From Considering Gestational Surrogacy to Delivery

Whether you have been a surrogate before or today is the first time you have considered it, working with Forward Fertility, you will find support, clear communication, and competitive compensation.

Meet Christie Olsen, the Nurse Practitioner who founded Forward Fertility and whose expertise and compassion will guide your experience as a surrogate from start to finish.

The Seven Steps for Gestational Surrogates shown below outlines the process from application to delivery. In general, from application to delivery takes a little longer than a year, in most cases.


If after reading about being a gestational surrogate you are interested in applying, complete the screening questions. Once the screening application is received and reviewed, you will receive an email directing you to the next step: either inviting you to complete the full application, asking you for additional information, or letting you know that your application was not accepted.

If you are invited to complete the full application, you will receive a link to a detailed application reviewing your health history, personal preferences, and social history. Once the full application has been received and reviewed, you will receive an email directing you to the next step: setting up an interview, asking you for additional information, or letting you know your application was not accepted.

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Christie Olsen, Nurse Practitioner & Founder of Forward Fertility, LLC

Christie Olsen, Nurse Practitioner & Founder of Forward Fertility, LLC

If your application is accepted, you will receive an email with a records release that allows you to request your medical records be sent to Forward Fertility. You may need to request records from more than one medical provider. Christie will call you to schedule an in-person meeting with you in your home. If you have a partner/spouse/significant other, she or he will also need to be present for the interview, as his or her support is critical. No need to take off work or move your schedule around — Christie will work with you to find a time that is convenient.The meeting typically takes less than two hours and is an opportunity to ask questions, clarify the process, and review your application. After the meeting and after reviewing your medical records, Christie will contact you to discuss any additional questions and to determine if you and Forward Fertility are a good match.

Learn more about Christie here.

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Now that Forward Fertility has connected with you – it is time to match you with the right recipient. Most gestational surrogates will be matched within two to four months, but the process can be as quick as a few weeks. Factors taken into consideration include your travel preferences, your willingness to carry twins, and individual feelings about critical decisions (such as selective reduction or genetic testing).

A good match between a gestational surrogate and parents-to-be is like any good relationship: both parties contribute to the quality and the relationship will grow and evolve over time. When each participant makes kind, honest, genuine efforts to build a solid relationship based on respect and trust, the outcome is best.

Forward Fertility works hard to facilitate that relationship and will be her for you to celebrate the successes and hurdle the obstacles.

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Before treatment begins, you will undergo a medical screening, meet with a mental health professional, and sign legal contracts.

Medical Screening.

As the gestational surrogate, you will typically meet with a medical provider at the fertility clinic to review the process and obtain informed consent. The fertility clinic will likely require you to complete some tests, including infectious disease testing, blood type, thyroid level, other hormone levels. Usually, there is also an evaluation of the uterus called a Sonohysterogram or a Hysteroscopy to ensure the uterus is healthy and able to carry another child.

Meeting with a Psychologist or mental health specialist.

The American Society of Reproductive Medicine is the guiding organization for fertility treatment in the United States. Their guidelines strongly suggest the gestational surrogate and her partner (if one is present) meet with a qualified mental health professional prior to beginning treatment. Forward Fertility supports these guidelines and requires all surrogates to complete this screening. Forward Fertility has worked with numerous psychologists and mental health professionals who are knowledgeable about the fertility process and assessing gestational surrogates. The meeting will give you and your partner an opportunity to discuss your decision to become a surrogate, your support system, current stressors in your life, your partner’s feelings, and your ability and strategies to navigate the relationship with the parents-to-be.

Legal Contract.

You and the Parents to Be will agree upon the terms of the Gestational Surrogacy Agreement. This agreement is a legal contract that discusses the rights and responsibilities of each party. Forward Fertility will connect you with an attorney who has expertise in the field of gestational surrogacy and assisted reproductive technology.
Topics addressed in the agreement include, but are not limited to your compensation, the parameters for getting pregnant, details of the delivery, and more.

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You probably didn’t learn how gestational surrogates get pregnant in your high school health class.

The basic process for getting pregnant via gestational surrogacy can be boiled down to three goals for the gestational surrogate. These goals are coordinated by Forward Fertility under the guidance and instruction from the medical team at the fertility clinic where you will be getting your care.

Triple Layer or Multilayered Endometrial Lining

Goal one: Keep the gestational surrogate’s body from ovulating.
Most women, when they are not on hormonal birth control, will mature one egg each month and release it. That process is called ovulation. When you are a gestational surrogate, we don’t want your body to do that. So, medications are used to keep your ovaries on “vacation” so to speak.

Goal two: Thicken the gestational surrogate’s uterine lining
Once the fertility clinic medical staff have confirmed you are not ovulating, they will give you medications to take that will temporarily thicken your uterine lining. After a set amount of time, you will return to the clinic so the medical staff can assess your uterine lining and confirm your ovaries are still at rest. If the ultrasound shows that your uterine lining has responded the way the medical staff would like, then you move on to goal three.

Goal three: Transfer one or more embryos into your uterus at the right time.
You will be instructed by the fertility clinic to begin progesterone medication and return on a particular day for the embryo transfer. The embryo or embryos must be placed into the uterus on the right day; this day is determined by the stage of the embryo and how many days you have been taking progesterone. You will usually have a blood pregnancy test in the clinic about ten to twelve days after the embryo transfer.

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Singleton pregnancy, 7 weeks from last period. Yolk sac present.

They say every pregnancy is different. A pregnancy as a gestational surrogate is surely unlike any pregnancy you have had with your own children. A whole team of people helped make this pregnancy possible: the medical staff at the fertility clinic, attorneys, psychologists, your support network, the Parents to Be, and you.

That means many emotions are present. Mostly, there is happiness and excitement. But, you should also be prepared for other feelings. Some mothers-to-be who have had multiple miscarriages may associate your positive pregnancy test with the beginning of a time for worry. Some gestational surrogates say they feel an enormous sense of responsibility, as if so much is riding on their every move.

The fertility clinic will refer you to your standard OB provider around seven to nine weeks from your last period, usually after an ultrasound has been performed to confirm the fetal heartbeat.Depending on what you have specified in the legal contract, the Parents to Be may or may not be in the delivery room. A woman in labor can have specific desires, but with surrogacy, medical decision making is often a group effort. Labor is a dynamic process and sometimes decisions must be made in the moment about interventions during labor or after the delivery. Forward Fertility is present to help navigate these decisions and advocate for you as the surrogate, parents-to-be, and the baby being born.

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Surrogate, sibling, and friend or mom, 262x174You have been the center of attention for the Parents to Be for the last nine months, but now they will be turning their focus to the little bundle of joy they have dreamed of having.The relationship between you, the parents, and the child certainly changes after the delivery. Perhaps you are an “auntie” or maybe receiving limited updates of the baby is what you have agreed upon. Your own family will likely welcome you back into the fold of family life. Recovering from the delivery and looking ahead for yourself and your family will be your focus.

Each gestational surrogacy match is different. Sometimes, the two families become very close. Other times, they tend to go their separate ways, always cherishing the chapter of the book they shared creating that little boy or girl.

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