At Hatch we ask our prospective Intended Parents (“IPs”) to complete an application and screening process in advance of signing up with our program. As a surrogate-powered program, our team understands the importance of ensuring we screen our potential IPs as rigorously as our surrogates. This ensures that Hatch surrogates have a safe, positive, warm, and ethical partnership and journey.
Prospective IPs attend a video consultation session with one of our Intended Parent Relationship Managers, who are parents of surrogacy themselves, where they will discuss the surrogacy process and will review in detail the requirements outlined in more detail below. If our team member believes the Intended Parents are well qualified, they will then have them fill out our application, and conduct necessary background checks and psychological screenings, before accepting them into our program.
At Hatch we have 8 Intended Parent Requirements that we believe are crucial to the safe and ethical practice of surrogacy.
We have age limit boundaries for both our surrogates and our IPs. For surrogates, the guidelines are set by the American Society for Reproductive Medicine (“ASRM”) and in consultation with our doctors at our partner clinic, Pacific Fertility Center Los Angeles (“PFCLA”). However, some prospective IPs may be surprised to hear that we have age limitations for IPs as well, which are 55yo when pursuing surrogacy as a single individual, or a combined age of 110yo as a couple. This is based on a variety of factors, such as an average life expectancy of 27 years at 55 years old, the potential decreased mobility of parents as they enter their 60s in caring for young children, and the average retirement age of 65-67 when parents begin to live on savings. At the core, the primary ethical concern at play is whether or not the parent(s) will survive through the child’s 18th birthday. Only 14% of 50 year olds will pass away by age 68, while at age 55 that number jumps to 21% and rises at an ever-increasing rate thereafter.
These limits can be very frustrating for folks just at or above the limit, which can be seen as a relatively arbitrary dividing line and based on total U.S. averages, incorporating parts of the country with lower life expectancies in the averages. Some IPs counter these limits with statements such as “I live a very healthy lifestyle,” that “I’m a young 60,” or that “wealthy folks have life expectancies well into their 80s.” While these may all be true, and every individual’s possible life expectancy is different and situationally-based, and in the end a line must be drawn somewhere as we cannot ethically provide family-building options to potential parents in their 70s with the possible child’s best interest in mind.
The final item to understand is that surrogates are generally reluctant to match with IPs in their mid-50s already. Sometimes we have to share a 55-year-old’s profile with many surrogates since they share the same ethical concerns as our physicians and staff. Many surrogates are on online message boards where experienced surrogates share stories about working with more elderly IPs that can scare them.
We do make exceptions for IPs who are pursuing a sibling journey with us and their same surrogate, but otherwise we cannot make exceptions for the age limit.
The advent of PGT-A testing in the past 20 years has given fertility doctors and their patients the tools to identify chromosomally abnormal embryos prior to transfer. The test also is able to identify the gender of the embryo, and whether there is a 47th chromosome - known as Down’s Syndrome - or other similar trisomy conditions. Most studies show an increase in live birth rates of around 10% with PGT-A tested embryos varying by age of the egg source. However, in the past few years, larger multi-center studies have indicated that PGT-A testing doesn’t statistically significantly increase success rates. Currently the ASRM does not recommend PGT-A testing with the goal of improving outcomes.
Despite the evolving landscape of medical acceptance and standardization of PGT-A testing, at Hatch we require our IP’s embryos to be PGT-A tested to work with our surrogates. This is for 2 primary reasons. First, while Hatch and most U.S. agencies screen surrogates to ensure that they will allow the IPs to make the key medical decisions regarding their fetus, including in the case of Down’s, we want to do what we can to mitigate and lower the likelihood of this occurring. Catching these conditions prior to embryo transfer avoids gut-wrenching decisions for our IPs and surrogates. Second,, many surrogates and surrogate candidates come to us uninterested in working with untested embryos for the aforementioned reasons. In limited cases we will grant exceptions to this rule if the IP’s doctor strongly advises against testing for the purposes of eventual pregnancy success.
The other embryo requirement we have is that IPs have 2 viable embryos ready at the time of surrogate match. This gives our surrogates, who invest significant time and energy in medical screening and the legal process, more than one chance of success. Generally, surrogacy pregnancy success rates for a single embryo averages 75%, which is high but not guaranteed.
At Hatch we firmly believe that if a surrogate is going to risk her health and life by carrying a pregnancy for someone else, that the IPs should not be able to safely carry a pregnancy full term for themselves. This is known as having a “medical need” or “medical indication” for surrogacy. Additionally, there is an extreme imbalance in the supply and demand for help from surrogates in the U.S. This shortage of women willing and able to become surrogates has resulted in long wait times for IPs at many agencies, with no end in sight to increasing demand. Voluntary surrogacy, known as “social surrogacy,” where there is no medical need, allocates surrogates away from those that need to work with a surrogate to have their child to those that do not. We believe that surrogates deserve informed consent to choose who they carry for, and women wishing to carry for families without medical need will be able to work with other programs accepting these cases. We are always upfront with our applicants that we are only accepting IPs with a medical need so they can decide if this is the right fit for them.
Our position on medical need is rooted in these two ethics-based reasons. Views around this position vary across agencies and shift over time. The Society for Ethics in Egg Donation and Surrogacy (“SEEDS”), of which Hatch is a member, subscribed to the medical need requirement for ethical surrogacy for many years. The organization changed its position in 2024 with the reasoning that the ethical framework of female empowerment should allow women to make the choice to work with a surrogate even if they can carry a child themselves. The organization Men Having Babies, of which Hatch is an Advisory Board Member, subscribes to the medical need framework.
We believe that the medical need framework aligns with surrogates who view their journey as a fundamentally altruistic gift to parents unable to conceive themselves, and that our proud expression of this belief attracts surrogates to our program who are altruistically-minded. We also want to be fair to both our surrogates and our IPs because we typically do not have applicants willing to carry for families without a medical need, and we want to be able to provide compatible matches for both parties to have a mutually positive journey together.
At Hatch, we defer to medical experts to provide us with attestation to a potential client’s medical need for surrogacy. The most common reasons for medical need include endometriosis, hysterectomy, and autoimmune diseases. If the IPs are working with a doctor at our in-house clinic PFCLA, the doctor will provide a medical indication directly to our team. If the IPs are working with an outside IVF doctor or OB, they will need the physician to fill out and sign a form to attest to medical need.
We do consider psychological fear of pregnancy, or other psychological needs, as a medical need for surrogacy, and potential IPs will need to provide us with a signed letter from a psychiatrist or psychologist attesting to that need. Single men or gay male parents are assumed to have a medical need.
Consistent with our commitment to altruistically-motivated surrogacy, our surrogates expect to have a relationship with the IPs for whom they are providing this generous gift. At Hatch, we expect our IPs to communicate with their surrogate from match until birth on, at a minimum, a weekly basis via phone, text, or via an in-person ultrasound visit.
That is not to say that the relationship is being prescriptively defined by our agency. Every IP/surrogate relationship is different. Like dating - you don’t know how the relationship is going to evolve from the first date forward. Speaking from personal experience, my relationship with my surrogate evolved and changed in ways I did not expect going into the match, being both business-like at times “How was your weekend?” and then closely familial as time went on. The important thing to understand is to keep yourself open to a relationship with your surrogate that you did not expect at the beginning of the process, and try not to force anything that does not feel natural. Our emphasis on the relationship comes from the surrogate perspective as they want to avoid the experience feeling too transactional or feeling 'used just for their uterus.'
Fostering a warm relationship with your surrogate during the pregnancy is not just for the surrogate’s benefit alone. When your surrogate feels supported, your baby feels supported. Post-birth, the surrogate/IP relationship can take many forms - some are friends for life, others send occasional photos/videos and holiday cards and maintain a distant acquaintance. At that point, it’s up to you, and the most important factor is to be kind, transparent, and make sure you and your surrogate are on the same page about what that will look like so she feels your gratitude and there are no hurt feelings.
Unfortunately, despite the U.S.’s example that surrogacy can be practiced safely and ethically, paid surrogacy is banned across much of the world. Therefore, many families facing infertility come to the U.S. to build their families. On average, a third of Hatch’s IPs live in countries outside of the U.S. For surrogates, matching with an international family can be an amazing way for them to learn about different cultures and develop a relationship that spans the globe.
However, consistent with our dedication to ensuring that surrogates and their IPs have warm relationships, we believe that English language proficiency on both sides of the relationship is a crucial requirement. Some of our team members have argued that the advent of AI language models that facilitate translation across electronic methods allows for an ease of communication between speakers of different languages. While that is true for electronic communication, many of the most connective moments of the surrogacy journey - the match meeting, ultrasounds, and the time together in the delivery room - demand face-to-face interaction that can’t be easily bridged by an electronic translator.
Consistent with ASRM standards, all surrogacy agencies run background checks on their IPs. At Hatch this will be done twice: once before signing up with the agency, and again during legal contract signing. The background check looks at criminal, civil, global watchlist, and motor vehicle history in the IP’s home country. We’re looking for any violent, domestic violence, burglary, murder, or drug convictions. Our pledge to our surrogates is that they are delivering a child into a safe home so we evaluate criminal history based on the safety of the household. Potential IPs can challenge the findings of the report if they believe the history to be inaccurate, and we’ve worked with IPs who have had a specific non-concerning conviction expunged while waiting for a match.
Consistent with ASRM standards, we ask the IPs to complete a psychological preparedness consultation with a psychologist or licensed marriage and family therapist who specializes in third party reproduction. During the hour-long session the IPs will discuss how they are mentally preparing to work with a surrogate, how they will tell their family about the arrangement, and how they envision they will speak to their future children about being surrogate-conceived. At Hatch, the psychological consultation is conducted before signup and is an integral part of the IP’s application to the program in order for us to provide assurance to our surrogates that our parents are psychologically sound, and emotionally ready before entering the match.
Beginning in 2025, Hatch implemented a policy to only allow single embryo transfers with our surrogates. Prior to the improvements in IVF technology and the advent of PGT-A testing, IVF physicians would often implant 2 or more embryos in an attempt to achieve a singleton pregnancy. In recent years, a popular option with gay couples who each desired a genetically-linked child was to implant 2 embryos (1 genetically linked to each) for a twin pregnancy. Pursuing a twin pregnancy with surrogacy is also a popular option for heterosexual couples for the primary reason that a single surrogacy journey is very expensive, and two journeys is doubly expensive - a cost that is financially out of reach for most people.
In the past few years the IVF medical profession has begun to strongly discourage twins for surrogacy pregnancies. Multiple studies over many years affirm the short-term and long-term health risks of having twins, both to the carrier and the children. Furthermore, during their screening sessions with surrogates, third-party psychologists and therapists warn prospective surrogates of the dangers of carrying twins - so by the time a surrogate is ready to match she is generally unwilling to agree to a double embryo transfer.
For the health and safety of our surrogates, and for the children they bear, we no longer accept IPs planning on a double embryo transfer. We understand that places a financial burden on some families planning on having multiple children, and contributes further to rising surrogacy demand, but we feel strongly that health considerations need to take precedence.
Our fertility clinic uses a different genetic testing method than PGT-A. If our embryos are genetically tested but with a different technique, do they meet Hatch's requirements, or must it specifically be PGT-A testing. As long as the testing identifies chromosomal abnormalities we can accept it
These Stories on Surrogacy - For Intended Parents
.png?width=150&height=150&name=Open-Door-Badge_Beyond-Inclusion-LGBTQ-101%20(1).png "Open-Door-Badge_Beyond-Inclusion-LGBTQ-101"){kind=icon}
