US citizen information

1.          Step by step

2.          Surrogacy information

3.          Take your newborn home to the USA

4           Cost estimation

Step by step details

Step 1 – Information gathering

 

This stage is dominated by emails back and forth to assess eligibility to surrogacy treatment with our partner clinic. Visit us on http://www.angelsfriend.com/intended-parents to find out the criteria to be eligible.

 

Step 2 – Reviewing and approval

 

The application need to have two approvals. The first one is with Angels Friend (AF). This may take up to 48h if all information is gathered. Then the application is sent to the clinic that may require further documents. Please send us your completed medical questionnaire along with any recent relevant test results or previous fertility treatment reports as early as possible if you wish to shorten the processing time. These documents are reviewed by the clinic and approval follows.

 

Step 3 – Contract and payments*

 

Once the review is completed and the clinic confirmed surrogacy treatment, we send you profile of surrogate mothers to choose the one you will feel comfortable to carry your pregnancy. Next, you will sign the contract to instruct the Angels Friend to assist you in the process. After the first payment is made your surrogacy journey starts and the clinic receives your contact details and communicates directly with you to prepare your IVF treatment (or to provide information in case of frozen embryo transfer).

 

Step 4 – The clinic and getting ready for treatment

 

The clinic will contact you directly to arrange all check up. These tests are needed to propose the best treatment approach for your particular case. There are various treatment protocols that can be applied. They will be able to assess which one of those will work better for your case depending on your age, medical history, and current ovarian dynamics. In the meantime your surrogate is undergoing her check up.

This check up can be done in your home country or at our clinic at a much lower cost.

If you have frozen embryos, the clinic will make all the arrangement with you to transfer it to their clinic and no further treatment is required from you.

 

Step 5 – Treatment

 

You and your surrogate will each be provided with a detailed timetable of your treatment protocol. Your treatment can start in your home country and you need to arrive at the clinic for your final scans, and your stay is approximately 7-10 days. During this period egg collection and fertilization will be done. If your husband is unable to travel with you at that time arrangement can be made to fly out at an earlier stage and freeze a semen sample so that it can be used for the fertilization. The use of frozen sperm does not affect fertilization rates and the final outcome of treatment.

 

Step 6 – Embryo transfer and test result

 

You may decide to stay for Embryo Transfer (ET) in which case your trip in Czech Republic will be for approximately 10-14 days. Your Surrogate is taken care of by experience doctors. On ET day her lining is scanned. The surrogate lay down on the bed at the clinic for about an hour or two after the transfer and is obliged to stay inactive for at least 6 hours thereafter.

14 days after ET the surrogate takes a pregnancy test and takes a blood test later for official confirmation of pregnancy. When pregnancy is confirmed the surrogate is followed by our pregnancy care team.

 

Step 7 – Pregnancy care

 

This starts from a positive pregnancy test result. Our dedicated team is instructed to follow step by step the pregnancy and update you all the way so you can picture the pregnancy as if you were living with the surrogate.

Surrogacy information

 

Overview

Introducing the surrogacy’s step by step guideline through Angels Friend, a Czech Republic agency registered in Prague. All steps are highlighted below. Kindly send us any other inquiry at info@angelsfriend.com should you require further information.

Surrogacy is neither lawful nor unlawful in Czech Republic legislation. Different clinics have their personal guidelines and they can all provide surrogacy under strict requirements for heterosexual (married or unmarried) couples only.

All IPs who require surrogacy in Czech Republic should provide the agency with medical proof that surrogacy program is required due to Intended Mother impossibility to carry a baby without help of a Surrogate mother or after a number of unsuccessful IVF treatments.

If you are unsure whether you qualify kindly contact us via email.

Surrogacy program will be managed by a specific coordinator till pregnancy. Then it could be managed by different team members during the pregnancy stage. Your Angels Friend’s coordinator will assist you from the start of your treatment and will provide you with all the relevant information, give full guidance of the program, help you to sign the contracts and confirm the payment. Once the payment is received program is passed to the Medical Coordinator who is in charge to do the final planning of the program and to give the timetable of the IVF. Medical’s or Angels Friend’s coordinator follows up with the parents until pregnancy test is received depending on the clinic taking on your treatment.

As soon as the pregnancy is received your file is passed to the pregnancy care coordinator. The coordinator is in charge to monitor and update the parents at every stage of the pregnancy. She is setting the doctor checkups, makes sure the ultrasounds are done at assigned date, she monitors that the surrogates have a stock of needed medications and vitamin supplements and of course she step by step informs you on the progress of the pregnancy.

Part 1                     SURROGACY TREATMENT

 

Check up before treatment start

Intended Mother and Surrogate Mother

A list of tests will be given to Intended Parents and Surrogate Mother to do. This will determine the best IVF treatment option in your particular case. Required check up tests will depend on the clinic that will provide your IVF treatment. Such tests may include some of the following:

– HIV                                                                           (valid 3 months)

– Syphilis,                                                                    (valid 3 months)

– Hepatitis B (HbsAg)                                                  (valid 3 months)

– Hepatitis C (HCV)                                                     (valid 3 months)

– Toxoplasmosis IgM                                                   (valid 6 months)

– Toxoplasmosis IgG                                                    (only once)

– Cytomegalovirus Ig M                                               (valid 6 months)

– Cytomegalovirus Ig G                                                (only once)

– Rubella IgM                                                               (valid 6 months)

– Rubella IgG                                                               (only once)

– Chlamydia Virus, PCR                                              (valid 6 months)

– Ureaplasma and mycoplasma                                    (valid 6 months)

– Urogenital smear microscopy                                    (valid 1 month)

– Pap smear /cytology                                                  (valid 1 year)

– Blood group and Rh                                                  (only once)

– Complete blood count (CBC)                                    (valid 1 month)

– Coagulogram                                                             (valid 1 month)

– Creatinine, urea, total protein, iron, a-amylase          (valid 1 year)

– Glucose                                                                     (valid 1 year)

– Urine test                                                                   (valid 1 month)

– Onkomarkers CA-125/CA-153/HE4/CA-199            (valid 1 year)

– Karyotype (genetic test)

Hormonal panel (these tests should be done between the 1-4 days of cycle):

– Prolactin                                                                    (valid 1 year)

– FSH – Follicle stimulating hormone                           (valid 1 year)

– AMH – Anti Mullerian Hormone                               (valid 1 year)

Also, we need to get the following reports from Intended Mother:

– Conclusion from GP that Intended Mother is healthy and doesn’t have any contraindications to stimulation process

– Chest X-ray, we need conclusion that Intended Mother is healthy (absence of tuberculosis)

– Conclusion from mammolog/ breast physician (breast ultrasound) (valid 6 months)

Also we must receive the report of Antral Follicle account with ovarian scan. The report should have very clear indication of how many antral follicles are visible in each ovary, including information about their size.

All the results must be on clinic original header with official stamp. If the test is not in English, then we must have official English translation with translator stamp.

Intended Father

Before we sing the contracts Intended Father should provide us with the following test results:

– HIV                                                                           (valid 3 months)

– Syphilis,                                                                    (valid 3 months)

– Hepatitis B (HbsAg)                                                  (valid 3 months)

– Hepatitis C (HCV)                                                     (valid 3 months)

– Sperm count                                                              (valid 6 months)

– Blood group and Rh                                                  (only once)

– Karyotype                                                                 (genetic test)

– Chest X-ray, we need conclusion that Intended Father is healthy (absence of tuberculosis)

All the results are reviewed and approved by the IVF clinic.

It may take only 6-8 weeks to have the treatment completed from contract signing date.

 

Signing contract

As soon as we have the dates from the parents and test results are approved by the clinic, parents should send us their passport.

Parents will sign the following documents:

  • General agency agreement for surrogacy program
  • Service Annex to general agency agreement
  • Payment Annex to general agency agreement
  • Confidential agreement
  • Surrogacy contract

In special cases some or all agreements can be signed in electronic version. After sending us the signed and scanned contracts, Intended parents should print and sign the following number of below requested contracts and send them to our office by post.

Medical Coordination  

As soon as contracts are signed (either electronically or travelling to Czech Republic) and first payment is received

 

Surrogate mother: candidate profiles will be sent to you to choose your own surrogate. The detailed profiles include pictures and all other relevant information collected during the surrogates vetting period.

 Medical Coordinator: The clinic coordinator will take over your file for treatment planning along with the surrogate details.

Special requirements of surrogate mother: any special requirements on surrogate mother should be send at the earliest stage of the program to be taken into account; for example: surrogate to be single, not to have more than one baby, not to have caesarean section history. Surrogate mother can be replaced in the middle of the process for various reasons such as endometrial thickness, sudden bleeding and so on. You will be update straight away updated if this occurs.

Treatment

 This can start from your home country.

Check up: The clinic will contact you to discuss your case in detail and provide your partner and you with the list of analysis to be done.

This will help to propose the best treatment approach that will work better for you depending on your age, medical history, and current ovarian dynamics.

In the meantime your surrogate and you will do her check up.  

Starting IVF treatment from home: IP can start check up and stimulation from home. All prescriptions of the necessary medications will be sent to via email along with your treatment timetable. Medical coordinator will be making sure that all is taken as should until arrival at the clinic. In that case you are required to stay in Czech Republic for about 6 days until egg collection; these days are usually from day 9 to day 15.

Alternatively stimulation can be completed at the clinic and you will need to stay for 15 days.

Synchronisation: Pills may be necessary to be taken by you or your surrogate to synchronise your monthly cycle. All comprehensive information will be given by the clinic.

Stimulation: it starts with a protocol (treatment timetable), which is the list of medications and injections you will take on specific date.

Your surrogate will have her protocol as well and you will be both stimulated at the same time.

If this start from home you will be required to send the results of the scan to the clinic.

Egg collection / Sperm collection in the clinic: When the final checkups are done IVF clinic will tell the IPs when they need to present in the clinic for egg and sperm collection. IPs should be aware that there are 3-5 abstinence days before sperm collection.

Embryo transfer: Parents are not obliged to stay for the embryo transfer. When the transfer takes place the clinic sends the parents embryo report including the following information.

Meeting with the surrogate mother: We always encourage the parents to have an option to meet the Surrogate Mother. This depends on both desire, IP and SM. So we act according to their request. Some SM does not speak English and you may consider an interpreter to help with the meeting. SMs are usually very shy during the meeting so IPs should not expect them to be very talkative. However, there are always exceptions

Pregnancy test result

Two weeks waiting for the pregnancy test: The official pregnancy HCG blood test is done on day 14 after the embryo transfer. You are informed as soon as we receive the result. However, delays may occur because of technical issues/weekends/bank holidays.

If the test is negative Angels Friend’s coordinator will contact you to plan the second attempt based on the date you desire to move forward.

Failed attempt with frozen eggs: Agency fee with Angels Friend qualify for two trials with the surrogate mother. Only treatment expenses are to be covered. In case parents have got frozen embryos left, for second trial agency fee are not payable. Same surrogate can be kept or can be change in case of Doctor Request.

Failed attempt without egg frozen: In case from the first attempt we do not receive enough embryos to freeze. The second attempt parents pay a reduce cost; mainly treatment

Here as well the expenses do not cover the Intended Mother’s stimulation injections, their monitoring during the stimulation and their test results.

Pregnancy is confirmed: ultrasound will be schedule 10 days after for further confirmation. Final confirmation of the pregnancy will be sent to Intended Parents including the first scan.

Part 2                    PREGNANCY CARE

Angels Friend is fully aware how stressful IPs could feel if they do not have information on their pregnant SM. Therefore there is a comprehensive procedure to make sure you live the pregnancy as if you were present with the SM. In addition Pregnancy Care Coordinator is instructed and obliged to keep you informed if there is any emergency, if the SM needs to be hospitalized, if she has any inconvenience or any medical complications. Parents are fully involved into the process no matter good or bad.

Contact with the SM: we advocate IPs to keep in constant communication, through Angels Friend, with their pregnant SM to value them. However, we do not encourage to exchange contact with SM as it may initiate asking for extra favours which may lead to frustrations at the least and/or problems at the end of the process. In order to have full control on the situation and keep behaviour within the frames of our policies we need to be the bridge between IPs and SM for all conversations.

Similarly we encourage parents to visit the surrogate mother during the pregnancy in her hometown, we will be more than happy to arrange their meeting.

Surrogate moving: where necessary and between 7-8 months of pregnancy surrogate move closer to the clinic to give birth. All arrangement is made for her wellbeing during that time until delivery.

Baby delivery: If SM has any medical indicator that C-Section is needed, then the clinic will perform it. Otherwise it cannot be asked neither by the parents nor by SM. In the majority of cases natural delivery takes place.

Parent’s arrival for baby delivery: parents are encouraged to be present on delivery day. This date is known 3-5 days prior to delivery. So the parents should be on standby all the time. When caesarean occurred most parents are present in the clinic to welcome the baby(ies).

Final account: In case of complicated pregnancy parents may be required to deposit extra €2000 any time during pregnancy to cover any extra cost should any occurred. The balance of the account will be done after being discharge from the hospital. Parents will be required to pay extra or will be reimbursed depending on balance.

Birth Certificate: around 7-8th month of pregnancy we will inform you on all necessary documents you will need to come along with you when travelling for delivery. These documents will be necessary to apply for birth certificate and they will be collected from you upon arrival.

Embassy and baby’s travel documents: parents are encouraged to approach their embassy or a lawyer as early as possible. After pregnancy confirmation, they should stay in close contact with the embassy and start collecting the necessary documents to be used after delivery. This will make the process quicker to get the newborn passport. Your embassy may take 3-8 weeks to process your baby travel documents. During that time at least one of the parents required is to stay with the baby.

Surrogacy Lawyers: Angels Friend cooperates with a number of lawyers in numerous countries. Their valuable knowledge and experience could get you home quicker and they can help with other related matter within your home country.

Flying back home: as soon as the baby travel document is issued, they are ready to leave very next day. Angels Friend will appreciate a family farewell at their office.

NB: If the parents are not afraid of multiple pregnancies, two surrogate mothers at the same time are advisable. In Czech Republic only 1 embryo is transferred therefore chances of twin are very slim.

Take newborn home

To take your newborn home to the USA is as easy as 1, 2, 3.

  1. Apply for your child CRBA and newborn passport (Consular Report of Birth Abroad)
  2. Proof your US citizenship and genetic link to the child
  3. Get passport and fly home.

To verify these three points above the following documents needs to be gathered and submitted to the embassy.

The CRBA is a citizenship document your newborn needs to obtain before travel document can be issued.

 In order to transmit citizenship to a child born abroad to a surrogate mother, legal parents need to have the original of each document below, along with a photocopy and a certified translation if it is not in English.  All application forms must be fully and accurately completed before the family arrives for an appointment.  Applicants who arrive at the embassy without complete application packages may be turned away.

  • The child’s Ukrainian birth certificate with English translation.
  • A copy of the medical report of birth with English translation. (The medical birth certificate is issued by the hospital where the birth occurred and will list the surrogate mother.)
  • Proof of both parents’ citizenship and identity (a valid U.S. or foreign passport works best).
  • Parents’ original marriage certificate (if applicable) and proof of how any previous marriages ended. All documents not in English should be accompanied by a translation.
  • Evidence of the physical presence in the United States before the child’s birth for the parent (or parents) who is a U.S. citizen and who has a blood relationship to the child.  Evidence that can be submitted includes school transcripts; employment, tax, bank, and medical records; utility bills, rent receipts, or other official documents.  Please submit old passports with U.S entry/exit stamps if available.
  • Proof that a U.S. citizen parent’s genetic material was used in the surrogacy process (documentation from the clinic which performed the procedure), with English translation.
  • Statement from the surrogate mother awarding parental rights to legal parents, with English translation.  Usually, a notarized original must be submitted to the Ukrainian civil state registrar office to get an official Ukrainian birth certificate. A photocopy of that document will be sufficient for the purpose of applying for the Consular Report of Birth Abroad.
  • A completed application form DS-2029 for the Consular Report of Birth Abroad. The form can be found at https://eforms.state.gov/. Please do not sign the application until a Consular Officer requests that you do so at the embassy.

Please Note:   Questions #24 and 25 on form DS-2029 (CRBA) asks for precise periods of time in the United States.  Please list all dates the U.S. citizen parent who is transmitting citizenship has been physically present on U.S. territory prior to the child’s birth. Do not include dates outside of the U.S., even if a trip was for a short period of time.

  • The USD100 application fee. Accepted payment methods are cash and credit card.
  • DNA test results confirming parentage; these will be received by the embassy directly from the lab.

The family must select an AABB-accredited laboratory, contact the laboratory directly, and make the necessary arrangements (including payment) for conducting the genetic test.   The use of an AABB-accredited laboratory is required for DNA tests at U.S. embassies and consulates abroad. DNA results obtained outside of embassy procedures will not be accepted. While consular staff cannot accept application materials or other supporting documents ahead of your actual CRBA appointment, you may, if you wish, get in touch with a lab from the list in advance and request that its staff send the DNA kit/s to the U.S. embassy directly (Attention: American Citizen Services unit). Also, you can request that, in addition to sending the original results by mail to the embassy, the lab also email the results to us at KyivDNA@state.gov.

This section is for guidance only. Refer to the the state government website for full information

https://travel.state.gov/content/travel/en/legal/travel-legal-considerations/us-citizenship/Assisted-Reproductive-Technology-ART-Surrogacy-Abroad.html#Will

Cost estimation

The cost of the service may vary depending on the service and the level of service required.

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