This time of year can be especially hard on people struggling to build their families. Family gatherings and child-focused events may emphasize a couple's longing. Amid the sense that something is missing, however, is a profoundly beautiful and unique gift that is waiting to be discovered - well-matched surrogate carrier arrangements are increasingly responsible for bringing children into waiting families.

Previously we talked with Kathy Stern, M.A., about her role in teaching mind/body techniques to infertility patients through her Wellness Concepts program. With her husband, attorney Greg Stern, Kathy also manages Texas' oldest third-party assistance agency.

Southwest Surrogacy Associates, LLC, (SSA) provides all educational, counseling, and legal assistance required for relationships involving donor eggs or surrogate carriers.

"Surrogate carrier" is the term used to describe a woman who carries a pregnancy from embryo transfer to birth on behalf of another person. No longer considered an unusual way to resolve infertility, Kathy says that she's seen the social pendulum swing from one end to the other in her 11 years in this field. "People used to be negative about [surrogacy arrangements], but now the public appears to be very open and supportive," she remarks. Kathy, who is a licensed professional counselor, tells a story in which a young woman who was acting as a surrogate informed her aerobics instructor that she'd be refraining from the more strenuous activities due to her new pregnancy. The surrogate was initially shocked when the instructor announced the news to the entire class, but all ended well when her classmates stood and applauded upon hearing of the surrogate's choice to give.

Some of her confidence comes from the fact that the state of Texas has the most protective laws in the country for gestational surrogacy arrangements. What makes the law so favorable is the legitimization of the relationships, even with the yet-to-be conceived child, prior to pregnancy. In order to take advantage of the resulting legal protections in Texas, the intended parents must be a married couple, and there cannot be a biological connection between the surrogate and the child (that is, the surrogate cannot provide the egg.) Other situations (for example, 'traditional' surrogacy in which the surrogate provides the egg) are not necessarily illegal, but they do not retain the same level of legal protection. The SSA website has more information on the "Texas Legal Advantages" at http://ssa-agency.com/legal-aspects- texas.html.

Who Would Do It?

• missing uterus due to hysterectomy or congenital condition, so long as the woman's ovaries are still present and functioning
• medical problems like diabetes, heart, or kidney disease which can make pregnancy life-threatening

Women interested in being surrogate carriers are thoroughly screened. Those few who are accepted must meet a list of qualifications that includes psychological, physical, and financial criteria.

Kathy Stern emphasizes, "One very crucial aspect is that the surrogate not be motivated by money. The best surrogacy situation is one where the surrogate wants to gain something emotionally from the altruistic experience, through this tremendous act of giving, as much as the couple wants to gain from it."

The Match is Key

"I tell people [who are interested in using gestational surrogacy] to prepare for a very close relationship for about two years. It's important that couples and surrogates be carefully and professionally matched from the beginning, based on their philosophies and values, on what they are all looking for in the arrangement, and on personality."

The time spent evaluating and counseling all parties involved allows Kathy to create the best possible circumstances for what will be a relationship that is unique by definition.

In Closing

When our patients can benefit from gestational surrogacy, we refer them to Kathy Stern of SSA for education and consultation. After an initial screening, the couple is then free to choose either SSA or another third-party agency for assistance in matching with a qualified surrogate.

Facilitating the gestational surrogacy experience for our patients is an enjoyable experience. As always, we are happy to answer any questions or concerns you may have about this and other options for resolving your family-building issues.

I hope the coming New Year brings hope and fulfillment to you and yours.

Sincerely,

Sonja B. Kristiansen, MD