Surrogacy Journey and Challenges of Surrogate Matching: What is happening behind the scenes?

Surrogacy matching is the most important stage of the surrogacy process, after which the preparation for embryo transfer begins, bringing you one step closer to realizing your dream of parenthood. While we frequently discuss this topic, today I want to shed light on the extensive time and challenges involved in selecting the right surrogate, which all agencies encounter during this careful selection process.

Many women express their willingness to become surrogates, and the selection phase encompasses several essential steps. The initial criteria are clearly defined: candidates must have had no more than one cesarean section, preferably be between the ages of 25 and 38-39, have previously experienced uncomplicated pregnancies, reside in the city where the program operates, and maintain a BMI in the range of 30-32. Each of these criteria carries important considerations; for instance, a candidate with two prior cesarean sections would most likely require another cesarean for your child’s birth, elevating both her health risks and the risk of premature birth for your child. Thus, surrogates with multiple cesarean sections are generally ruled out. Similarly, candidates who have faced complicated pregnancies or stillbirths are automatically disqualified from the process. This is just the initial phase, and I can confidently say that approximately 60 percent of applications received do not meet the established criteria.

What comes next? After exchanging initial contact information, the coordinator reaches out to the surrogates and arranges a meeting, either in the office or via Zoom. This phase is quite intriguing, and we are often surprised to find that a significant number of women who express interest in becoming surrogates and advance to this stage do not attend the scheduled meeting. The reasons for this can be unclear; sometimes, they simply do not respond, which means the opportunity for an interview with the candidate is lost. Those who do attend the meeting are generally ready to begin the process; a preliminary contract is established, outlining that the surrogate will undergo medical examinations and mandatory clinic visits, psychologist and a social worker evaluation, as well as follow the doctor’s recommendations.

It’s worth noting that the requirement for a social worker to visit the surrogate’s home has recently become mandatory, complicating the selection process further. While we recognize the importance of a suitable living environment, this additional criterion has led to an increase in disqualifications due to inadequate housing. It troubles me personally, as it means we are unable to assist women who could benefit from our support and achieve some financial stability. We considered the option of renting apartments for these families to improve their living conditions, but the social worker rejected the idea, arguing that it might misconstrue our intentions and complicate the legal situation for you. However, I disagree with this as I believe that if we have the means to help and enhance their conditions, we should act. Nevertheless, we must adhere to the advice of local lawyers, while I maintain my perspective on the matter.

I share all of this to give you insight into the lengthy process of surrogate matching that occurs before the team introduces you to a candidate. So, what happens next? Let’s assume we have a candidate who meets the initial criteria and has received approval from both a psychologist and a social worker to proceed. At this point, a medical examination becomes essential, encompassing thorough reproductive and overall health assessments to ensure the surrogate’s health is suitable and that she is ready to embark on this journey, both psychologically and physically. Our observations reveal a notable prevalence of thyroid disorders, elevated prolactin levels, breast lumps, and uterine polyps among candidates. When we encounter these issues, we arrange for additional consultations. In Argentina, this can be time-consuming, as securing doctor appointments often requires several weeks in advance. This results in further delays before we obtain a final assessment from the clinic or schedule additional tests to investigate or confirm any potential health issues.  This step acts as a health screening, during which various medical conditions may be identified. In such cases, surrogates may undergo complex treatments or be referred to specialists for ongoing care. If the woman’s health status does not contraindicate surrogacy, she will receive treatment, and the process will commence under the close supervision of the medical specialist. Naturally, many candidates are disqualified at the medical examination stage, too.

Another challenge arises when a matched candidate declines to begin the process for various reasons or starts but decides to stop after an unsuccessful transfer. While we fully respect her right to make that choice, it inevitably delays your journey, requiring us to find a new candidate for you. Such decisions occur unexpectedly, and given that the surrogate selection and screening processes are already time-consuming, identifying new candidates will also require additional time. Despite our efforts to make these processes smooth, certain aspects are beyond our control and are inherently tied to human psychology and physiology.

I wanted to show that an immense amount of work goes into presenting each candidate. A dedicated team of up to 10 members—including coordinators, psychologists, social workers, and lawyers—collaborates until we find the right woman to carry your child. This process is time-consuming, requiring numerous careful steps to ensure that every detail is in place. I would like to express my gratitude to the incredible team who work tirelessly to find a suitable candidate for you, and most importantly, to the surrogates themselves who begin the journey and see it through to completion. Such women are truly exceptional and can be considered angels.

Thank you for taking the time to read my article. I wish you all the best in your surrogacy journey, and remember that every member of our team is motivated by a single goal: to help you achieve your dream.

Tamari Kachlishvili MD. MPH,
Founder & CEO of GC Consulting