from the intended father. Donor sperm may also be used.

Gestational carriers are now more common than traditional surrogates. Why is this? Since a traditional surrogate donates her own egg, she is technically also the biological mother of the child.

While this can definitely work out just fine, it can create complex legal and emotional issues.

The Advantage of Surrogacy in Iran

. Surrogacy helps childless couples achieve their long-standing dream of having a baby, which leads to family survival. This will pave the way for reducing divorce rates and solving the problems of infertile couples.

. The baby produced by this method has all the characteristics of its parents genetically. Therefore, surrogacy is probably the most well-known alternative family-building method to adoption.

. This method helps women who do not have ovulation problems and have other fertility problems to get pregnant.

. Jurisprudentially, a child raised through surrogacy is considered legitimate.

. One of the most important advantages of surrogacy in Iran is its affordable cost.

The Disadvantage of Surrogacy in Iran

. Society has not yet accepted this method, and many people are unaware of it. Therefore, there is no proper social view toward the surrogate mother.

. The surrogate mother and her family, as well as the intended parents, may struggle with many emotional and psychological problems.

. The possibility of financial, legal, and medical abuse in this method has not been ruled out, which is claimed by the expansion of the brokerage market in this area.

The Disadvantage of Surrogacy in Iran

. Society has not yet accepted this method, and many people are unaware of it. As a result, there is not a proper social view toward the person who carries a baby for an infertile couple.

. The surrogate mother and her family, as well as the intended parents, may go through many psychological problems.

. The possibility of legal, financial, and medical abuse in this method has not been ruled out, which is claimed by the expansion of the brokerage market in this area.

Does a Surrogate Mother Share DNA with the Baby?

Depends on the surrogacy method you need. In traditional surrogacy, there is a DNA connection between the child and surrogate mother. In gestational surrogacy, there is not any genetic or DNA connection between the child and surrogate mother.

Process of Surrogacy in Iran

In Iran, surrogacy is done in 8 steps:

. Finding the right fertility center and infertility institute

The first step in surrogacy is choosing a facilitated fertility clinic or a good infertility institute. It is worth mentioning that the fertility clinic only performs the in vitro fertilization of sperm and egg. Still, the infertility institute also bears other responsibilities, such as catching up on the paper works of surrogacy.

. Medical examinations

In the next step, the intended parents and the surrogate mother should take medical and physical tests, most of which are performed by specialists at the clinic or institute.

. Genetic counseling

Genetic counseling is one of the most important stages of surrogacy because, in the counseling sessions, both parties’ inherited diseases and disorders are identified.

. Getting legal advice

Getting legal advice and being aware of the regulations and conventions of surrogacy puts an end to most concerns about legal issues of this method.

. Choosing an egg donor

If the couple needs a donated egg for surrogacy, they can either receive it from the egg bank of the infertility institute or ask for an egg donor. We should mention that the egg donor must undergo clinical screening before donating the egg.

. Choosing a surrogate mother

At this stage, the couple can find the surrogate mother on their own or choose one of the surrogates suggested by the infertility institute. In any case, the gestational surrogate should take medical and psychiatric tests and provide a complete medical history to the doctor.

. Medical process

Before starting the surrogacy process, one of the assisted reproduction methods, such as IVF or IUI, should be chosen for fertilizing the egg. When doctors fertilize the egg, it can be transferred to the surrogate’s womb.

. Pregnancy and Birth

About 15 days after transferring the embryo, the surrogate should take a pregnancy test to confirm the pregnancy. If the surrogate gets pregnant, she will be fully supported by the team of the infertility institution and, of course, the biological parents. Finally, after the birth, the baby is handed over to the intended parent as was agreed.

How Long Does the Surrogacy Process Take in Iran?

Surrogacy is a relatively long and complicated procedure, so you should be patient and realistic when choosing this infertility treatment method. The surrogacy process can take approximately 15 to 20 months, from the day you submit the initial application form to find a surrogate mother to the day you hold your baby.

Surrogacy Success Rate

Before the IVF procedure and embryo transfer, several medical evaluations are performed on the gestational surrogate to ensure that her body is ready to receive the embryo. Therefore, when the doctors confirm pregnancy, the chance of having a healthy baby is more than 95%. However, some factors affect the success rate of surrogacy, including:

. The quality of sperm and eggs

. The surrogate’s ability to carry a baby for nine months

. The age of the surrogate and biological parents

. The process of egg fertilization

. In the case of egg donation, the age and health condition of the egg donor.

Surrogacy Review in Iran

Nadia’s successful experience with surrogacy and egg donation in Iran (2022)

Due to a past medical issue, Nadia had a hysterectomy and came to us for surrogacy. We will share her treatment journey in Iran including ultrasound and BHCG test results that indicate a positive pregnancy.

Read more about Nadia’s successful experience with surrogacy and egg donation in Iran (Review 2022)

Read more about : Nadia’s successful experience with surrogacy and egg donation in Iran (Review 2022)

The Final Word

Why surrogacy cost in Iran is by far lower than in other countries?

The low price of surrogacy in Iran is due to the devaluation of the Iranian currency (Rial) since 2019. While in many countries an infertile couple must pay tens of thousands of dollars and nearly $100,000 in the United States, surrogacy in Iran usually costs less than $10,000.