Surrogate Mother Selection Criteria

In reality, it is not that simple to formulate the golden standards for the surrogate mother selection. Criteria can sometimes  be different across the countries and agencies. However, it is important that intended parents have the general understanding and have an idea of what should they expect and how their surrogate mother is controlled before being finally  chosen for the program.

Intended parents need to be ensured that the agency will do it’s best, double check medical condition of the surrogate mother and choose the most appropriate candidate with the highest likelihood of success.

Does not matter whether baby is genetically connected to the surrogate mother or not. There exist a number of medical complications and conditions  which may occur or transmit  while the baby is being carried by the surrogate.

Most of the surrogacy agencies will require that surrogate mother does or provides the results of routine medical tests, such as : complete blood count, HIV test, hepatitis C,  measurement of hormone levels, pap smear test  and more.

The list of tests and requirements may vary across countries and agencies.  In some cases, apart from the ordinary tests, the surrogate should provide additional reports:


  • Chest X-ray and the conclusion that surrogate does not have tuberculosis.
  • Conclusion from the breast physician.
  • It is often required that the surrogate mother has her own children. It is important to check the report from the pediatrician and make sure that surrogate’s biological children are healthy and do  not have any medical problems.
  • Conclusion from the narcologist.
  • Report from the psychologist – yes, it is important to know that a surrogate mother is mentally healthy and completely ready to get started with the program and such a responsible journey.
  • The reports should of course include the final conclusion that the surrogate mother is healthy and does not have any pregnancy related issues.


During the introduction to the agency and the preliminary discussion, intended parents can require the list of surrogate mother selection criteria and double check that their candidate is satisfying them.

Huge amount of tests does not necessarily mean more qualitative check up and service. It is crucial that all of the tests have their purpose and are connected to the pregnancy. Intended parents should not hesitate to ask as many questions as needed and desired.


HIV and Surrogacy

Human immunodeficiency virus (HIV) is a kind of a virus that attacks immune system. Immune system is body’s way of fighting illnesses, bacteria, any unknown or threatening viruses. As HIV destroys the immune system, more concretely the cell called T-helper, body becomes gradually less capable to deal with infections and diseases.


HIV and surrogacy

HIV is found in breast milk, vaginal fluids and blood. For that reason, when we talk about HIV and surrogacy,in sake of safety, we refer to intended biological fathers only. As for males, HIV is found in semen, but after a procedure called ”sperm washing”, it is safe to proceed with IVF. Sperm itself, is resistant to HIV virus.


Sperm washing

During sperm washing, sperm is separated from semen. The procedure removes dead sperm, debris, white blood cells and other chemicals that may lead to unexpected or undesired reactions and results during IVF. Sperm washing is performed not only in case of HIV, but also when males have lower sperm count or decreased sperm mobility, even when they experience unexplained infertility.

Sperm wash is usually performed in IVF clinics. The method may vary according to the clinic and individual characteristics of each case. Techniques include: centrifugation wash, density gradient wash and swim up technique.

After the molecular based sperm wash is performed, the clinic will usually double check the sample on HIV virus. After completing and confirming the procedure successfully, there is practically no chance of transmitting the HIV either to carrier(intended mother/ surrogate) or to the baby.

As sperm washing requires special equipment, different facilities and strong skills. Surrogacy agencies will usually charge  a different fee for the HIV programs.


Requirements and communication with a surrogacy agency

Result oriented  and professional surrogacy agencies, have requirements before they admit an HIV positive father to a program. In order for the IVF to make sense and be successful, it is essential to be under a treatment. Antiretroviral therapy is used to control the virus. Agencies will also require results of the tests that confirm that viral load is undetectable. The test should not be performed earlier than 6 months and should be followed by the second one at the time of going to the agency. Surrogacy agency will require additional medical tests such as HIV in semen, HBV/HCV in semen and so on.

If the viral load is too high, agencies will not be able to currently accept an intended dad to the program.

Assisted reproductive technologies(ART) have undoubtedly reached a high level of development.Thanks to medical breakthroughs, more and more people are becoming able to enjoy the magnificent joy of parenthood. Before choosing a surrogacy agency, we would recommend to have a very detailed conversation, because the case of HIV and surrogacy is still different from other IVF cases. Make sure that the agency supports you, understands your case and has a very specific action plan.

HIV positive dads should not feel confused or offended if the agency asks for too much details or tests. Vice versa, this is all done in order to ensure baby’s safety.


Communication With Surrogate During Pregnancy

Surrogate pregnancy is a very emotional journey. On one hand, there are intended parents who have finally fulfilled their dream of becoming parents. In most cases, they have already gone through a lot of stress, disappointment, fear and struggle. On the other hand there is a surrogate mother, who independent from her motivation goes on a complicated journey of pregnancy and makes the dream of intended parents come true.


Surrogacy agency is responsible for informing intended parents about every single aspect of pregnancy : results of prenatal tests, condition of a surrogate mother, overall evaluation of course of pregnancy. While the information exchange process has to be regular, surrogacy agency should not be the only one having communication with surrogate mother. Intended parents too, should be involved in the pregnancy process. We have provided several reasons why parents might want to have communication with surrogate mother:


Express appreciation

During pregnancy, surrogate mother may not be feeling well. She might have nausea, lack of energy, change in appetite and mood swings. While this kind of discomfort is common during pregnancy, intended parents should express their appreciation that surrogate goes through this for them and their baby. Surrogate mothers need to be supported, know that their commitment is not taken for granted and that their health and condition matter a lot too. People are always more encouraged and motivated when their dedication has a value.


Why not double check?

While intended parents are getting all essential information from the agency, it is a good practice to ask surrogate directly. Intended parents might want to know how is she feeling, whether she has everything she needs. It is important to trust a surrogacy agency, however, hearing the same from surrogate is more calming and sometimes more valuable.


Discuss postnatal issues

After the delivery surrogate can be experiencing discomfort and weakness. This is not the best time for discussing issues that are needed to complete the surrogacy journey. For example parents might want a surrogate to breastfeed a baby for even a short period of time. This has to be clarified in advance because surrogate might be planning to dry up her milk with medication.


On the other hand, in some countries, completing the journey is only possible when the surrogate gives her consent and signs documents that confirm the parenthood rights of intended parents.  For example in Russia,where surrogacy is not regulated by law , there have been several court cases because of a surrogate refusing to abandon her parenthood rights and her role as a mother. Earlier communication with surrogate can help to avoid similar issues.


Often there establishes such a strong bond between parents and surrogate, that they stay in touch even long after the delivery.


There are several factors that may hinder the communication with surrogate mother. For example, it happens that surrogate is several countries away and intended parents can not visit her often. Parents should not be scared of distance and should arrange Skype/phone calls with their surrogate. Another issue that may arise is that surrogate and intended parents do not always speak the same language fluently. However, this should never be an obstacle. Sometimes just seeing and feeling that surrogate is doing good and baby is gradually growing in the belly can be as exciting as an hours of conversation and communication.


Intended parents should trust their surrogacy agencies, request and clarify all the information they need. However, at the same time, they should remember that establishing a communication with surrogate is always a step forward to having a good surrogacy experience. One more advice would be to keep the agency posted about the relationship with surrogate mother and arrange meeting through their mediation.


Tuberculosis and Pregnancy

Back in the previous centuries, tuberculosis was one of the leading infections responsible for death of thousands and thousands of people. Nowadays, recovery can take a long time and the infection is usually cured with the help of antibiotics. It is possible to get infected during pregnancy and pregnant females who have discovered they have tuberculosis, should consider getting treatment as soon as possible. Further we will discuss the relationship between tuberculosis and pregnancy, symptoms, consequences and action plan in different situations.


About Tuberculosis

Tuberculosis (TB) is a contagious infection that is caused by the bacteria called “mycobacterium tuberculosis”. Mostly, TB  attacks lungs, but can also affect other parts of the body, for example : bones, brain, spine and kidneys.

Infected person may have tuberculosis in two forms, active or latent.

Latent tuberculosis means that the immune system is able to block the germs(microbes) from spreading. Latent TB is not infectious and does not cause any symptoms. However, the bacteria is present and the infection may once get activated. Medicines can diminish the probability of activation.

Active tuberculosis, on the other hand, is contagious. The microbes are multiplying, spreading and causing symptoms.

As latent TB doesn’t cause symptoms, it is only possible to identify the infection through medical tests. Active TB , however, has somewhat distinctive symptoms including :


  • A long-lasting cough (21 days or more)
  • Cough that brings up phlegm, sometimes bloody.
  • Pains in the chest
  • Loss of appetite and weight
  • Constant fatigue
  • Fever and night sweats
  • Nausea


Tuberculosis can be transmitted like flu or cold. Microbes can be spread when an infected person speaks, sneezes, coughs, laughs and so on. However, the infection is not easy to catch. A healthy immune system has the ability to fight and even kill the bacteria. It’s also not likely to get infected after having a brief contact with the infected person. The microbes grow relatively slowly and a frequent/long contact is required to catch the TB.

Smoking is proved to greatly increase the risk of getting Tuberculosis.


Tuberculosis and Pregnancy

After introduction to common symptoms of tuberculosis, it is not hard to notice a coincidence with the ones of pregnancy(change in appetite, nausea, fatigue). For that reason , sometimes the only noticeable symptom of TB during pregnancy can be coughing accompanied by the phlegm.

After noticing any of the symptoms, doctors will usually advice to do the phlegm, blood or skin tests. Chest x-ray may also be needed. Mendel-mantoux test, also known as tuberculin sensitivity test is another way to screen for the TB bacteria. A small injection in the skin followed by a swelling in the area is a sign of existence of TB bacteria. The swelling may appear throughout 2-3 days after the injection and it’s presence, doesn’t necessarily indicate the active form of tuberculosis.

Parents should not fear of the tests, as if not identified on time, tuberculosis has the potential to be very harmful for a baby. The consequences may include:


  • Miscarriage
  • Premature birth
  • Preterm labour
  • Baby getting infected with TB (If TB is active and mother has not started treatment yet, there is a chance that baby gets infected during labor. Doctors will make the test after the baby is born.)


The treatment includes antibiotics and can kill the infection if are taken regularly, according to doctor’s prescription. Majority of medicines are safe for both, mother and baby. The treatment may last up to 9 months, until the bacteria is finally killed. However, unfortunately, there are cases when tuberculosis is resistant to medicines(drug-resistant TB) and treating it can be more difficult.

Pregnant females should combine doctor’s treatment with the lifestyle that will make their immune system stronger. Eating healthy food and getting as much fresh air as possible, play an important role in the recovery.


Tuberculosis and Surrogacy

Of course the surrogacy agency and clinic will screen a surrogate mother on tuberculosis. However, it is possible that surrogate mother catches the infection during pregnancy – just like any other pregnant female. It is important that the surrogacy agency is not only monitoring the pregnancy, but has the ability to act operatively in similar situations. If surrogate gets infected, the agency should act accordingly and promptly to perform the steps that are needed to eliminate the issue. Surrogate mother should receive immediate treatment, get checked regularly and be controlled to lead the lifestyle that will increase the chance of a successful pregnancy to maximum.

Intended parents may want to get informed about surrogacy agency’s action plan in similar situations before the beginning of the program.

Parents have to stay positive. Despite the fact that tuberculosis is not a desired condition, especially while expecting a baby, it is better to be aware of it  and receive  treatment in a timely manner. There is always a way to make the situation better, especially with the disease that is proven to be treatable.


Surrogacy – Possible Medical Risks

Gestational surrogacy is an emotionally overwhelming process. Finding a professional surrogacy agency, preparing for the program, going through IVF, transferring an embryo to surrogate and waiting for the positive results… There are more details in between these steps.


It is a great relief when everything is completed successfully and your gestational carrier(surrogate mother) is now bearing your baby. The most complicated and complex tasks are already left behind. The fact that embryo transfer and implantation was successful is already a huge step forward.


Gestational problems are not very likely to occur to a surrogate mother  and we will further explain why. However, because there is still a chance that pregnancy can go wrong, intended parents should be informed about possible medical risks of surrogacy.


Health of a surrogate mother is observed and monitored intensively before admitting her to the program. Her medical history must be absolutely suitable for a future pregnancy. A lot of agencies require that surrogate is already a mother to a healthy child. Unhealthy habits (smoking, drinking alcohol and etc) have to be absent absolutely. Intended parents are and should be allowed to request any information concerning their gestational carrier’s medical and mental health. After such a close observation and control, surrogate mother is very likely to have a successful pregnancy and deliver a healthy child.


However, let us address possible medical risks of surrogacy anyway.


Possible medical risks

Surrogate mothers, similar to any other females are likely to experience slight weaknesses that accompany nearly every gestation. Symptoms may include :

  • Sickness
  • Mood swings
  • Change in appetite
  • Nausea
  • Slight abdominal and lower back pain


If any of the symptoms are no longer mild and cause a serious discomfort, surrogate mother should address a healthcare provider and inform the surrogacy agency as soon as possible.


Severeness of any symptom may lead to miscarriage, preterm labour and other serious complications.  Pregnancy may seem healthy  but it is still possible for gestational carriers to experience common types of pregnancy complications (gestational diabetes,preeclampsia and so on). Baby might inherit genetic abnormality from intended parents that needs to be captured on time.


As already mentioned, surrogate mothers may experience mood swings. Sometimes it is emotionally intimidating to carry a baby for 9 months, monitor your and his/her health throughout the process, go through labour and finally have to give the baby up (independent of having no biological connection to the child).


If needed, surrogate mothers should have the ability to attend therapies. Agency should explain to them  the distribution of roles in surrogacy and reinforce the position of both sides in legal documents.


What should be done for the best results?

First of all, commissioning parents have to discuss all scenarios with their surrogacy agencies :


  • What are the medical risks of surrogacy?
  • What will happen if gestational mother has pregnancy complications?
  • How do we know that surrogate visits doctors regularly?
  • What is the backup plan?
  • How are we sure that surrogate will give up the child? (This is not an issue in countries where surrogacy is regulated by the law  – Ukraine and Georgia are perfect examples.)


Commissioning parents should request and receive regular information about :


  • Surrogate mother’s health
  • Baby’s health
  • The course of pregnancy
  • Test results


Surrogacy agency, on the other hand, is responsible for :


  • Controlling surrogate’s visits to health care provider
  • Collection of medical data
  • Informing intended parents


Independent from their motivation , surrogate mothers are doing an amazing job delivering babies to their biological parents.To avoid any kind of complications and medical risks, like any other female –  lifestyle, mental and physical health of gestational carrier  has to be monitored on regular basis.


Surrogacy in Russia

Surrogacy in Russia was first practiced in 1995 and has become a popular destination for foreign patients gradually. A lot of surrogacy agencies and clinics are operating successfully and are promising to deliver the best results. However there have been several doubts about choosing Russia as a surrogacy destination. By going through the surrogacy legislation and regulations in Russia, we will discuss all of the important issues to be aware of.



Surrogacy is legal and is regulated by the Family Code of Russia. According to the law, commissioning parents are not required to be married and single parents are also allowed to participate in programs. Foreigners are welcome.

Intended parents have to provide a medical assessment that proves their inability to become parents without assistance. This could include :

  • Uterus absence or deformation
  • Somatic diseases that do not allow / are dangerous for pregnancy
  • History of several IVF failures


Surrogate Mother

Surrogate mother is required to have at least one healthy child of her own. Her medical and mental state must be checked and observed carefully before admitting her to the program. Surrogate mother can not be an egg donor at the same time. However, despite the absence of genetic connection with the child, surrogate mothers still have full parental rights for babies. Gestational mother gives parenthood rights to commissioning parents only with her consent.


Commercial surrogacy plays a major role in solving the problem. Fortunately it is legal in Russia to pay a surrogate mother for the service of carrying pregnancy(similar to Ukraine, Georgia and some states of the USA). A lot of gestational mothers see surrogacy as an opportunity to live better lives with their families. Surrogacy agencies and clinics are also promising to handle all of the legal aspects themselves. However, it is still strongly advised to work with the family law agency throughout the surrogacy period.


Service and Costs

Surrogacy programs are offered in several Russian cities. Of  course, the most popular destination is the capital city – Moscow. Apart from being a popular tourist destination with picturesque views and great history, Moscow offers a number of medical centers with modern equipment. Surrogacy agencies have years of experience and are indeed reliable companions on the journey to parenthood. Average cost of IVF, medical care and legal support is on average 40-50 000 $. This price is considered to be affordable for surrogacy and is somewhat higher than the average cost in Ukraine, Georgia and Kenya, but still half of the price in the USA.


Surrogacy in Russia has no doubt a lot of advantages to go for – affordable prices, experienced agencies and clinics, well equipped medical centers. However, intended parents should note that there have been several cases when surrogate mothers refused to give up their parenthood rights. We would strongly encourage intended parents to use service of a lawyer throughout the entire process of surrogacy. Lawyer will negotiate with the gestational carrier from the very beginning and prepare all of the documents for abnegation of parenthood rights. If something goes wrong, family lawyer will also represent intended parents in court.


Surrogacy in Ukraine

Ukraine is considered as one of the most popular surrogacy destinations for heterosexual couples. We are going to introduce some of the interesting details and then try to decide, whether Ukraine is a suitable choice to consider.


Ukraine is one of those very few countries in Europe that are accepting surrogacy. The capital Kiev is a safe, active, developed and a beautiful city. The development of the country matters in our case, because it is connected with the quality of medical service as well. No worries, in Kiev there are several professional surrogacy agencies and a number of clinics with high quality service and equipment. There are medical centers in other cities as well (Odessa, Lviv, Kharkov and so on). Success rate of IVF is as high as up to 60%. Doctors are professional and caring. Pricing whatsoever is relatively affordable (up to 50% lower) in comparison with USA and Canada.


Surrogacy in Ukraine is legal, which obviously means that it is regulated by the law. Regulations are indeed advantageous for intended parents for the following reasons :


  • No need of adoption

Ukrainian law allows to issue birth certificates with intended parents’ names. No matter what the real biological tree looks like, baby’s documents will only have the names of IP(s) in them.


  • No disputes

Thanks to regulations, there has not been recorded even a single dispute about the custody over the child. Actually, it is not allowed for surrogate mother to be an egg donor at the same time. No genetic connection of a surrogate with a child, contributes to the absence of conflicts as well.


  • Families don’t experience delayed stays 

No complications with documents + no dispute about parental rights = no delayed stay in a foreign country.


Requirements for intended parents (IPs)


In order to participate in a surrogacy program in Ukraine, IPs have to be married. Additionally a  couple has to provide surrogacy agency and clinic with medical reports. They should prove that the couple’s decision to proceed with the program is reasonable. Conclusion should be the following – intended mother is not able to bear a baby herself, without a surrogate mother. Reasons may include :


  • Absence of womb
  • Deformation of uterus that makes pregnancy and delivery impossible
  • Diseases that do not allow to bear a child, because it may become fatal for mother
  • At least 4 unsuccessful IVF attempts with embryos of high quality


Surrogate mothers’ age should be between 20-40 years. They are required to have at least one child previously.  

To sum up, let’s list pros and cons of Ukraine as a surrogacy destination.




  • Professional doctors
  • Well equipped clinics
  • Professional surrogacy agencies
  • Low costs
  • Simple collection of documents




  • Ukraine is not a member of European Union (strict legal EU protection does not apply to clinics).


Verdict : When intended parents make right decisions concerning clinics and agencies, there is no need to worry about membership of EU. You can read about how to choose a right surrogacy agency on our blog. We will be offering more information gradually. Taking into account all of the advantages that the country offers, the answer is –  yes, parents can and should consider Ukraine as an attractive option for surrogacy.


Choosing the Right Surrogacy Agency

Parenthood is no doubt one of the most life changing experiences . People tend to plan and prepare for it years in advance. While realizing that one has faced fertility issues that can not be solved without the inclusion of the surrogacy agency, then the first job is to find the reliable one. The aim is to find the service provider that will make this exciting and significant process as light, joyful and effective as possible.


Of course there are several ways that will help to identify in advance whether the agency is going to be trustworthy, proficient and how much effort they tend to put in your advantage.


Customer service

The agency has to provide prompt qualified responses to any of the customer’s requirements. Customer service should be always at your disposal and manage to earn trust and positive attitude from the very beginning of the collaboration. You should never feel that service provider simultaneously deals with multiple cases and you are just the part of their daily working routine.


Ability to listen

Of course every agency has its own plan. They provide you with terms and conditions, legal and financial information, follow the system that will manage all the formal parts of the agreement. However, when we put the formal routine aside,if you don’t feel the individual approach to you as a customer, then you should consider further alternatives. As we always mention, our cases and concerns are different. Agency should patiently listen to each customer  to share their very individual worries, points of view and express readiness to find the most appropriate approach.


Transparent financial policy

One should know what one pays for. Some of the agencies tell their customers the fixed price that they have to transfer straight to the agency’s account. The best of agencies provide parents with the detailed description of all costs clearly defined in relevant sheet with payment system and timing.   The paper has to differentiate the medical and the surrogate mother’s service fees and should be tailored in a way to make it possible the surrogate mother’s commissions to be paid directly to her. Transparently disclosed financial policy protects the customers from undesirable and unforeseen financial surprises.


Proper medical screening

Surrogate is going to have one of the most important roles for the next several months. The agency has to ensure that her mental and physical health are fully corresponding to the requirements and she is completely ready to proceed with the agreement.Parents should never feel uncomfortable to request all kinds of information about the state of their entrusted person.


Pregnancy care

During the pregnancy  female body is undergoing a number of changes, both physical and mental. Surrogate mother needs to be monitored on regular basis to ensure that the process is going on without any complications. For that reason, it is of greatest importance that the agency provides the service of individually assigned pregnancy care coordinator. This person has to be in charge of controlling surrogate mother’s systematic visits to the clinic and delivering results and up to date information to the parents. Pregnancy care coordinator is supposed to be eyes and ears of clinic, surrogate and parents throughout the whole process.


After birth care

After the delivery of the baby, it may be required to travel to the foreign country. Journey to a completely strange country might have some complications. Agency must be helpful after birth as well and provide the service until needed.


Sharing experience

The common behaviour before purchasing any product is to ask for reviews from other customers. Same works in the field of fertility.The agency should be ready to connect you with the previous customers who would like to share their positive or negative experiences, happy or sad stories regarding the whole process.


If the agency you were considering corresponds to all of the requirements listed above, then you are more likely to get positive experience and desired results.


ABC of Surrogacy


To start with a bare definition, surrogacy is a process when a surrogate mother carries and delivers a child for intended parents. It may seem complicated and unclear at first , but we are going to break the process into pieces.

What we already know is that there is a surrogate mother, a female, who with the help of medical procedures is intended to get pregnant and deliver child to biological parent(s). The process is called surrogacy and may be achieved in more than one ways.

Gestational surrogacy is the process that uses the technique called “in vitro fertilization”(IVF) to impregnant the surrogate. It is as simple as that – Eggs from mother are fertilized with the sperm of father and later transferred in surrogate mother for development and delivery. You may find this simple scheme easier to comprehend :


Mother’s eggs X Father’s sperm ⇒ Surrogate mother


Child does not inherit genetics from the surrogate mother and does not develop any kind of attachment towards her. Surrogate mother does not offer anything but  the environment for embryo to grow and develop until ready for birth. This technique comes in handy when biological mother does not have fertility issues but because of other medical problems, she is not able to carry a child herself.

It is also possible to gather eggs from a donor, fertilize them with sperm of a father and place them in surrogate mother’s uterus. This technique is a perfect solution for LGBT parents, single males or traditional couples, in which females due to medical issues are not able to become biological mothers. You can read about donation on our blog here


Donor’s eggs X Father’s sperm ⇒ Surrogate mother


These and many other combinations have made parenthood possible for hundreds and thousands of people who could not adopt a child or could not make it themselves because of fertility problems.

If you are considering surrogacy as an option, there are a number of agencies that provide service from the very beginning until the end. Terms of service may vary , but usually a surrogacy agency is responsible for :


  • Finding  and choosing an appropriate surrogate mother
  • Connecting parents and surrogate to the clinic where they receive all of the essential medical procedures
  • Supervise the health care of the surrogate and collect her medical transcripts from clinic on regular basis
  • Planning the birth
  • Planning the trip if needed (Surrogate and parent(s) may reside in different countries)
  • Ensuring that child continues life with parents without any complications


If you are not able to find the service in every country, do not be surprised. A lot of legal processes are included that vary from place to place. For that reason you may need to travel to a foreign country and the agency will help you to arrange the trips as well.