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My Surrogacy Journey paves the way

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by Dr Carole Gilling-Smith, CEO and Medical Director, The Agora Clinic

My Surrogacy Journey Advisory Board Consultant Fertility expert, HIV, Trans & Fertility Preservation expert

Advising patients embarking on a surrogacy journey, whether they be IP’s, surrogates or donors, is the most complex work I do as a fertility specialist, and my team of nurses and scientists would echo that sentiment. Yet it is also the most rewarding work we do. It requires a level of expertise, experience and knowledge of the legal and regulatory framework like no other area of reproductive medicine. A typical surrogacy parenting journey is long, often two years or more, involves several human lives, high stakes, a multitude of emotions and many, many critical decisions along the way. The regulatory and legal framework is also a minefield to comprehend and finally there are still many unchartered waters to navigate when it comes to pregnancy and delivery of the baby, especially for those in the LGBTQ+ community. 

Despite having decades of experience in this field, I still find myself confronting new problems or challenges as I advise patients on their surrogacy pathway and invariably have to signpost my patients to many other professional experts in the field. This include legal experts, counsellors and geneticists, for advice and support. So I can only imagine what that journey must look like from the patient’s perspective, particularly when starting out. Also, how daunting this whole journey must feel as none of this expertise so far has ever been available under one roof.

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Lived Experience

MSJ, the brain child of Mike and Wes who successfully travelled this journey themselves twice, has been created through their deep and personal understanding of the complexity and potential pitfalls of this often long surrogacy journey.  They have a unbelievable passion and commitment to deliver exactly what IPs really need on that journey and offer through MSJ the level of personal support and professional guidance required to make that journey very special, very safe and of course hopefully successful. As the voices of Two Dads UK, they have amassed a wealth of experience through working with many professional experts in the field as well as listening and talking to patients involved in surrogacy. This has allowed them to bring together a comprehensive package of professional expertise, educational resources, psychological support and personalised care to deliver exceptional care all who need to use a surrogate during their route to parenthood.

Patient Pathway

As a Fertility Consultant at The Agora Clinic in Brighton, I am often the first point of contact for an intended parent, egg donor or surrogate. Initially, my role is to listen. I always ask patients what their ideal scenario would be. Do both intended parents want to be biological parents? Who wants to be biological parent first? Do they need to find an egg donor and a surrogate or have they someone already in mind for either of those roles? Have they any concerns or worries? Then I focus on educating and guiding my patients through their options, whatever their role is to be in the surrogacy journey. I do this by painting out the whole route from start to finish and clarifying the many different pathways available. This includes the medical and scientific technicalities involved, whether that be  sperm freezing, the creation of embryos through IVF or ICSI or the replacement of a frozen embryo into a surrogate. I also demarcate the likely timescales, the risks, the legal implications, the regulatory requirements and costs.

Finally I focus on the personal health of the individuals involved, identifying any potential issues and additional steps that might need further investigations or procedures. Then with the support of my nursing and scientific team, we sketch out an initial plan for the IP’s and everyone else involved at that stage. Beyond this we signpost IP’s towards the various different professionals they will need to engage with as they proceed on their journey.

The Advisory Board

This is exactly how the MSJ Advisory Board has been framed, with the added benefit that all the experts are within one virtual hub, on a single road map with all the necessary communication between themselves seamlessly co-ordinated.

At the start of their journey, IP’s will be allocated a dedicated MSJ co-ordinator. Totally unique to their journey, and then offered a Clinical Consultation to ensure that initial conversation about who, what, where and how is fully explored. This will be followed by counselling sessions with an accredited fertility counsellor, experienced with dealing with, not only the implications of having a child using donor eggs and/or sperm and a surrogate, but also the myriad of emotions that may be experienced by both the biological and non-biological parent along the way. IP’s will also be offered sessions, as and when these are needed, with lawyers specialising in surrogacy, parental orders, workplace rights and preparing for the birth. When it comes to finding an egg donor and/or surrogate, expertise will also be on hand providing clinical guidance on donor matching, genetic and other screening options and quarantining of frozen samples.

Packed with innovation

MSJ will also provide access to a Directory of other professional services that may be helpful along the way, including advice on fertility clinics that specialise in surrogacy, as well a multitude of educational resources including webinars. Once pregnancy is achieved, there will be further guidance and services offered such as pre-natal screening, preparation for birth and even the support of a virtual Doula via their innovative partnerships!

So this is the incredible future for those planning surrogacy from now on, completely adapted to the new virtual world we have become so used to living in as a result of world pandemic. For my part, I am incredibly honoured to a part of all this, providing my medical expertise as and when it is needed and being able to make a real difference to how surrogacy care can now be delivered.

Editor Notes;

Dr Carole Gilling-Smith

Carole is the CEO, Medical Director and founder of the Agora Clinic in Hove. The largest Fertility Clinic in Sussex offering both NHS and privately funded treatment. She is a Consultant Gynaecologist with particular expertise in Fertility and Reproductive Medicine. She graduated in Medicine from Cambridge in 1984 and completed a PhD thesis during her specialist training. Carole has a diverse research portfolio and continues to publish and lecture nationally and internationally on a wide range of fertility related topics. Carole pioneered the first fertility program for patients in the UK living with HIV and remains an international expert in this field.

The Agora believes in empowering all those who would like a family, either now or in the future, with the freedom of reproductive choice, whatever their gender, race or sexual orientation. Set in the UK’s  LGBT+ capital of Brighton, the Agora has long been renowned for embracing equality and diversity and for opening its doors to all. The clinic offers a full range of bespoke fertility programs to help those in LGBT+ community find their perfect route to parenthood.  Their ethos is excellence through wisdom, honesty and compassion and the clinic has the highest IVF live birth success rates across both London and the South East. They have also won numerous awards for their outstanding patient support.

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