2019Q2

  • 5/10 Contacted OIC to start our surrogacy journey.
  • 5/17 UPDATE
    • “As for surrogates, we currently do not have anyone who’s available to match. There are two couples before you on the waiting list.”

2019Q3

  • 7/22 UPDATE
    • “You are still on the waiting list for the surrogate mothers. However, in the past few months, it’s been difficult to find a qualified surrogate mothers as many of them don’t get medically cleared since the qualifications policy has been changed this year. We thank you for your patience. We will keep you posted in the next few weeks if we do have someone who’s available.”
  • 8/30 UPDATE
    • “Great news! We have one surrogate available to match soon. I will go ahead and send you her profile for review next week. Also, I forgot to ask you for a copy of your IDs when you signed the OIC Retainer. It’d be great if you can E-mail those to me.”
  • 9/3 Surrogate S528 Kimberly Marrow
    • 32yo, BMI 32.2, 2 Deliveries
    • Price: $42,000 (First-Timer)
  • 9/4 Q&A #1
    1. Her BMI is 32 according to her profile. We thought the clinic standard was under 30. Did Dr. Lin screen her? What is his opinion about this surrogate?
      • RFC has reviewed her medical records and she’s okay to go. She has lost some weight; thus her current BMI is under 32. The clinic standard is 32.
    2. It states that she is a catholic. Would she agree on termination/abortion if defects are discovered during pregnancy (we wouldn’t request for selective reduction)?
      • We have asked the surrogate. She agrees on termination/abortion if that is the IPs’ decision.
    3. It seems she has signed up with your agency back in October 2018. Why is she still on the list as of today? Did other intended parents decline her? If so, what were the problems they had with her?
      • Usually it takes a while for us to fully process a surrogate candidate. Once they signed up, our Surrogate Coordinator would have to do a home visit, and obtain all the medical records to give to RFC to review in order to determine if they qualify to be surrogate mothers. She also understood her BMI was a bit high. That’s why during this time she’s been trying to lose some weight.
    4. When can she start?
      • She can start once she is matched with the Intend Parents. RFC cannot bring surrogates in for screening to be medically cleared until they are matched with IPs. And the IPs will be responsible for the GC’s medical charges.
  • 9/12 Q&A #2
    1. What level of health assessment have you done with this surrogate? Have you performed a cholesterol and glucose test, blood pressure, etc?
      • As of now, the surrogate Kimberly has had a mid-cycle screening which includes a mid-cycle lining check to see if the uterine lining grows appropriately, Sono which is placing water into the uterus to determine if there are any uterine polyps or fibroids that can hinder a pregnancy, a history and physical which does include vital signs (blood pressure, heart rate, wt , ht). All lab workup which does include the glucose, liver function, sodium, Calcium, Vitamin D, etc, and all infectious diseases needed by FDA guidelines and drug screen.
    2. Regarding screening fees, we understand that screening will be done after the “match”, and the cost of screening will be on IPs. Can you clarify the “matching” in this context? Are we required to complete all the paperwork and make a partial payment on the agency fee before performing a screening by Dr. Lin?
      • By matching, it means agency will send you a Match Paperwork to confirm the match with the surrogate. You’d be asked to pay the 1st agency fee and the psychological evaluation for the surrogate. In the meanwhile, we’d be sending a match-sheet to the clinic, so they would bring the surrogate in for further screening.
    3. According to the cost breakdown, surrogate compensation is $42,000+. Is this fee flat regardless of the surrogate experience (first-timer or experienced)?
      • Yes. First time surrogate would start with $42,000; but sometimes a surrogate may ask for higher compensation by comparing to other agencies.
  • 9/16 Q&A #3
    1. If the surrogate fails the psychological tests or Dr. Lin screening, what happens to the first agency fee payment that we have paid upfront?
      • If the surrogate is disqualified for medical reasons, you get a 45-day period of rematch without paying extra fees.
    2. You stated she had done a mid-cycle lining check, a sono, a physical and lab workup including infectious diseases. Can we have access to this report?
      • I’ll ask the clinic for the records. However, based on the last update from the clinic, surrogate Kimbery currently has a bit of elevated liver level. Thus, she’s asked to come back for a follow up check up in a month. Do you guys want to wait?
  • 9/17 UPDATE
    • “Just talked to the clinic and our surrogate coordinator, we are not certain this surrogate will be ready in a month or so; not sure if her liver level can be lowered and maintained in a month. We wouldn’t want you to wait that long either. Thus, we just got another update from the clinic this morning that the another surrogate candidate can now be matched and will need to be brought in to clinic once she has her period.”
  • 9/18 Surrogate S529 Edith Madrigal
    • 23yo, BMI 25.2, 1 Delivery, 1 C-Section
    • Price: $45,000 (First-Timer)
      • “This surrogate is asking for $45,000 for her compensation, because she’s saying that’s what a different agency is offering her.”
  • 9/20 UPDATE
    • “I have just gone over your embryo status with RFC. They informed me that your embryos were frozen in 2010 when they were not doing much PGS testing back then in order to determine how many normal embryos you have. Your embryos were fertilized and froze on day 1.  But clinic would have to thaw and grow to day 5 for transfer. RFC would need you to make an appointment with Dr. Lin to discuss your case. It is likely that he might recommend that they thaw, grow to day 5 and PGS them and refreeze to wait and see what is normal. Please give them a call at your earliest convenience in order to schedule an appointment with Dr. Lin. You can reach them at 949-453-8600.”
  • 9/21 UPDATE
    • “I just wanted to follow up with you regarding your request for an appointment with Dr Lin. Your chart will have to be retrieved from storage since it has been some time since you have been seen. We also want to provide you with an appointment time that will allow you an appropriate amount of time to review and discuss your desired treatment. I will follow up with you again on Monday to determine the date/time of your appointment.”

2019Q4

  • 10/10 PGT for Frozen Embryos ordered
    • “They will thaw and watch them grow to day 5-6 in the lab. They can only biopsy embryos that make it Hatching blast stage. So not all of them will make it for biopsy. We then refreeze the embryos awaiting the PGT results. Then we will know what you have to transfer into a surrogate.”
  • 10/11 Q&A #4
    1. Has she completed a mid-cycle lining check, a sono, a physical and lab workup including infectious diseases? If so, can we access to her report?
      • Edith has not done the mid-cycle or the infections disease screening yet.  The clinic demands to have all the surrogates matched before bringing them in for any check ups.  Thus, if you’d like Edith to come in first for all the screenings, I will go ahead notify the clinic that you have agreed to work with Edith, which then you will also be charged for the screenings.  You will also be able to obtain reports on the surrogate from the clinic.
    2. As you mentioned she is ready to go, what is the our next step? We are ready to move forward as well. We expect to have 2-3 high grade embryos at minimum after the PGT.
      • Just as I have mentioned before, once you agree to work with Edith, the next step is that we will then have RFC bring her in for screening after she gets her period.
  • 10/11 Q&A #5
    1. We thought these tests were part of the surrogate pre-screening process as Kimberly had done the mid cycle and infections disease screenings according to your previous email. If the clinic demands to have all the surrogates matched before bringing them in for any check ups, does it mean Kimberly had matched with other IPs before us, and they paid for the screenings?
      • Apologies for the confusion. We were informed by the clinic on 9/3 that they have changed their policy regarding the preliminary screening process. They notified us that they will not be able to screen any surrogate until they are matched. That’s when I advised you that RFC cannot bring surrogates in for screening to be medically cleared until the they are matched with IPs. And the IPs will be responsible for the GC’s medical charges. Kimberly was actually screened before they officially implemented the changes, which I believe was back in July. Hope this helps.
    2. We will start the matching paperwork after we get the PGT results.
      • Noted!
  • 10/14 Q&A #6
    1. Have you updated the retainer agreement since the clinic changed the procedure policy on September 3rd 2019?
      • We are currently working with the director regarding the changes on the OIC Retainer.
    2. You mentioned “a 45-day period of rematch without paying extra fees if the surrogate is disqualified for medical reasons”. Is this a new policy added after 9/3? We do not see it written in our current agreement.
    3. Since we don’t see you have many surrogates in the pipeline, what if you can’t provide anyone within the 45-day period? Will you waive the fee of the “next” rematch?
      • Once you have been matched with a surrogate, meaning you have agreed and signed the match paperwork with us (separate from the OIC Retainer), and yet the surrogate is disqualified for medical reasons, the 45-day re-match period will be based on the date when we provide you with the new surrogate’s information.
  • 11/20 UPDATE
    • “Dr. Yang is looking for media that was used in 2010 when the embryos were frozen for the thaw. He has been out of office and has just returned. We did not thaw and biopsy just yet.”
  • 12/23 UPDATE
    • “The lab informed me that it has been challenging to try to find a match on the media that is needed. The company that did make the media does not make it any more. We do not want to thaw until we find another good replacement. I was told they are looking into two other media’s to potentiality use. They are getting info to decide. The lab is shut down for the holiday for cleaning and maintenance. No thawing will be done until after the new year.”

2020Q1

  • 1/6 Dismissed Surrogate Edith
    • “We have been keeping Edith in the loop for these past few months and she’s been very patient. However, since the wait is still uncertain, and we have given you the courtesy hold until now. We would need you to sign paperwork, pay both agency fee and surrogate reservation fee of $1,000/month in order to secure the surrogate and to pay for our continued service.”
  • 2/11 UPDATE
    • “The lab was finally able to locate Media to use. I have instructed them to do the thaw for PGS only. They will work on this in the next week.”
  • 3/6 Embryo Thawing completed
    • “The lab did embryo thawing today, and all nine embryos survived. Their overall grading is 7 (10 being best). They will grow to day 5 or 6, perform PGS testing, then refreeze while waiting for the results. We will have final number of what was biopsied on Tuesday.”
  • 3/11 Embryo Culture, Assisted Hatching, Cryopreservation, and Biopsy completed
    • “The final count that lab did biopsy is 4. They will be sent out for PGT.”
  • 3/16 UPDATE
    • “Final results will come in about 10-14 days from last week. Grading was Hatching blasts, Fair 2 BA’s and 2 BB’s. This grading is appropriate for pregnancy success and the percentage is if the uterus is OK (about 70-75% chance of 1st time success if transferring a normal PGT tested embryo.) The grading of 7 was just a grading giving an overall view of how they were growing that day when the lab looked at them. Not official grading.”

2020Q2

  • 4/3 PGT completed
    • “All 4 embryos report as normal on the PGT screening. We are now ready for you to work on finding a surrogate for your case. In this time of Corona Virus, we are not doing any cycles at this time but are hopeful to start back up after 5/1. We can, however, review possible surrogacy candidate from the agency and get started with some initial work up. You just need to let us know what you want to do. Some patients are waiting until all this calms down.”
    • “You have 1 male and 3 females for transfer. Our goal is to start cycling again in May.”
  • 5/1 RFC reopened
  • 5/11 Reconnected with OIC
    • Experienced surrogate available immediately. The price ranges from $55,000 to $65,000.
  • 5/13 Surrogate S522 Xochitl Mendez
    • 25yo, BMI 25.0, 3 Deliveries
    • Price: $63,000
    • Abortion OK (NOTE: OIC does not work with GC’s if they do not agree with termination/abortion.)
    • Had a successful pregnancy after the first embryo transfer.
    • Can start ASAP
  • 6/2 Agency Match Paperwork received, requested the editable PDF.
  • 6/5 Updated Agency Match Paperwork received, signed, and returned.
  • 6/8 Wired $11,800 to OIC
    • GC 1st OIC Fee $10.800
    • GC Psych Fee $1,000
  • 6/12 Medical Clearance completed. GC FET Financial bill received
    • The total for the cycle including pre-cycle medical screening is $7,525.
    • The $2,500 deposit was paid upfront.
  • 6/19 OIC got the GC’s screens back from RFC, moving on to Legal work.
  • 6/22 Annual Frozen Embryo Storage bill of $700 received
    • 6/23 Request to check with the insurance provider for coverage.
    • 6/30 “The Billing Department had confirmed they will proceed in billing your insurance for the yearly storage. Please omit the statement you received for the $700.”
  • 6/29 Surrogacy Contract draft and Retainer Agreement received. Provided feedback.
  • 6/30 Updated Retainer Agreement received, signed, and returned. Discussed with Attorney, move forward with the contract.

2020Q3

  • 7/2 Surrogate Accidental Death and Life Insurance Equivalent Policy received, signed, and returned.
    • 7/6 Paid $455.76 to ART Risk
    • 7/7 Updated the benefit to $500,000, paid additional $403.36 to ART Risk
  • 7/7 Final Surrogacy Contract received, printed, signed, notarized, and mailed.
  • 7/7 Maternity Insurance Options received.
    • 7/8 Discussed with the agent.
    • 7/9 UPDATE
      • “Medi-Cal cannot be used for surrogacy.”
      • “If she currently has insurance, she does not qualify for the special enrollment period that ends in July. This is for anyone who currently has no insurance in place due to COVID.”
      • “She can enroll in an ACA plan starting January 1st 2021.”
      • “The ACA costs approximately $400 to $700 per month. The highest out of pocket maximum was $8,150 for 2020. This is the most you can spend on medical care in a calendar year on top of your monthly premiums.”
      • “You cannot switch from the New Life or UFI to the ACA and obtain a refund. You will need to pick either going with the ACA beginning January 1st or the New Life/UFI option for the entire pregnancy.”
    • 7/9 IP application for maternity insurance received, signed, and returned.
  • 7/9 Escrow Trust Account opened.
    • 7/13 Wired $75,050 to Escrow ($50 reserve for the incoming domestic wire transfers fees – $15 per transfer).
  • 7/14 UPDATE
    • “Xochitl is scheduled to have medication start on 07/27/20, transfer on 08/12/20.”
  • 7/15 UPDATE
    • “Please find Xochitl’s OB and Hospital information below:”
      • PIH Women’s Center: 12675 LA MIRADA BLVD STE 401 LA MIRADA CA 90638-2236
      • PIH Hospital Whittier: 12401 WASHINGTON BLVD WHITTIER CA 90602-1006
    • “It is fine for them (attorney) to file the court documents in OC regardless which county the surrogate will deliver.”
    • “A Judgment entered in any county in California is valid throughout the state.”
  • 7/17 IVF Insurance Certificate received. (Effective Date: 07-27-2020)
  • 7/21 GC medications ordered
    • Paid $634.48 to MDR Pharmacy
  • 7/24 Invoice from New Life Agency received
    • Surrogate Maternity Care Major Singleton (A83) Medical Plan: $9,000
    • CA-Tax 3.25% Surplus Lines Taxes and Fees: $292.50
    • SMC Major Deductible (A83) Policy: $20,000
    • “Please find the attached invoice for the Maternity Major Policy here. I will confirm once the funds arrive. We will just need a Confirmation of Pregnancy (form attached) to place this policy.”
    • “The policy will become effective with the payment and the confirmed pregnancy, so I would say once the 6 week ultrasound has occurred, that would be the ideal time to send over the Confirmation of Pregnancy form and submit your payment.”
  • 7/24 UPDATE
    • “We saw Xochitl today, and everything looked great. Her estradiol was 27.7, and her progesterone was 0.29. We let her know that she is good to start according to her calendar. We will be seeing her again on 8/3. I will update you with her next appointment.”
  • 7/27 Surrogate started her FET cycle.
    • “Surrogate Xochitl started her FET cycle on Friday, so we will need to proceed with collecting the remainder of your cycle payment.”
    • “Additional fees that aren’t included in your total include:”
      • medication ($634), which is paid to the pharmacy directly
      • pregnancy visits ($290), which will be collected at Xochitl’s OB visits.
    • 7/28 Paid $5,025 to RFC
  • 7/28 GC Xochitl requested to meet.
    • 7/29 A Zoom meeting with GC and OIC is scheduled for Tuesday August 4th at 11 AM.
    • 7/30 GC Xochitl requested to reschedule to Monday August 3rd at 10 AM instead. Declined due to a schedule conflict.
    • 8/3 “Xochitl and her husband will be free any day of the week after 5pm to do a Zoom call.”
    • 8/4 “Xochtil is asking if today at 5:30pm would work instead of 5pm.”
  • 7/29 Consent documents for GC transfer received, signed, and returned.
    • “I need to know your thaw plan. Which embryo and/or Gender would you like us to thaw? It can be “thaw the best graded embryo or thaw best graded female or thaw the male.” Please email me written verification of what you want done.”
    • “I will put on paperwork for this cycle that you want #4 HHBFBA female thawed – Best female graded embryo.”
  • 8/3 UPDATE
    • “Today we saw Xochitl Mendez and she had a 10.7 trilaminar lining. We are awaiting her labs this afternoon, but it looks good and we are planning on starting the progesterone on Thursday for Embryo transfer on Wednesday 8/12 at 9 am. She will arrive at 8:30 am to suite 909 for her appointment. I have put in the order to thaw the best female for a single embryo transfer.”
    • “We saw Xochitl today, and her lining looked great. It was 10.7 trilaminar. Her estradiol was very low though at 93.5. We have instructed her to increase her estrace to 2am/2pm. She is coming back for a repeat appointment on Thursday.”
  • 8/6 UPDATE
    • “Today Dr. Lin did the ultrasound and all looks great for Xochitl. She had a 13.7 trilaminar lining, estrogen went up to 267 from 93, and progesterone is low where it should be at this point at 0.20. She will follow the transfer instructions and start her progesterone shots tonight for a planned transfer on Wed. 8/12/20 at 9 am.”
  • 8/10 UPDATE
    • “One more sheet of paper for you guys to sign. I thought I had sent with all the consents, but did not see it returned. If you can sign and date, I would appreciate it. It is for the FDA to show how you know each other. Transfer is on Wednesday at 9 am.”
    • “We do take pictures of the embryo before transfer and I can get a copy for you.”
  • 8/12 Embryo Transfer
    • “Xochitl had her transfer this morning at 9 am. It went well. We got her flowers on your behalf. Doctor said her uterus looked great! The result should be back in 10 days. As of now, her pregnancy test will be drawn at Labcorp on 8/21/20.”
    • “The transfer went smooth. She is on bed rest for the next 48 hours from transfer. We did transfer the #4 best graded female and pregnancy test is 8/21/20. She was given a Labcorp slip to go to the lab in her area on that date. If positive, we will repeat on the 24th. If the levels go up good, then we will do ultrasound in about 10 days. If negative, we will have Xochitl stop medications and call with period so we can regroup for another FET try.”
    • “We are asking for same day results. It will be in the later afternoon by 3 pm.”
    • “We are 4 weeks pregnant at a positive pregnancy test. Dr. Lin is seeing patients at 5 weeks and 5 days or so, to make sure the gestational sac is found in the uterus and the yolk sac is present. We may not detect a fetal heartbeat that early, but sometimes we can. We will determine when to bring her in for the first ultrasound at the 2nd blood test.”
  • 8/19 Executed Gestational Surrogate Contract received. (Effective Date: 07-13-2020)
    • “Attached are scanned copies of the Gestational Surrogate Contract executed in counter-part by all parties. Please keep these in your file. The Contract was effective as of July 13, 2020 and clearance has been issued to Dr. James Lin.”
  • 8/21 Home Pregnancy Test: Positive
    • “We did not get results back for Xochitl’s hCG today. She went to Labcorp at 1 pm because that was the only time they had an appointment. I will report the results to you tomorrow since I will be in the office. Xochitl did tell us that she took a home pregnancy test, and it was positive. Hopefully that the results tomorrow look great.”
  • 8/22 Blood Pregnancy Test: Positive (hCG: 93 mIU/mL, P4: 32.36 ng/ml)
    • “We received Xochitl’s results, and they looked really good. Her P4 was 32.36 and her hCG was 93. We will have her stay on all the same medication, and go in for a repeat test on Monday. We will follow up Monday with those results.”
  • 8/25 Blood Pregnancy Test #2: Positive (hCG: 375 mIU/mL, P4: 32 ng/ml)
    • “Her hCG level is good at 375 and progesterone level is good at 32. Congrats! She will continue all medications except the Vivelle-Dot Patch. She will get an ultrasound on 9/2 at 6 am. We will order more medication and MDR will be calling for that.”
    • Paid $279.50 to MDR Pharmacy
  • 9/2 Ultrasound (5 Weeks 6 Days): Good (P4: 26.43 ng/ml)
    • “Today we brought in Xochitl for her Obstetric ultrasound to confirm that the pregnancy was in the uterus and that it was developing normally. We did see a gestational sac and a well formed yolk sac, but no fetal heart tone yet. Dr. Lin is having her return on 9/16 at 6 am to locate the fetal heartbeat.”
    • “Her progesterone is 26.43 today. We are happy with anything over 20. She will continue staying on all medications until we check the fetal heartbeat at the next visit.”
    • 9/3 Paid $290 to RFC
  • 9/14 Ultrasound (7 Weeks 4 Days): Good (HR: 160 bpm, P4: 26.35 ng/ml)
    • “Today we scanned Xochitl. She was 7 weeks and 4 days pregnant. Her ultrasound showed a heart beat of 160 BPM and her size was equal to dates in fetal growth. This is great news. We drew a progesterone level and we will let her know this result later today. She is to follow up with her OB now, so we had her sign a records release. Once you know her OB name/address, please let us know so that we can send records.”
    • “Xochitl called and asked to move the appointment two days earlier. She didn’t mention the reason, but I am assuming it was due to scheduling conflict.”
    • “Xochitl’s progesterone level today was 26.35 which is good. Tomorrow Leahanne will be following up with Xochitl in regards to the weening protocol for her medication.”
    • 9/16 Paid $290 to RFC
  • 9/15 UPDATE
    • “We informed Xochitl of her weening protocol for her medication. Her records are being prepared for the OB. I just wanted to let you know that Xochitl did let us know she needed refills for some of the medications as she was running low. We put in an order to the pharmacy, so they should be following up for payment sometime today.”
    • Paid $356.70 to MDR
  • 9/21 A Zoom meeting with OIC is scheduled for Thursday September 24th at 11 AM.
  • 9/22 Wired $9,000 to OIC
  • 9/24 UPDATE
    • “We (RFC) can monitor up to 10 weeks or so, but after that we can’t. So I can do one more scan. The OB usually wants to see the patients between 10-13 weeks as they have certain early screenings or testing they might want to do.”
  • 9/24 A Zoom meeting with OIC
    • What’s Next?
      • The pre-birth order process begins after week 10-12 of the pregnancy. It usually takes about 1 month to fill out legal paperwork, and 1 month to the issuance of the judgment.
      • We will discuss a birth plan 2 months before the expected delivery date.
    • 2nd Surrogacy
      • The GC pipeline remains the same while the IP pipeline is reduced by half as OIC lost international customers due to the pandemic. Currently they have 3 IPs and 1 GC. They usually find a new GC every 2-3 months.
      • The price of GCs goes up as they experience more – 1st-timer <<< 2nd-timer < 3rd-timer < 4th-timer.
      • “As of now, we have more experienced GCs than first-time GCs; the current percentage is 75% of our GCs are experienced.”
      • OIC does not offer any incentives for returning customers; however, Cindy will ask if they can do anything for us.
      • “Once the surrogate had 3 C-sections, she can no longer be a surrogate. If a potential surrogate had 2 pregnancies that were 2 C-sections, then she can only do one more C-section as a surrogate.”
    • Health Insurance
      • We will pay her medical bills in cash from October until the new year.
      • We will enroll her for ACA 2021 to cover her medical expenses starting January 1 for the remainder of the pregnancy.
      • “I’ve spoken with the IPs earlier today, they’d like to pay out of their pockets for the remainder of this year and then just wait for Open Enrollment to start and apply for ACA 2021.”
  • 9/29 Wired $8,000 to OIC
  • 9/30 Paid $2,592.60 to OB/GYN
    • “I was informed by Isabel that Xochitl’s OB will be charging her $2,590 for all the OB visits until she delivers, this does not include labs & ultrasounds. The other option is to pay $4,321 on or before 27 weeks. Xochitl’s first OB is now scheduled Wednesday 9.30.2020 at 1:45 pm.”
    • “The OB clinic informed us that the payment MUST be made at tomorrow’s OB appointment, Wednesday 9/30 @ 1:45pm if you’d like to take advantage of the 40% cash discount in the amount of $2,592.60. You can pay with a Visa credit card or Visa debit card they will take it as a credit card payment. Isabel asked the OB if you can only pay up until December 31st and would the price be reduced and they said they can not. Victoria from the OB said this price is for the full service of maternity care.”
    • “Isabel spoke with the hospital earlier today. And below is the information she got:”
      • Approximately for Maternity C-Section Birth or a Natural Birth cash price estimated would be $8,713, this includes the GC stay for up to 3 or 4 days if there are no complications. (If complications she is not able to give me a price because she just does not know what it would be.)
      • Approximately Baby: General Nursery Board would be $1,101 per day this is for one night stay in the nursery. If baby has to go to NICU then it would range from ICU NICU $4,996 to INTENSIVE CARE $6,142 PER DAY. This does not include baby labs, Neonatologist, respiratory Dr., Therapist Dr. & x-rays. ONLY for the baby staying in the nursery. (She could not tell me just yet for the IP’s if they wanted to stay the night how much it would be. She said to inquire 1 month before GC delivers.)
      • GC Observation: If GC has bleeding, does not feel the baby move or having pain and needs to be seen by urgent care at the hospital then it would be $244 for the day. This is not an overnight stay price. Again, it does not include Dr.’s fees, labs, ultrasounds, x-rays etc. Those are additional fees.
  • 9/30 Ultrasound (9 Weeks 6 Days): Good (HR: 171 bpm)
    • “Xochitl’s FOB appt. yesterday went well. She is 9 weeks 5 days, her blood pressure and weight were normal. We were seen by the nurse who gave us information about list of medications Xochitl can take while pregnant, free classes for maternity like group sessions with other mothers. Nurse asked if Xochitl would be breast pumping after birth? Around the 28th week of pregnancy nurse said she will be recommended to get a whooping cough vaccine for herself and whoever will be with the baby after she is born.”
    • “Dr. did a vaginal ultrasound and all looked normal and examined Xochitl’s heart and lungs sounded normal. Dr. said baby size is a of a walnut size he said lol he gave her a date of delivery of May 1st. Baby’s heartbeat was good.”
    • “The office took the payment for the OB Maternity care and I have attached receipt for your records. Dr. would like to see Xochitl back in two weeks to talk about genetic screening from the parents and he would like to know what due date did the fertility center gave her. Xochitl’s next visit is on October 15th at 11:15 am. I will update you on her next appt.”

2020Q4

  • 10/15 Surrogacy Assistance Program
    • “The maximum children per program is 2 kids. If using a surrogate for 3 kids they can only apply for 2 regardless of whether there is an adoption at the end of the process.”
    • “If you are using a surrogate for all 3 children – you can only use the surrogacy assistance program for 2 – regardless of whether an adoption is part of the surrogacy process. However, if you used a surrogate for 2 children and then adopted a third child (no surrogate) – you could use the adoption assistance program.”
  • 10/15 Ultrasound (12 Weeks): Good (HR: 153 bpm)
    • Xochitl’s OB visit yesterday morning went well. Xochitl is 12 weeks 5 days, her weight and blood pressure 118/80 were normal.
    • Xochitl had a vaginal ultrasound, baby’s heartbeat was 153 which is normal.
    • Her labs results were all normal and I have attached her lab results in this email for you to review.
    • Dr. said she will have a perinatal scan sometime in the next 2 weeks to do anatomy of the baby, I will let you know once the Dr. office calls Xochitl to schedules it.
    • Dr. said she can stop the fertility medications today at 12 weeks.
    • Her next OB appt. is on November 12th at 10:30 am. I will update you after appt.
  • 10/18 Parentage Documents
    • “Your names will go on the court documents, the court judgment and the birth certificate exactly as you signed the contract and had your signatures notarized. So whichever identification you used for that is what you will use at the hospital. We don’t need anything to file the court documents other than the contract you already signed with the names on the contract.”
    • “The first step is for Cindy at Options in Conception to gather the necessary information from Dr. Lin, you, and your Surrogate. Once I have that (dates, addresses, etc.), then I will reach out to you to confirm the information and get more information if necessary and then start to prepare the pleadings.”
  • 10/21 Nuchal Translucency Ultrasound
  • 10/28 ER Visit
    • “Isabel called her back and Xochitl said she called her OB and her doctor advised her to go to the hospital emergency.  And since she doesn’t have insurance so they will be billing her. She said when she wiped herself little light pink stuff came out not sure if it’s blood she said. She said the OB Dr. told her it happens with pregnancy.”
    • “The nurse informed Xochitl has something called Placenta Previa that can cause her to spot or bleed during pregnancy. That was the reason why she was spotted last night.  She informed her she won’t need to be on bed rest but to just need to take it easy and not to do anything crazy.   Xochitl told us that she will then send over the info regarding the receipt for the payment later once she rested a little.”
  • 10/28 Parentage Documents received, signed, and returned.
  • 10/30 OB Appointment (14 weeks and 1 day): Good (HR: 150 bpm)
    • “Xochitl’s blood pressure and weight were normal they checked baby‘s heartbeat and it was 150 bpm, Doctor said everything looks good what she possibly had was from constipation so he gave her over the counter to take Colace and milk of magnesia this should help her constipation he also told her not to lift anything heavy.  Her urine was normal and no more light pink bleeding.”
    • “Isabel also got back the results from the ultrasound that she had for the nuchal translucency. They all came back normal. She can scan and email the results to me on Monday morning but here’s a picture she sent me in the meantime.”
  • 11/10 ACA Insurance Quote received.
    • “Please find attached the quote for your surrogate. The quote provided is based on your surrogates specific information. All insurance choices are found to be safe for the use of surrogacy.”
      • Oscar – Circle Bronze EPO – $11,471.44 Overall Cost (12 months of premium + OPM)
      • Oscar – Circle Silver EPO – $11,587.44 Overall Cost (12 months of premium + OPM)
      • Oscar – Gold Select EPO – $12,089.20 Overall Cost (12 months of premium + OPM)
  • 11/12 OB Appointment (16 weeks): Good (HR: 163 bpm)
    • “Xochitl’s OB appointment yesterday went well. Xochitl is 16 weeks 5 days as of yesterday, her blood pressure and weight was normal.  Baby’s heartbeat was normal at 163bpm, and the doctor told them her belly is growing normally.”
    • “Xochitl was given the flu shot yesterday, which was recommended by the doctor and safe for pregnancy. The clinic did not give her a price yesterday. The shot will be billed later.”
    • “Doctor told them she needs to schedule the baby’s anatomy ultrasound. The clinic will call her sometime in the next 3 to 4 days to schedule her. Xochitl will keep Isabel posted on the date and time, but she will not be able to attend this appointment; only patients are allowed.”
    • “Please note: Xochitl’s next OB appointment will be a phone consultation on December 7th at 10 am, Doctor told them this because Xochitl is doing great and would like to see her back in January at the clinic. They will schedule her an appt after her phone consult with the doctor.”
  • 11/23 ACA Enrollment completed
    • “Xochitl is set to get applied for her ACA policy today at 12:30pm PST. However, because she is being applied for Oscar Insurance, the premium will need to be paid through an ACH account. If possible, please have the DocuSign below filled out by the intended parents so that Xochitl can get applied for her insurance today and so that her binder/premium payment is paid when the application is submitted.”
    • “ArtRisk has sent me the DocuSign to get Xochitl applied for the insurance today. If you’d like, I can fill out this form for you once I get the ACH information from the attorney to have this set up from the trust account.”
  • 12/21 Maternity Hospital
    • Xochtil got back to you this afternoon regarding her decisions:
      • I would like to keep my current OB with restrictions according to IPs’.
      • I’m ok changing OBs to St. Joseph Hospital if my glucose test comes abnormal.
      • And I’m ok delivering at St. Joseph Hospital.
  • 12/22 Pre-Birth Judgment received
    • Attached are the “Conformed Copies” of the pleadings, as well as a scanned copy of the Certified Judgment. These have been dated and stamped by the Court Clerk. Please keep them in your file for future reference. I am mailing an original certified copy of the Judgment to Options in Conception. They give that to the Birth Clerk at the hospital at the time of the birth. The Birth Clerk will use that to issue the Birth Certificate for the baby. I am simultaneously mailing you two (2) certified copies of the Judgment. Please keep those in your file for your future reference.
    • The Birth Clerk will keep the certified Judgment. (that should be the one that was sent to Options). You will still have two (2) copies of the certified Judgment in your possession. We also hold one certified copy of the Judgment in our file for emergency purposes. If you do a hospital tour, the hospital may ask you for a certified copy of the Judgment. I would recommend taking a COPY of the certified Judgment with you and giving them that. Tell that that you “forgot” the original stamped certified Judgment.  Hospitals are notorious for losing the original document. I always recommend waiting until the baby is born and giving the certified Judgment o the actual birth clerk on staff at that time. Much less chance that it will be lost then.
  • 12/23 Q&A
    • Where do GCs live?
      • Mostly from LA and San Bernardino, less from OC, and some from Riverside (Palm Springs). OIC only covers Southern California and Las Vegas.
    • GC pipeline
      • In 2020, OIC was getting more returning GCs and there was no 1st timer.
    • As an IP, we feel we have less negotiating power. Can we make an adjustment to our contract such as “increasing her base compensation to match whatever she asks, but drop C-section compensation instead”?
      • Some GCs concern about time more than money. If we are OK to wait until we find a right one, we will have more negotiating power. This is no different from regular business contracts. That being said, some GCs never calculate and others care about money a lot. It really depends on who they are.
    • Why is a gift budget so high ($2,000)?
      • It is only the guidance. Chinese IPs have the culture of giving money in red envelopes to GCs after delivery. IPs should not feel pressured to give anything. OIC only recommends sending a small gift for the holidays or birthdays to build an emotional connection with GCs.
    • Maternity Hospital selection
      • GCs tend to want to stay with their OB/GYN. If we want to choose a specific maternity hospital, make sure to discuss early so that it is on the surrogacy contract.
    • Is support meeting required under California Law or offered as a benefit? If not mandatory, can we remove?
      • “No laws require the surrogates to have the psychological evaluations; it’s common sense that they do. The $100 monthly support meeting is what most agencies have in the policies. It is to assist the surrogate in attending the support group meetings and the time spent for doing so.”
    • What are the chances of a miscarriage after the key events?
      • 30% after a blood test positive
      • (almost) 0% after a heartbeat detection. There was a case that it was fine at 6 weeks, then a baby disappeared at 8 weeks.
      • never experienced an abortion after seeing an ultrasound
    • How many embryo transfers before success?
      • Usually after 1-2 transfers, rarely 3. In some cases, they run out of embryos and stop.
    • Have any GCs walked away from a contract?
      • It usually happens after multiple failed transfers. GCs tend to get emotional. They feel responsible for failures and are unable to start another cycle.
  • 12/23 Holiday Gift purchased
  • 12/29 OIC – Hospital Delivery Process
    • Prior to Hospital Arrival:
      • Contact the delivery hospital for a hospital tour and inform them about upcoming surrogate baby delivery to see if they can arrange two rooms next to each other in advance; usually the surrogate would do the tour.
      • A good time to tour the hospital is between week 30 and week 34 of pregnancy.
      • Hospital may ask for a copy of the certified copy of the court documents in advance just in case
    • Arriving to Hospital:
      • Bring passport or driver’s license to hospital.
      • Bring court/parentage document to hospital; hospital will need the actual certified copy this time
      • Car seat ready in the car.
      • Flower bouquet and/or red envelope, or any gift you find fitting to surrogate to thank her for the entire surrogacy journey.
      • Bring a set of baby clothing for the baby to change into when going home.
      • Some hospitals may have the intended mother sit in the wheelchair holding the baby and they wheel her down while the intended father drives the car to the entrance in order to do the full discharge experience.
      • You may choose to stay in contact with the GC in case you want to share future photos/videos of the baby with her.
      • Birth certificate is to be picked up at the vital records; the hospital will provide you the contact information.
      • Social Security Number Card will be mailed to you to your home address.

2021Q1

  • 1/2 出生届用紙 request mail posted
  • 1/4 Holiday Gift delivered (9405511202079473325584)
  • 1/7 UPDATE – Anatomy Ultrasound for GC
    • “Xochitl’s OB doctor called me earlier today saying that she’s 25 weeks and 4 days pregnant.  And he’s asking you to reconsider having Xochitl do the anatomy ultrasound because even though she has her regular OB visits and/or ultrasound, it’d still be much safer to do the anatomy ultrasound now for the doctor to see if there’s any possible abnormality and prepare in advance.  He said if money is an issue, he can refer her to a cheaper anatomy ultrasound, which shouldn’t cost more than $500 instead of like $2,000+.”
  • 1/7 Paid $450 to ART Risk
  • 1/9 出生届用紙 received
  • 1/11 Maternity Hospital
    • “Xochitl informed me this morning that she will be going to the OB at St. Joseph’s. The initial visit will cost $65 and they will inform her the copy’s after the first visit.”
    • “She will be switching her OB to St Joseph’s. As for the anatomy test, she will be referred by her OB once she is seen after the initial visit.”
  • 1/15 OIC-CS transition
    • “I will be able to schedule a meet and greet via Zoom once OIC and CS have completed the transfer on our end internally.”
    • “We will take next week to finalize all paperwork, communication, and transfer files etc, so we are looking as soon as the end of January or beginning of February.”
    • “After the transition your case will be coordinated by CS. I will give you more details regarding your coordinator once we iron out the details with CS. I will also facilitate a virtual meeting to introduce you to your new coordinator.”
    • “Your CS coordinator will be able to attend the delivery (hopefully hospitals will allow by May, past few deliveries OIC was not able to attend per hospital COVID regulations). I will be sending all paperwork (including the judgement that we received) to CS prior to your delivery date.”
    • “We will check in every week with you to make sure your case is going smoothly and will be able to provide assistance if needed (if/when CS is unable to fulfill your request).”
  • 1/19 OB Appointment at St Joseph Hospital Orange
  • 1/22 OB Anatomy Ultrasound at St Joseph Hospital Orange
  • 1/28 Introduction call with OIF
    • “I will send over the Welcome Packet for you to review later this week.”
    • “I will reach out to the Intended Parents directly once I have a potential surrogate ready to match.”
    • “We probably won’t have surrogates available to match until late Feb/early March.”
    • “Most likely I will send you the Retainer for you to review and sign in two weeks or so in order for us to start the matching service and for you to hold a place on the IP list.”
  • 1/28 OIF Welcome Packet received
  • 2/7 OIF documents and forms signed and returned
    • NDA
    • Application & Wishlist
  • 2/10 Introduction call with CS
    • CS will provide event-based updates.
    • CS will set up a separate meeting to create delivery plans.
    • Only one of IPs needs to be present to complete the birth certificate paperwork.
    • Insurance termination should be after the 6 weeks postpartum checkup.
    • CS covers OC and LA area.
  • 2/12 CS Welcome Packet received
  • 2/16 OIF Additional paperwork received
    • “Just thought I’d send over a few more paperwork for you to review and fill out as we have a few surrogates who are ready to start already!”
      “Once you sign back our IP-GC Retainer and submit the first payment of $5,000 (issue check payable to Options in Family), I will then send over our current GC profiles for you to review and get started on the matching process.”
  • 2/18 CS UPDATE
    • “I want to let you know that I spoke with Xochitl over the phone yesterday. She had her OB appointment on February 5th with Dr. Akerman. She stated that everything is going well with the pregnancy and there is no issues or concerns. Her next OB appointment is on March 3rd.  Due to covid only the patient is allowed at the appointments. I’ll have Xochitl ask the OB if they will allow one more person with her at her next ultrasound appointment. If they do, I will let you know so we can coordinate. Xochitl has not registered at the hospital just yet but she will ask Dr Akerman if she needs to register already. I asked  Xochitl for a couple of ultrasound pictures. She sent me some this morning. The pictures are from her last ultrasound appointment on January 22nd. I’m forwarding them over to you in case you don’t have them. Your baby looks beautiful.”
  • 2/18 CS login approved
    • 15 Available Surrogates:
      • 1 Preview
        • S2185 – 31yo, BMI 21.8, 3 Deliveries, 1 Failed Transfer – D&C (placenta accreta)
      • 4 Available
        • S2669 – 32yo, BMI 28.8, 1 Delivery, 1 C-Section
        • S2031 – 37yo, BMI 24.6, 4 Deliveries, 1 C-Section
        • S1676 – 34yo, BMI 22.0, 5 Deliveries, 1 Failed Transfer
        • S2401 – 38yo, BMI 24.1, 2 Deliveries, 2 C-Sections
      • 2 On Hold
        • S2544 – 27yo, BMI 26.5, 2 Deliveries, 1 C-Section
        • S2329 – 34yo, BMI 21.9, 2 Deliveries, 1 C-Section
      • 5 Matched
        • S2634 – 31yo, BMI 24.1, 2 Deliveries, 2 C-Sections
        • S2507 – 37yo, BMI 28.3, 3 Deliveries, 1 Failed Transfer
        • S2198 – 41yo, BMI 22.0, 3 Deliveries
        • S2461 – 35yo, BMI 22.3, 3 Deliveries
        • S2038 – 36yo, BMI 25.1, 5 Deliveries
      • 3 In Cycle
        • S1970 – 37yo, BMI 23.0, 4 Deliveries, 1 C-Section
        • S1359 – 34yo, BMI 30.0, 3 Deliveries, 3 C-Sections, 1 Failed Transfer
        • S2263 – 36yo, BMI 30.6, 3 Deliveries
  • 2/19 Call with OIF
    • We will hold the payment until they are ready to accept wire transfers.
    • OIF will discuss internally regarding the timing of the “Surrogate Retainer” payment.
    • OIF already has a surrogate who is ready to start NOW.
  • 2/23 OIF documents and forms signed and returned
    • OIF Retainer
    • Disclosure of Physician Ownership
    • Waiver and Authorization for OIF to access IP’s Medical Information
    • Authorization for Disclosure and Use of Medical Information
  • 2/24 Surrogate S1004 Amely
    • 33yo, BMI 25.6, 2 Deliveries, 2 C-Sections – Hypothyroidism
    • Price: $65,000
    • City: San Bernardino, 92407
  • 2/25 Q&A
    1. How soon does she want to start?
      • She’d like to start ASAP.
    2. Did she have thyroid problems for a long time or she got it during her recent pregnancy? What was her doctor’s comment regarding a potential impact on pregnancy?
      • She didn’t initially have thyroid. What happened was that she had some benign nodules in her throat after the pregnancy (surrogacy). They had to remove a little of her thyroid, which they did. She’s obtained medical clearances from her doctors in 08/2019 and again in 01/2020 stating that she is okay to do another pregnancy. No specific comments regarding thyroid and pregnancy.
    3. How did she cover her pregnancy and childbirth medical bills during her first surrogacy? Her own insurance, private insurance (surrogacy insurance), or ACA?
      • It was New Life Insurance.
    4. Can you provide her city and zip code if not the entire address? There is only one hospital in San Bernardino County under the Oscar plan. We are concerned about the distance if we go with ACA.
      • City of San Bernardino, zip code 92407.
    5. Who gave her a ride during her last pregnancy?
      • Her ex-boyfriend gave her a ride to the hospital to deliver the baby.
    6. On her profile page 9, “Date of Transfer” is 12/2019. This does not make sense when “Date of Delivery” is also 2019.
      • Apologies, she remembered the years wrong and we didn’t catch that. Date of Transfer was 12/2017. Date of Delivery was 08/2018.
    7. Is she open for negotiation? Xochitl’s profile was better overall and her compensation was less. We are hesitating to accept her asking price.
      • She said she would really like to stay with $65,000.
    8. Did/does she have health insurance in 2017-2018 and 2021 (current year)? If so, which provider?
      • Yes, she had private insurance through her job. It was United Health Care.
    9. To clarify Q2 – “she had some benign nodules in her throat after the pregnancy (surrogacy)”, did she get the thyroid problem during the pregnancy or after the delivery?
      • She got it after the delivery in Jan 2019.
    10. Related to Q9, did she have the thyroid removal surgery during surrogacy? How did she cover the cost of the procedure and subsequent drugs? How is she paying for her ongoing cost?
      • She used her own insurance.
    11. Is she ok to deliver in San Antonio Regional Hospital? It is about 23 miles away from her place. We figured that since she will likely have a C-section, the distance to the hospital will not be a big issue.
      • She is ok with delivering wherever the IP desires.
  • 3/1 Dismissed Surrogate Amely
    • “We decided to pass. We have done extensive research on the impact on surrogacy associated with her thyroid treatment. In short, there is a sharp decline in the success rate of IVF pregnancy in levothyroxine-treated women with hypothyroidism compared to euthyroid women. The difference observed in a study was very significant that we could not simply ignore the risk factors. Provided she has turned down our best offer; hypothyroidism is associated with higher risks of IVF implantation failure, it is in our best interest to find another match.”
  • 3/1 Surrogate S1002 Valeria Ortiz
    • 25yo, BMI 25.9, 3 Deliveries
    • Price: $60,000
    • City: Bellflower, 90706
  • 3/5 CS UPDATE
    • “Xochitl said that March 1st appt went great. She was 32 weeks that day. Baby’s heartbeat was normal and no issues or concerns. Her next OB appointment is March 16th.”
  • 3/8 IP GC Match Paperwork signed and returned.
  • 3/8 Paid $6,650 to OIF
    • Surrogate Retainer $5,000
    • Surrogate’s Psychologist $1,650
  • 3/8 OIF UPDATE
    • “I have already reached out to the clinic regarding the next steps.”
  • 3/12 OIF UPDATE
    • “As of now, the clinic is asking the GC to contact them when she gets her period, which should be end of the month.”
  • 3/17 CS UPDATE
    • “Her appointment yesterday went well. She was seen by the nurse and was told that they are having her do another ultrasound to see the growth of the baby. Then, the nurse realized she had an ultrasound done at 26 weeks. Xochitl expressed that she doesn’t think is necessary to do another ultrasound when everything is going great with the baby. She wants me to ask you if you want her to go ahead and schedule the ultrasound. She doesn’t mind scheduling the appointment but she wants to confirm with you. I’m not sure if she can say don’t do it when the doctor is ordering the ultrasound. Let me know what you think. Now that she is close to delivery day she will be start to be seen every two weeks. Her next appointment is on March 30th.”
    • “Juli will be contacting you in a couple of weeks or sooner to discuss delivery plan. As of right now what we now is that St Joseph Hospital is only allowing one person during delivery. With everything opening up hospital rules may change by the time of delivery. In the meantime may you please answer the questionnaire attached to this email and also send me a copy of your driver’s license so we have it when we send all documentation to the hospital. If only one person is allowed at the hospital Xochitl would like for the intended mom to be present. If the hospital allows two persons. Xochitl would like both of you to be present.”
  • 3/19 CS UPDATE
    • “Xochitl scheduled the ultrasound for March 23rd. She might have to pay a copay of $65 since it’s a specialist visit according to the insurance. She wants to make sure she can use the credit card to pay for that. The ultrasound order she was given says “Fetal growth ultrasound”. It’s basically to check how the baby is growing and to check fluid.”
  • 3/24 CS UPDATE
    • “Xochitl said that everything went well with her ultrasound appointment yesterday. Her OB appointment is next week March 30th. She will ask for the report when she sees her OB. Xochitl was given a document saying that she can pay $5.00 for all the ultrasound pictures that were taken that day. She is asking if you are interested in the pictures. If, so she’ll go ahead and request for the ultrasound pictures.”

2021Q2

  • 4/1 CS UPDATE
    • “Xochitl’s OB appt went well baby is growing great and healthy no concerns with the pregnancy. Xochitl requested results for the fetal growth ultrasound. Please find them attached to this email. Juli will be reaching out to you soon for the birth plan. There is probably not much to go over since you are not anticipating to be present at the delivery.”
  • 4/2 OIF UPDATE
    • “Valeria has just started her period yesterday afternoon and she contacted RFC already. They instructed her to start taking estrogen pills today and then possibly schedule her on 4/13 for an ultrasound.”
  • 4/6 CS UPDATE
    • “Xochitl had an appointment yesterday. Xochitl is measuring 35 weeks but she was told it is completely normal. Overall everything went great. Her next appointment is next week. Tuesday at 4:30 pm. She might change it for next day because the time is too late for her. Attached please find Xochitl’s monthly progress report from therapist Rosa Santoyo.”
  • 4/13 OIF UPDATE
    • “We were informed by Valeria’s husband that Valeria got into a car accident on the way to her appointment this morning. As of now, he said she sounded okay on the phone, but she’s being sent to the hospital. Thus, he will then keep us updated once he goes to see her.”
    • “Isabel talked to Valeria’s mom just now. Valeria has a neck brace on and is currently in the emergency room at UCI Medical Center in Orange. According to her mom, she is doing okay. But most likely she won’t be able to reschedule her ultrasound appointment for the next few days. Once we hear more updates back from them, we will then keep you updated.”
  • 4/14 OIF UPDATE
    • “Valeria text Isabel last night to let her know that she’s okay, no broken bones, and her x-rays came back negative. Valeria will be going home sometime this morning. The clinic has followed up with her again this morning and ask her to contact them on her next period. They are not doing medical clearance until next month.”
  • 4/14 CS UPDATE
    • “I am working on finalizing the birth plan and I do have the information that you provided to our director. St. Joseph hospital does have expectations that the parent will be at the hospital either shortly prior to or right after the birth. We usually ask that the Surrogate or her support person call or text the parents when she is in labor, admitted and progressed to 7 cm of dilatation. You would be expected to remain at the hospital and will be “banded” with wrist bands identifying you as your child’s sole “parents” with all legal and parental rights, decision making for the child’s care and so forth. Usually the baby is “handed off” to the parents upon completion of the post birth medical assessment. You will either have a room or be in the bonding room to care for and start “skin to skin” contact with your baby as soon as possible post birth.”
    • “Generally the stay at the hospital can be approximately two days. Depending on the time of the birth and if there are any issues that may require more time such as jaundice. The surrogate could deliver one day and the baby be ready to be released the following day, once deemed ready for discharge by the attending pediatrician. While you are at the hospital and prior to release if possible, one of the Birth Clerks will meet with you to complete the documents for the birth certificate recording with Orange County Vital Records.”
  • 4/16 CS UPDATE
    • “Thank you for sending back the information about the health insurance. I have been in contact with the St. Joseph Hospital social worker and the Vital Records/Birth Clerk in preparation for your upcoming birth. At least one parent will need to come to the hospital either prior to or just after the birth event. Usually we ask the surrogate or her support person that she designates to be with her at the hospital to contact one of you by text or call your cell phone.”
    • “The plan is for an induction so some time will pass once she gets to the hospital to prep her and start the induction process. She could let you know when she is progressing toward the half way point of 5 cm and then when she reaches 7cm since you will be driving to Orange. She did offer to allow you to be in the birth if you wish, or to come in while she was in labor. I know that you didn’t anticipate this but it is a warm gesture and opportunity extended to you.”
  • 4/20 CS UPDATE
    • “I hope your day is going well. Just a couple more weeks for the birth of your little bundle of joy! Xochitl had an appointment this morning. She was seen by the nurse practitioner. As expected all is going well. Baby is still high. Her next appointment is scheduled for next Tuesday at 9:15 am unless she goes into delivery before then. I let her know to call me as soon as she starts going into labor. Xochitl asked if you would like her to contact you directly, by texting you or calling you once she is going to the hospital. Let me know if I can give her your contact information.”
  • 4/27 CS UPDATE
    • “Xochitl had an appointment this morning. Dr. Akerman is recommending Xochitl to be induced this Saturday if your baby is not here by that day. She would need to schedule a COVID-19 test per the hospital’s protocol. She mentioned she was having some tightness in her belly. Xochitl may deliver at any moment. How exciting!”
  • 4/28 CS UPDATE
    • “Xochitl will be induced on Saturday starting at 4:00 P.M. Induction does take time so she will be able to let you know when to come to the hospital. I spoke to the Birth Clerk today to confirm that they have the Certified Judgment, and also inform her that Xochitl would be likely delivering on Sunday, from Saturday induction. It takes between 6-12 hours once she gets going, but she has had prior births so I would estimate 5-8 hours.”
    • “If you arrive for your delivery on Monday to Saturday between 4:30 a.m. and 8:30 p.m. or on Sunday between 7 a.m. – 8:30 p.m., enter through the main hospital entrance off Stewart Dr. The staff in the main lobby will escort you to OB Admitting located on the second floor. After Hours enter through the Emergency entry. Phone: (714) 771-8246”
    • “Cafeteria: 8:00 a.m. to 8:00 p.m. Outside Ordering: DoorDash or similar delivered to main lobby and nursing staff will go down and pick up. Main Lobby hours only.”
  • 4/29 CS UPDATE
    • “You should not have to bring your original certified Judgment into the hospital. We have confirmed with the Social Worker and Birth Clerks that the document is in the Birth Clerks office. I have updated the birth clerk that there is a planned induction to begin on Saturday and she is scheduled to be admitted for at 4:00 PM. Because the birth will be on the weekend, sometimes it causes concern with the staff on duty, if the birth clerk is not there to tell them she has the Judgment in her office. You may feel pressured, but there is no reason to bring in your copy or let them know you have a copy. The birth clerk has 3 days post birth to complete the birth registration/birth certificate forms. You can always call us if needed.”
  • 5/4 CS UPDATE
    • “I wanted to let you know that there is a shortage of $2,927.35 on the trust to account to pay Xochitl’s final compensation. I added $1,000 for miscellaneous. Any remaining balance will be reimbursed back to you once we settle all payments. Per your agreement you agreed on providing gifts to the surrogate through the agency via your trust account or on your own. We can do a massage and flowers if you like (just an idea). Let me know if you would like me coordinate that for you.”
    • “Congratulations on the birth of your daughter from all of us at Coastal Surrogacy! We consider it a privilege and a blessing to have the opportunity to be a small part in this very amazing event in your lives. We know that your lives are very busy now and you will be lacking sleep these first few months but we wanted to reach out to you and let you know that we will be following all the insurance billing and processing for Xochitl’s medical care and making sure that if there are any issues with payment or processing that we will bring to your attention and hers, and request any reviews that may be needed.”
  • 5/5 OIF UPDATE
    • “As of now, we are still waiting for Valeria’s period to come and then contact the clinic to go in for checkups.”
  • 5/7 OIF UPDATE
    • “GC Valeria has gotten her period last night and informed the clinic already. We will keep you updated once they schedule her an appointment for the screening.”
  • 5/10 OIF UPDATE
    • “GC Valeria has been scheduled for Thursday May 20th at 10:45 am for her appointment at the clinic.”
  • 5/20 OIF UPDATE
    • “Valeria was seen by the clinic today. They drew her precycle labs and had her sign consents. Her cavity looked good, but her lining was only 5.6mm trilaminar. They are going to keep her on Estrace and bring her back next Wednesday to look at the lining again. They have given her a lab slip for her partner, so if everything looks good next Wednesday, he will go to have his labs drawn.”
  • 5/21 RFC – FET Financial
    • The total for the cycle including her pre-cycle medical screening is $7,525.
    • At this time, we will need to proceed with collecting the $2,500 deposit (which will be applied and deducted from the cycle total). I’ll reach out to collect the remainder of the balance when we are ready to proceed with her embryo transfer cycle.
  • 5/26 OIF UPDATE
    • “Valeria came into the Corona location earlier today for a follow-up appointment. RFC updated us that her lining looked good today. It was 9.0mm. They did receive back all her labs and everything was negative which is good. However, her vitamin D level was really low. It was 11.7 ng/mL. RFC would like to see it over 30 ng/mL. Thus, they have asked Valeria to start taking vitamin D supplements. Also, Valeria’s husband still needs to have his labs drawn. The clinic will need to wait for those results before they can give final clearance.”
  • 6/7 RFC UPDATE
    • “We got Valeria’s labs as well as her husbands back for infectious screening. They are good to move on to Legal now.”
      • “We do a protocol:
        – Birth control pills at period start x 2 weeks.
        – off pills x 5 days to get bleed
        – Start meds on the 6th day off pills
        – then 17 days of meds to grow the lining and transfer
        So a total of 36 days approximately from start of birth control pills to transfer date. IF her period starts beginning of July, Transfer will be 1st part of August.”
  • 6/7 OIF UPDATE
    • “We received an update from RFC this morning that both Valeria and her husband’s labs are good. She’s now medically cleared. Thus, we already followed up with Valeria to have her reach out to the psychologist for her psych evaluation.”
      • “It depends on the availability of both the GC and the psychologist. The evaluation itself shouldn’t be more than an hour so. The psychologist usually will give us a verbal report whether she’s cleared or not once she’s spoken with the surrogate. We are hoping to have it done by this week.”
  • 6/8 OIF UPDATE
    • “The psychologist has scheduled her appointment with Valeria tomorrow 6/9 at 4 pm by phone.”
  • 6/10 OIF UPDATE
    • “We just got a clearance from the psychologist for Valeria! We will now proceed with the legal process. I will reach out to the attorneys first then keep you posted.”
  • 6/17 Surrogacy Contract
    • “Nice to be working with you again. I have attached the Contract with Valeria and my Retainer Agreement for your review. Once you have gone through this please contact me to set a time to discuss it and answer any questions or concerns. It is very similar to the last one we did.”
    • “Thanks and I can incorporate these into the contract. How about this Tuesday at 10:00 a.m. to talk?”
      • 6/18 “Thanks, talk to you then. Attached is the revised contract.”
  • 6/22 OIF UPDATE
    • “Just to give you a quick update, GC Valeria is scheduled to have her legal consult next Monday 06/28 at 10am. Valeria started her period yesterday. RFC is asking her to start on her birth control pills today and putting a tentative calendar already, hoping that we should have the legal done in 3 weeks to get her going with this cycle.”
  • 6/23 OIF UPDATE
    • “We are still waiting for RFC to provide us a tentative schedule either today or tomorrow. We will keep you posted once we got it from them. Meanwhile, I will be forwarding you E-mails from ART Risk regarding insurance applications/options sometime today.”
  • 6/23 Surrogate Accidental Death Insurance
    • “Please find the SAD Application and information below in this E-mail message.”
  • 6/25 RFC Consents
    • “Happy Friday! I know you guys are still in the process of working on legal, but I just thought I would send over the cycle consents. One of the consents is from the pharmacy we will be ordering Valeria’s medications from. The pharmacy needs that consent signed in order for us to order medications. Let me know if you have any questions.”
  • 6/25 FET Cycle Calendar
    • “Please find the tentative calendar attached for your reference. GC Valeria’s stim start is scheduled to be 07/17 and embryo transfer on 08/02. Thus, we will have to complete the legal before 7/17. Is that doable for you?”
  • 6/28 Surrogacy Contract finalized
    • “Valeria has approved the contract without any changes. Please print this out, initial all pages and sign it in front of a Notary Public. Email me the signature/notary pages and mail me the entire hard copy original.”

2021Q3

  • 7/1 OIF UPDATE
    • “GC Valeria and her husband also signed their contract this afternoon. Thank you all for being so efficient!”
  • 7/2 UPDATE
    • “Attached is my legal clearance to Dr. Lin for the above surrogacy case. Please advise if you need anything further from me at this time.”
  • 7/8 OIF UPDATE
    • We received two updates from RFC yesterday evening:
      1. It seems like the pharmacy hasn’t been able to get a hold of you to pay for Valeria’s medications so they haven’t shipped the meds to her yet. I provided your numbers (858-209-3365) again for RFC to update the pharmacy. Let me know if they have already been able to reach out to you.
      2. RFC informed us that Valeria didn’t pick up her birth control pills last month. Thus, we would have to get a new calendar; we won’t be moving forward with the current calendar schedule. Isabel and I have spoken with Valeria earlier this morning. It looks like the communication before with the clinic wasn’t really clear enough for her. Hence, moving forward, we will make sure all communication/instructions are given and understood clearly so we don’t come across issues like this again.
  • 7/8 OIF Follow-Up
    1. It seems like the pharmacy tried reaching out to you at 858-472-9826. Not sure why they didn’t try the other numbers before because I provided both to RFC since the beginning (like how I did with the insurance and legal).
    2. Valeria contacted RFC back in 6/21 to inform her period started on 6/20. Since then there were multiple e-mails going back and forth among all of us regarding the next steps, such as psych and legal. And in one of the e-mails, it was addressed to me instead of Valeria mentioning how they’d like Valeria to start her BCP the next day along with other updates, hence the message was overlooked by her. Moving forward, I’ve discussed with the clinic earlier today how we can improve communication so we can ensure this doesn’t happen again!
    3. The clinic has responded back to us indicating they can use the hysteroscope from this month for next month’s FET cycle, but if for any reason this gets delayed further then they will have to do an endometrial scratch for any other cycles past the one-month delay.
  • 7/23 FET Cycle Calendar #2
    • “Valeria has informed the clinic yesterday evening that she just started her period. Please find her calendar attached to this E-mail for your reference. She is instructed to start her BC tomorrow 7/24. The embryo transfer is scheduled for Thursday 09/02 as of now.”
  • 7/29 CS Follow-Up
    • “I had emailed you for payment pending for $75.00 for date of service 3.23.21. However, Xochitl has not received the actual bill for the service, it is showing on her claim summary but not yet been sent out to her yet. She will wait until they send a paper bill to pay it. The payment she just made for $40 is for the invoice attached. That is how I got confused with the first email I sent you for payment.”
  • 8/17 RFC Update
    • “Just wanted to let you know that everything went well at the surrogates FET start appointment today. She is going to be starting medications tonight. We are going to see her back next Monday, so I will have an update then.”
    • “Yes as of right now we are still on schedule for 9/2 transfer.”
  • 8/17 OIF UPDATE
    • “Valeria started her period yesterday. Thus, she was scheduled to go to the clinic this morning for the FET start. Her next appointment will be next Monday.”
    • “We received an update from RFC just now: Everything looked good today. Her estradiol was 64.3 and progesterone was <0.20. She is now all set to start according to the calendar.”
  • 8/23 RFC Update
    • “We saw Valerie today and everything looked good. Her lining was 9-10mm trilaminar and her estradiol was 568. We are going to see her back on Thursday and if everything looked good she will start progesterone on Friday. I will have an update for you then.”
  • 8/23 OIF UPDATE
    • “We just received a quick update from the clinic.  Everything looked great at Valeria’s appointment today. Her lining was 9-10mm trilaminar and her estradiol was 568. They will see her again on Thursday for her next appointment.”
  • 8/24 RFC – Cycle Payment Follow Up
    • “I am reaching out to collect the remainder of the cycle payment due for Valeria’s embryo transfer. With the $2,500 deposit that you paid in May, the remaining total is $5,025. As a reminder, this fee will carry through to cover Valeria’s embryo transfer and up to (2) pregnancy tests that will follow. If the cycle is successful, we would monitor Valeria for pregnancy visits, which are $290 each.”
    • “Yes, that payment was for Valeria’s hysteroscopy procedure. This was not included in the original financial summary as it was a further uterine evaluation recommended after her medical screening visit. The initial balance of $7,525 was for Valeria’s medical screening and embryo transfer cycle, as detailed on the attached financial summary. With your $2,500 deposit made in May, that leaves $5,025 as the balance.”
  • 8/26 RFC UPDATE
    • “Everything looked good with Valeria today. She is all set for transfer next Thursday, 9/2. She is checking in at 8am for 8:30am transfer. I wanted to confirm with you what embryo you want to transfer?”
  • 8/26 OIF UPDATE
    • “We just received an update from the clinic, Valeria is confirmed to have her transfer next Thursday, 9/2 for 8:30am transfer.”
  • 9/2 Embryo Transfer
    • “The transfer did get delayed from this morning to this afternoon. Valeria was late, and Dr. Lin did have to leave to another office. We did confirm with the our lab manager Sandra, and she said this was okay since she was still waiting for the embryo to fully expand from thawing.”
      • “Valeria informed us that she had to take her kids to school this morning and then got stuck in traffic heading to Irvine, that’s why she’s running behind on the schedule.”
    • “Dr. Lin said the transfer went very well! Her first pregnancy test is on Monday, 9/13 and I am waiting for the lab to send me a picture of the embryo. I will most likely have the photo tomorrow morning, but as soon as they send them to me I will email them to you.”
      • “Here is the photo! The lab admin said the photo is a little grainy since she had to enlarge it because the original photo was a bit small.”
  • 9/13 RFC UPDATE
    • “I just wanted to let you know that we still haven’t received the result on Valeria yet. She went to an outside Labcorp near her home, so I am not sure if they are running the lab stat. I am going to be leaving in a couple minutes, so I will be in touch tomorrow morning with the result.”
  • 9/14 Blood Pregnancy Test: Positive (hCG: 136 mIU/mL, P4: 15.9 ng/ml)
    • “Valeria is pregnant! Her β-hCG was 136 yesterday. She is going back for repeat blood work tomorrow. I am so happy for you guys and fingers crossed for a great number tomorrow!! I am going to be out of the office starting tomorrow for the rest of the week, so the other nurse coordinator will be following up tomorrow.”
      • “Of course! So her progesterone yesterday was 15.9. Dr. Lin did increase her progesterone oil to 2cc a day and the rest of her medication stayed the same. I am not to sure about her appointments since we gave her Labcorp slips for yesterday and tomorrow. She has been going to her local Labcorp. I believe she said she went at 11am yesterday and for tomorrow I told her to go before 10am.”
        • “Yes usually if labs are drawn before 10am they are returned stat!”
          • “Just a little heads up I ordered Valerie some medications that she was almost out of, so the pharmacy will be contacting you today or tomorrow for payment.”
    • “We just received an update from the clinic that your GC Valeria is pregnant! Her β-hCG level yesterday was 136 and her progesterone was 15.9. Dr. Lin is having her increase her progesterone oil to 2cc a day because her progesterone needs to be over 20. She will be going back tomorrow for a repeat test.”
  • 9/15 Blood Pregnancy Test: Positive (hCG: 319 mIU/mL, P4: 83 ng/ml)
    • “We just received an update from the clinic that Valeria’s results came in and looked good. Her HCG level is now 319. Progesterone is now 83. Now they’ve asked Valeria to continue her meds and they are going to schedule her next appointment to be on 9/24/21.”
  • 9/24 OIF UPDATE
    • “Arlene confirmed with me that Valeria’s appointment is scheduled for Monday 09/27 @ 9:45am and Valeria is aware of it. It was a typo on their end when they updated me last week indicating the appointment is on 9/24. I clarified with them this morning. Valeria will be 6 weeks tomorrow, so she is scheduled to be seen next Monday for her fetal heartbeat ultrasound.”
  • 9/27 Ultrasound (6 Weeks 2 Days): Good (P4: 48.88 ng/ml)
    • “We don’t have her lab result back yet, but Dr. Lin did see a viable sac this morning on the ultrasound. There was no heartbeat, but she is 6 weeks today so it could be too early to detect one. He is having Valeria come back in 1 week for another ultrasound. He will be looking for a heartbeat at that appointment.”
    • “I have attached the ob scan photos from this morning. Her progesterone level today was 48.88 which is good. Her appointment is next Monday, October 4th at 9:45am.”
    • “Dr. Lin did note that he saw a visible yolk sac on the ultrasound.”

2021Q4

  • 10/4 Ultrasound (7 Weeks 2 Days): Bad
    • Dr. Lin just saw Valeria and I am very saddened to report that there was no heartbeat on the ultrasound today. Dr. Lin wants Valeria to come back in one week to do an ultrasound to see if the sac has passed naturally. We will continue to monitor her, and once the sac has passed we will monitor her β-hCG level until it gets into the negative range. Dr. Lin would like to speak with you via phone consult if you are free this week to do so. Let me know and I can set it up. If you have any questions please feel free to reach out as well.”
      • “Great I have you scheduled at 3:15pm tomorrow. Please give the office a call at that time and they will connect you with Dr. Lin. The number is (949) 453-8600.”
  • 10/4 OIF Follow-Up
    • “Unfortunately, we were informed by Arlene earlier today that Dr. Lin did not detect a fetal heartbeat for Valeria’s ultrasound today. She indicated that she has informed you already as well. Valeria will be asked to stop taking her medications today and come back next Monday for a follow-up appointment. Please keep us posted once you have scheduled a consultation appointment with Dr. Lin and let us know if you need anything else from us.”
  • 10/5 OIF Follow-Up
    • “Valeria would like to follow up with you to see how you both are doing. She is very sad that the embryo didn’t take and she knows this must be even more difficult for you. We will all be here for you if anything. Please let us know.”
      • “Thank you for your response. We will go ahead and advise Valeria of your thoughts. She had her psych evaluation earlier today, once we receive the update and invoice from the psychologist we will then send them over to you. Meanwhile, please keep us posted after your consult with Dr. Lin.”
  • 10/6 OIF Follow-Up
    • “Thank you for such a thorough update. Based on the e-mail Arlene sent out to Valeria, she’s been asked to stop all medication starting Monday and asked to be seen in one week for another ultrasound. We will keep you posted once the next appointment has been made.”
  • 10/11 RFC UPDATE
    • “Just wanted to let you know that we saw Valeria today. The sac has not passed naturally yet. Dr. Lin wants her to return in 2 weeks for another follow up ultrasound. He may recommend surgery if it has not passed by them. We did inform Valeria of this as well. Hopefully in 2 weeks when we see her again we will have a bigger update on next steps.”
      • “Her next appointment is on 10/25 at 6:15am.”
  • 10/11 OIF UPDATE
    • “Valeria came today for an ultrasound. Dr. Lin stated that the tissue from the sac was still there, so he wants to wait and see if it can pass naturally. If not, then he may recommend surgery to remove the tissue. He wants Valeria to come in 2 weeks for another ultrasound to see where she is at with everything. Valeria may experience super heavy bleeding that due to her body passing the sac. If the bleeding gets out of control, she is asked to go to the emergency room and call the clinic.”
    • “Please find the psych report attached to this e-mail. Also, for psych consults, it’s usually 1 initial consultation plus 10 monthly consults, unless recommended or requested otherwise. Thus, would you like Valeria to continue her monthly consults in November or wait until she’s ready to do another cycle again? Additional psych consults will be $100 each.”
  • 10/15 CS Follow-Up
    • “I wanted to let you know that Xochitl received a bill from MRD Imaging for the Fetal Growth Ultrasound on March 23rd 2021. She had initially received a bill for $214.00. Xochitl called Oscar Insurance and requested to reprocess the claim because the insurance was not paying anything for the services. Oscar Insurance reprocessed the claim, the outstanding balance is the copay for $75.00. How would you like me to proceed for the payment?”
  • 10/25 RFC UPDATE
    • “I let Cindy and Isabel know that Valeria let me know this morning she was having car problems and wouldn’t make it to her appointment. She rescheduled to tomorrow morning.”
  • 10/26 RFC UPDATE
    • “We saw Valeria this morning and Dr. Lin did not see a sac anymore. He did note that the endometrial lining was still very thick though. We are running a β-hCG level today and we will continue to monitor her β-hCG level until it is in the negative range which is <5. I will be out of the office at 11am today, but I will have one of the other nurse follow up with her β-hCG level from today this afternoon.”
      • “Dr. Lin said he wants to wait for her β-hCG level to see what it is. If the sac passed the level should be somewhat on the lower end or at least dropped from the last time. Last time we checked it was 23350 on 10/11. Sometimes if the level is still high then there could be remaining tissue. Even in that case though we will continue to monitor to see if surgery is needed or not.”
  • 10/27 RFC UPDATE
    • “Yes it was 22! We are almost at the negative range which is <5. We are going to have her repeat the β-hCG level sometime next week and hopefully it will be negative at next β-hCG. I am confirming with Valeria which day she wants to come, so once I hear back from her I will let you know.”
      • “Valeria will go to her local Labcorp next Thursday, 11/4 for repeat β-hCG. Once we see her β-hCG in the negative range, I will ask Dr. Lin if he is okay with starting another FET with her next period or if he still recommends waiting until February.”
  • 11/4 RFC UPDATE
    • “I reached out to Valeria since I hadn’t gotten her lab result back yet and she said she wasn’t able to make her appointment this morning due to school. I will reschedule another time with her to go to Labcorp just wanted to let you know.”
      • “Valeria said she will go tomorrow! I will be in touch tomorrow afternoon with the result.”
  • 11/5 RFC UPDATE
    • “I just wanted to let you know that Valeria’s β-hCG level still shows as pending in the Labcorp system. She did go early this morning around 8:30am but they were very backed up so they didn’t take her back until almost 11am. I will be leaving for the day so I will be in touch on Monday morning with the lab result. Hopefully the level is negative and we can start working on next steps.”
  • 11/8 RFC UPDATE
    • “Just wanted to let you know the β-hCG level from Friday was 3 which is considered a negative range. I am waiting for Dr. Lin to confirm if he is okay with starting another FET cycle or if he still wants to wait until February before attempting another cycle. I will let you know once he gets back to me.”
      • “Dr. Lin would like Valeria to call with her next period. We will start her on birth control pills and have her go through that pack of pills. Shortly after finishing that pack she will get a second period and with that period we will restart birth control pills and get an FET calendar set up. We want her to get two normal period cycles before attempting another FET. I informed Valeria to email me with the first day of her next period.”
  • 11/15 OIF UPDATE
    • “Valeria has informed the clinic that she just started her period on Saturday 11/13. Thus, Arlene has advised her to start birth control pills tonight.”
  • 12/20 OIF UPDATE
    • “Valeria has informed us that she went to the emergency room early last week because she was experiencing so much pain. They did an ultrasound and was admitted to the hospital because the results showed that she had gallstones and would need a surgery. After 2 days of not eating, they did surgery to remove both her gallstones and gallbladder. She stayed in the hospital to rest then she went home with pain medication and antibiotic and just waited for her stitches to fall off and she is good now.”
    • “She has notified Arlene already and also scheduled a follow-up appointment with the doctor who did the surgery this week just to make sure she’s cleared to move on with surrogacy.”
  • 12/27 OIF UPDATE
    • “Valeria has updated us and Arlene that her doctor told her she’s okay to move forward with surrogacy and that she was fully recovered. Thus, Arlene has advised Valeria to e-mail her with the first day of her period and they will start her on birth control pills. She will have to cycle through this pack then get another period and restart the pills again (with the second pack of pills they can get her FET calendar ready).”
      • “Since Valeria had her emergency surgery, she never started her first pack. I followed up with Arlene, she said if you are insisting to follow the same timeline, they can set her up with her FET with Valeria’s January period. Valeria knows to email her with her next period to start the birth control pills, which should be coming any day now. Let me know so I can advise Arlene.”
  • 12/29 RFC UPDATE
    • “Just wanted to let you know that Valeria started her period so she will be starting birth control pills on 12/31. She is scheduled for FET start on 1/19 and her transfer will be 2/4.”

2022Q1

  • 1/7 OIF UPDATE
    • “Just to follow up, when would you like Valeria to resume her psych evaluation with the psychologist? Would you like her to set up one this month?  Let me know.”
      • “Okay.  We will have Valeria schedule a psych evaluation in February after the 4th.”
  • 1/13 RFC UPDATE
    • “I just wanted to let you know that Valeria was unable to make her appointment today for her endometrial scratch+COVID-19 test. Due to the fact that we need her on birth control pills at the time of endometrial scratch we are are going to keep her on pills for a couple days longer and reschedule the endometrial scratch to next Monday or Tuesday. I will send out a new calendar to everyone tomorrow. This will push the transfer back a couple days. Let me know if you have any questions!”
  • 1/13 OIF UPDATE
    • “Valeria called us and also RFC around noon informing us that there was some emergency with her kid at school so she was not able to make it to her endometrial scratch today. I asked Arlene if there’s any way for her to still make it later this afternoon for her appointment. Unfortunately, she informed me that Dr. Park’s last patient was a 1pm and she is leaving for the day. So they will have to reschedule Valeria to Monday or Tuesday. And Arlene is going to have to make a new calendar for her by tomorrow.”
    • “I am really sorry that her cycle keeps on getting delayed due to so many unforeseen situations that kept on happening with Valeria. Isabel and myself have firmly informed her that this is not acceptable at all and today is the very last time we can tolerate.”
    • Below is an e-mail Valeria wrote for you:”
      • “Hi I want to start off by apologizing for not making it to the appointment due too my daughter not feeling good in school. I was on my way to the appointment when I received a call from my daughters school stating that she wasn’t feeling good for that said I had to go back and pick her up because there was no one else to pick her up. I am really sorry it wasn’t my intention to miss the appointment.”
  • 1/14 RFC UPDATE
    • “So I sent out a new calendar to Valerie this morning. I am waiting for her to confirm but her are her new appointments:”
      • 1/18- endometrial scratch+COVID-19 test
      • 1/24- FET start
      • 1/31& 2/2- cycle appointments
      • 2/9- embryo transfer
    • “I am waiting for Valerie to confirm which meds she is low on (she has some from previous cycle) and I know there are some she will for sure need refills on, so I am hoping to place the order next Monday or Tuesday! I will make sure the pharmacy has your updated phone number.”
  • 1/18 OIF UPDATE
    • “Just to provide you a quick update, Valeria has arrived 20 minutes early to her appointment this morning. Once RFC provides us an update after her appointment then we will keep you posted.”
  • 1/18 RFC UPDATE
    • “Just wanted to let you know that everything went great with the endometrial scratch today. We will see Valeria next Monday, 1/24 at 9am for FET start.”
    • —> We received a call from the pharmacy yesterday for payments for her meds. They said they will call Valeria to verify her mailing address, but we haven’t heard back from them since then. Is everything ok?
      • “I just confirmed with Valeria and she spoke with them yesterday. The medications will be getting delivered today.”
  • 1/19 RFC Consents
    • “As we get ready to start the new transfer cycle we will need you guys to complete new cycle consents. I have attached them to this email, so please complete them and send them back at your earliest convivence.”
    • —> While we have no problem signing them again, we have done this last year (June 25, 2021) for this surrogate. You are asking again because they have expired (maybe 6 months?) or you ask for every FET cycle regardless?
      • “We collect consents for each new cycle that is being done!”
  • 1/24 RFC UPDATE
    • “We saw Valeria this morning and Dr. Lin did see a cyst on her left ovary. We got back her labs and her estradiol level was at 176 and her progesterone was 10. We need her estradiol to be under 75 and progesterone under 1 in order to start medications. Dr. Lin wants to see her back on Friday to see if the cyst has resolved itself. If it has then we can start medications. If not then Dr. Lin will follow up with next steps.”
    • —> Thanks for the update Arlene. So the earliest date to start medication at this point is Jan 28th Friday? Do we shift the calendar by 4 days if that’s the case?
      • “Yes the earliest for medication start would be Friday. If everything looks good on Friday then I will create a new calendar to send out.”
  • 1/28 RFC UPDATE
    • “My name is Rose and the other 3rd Party Coordinator. I wanted to give you an update on Valeria’s appointment today. Dr. Lin would like for Valeria to start Birth Control today for 1 week and repeat her E2 & P4 levels to check that they have lowered. I emailed a LabCorp order for Valeria to complete the blood work on 2/4 before 10am. I will provided you with another update on 2/4.”
    • —> Has the cyst resolved itself and we are waiting for her E2 & P4 levels to go lower, or everything has been the same since Monday and Dr. Lin wants more time to monitor?
      • “The ultrasound shows the cyst is shrinking but her lab work results show different. This why Dr. Lin would like for her to start Birth Control in hopes it will lower her levels. We need for her levels to be low in order to continue.”
      • —> If everything looks good in her next appointment, will Feb 4th be the start of the cycle, or it is postponed to TBD regardless?
        • “Her lab work on 2/4 will determine next steps.”
  • 1/31 RFC UPDATE
    • “I wanted to provide you with an update on Valeria. We have scheduled to return to the office on 2/7 for Ultrasound and Blood work. If everything looks good at this appointment then she return in 1 week for FET start.”
    • —> I just wanted to double check that I understood it correctly. If everything goes well, the earliest day to start FET will be Feb 14 (or sometime around that date) correct?
      • “Correct if everything looks good on 2/7 appointment then we will start the process again on 2/14.”
  • 2/7 RFC UPDATE
    • “We saw Valeria today and everything looked great. Her cyst is gone and her levels were low. She is going to take her last birth control pill tomorrow and we will see her next Monday for FET start. Her scheduled transfer with this new start date is Wednesday, 3/2. Let me know if you have any questions otherwise I will be in touch next week!”
  • 2/7 OIF UPDATE
    • “We received an update from the clinic that Valeria’s appointment went well earlier this morning. Her estradiol was 65 and her progesterone was 0.2. She is instructed to e-mail Arlene once she starts her period, and they will see her next Monday for FET start.”
  • 2/14 RFC UPDATE
    • “I wanted to provide you with update on Valeria. She was seen today for Ultrasound and blood work. The ultrasound did show a follicle larger then the rest. The E2 level came back 96.4 slightly higher then we would like to see it. We like to see the level below 80 and her Progesterone was 0.24 low and we like the level low. Dr. Lin would like for Valeria to repeat her lab work in 2 or 3 days to check if the follicle will continue to grow or not. I’ve sent a LabCorp order to Valeria to have her blood work done closer to home before 10am on Wednesday 2/16. I will follow up with your on Wednesday 2/16 once labs are reviewed by Dr. Lin.”
    • —> Thanks for the update Rose. So it seems like the cycle is put on hold once again. What is the new target FET start date If everything goes well on Wednesday 2/16?
      • “As of right now it can be pushed by 2 days pending her lab results on 2/16. We will have a better idea then.”
  • 2/16 RFC UPDATE
    • “We received Valeria E2 level and it was 196 which means it did rise from the previous level. Dr. Lin is having Valeria return to the office in 1 week for Ultrasound and blood work. The ultrasound will confirm if follicle is still present or if ovulated in order to restart the process. I will follow up with you on 2/23 after Valeria appointment and lab results are back. Let me know if you have any questions.”
    • —> When you say “restart the process”, is that a start of the FET cycle or 6 weeks of the whole process?
      • “Based on how her levels look we will be able to determine if she can start. The follicles are growing and producing estrogen which is why her estradiol level is high. Dr. Lin is hoping the follicle can ovulate on its own.”
      • —> It sounds a bit more complicated than we thought. So our understanding is that based on how her levels look next week, Dr. Lin will determine if she can “restart” FET, and a new calendar will be created. Is that correct?
        • “Yes that is correct. The issue right now is she is continuing to grow lead follicles (cysts) that are growing and producing hormones which can really throw everything off. We need her to have no lead follicles (cysts) to make sure that her levels are low and both ovaries are quiet.”
  • 2/23 RFC UPDATE
    • “So we saw Valeria today and there were no cyst on her ultrasound report. There was some fluid on the outside of the ovary but as long as the fluid does increase in size then we can move forward with start. Dr. Lin is recommending we bring Valeria in next week for endometrial scratch since Valeria will be getting her period shortly. We usually like to do a new endometrial scratch with each period/ cycle start. So we can do endometrial scratch next week and then have her call with her period for FET start. I know you guys paid for an endometrial scratch on 1/13, so Dr. Lin said another option is to just have Valeria call with her period and we can bring her in for FET start. Please let me know which you guys would like to do so I can arrange with Valeria.”
    • —> Regarding the endometrial scratch, we elect to skip it this time if it is optional as she is a great surrogate and our embryo doesn’t have a problem. Please just have Valeria call with her period and bring her in for FET start. In terms of timeline, if she gets her period tomorrow or so and you bring her in on 2/28, will the transfer date be around 3/16 (+16 days)?
      • “Okay great I will let Valeria know to call with her period! Yes if we bring her in on 2/28 for start then transfer would be 3/16.”
  • 3/4 OIF UPDATE
    • “My name is Jessica, I would like to give you an update since Cindy is not in the office till next Monday. Valeria has not had her period since 1/28. She will update us as soon as her period starts. Please let us know if there are any further questions.”
  • 3/8 RFC UPDATE
    • “We saw Valeria this morning and everything looked great. Dr. Lin didn’t see any cyst on the ultrasound. Her labs looked good also. Her estradiol level was 19.6 and her progesterone was 0.43. Dr. Lin said she is good to start medications tomorrow. Her next appointment with us is Tuesday, 3/15. She also has another appointment with us on 3/18, and she will be doing the intralipids at that appointment. Her transfer will take place on Friday, 3/25. Let me know if you have any questions otherwise I will be in touch next Tuesday.”
  • 3/9 OIF UPDATE
    • “We received updates from the clinic yesterday regarding Valeria’s appointment that her estradiol was 19.6 and progesterone was 0.43. Thus, she’s asked to start her medication today.  Her next appointments will be Tuesday 3/15 and Friday 3/18. And as of now, her embryo transfer is scheduled to be 3/25.”
  • 3/15 RFC – FET Financial
    • “Arlene confirmed that Valeria has started her FET cycle, so I am reaching out to collect the fees for her cycle. I have a financial summary attached to this email for you to provide your initials and signature on. As you’ll see, all of the pre-cycle testing has been completed and all associated fees paid for, so the total being collected is for Valeria’s embryo transfer cycle only. This fee is $5,000 and will include Valeria’s monitoring (ultrasounds, office visits, estradiol and progesterone hormone tests) through embryo transfer and cover up to (2) pregnancy tests that will follow. If the cycle is successful, we would monitor Valeria for pregnancy visits, which are $290 each. If the cycle is unsuccessful, the fee for another cycle is $5,000.”
  • 3/15 OIF UPDATE
    • “I just received an update from RFC regarding Valeria’s appointment this morning. They informed me that currently they are waiting for Dr. Lin to review her lab results from today in order to confirm the next appointment. Once I hear more back from the clinic I will then keep you posted.”
  • 3/16 RFC UPDATE
    • “We saw Valeria yesterday and her Estradiol level was low. Dr. Lin is having Valeria to add Estrace vaginally twice a day. At her next visit we will check her Estradiol level to make sure its rising. Dr. Lin also informed us there is a possibility that the cycle may be canceled. We will let you know after Valeria next appointment.“
    • —> What is the reason for the cycle cancellation?
      • “One reason is her estradiol level being so low, and also she has a lead follicle that is beginning to grow. Right now we aren’t sure if the lead follicle will continue to grow, but when she comes back on Friday we will measure it to see how it is doing.”
  • 3/18 RFC UPDATE
    • “We saw Valeria today and everything looked great. Her lining was 9mm trilaminar. Her estradiol was 319 and her progesterone was 0.70. Dr. Lin said she is good to start her progesterone oil tomorrow night. She is returning to the office on Monday morning for intralipids. Everything is all set for her transfer next Friday, 3/25.“
  • 3/18 OIF UPDATE
    • “Valeria had her appointment this morning and the clinic updated just now regarding her lab results. Her estradiol level was 319 and her progesterone was 0.7. She is scheduled to go back for another appointment Monday at 3/21 @ 10:30am. As of now, her embryo transfer is scheduled to be 03/25 @ 8:30am. Also, it was her birthday earlier this week 03/15. Thus, as a token of appreciation or your thinking of her, would you like us to give her a birthday card or present on your behalf?”
  • 3/21 RFC – Embryo Selection
    • “I hope you are well. My name is Mayra, and I am one of Dr. Lin’s coordinators. In preparation for the upcoming transfer, kindly confirm which embryo you wish transfer to Valeria please. We look forward to your response.”
    • —> Please transfer #152537-2 HBFBB Female.
  • 3/22 RFC – Embryo Selection
    • “I hope this email finds you well. Arlene confirmed that Valeria had her Intralipids injection done yesterday. The Intralipid injections are $500 each and if done in a series of 3, the 3rd is discounted to $250. Would you like me to proceed with charging the card on file, ending in 5556, for the $500?”
  • 3/25 OIF UPDATE
    • “Valeria checked in at 7:50am this morning for her 8:30am embryo transfer today. Everything went well. I’ve given her a bouquet and the birthday card on your behalf. Once I do hear more back from the clinic I will then keep you posted.”
      • “As of now, Valeria is scheduled to have her pregnancy test in RFC Irvine on Monday 4/4 at 9am.“
  • 3/25 RFC UPDATE
    • “The Transfer went well. She will be on bed rest for the next 2 days. Her next appointment will be on 4/4 for her Pregnancy Test. I will ask the lab for a picture and send it to you.”

2022Q2

  • 4/4 RFC UPDATE
    • “We received Valeria’s lab result and unfortunately the β-hCG level is confirmed negative. I am so sorry. Based on the results, Valeria will stop all medications and let us know once her period comes. Please let me know if you would like to schedule a follow up with Dr. Lin to discuss next steps.”
      • The values are – β-hCG <1 and Progesterone is 34.3. I can schedule you for Wednesday 4/6 at 4pm or Friday 4/8 at 4:45pm. Let me know which time works best for you.”
  • 4/4 OIF UPDATE
    • “The clinic has informed us that they got the BHCG results back from Valeria’s appointment this morning. Unfortunately, the result BHCG level is confirmed negative with a value of <1. I believe the next steps as of now is for you to speak with Dr. Lin. Please keep me posted once you’ve scheduled to have a consultation with Dr. Lin.”
  • 4/7 RFC UPDATE
    • “I spoke with Dr. Lin this morning regarding your phone consult yesterday. After reviewing Valeria’s chart with him he feels it would be best for you to find a new surrogate and not attempt a third cycle with Valeria. Please let me know if you have any questions about this.”
    • —> We have a strong desire to attempt a third cycle with Valeria UNLESS she is no longer qualified for being a surrogate. We understand risks and will accept the outcome. Please advise.
      • “Dr. Lin is recommending not using her again but if you guys understand the risks of going forward with a third cycle then that is up to your discretion. We can do an ERA cycle first and then the third transfer cycle after that. We will do ERA protocol + Intralipids + heparin with the third cycle. Please let me know if this sounds good to you.”
      • —> How does the ERA test help us and what will the schedule look like? Assuming Valeria has her period on April 15th, when will we start/end the ERA test as well as FET start/transfer?
        • “The ERA biopsy will result in providing us with “ERA hours.” This indicates when Valeria is most receptive to progesterone intake for transfer. We will time when she starts her progesterone for transfer based on the ERA hours reported back. If Valeria starts her period on 4/15, then we will have her come in for “ERA start” on cycle day 3 of her period. We will make sure she has no cysts and that her labs are normal. She will then start Estrace that night if everything looks good. We would see her back on day 10 of being on Estrace for another ultrasound and blood work. If all looks good at that appointment we will confirm progesterone oil start and perform the ERA biopsy 120 hours after starting progesterone. After, Valeria will stop all medications and her period will follow a couple days after stopping the medications. With that next period we can set her up for a third transfer.”
        • —> Thank you for providing so much detail. I created a calendar based on the steps you described:
          – 4/15 period
          – 4/18 (day 3 of her period) – ERA start
          – 4/28 (day 10 of being on estrace) – Ultrasound and Blood Test
          – 5/3 (120 hours after starting progesterone) – ERA Endometrial Biopsy
          – 5/15 period – set up for a third transfer

          Is this schedule correct? If Valeria fails the ERA test, does it mean she is officially disqualified as a surrogate and RFC cannot move forward with her for the third transfer, or it is information only and still up to our discretion?
          • The schedule is pretty accurate but based on the days that Dr. Lin is here I have adjusted it a little bit:
            – 4/15 period
            – 4/18 ERA start
            – 4/27- ultrasound/ blood work
            – 5/4 biopsy (start progesterone on 5/2)
            – Start birth control pills for third transfer sometime between 5/11-5/18

            The good thing about the ERA test is you can’t “fail.” The biopsy result will provide “hours” so that we can time progesterone start for her next transfer. For example, if the biopsy reports that she is most receptive at “144 hours” then we will start progesterone 144 hours prior to her transfer time.”
          • —> Please proceed with ERA protocol + intralipids + heparin for the third cycle.
  • 4/7 OIF UPDATE
    • “Thank you for the update! I also saw you and Arlene’s e-mail communication from this morning. So I will wait for the clinic’s response. Meanwhile, we do have a new GC whom I may be able to present to you later today if you’re interested to look at her profile for reference.”
    • —> What a timing! Yes please share with us when it is ready. Our preference is to continue working with Valeria for the next attempt. But if RFC rejects her, we have no choice.
      • “Please find our new GC profile Karina attached in this e-mail for you to review. She lives in San Diego and is a first time GC with 3 kids. Let me know what you think of her.”
  • 4/8 Surrogate S1021 Karina
    • 30yo, 3 Deliveries, 2 C-Sections
    • Price: $60,000 (First-Timer)
    • City: San Diego, 92113
  • 4/8 RFC UPDATE
    • “Our office has a package fee of $800 for the ERA cycle, which will include the monitoring for her cycle (ultrasounds, office visits, estradiol and progesterone hormone levels, endometrial biopsy). The biopsied sample will be sent to a laboratory called CooperSurgical, where they will run the ERA itself. Their cash price is $599 and they will bill you directly.”
    • —> Another question regarding the upcoming 3rd FET cycle fee. Our last FET failed at the very first blood test. We believe the $5,000 fee included 2 blood tests and 2 ultrasounds. Will we have credit for unperformed tests (1 blood & 2 ultrasounds) for the bill for the 3rd FET? Also will RFC refund some portion if the 3rd cycle fails similarly at the very first blood test?
      • “Valeria did come in for 3 ultrasounds and 3 blood tests (estradiol and progesterone or both) during the cycle. Which are you referring to? The FET package price includes the monitoring (gestational carrier cycle management, physician management of treatment, nurses’ visits, education sessions, cycle office visits, cycle ultrasounds, cycle estradiol and progesterone levels, cycle supplies, thawing/processing of embryos, embryo transfer and (2) pregnancy tests. It does not include pregnancy services. Ultimately, the packages that we offer are inclusive and discounted since the services aren’t able to be billed to insurance. Unfortunately, this means that they aren’t able to be itemized for any purpose.”
  • 4/25 OIF UPDATE
    • “Valeria has been doing okay. I’ve checked in with her a few times these past two weeks. As for the new GC 1021 Karina, we are actually still waiting for her medical records.”
  • 5/17 OIF UPDATE
    • “I have informed the clinic last week that you’d like to move forward with Valeria. Valeria’s last period was 5/5-5/10. RFC informed me that it is now too late for this cycle to do the ERA. Thus, I’ve instructed Valeria to contact the clinic on the first day of her next full flow period. They will then schedule her in for ultrasound and provides her instructions on when to start estrace.”
      • “My apologies that this has caused such inconvenience to you. Somehow I was under the impression that you were still thinking about the ERA cycle. So I’ve been in contact with Valeria for the past month just to check how she’s doing. And it seemed to me that RFC was not aware that you wanted to proceed with the ERA cycle either.”
  • 6/13 OIF UPDATE
    • “Valeria just informed me this morning that she started her period. I’ve reached out to the clinic earlier to update them and now waiting on the instructions for the next steps.”
  • 6/14 RFC UPDATE
    • “I hope this email finds you well! Valeria informed us she started her menses yesterday so we went ahead and scheduled her for the baseline ultrasound and blood test for the ERA cycle start. I will let you know how the appointment goes after her results are received. Let me know if you have any questions. Thank you!”
  • 6/15 RFC UPDATE
    • “Valera was seen today and all looks great to get started on her ERA cycle. She was provided with medication instructions and will return on Friday 6/24 to confirm her progesterone start. I will update you after the results are received. Let me know if you have any questions. Thank you!”
  • 6/16 RFC – ERA Financial
    • “As we has discussed previously, the cycle package fee for an ERA cycle is $800 and includes all of Valeria’s monitoring for the cycle (ultrasounds, office visits, estradiol and progesterone hormone levels and endometrial biopsy). The ERA test itself will be run through CooperSurgical and they will bill you directly, the cash price is $599. We can take payment for the cycle package fee at this time. Would you like me to proceed with the card on file ending in 5556?”
  • 6/24 RFC UPDATE
    • “Valeria was seen today for ultrasound and blood work. The ultrasound shows that Valeria lining is not at where we would for it to be 7.5 and above. The blood work is still pending. Dr. Lin would like for Valeria to continue Estrace and return to the office on Wednesday for another ultrasound and blood work to confirm lining is thick. We will follow up with you next week.  Have a great weekend.”
  • 6/29 OIF UPDATE
    • “Just to give you a quick update, the clinic and I have not been able to get a hold of Valeria since yesterday morning. I tried reaching out to Valeria’s mom too but unfortunately she wasn’t able to help either. Valeria is supposed to have an appointment this morning 9:15am at RFC Irvine. Hopefully I will be able to get a hold of her later this morning, I will keep you posted,”
      • “The clinic has informed her of today’s appointment since Saturday. Both clinic and myself have been trying to confirm and remind her of the appointment today since Monday. As of now, no one can seem to get a hold of her.  All the calls went straight to voicemails.  No responses from e-mails or texts either.”
        • “I finally got a hold of Valeria this afternoon. Rose from the clinic is trying to set up another appointment for Valeria on 7/1. I will keep you posted after.”
          • “Valeria informed me that she got the appointment dates mixed up and she had court this morning for a parking ticket from awhile back. She is now scheduled to go back to the clinic on Friday 07/01 @ 10am. I’ve advised her and warned her once gain to always be reachable via phone and e-mails since it’s been difficult to get a hold of her the past 2 days.”

2022Q3

  • 7/2 RFC UPDATE
    • “Good morning. We had the opportunity to meet with Valeria yesterday for an ultrasound and blood test. Her ultrasound confirmed her lining measured 8.6mm with a trilaminar pattern. The lab values were reviewed this morning and confirm her estradiol is low at 58 and the progesterone level is high at 3.4. Based on the results, the ERA cycle is canceled. Unfortunately the levels are not optimal to proceed with the ERA biopsy. We will regroup and review her cycles to determine next steps.“
  • 7/5 RFC UPDATE
    • I have answered your questions in red below-
      1. What are the optimal levels for estradiol and progesterone? – the estradiol should increase from the previous appointment and ideally >200. The progesterone should be <1 at the time of progesterone medication start.
      2. What are the possible next steps? Will we redo the ERA cycle or go straight to the FET cycle after her next period? – Dr. Lin may suggest to redo the ERA cycle, but he has Valeria’s file for review. We will update you once he confirms.
      3. When will we expect the next update regarding the next steps? – We should have an update later this week.
    • —> Do you know why there are large gaps in estradiol and progesterone levels? We are wondering if GC followed the RFC’s instructions.
      • “We reviewed the calendar and medication instructions thoroughly with her and asked her to verbalize what she understood from the instructions and it was correct. But there is a gap from Valeria’s previous estradiol level to Friday’s level so it could be a possibility medication was missed.“
  • 7/8 RFC UPDATE
    • “Its Rose replying back to you since Mayra is out of the office for the week. We did provide Dr. Lin with the chart for review. He just got back on Tuesday from being out of town. I’m hoping that we will have more information today. Has the Agency contacted you at all?”
    • —> No, we haven’t talked with the Agency since last week. Did you provide them updates separately? We have been waiting for Dr. Lin’s feedback to decide on the next steps, specifically if we continue on another ERA cycle or Valeria is officially disqualified as a surrogate based on the latest result.
      • “We did inform the agency of the results of last appointment. I just spoke with Dr. Lin about Valeria ERA cycle and he agrees that it would be best if you look for another surrogate. The reason for the decision is she doesn’t comply and if she was to get pregnant not sure she would comply then. Please let us know if you have any further questions. I will let the agency know of Dr. Lin’s recommendations.”
  • 7/8 OIF
    • —> Forwarding feedback from RFC. Can we set up a phone/zoom call to discuss the situation?
      • “Yes, we have been discussing the matter with the clinic the past few days as well. Are you available to do a call/zoom today at 3pm or after then?”
  • 7/11 Contract Termination
    • “Cindy at Options in Family notified me that you wish to terminate the contract with Valeria. Please confirm that directly with me so I can issue a termination of contract notice. Sorry to hear this.”
  • 8/9 OIF – Potential GC Candidate
    • “We currently have an experienced GC who just delivered in June this year and she’s eager to start a new cycle already. Thus, would you be interested to wait and work with her once she’s ready to start again in 6 months? She’s a local GC based in Chino, CA. Let me know if you’re interested in viewing her profile first and possibly schedule a zoom meeting first if you’d like to meet. Also, we’ve updated our GC benefit packet since it’s been competitive in the surrogacy industry.  Your agency fee will still be the same, just the remaining $2,800 after fetal heartbeat confirmation.”
  • 8/10 Surrogate S1007 Allison
    • 27yo, BMI 27.0, 2 Deliveries – Hypothyroidism
    • Price: $85,000
    • City: Chino, 91710
      • “I will follow up with her regarding this questions. Before I do that, let me disclose that she actually did not go through Dr. Lin for embryo transfer. For her last surrogacy, the intended couple were using adopted embryos from HRC. Thus, the embryo transfers had to take place in HRC Newport. It took 2 transfers. The first transfer the HCG result came back negative and they couldn’t find out the reason why.”
        • “I was diagnosed with hypothyroidism back in 2016, way before pregnancy. My daughter took on the first transfer with Dr. Lin’s protocol. I’m still on 50mg levothyroxine (low dose) of meds that I take daily. My thyroid levels have remained normal and consistent since 2016. Dr. Lin & HRC IVF Physician said since it didn’t fluctuate with my pregnancy with my daughter, it most likely wouldn’t fluctuate with this last pregnancy (which it didn’t). The medication keeps it stable. The only data I have is my blood test numbers that showed it stayed normal the entire time during pregnancies. I also go in for blood draws more frequently to check my levels to make sure they remain the same. If they were to change at all, they just adjust my medication. My thyroid has always been stable on meds, it has never dropped or switched to hyper.

2022Q4

  • 12/20 ART Risk
    • “In doing the quote for Allison Clay be advised that she lives in San Bernardino County. In San Bernardino County the plan available to her without a lien will not allow her to have two insurance plans. As she has Kaiser, this would not be an option for her. The other two plans will also place a lien on her compensation up to the amount that she is compensated. The Kaiser plan will only place a lien on her compensation for 33.3% of her compensation. Due to this, her current Kaiser plan may be the best option.”
      • “I provided the OC address to ArtRisk but they informed me that unfortunately they can only quote from Allison’s address.  I followed up with them again to see if there’s any way to get quotes from the OC address since Allison is also okay with going to hospital and OB in OC, just waiting for response now. Meanwhile, would you like me to maybe try with a different insurance agent?”

2023Q1

  • 1/3 RFC UPDATE
    • “Happy New Year! I wanted to let you know Allison was seen for her medical screening today and her exams are all within normal limits. The midcycle ultrasound confirms her lining is 10mm with a trilaminar pattern, and her saline infusion sonohysterogram was normal. We are pending her and her husbands lab results. We will update you once those are received.”
      • “The results for Allison can take anywhere from 24hrs to 72hrs to receive.  Her husband will be having his bloodwork done on Monday 1/9 and his results usually take about 1 week for us to get. We will update you once we receive the results.”
  • 1/5 OIF ACA Enrolment
    • “Allison was having issues with applying Covered California so she went ahead and called them to complete the process, please find the attached. She asks if it’s okay to provide your payment information to complete the enrollment.”
      • “Allison says they need credit card info instead of bank account. Thus, could you fill out the attached for me to provide to her?”
  • 1/9 RFC UPDATE
    • “We received Allison’s lab results and all came back negative expect her TSH level (Thyroid). The level was 3.16 and we like for the level to be below 2.0. We placed an order to her local pharmacy and she has been instructed to start the medication tomorrow morning.  We will have Allison repeat the level in 6 weeks to confirm medication is effective.  Also her husband had is bloodwork done this morning and we should receive the result in about a week. Please let us know if you have any questions.”
      • 1. Will her next test be 2/20 followed by another 1 week for results?
        • She will be retesting on 2/21 that is exactly 6 weeks from starting medication tomorrow.  This medication is to be taken 30 minutes prior to breakfast.
      • 2. If she fails again in 6 weeks, does it mean she is disqualified?
        • It doesn’t mean she is disqualified but we do like for the level to be below 2.0 prior to moving forward with Embryo Transfer cycle. Also we are still pending her husband results.
      • 3. Her period seems to start around the 20th of the month. Based on that, is it fair to expect the earliest time to start a transfer cycle is on March 20th?
        • Yes that would be fair to say.
  • 1/9 OIF UPDATE
    • “Just a quick update that Allison is responding to the clinic indicating that she’s already taking levothyroxine daily and her past results with Kaiser have been normal. Clinic responded that 3.16 level is typically not considered high but when going to Fertility and Embryo Transfer this is considered high. Allison may be asked to adjust her current dosage because taking the AM estradiol dose could’ve been the reason messing up with her absorption of her thyroid pill. I will keep you posted if I hear more back.”
  • 1/24 RFC – Medical Clearance
    • “We just received Cody’s result and everything came back negative. Allison is medically cleared and ready to proceed with legal & psych clearance.“
  • 1/24 OIF – Psychological Evaluation
    • “Just letting you know, since Allison’s previous psych clearance has been over a year ago, so I already had her scheduled her initial psych with psychologist for this year.  I have sent the new psych clearance to the clinic for their records as well.”
      • “Her previous psych clearance was 04/27/2021.  Since it’s been over a year, thus, I have her scheduled for another clearance in December in order to provide an updated psych clearance for this case. So her latest psych clearance was then issued 12/27/2022.”
  • 3/15 RFC – FET Start
    • “Hope this email finds you well.  I wanted to provide you with an update on GC Allison.  She was seen today for ultrasound and blood to confirm she is good to start.  Her Estradiol level was 15.41 and Progesterone 0.45 all low and what we like to see at start.  Allison was instructed to decrease Lupron to 5 units starting today and start Estrace 1 pill tonight.  We provided Allison with an updated calendar.  I will provide you with another update after her next appointment on 3/22.  If you have any questions please let me know.”
      • “You’re welcome.  The original calendar was for 3/29 but that was if she started on 3/13 but since she started today it pushes back the transfer date by 2 days.  Her transfer is scheduled for 3/31.”
  • 3/15 RFC – Embryo Selection
    • “I wanted to follow up and let you know that Allison is looking to be on schedule for a Embryo Transfer on 3/31. I need to ask you which embryo are you wanting us to transfer?”
      • “I reviewed your chart and yes you have #1 embryo left 152537-1. I’m having the lab confirm and awaiting there reply. Also I need a copy of your picture ID.  The one I have in your chart expired already.”

2023Q2

  • 4/10 RFC – Update
    • “I am following up to confirm Allison C. BHCG result was 233. She just called the office and I relayed the results along with instructions to continue her medications. She will repeat the blood test on 04/12, just to confirm a doubling effect.”
      • “Thank you for confirming. Her appointment is confirmed for 04/12/23.”
  • 4/10 OIF – Update
    • “I just received an update from Allison that she got the result from the clinic for her blood work this morning. Her pregnancy test was positive! Beta: 233; Prog 24. She’s scheduled to come back Wednesday at 10:30am. It may be rescheduled to a later time since she didn’t get drawn until 12pm today and they usually need to do the repeat after 48 hrs. As for her ultrasound, it’s scheduled to be 04/26, no exact appointment time yet.”
      • “No, last Tuesday Allison asked to change her appointment time from 9am to 11:30am.  So she waited about half an hour.”
      • “Just to clarify, when I said there’s a possibility her 10:30am Wednesday may need to reschedule I meant to it to be a later time that’s closer to 12pm to hit the 48hrs mark.”
        • “Allison’s repeat pregnancy test on Wednesday has been changed to 12:15pm.”
  • 4/12 RFC – Update
    • “Hope this email finds you well. I wanted to provide you with an update on Allison’s #2 HCG level of 696 great level and it doubled as planned. The next step is to schedule her for her 1st OB ultrasound on 4/24. We will provide you with another update after this appointment on 4/24. Please let us know if you have any questions.”
      • “You’re welcome. The HCG level is all that was tested since we tested her Progesterone level at the 1st HCG level. We will be testing her Progesterone level when she is scheduled for her OB Ultrasounds.”
      • “I do apologize for the delay in getting the picture to you. Attach is the information our lab provide for me.”
  • 4/12 OIF – Update
    • “We just received an update from the clinic that Allison’s HCG today was 696, it doubled as planned. Thus, Dr. Lin would like her to continue all her medication and the ultrasound is scheduled Monday 04/24 in RFC Corona, still pending the exact time. This is exciting!”
  • 4/24 OIF – Update
    • “Today Allison’s fetal heartbeat ultrasound went well. She’s pregnant! The baby’s heartbeat was strong 114bpm. She’s measuring 6wk1d. Estimated due date is 12/17/23. This is easy for me to remember because that’s also my birthday haha. We used Allison’s phone to record today, so she will send me the video later today then I’ll forward that to you both after. And attached are the ultrasound pictures from today. One more thing to let you know is that she had some random bleeding on last Thursday night. Even though the bleeding stopped by Friday already, but she still went ahead to be seen at RFC by Dr. Lin because she wanted to make sure everything was okay. Dr. Lin put her on bed rest from Friday to Sunday; though she’s also told that bleeding for IVF pregnancy is common so there’s nothing to worry about. So everything’s good! I’ve also attached the ultrasound pictures from last Friday for you here.”
      • “There should be at least one more appointment for her at RFC before she graduates and starts going to her OB appointment with her own OB. Currently we’re waiting for more instructions from RFC 3rd party regarding the next steps and appointment. Once I have more updates I’ll keep you posted.”
  • 4/25 RFC – Update
    • “Yesterday Alison had visit for OB ultrasound and blood test. Everything looked great. There was heartbeat of 114 and there was a good size baby. She will be back in 2 week on 5/8/23. Congratulations again.”
      • “Of course, it was 19.35. Also please note as Dr. Lin wanted to be careful he increased her Progesterone injection to 2 ml daily.”
  • 5/8 RFC – Update
    • “Allison visit went well. Just got her blood test level. Her Progesterone is 56 and she is going to take only 1 ml progesterone and her last estrace pills will be Friday. Scheduled her on 5/22/23 in corona office at 12 pm. It would be her last visit with us.”
  • 5/8 OIF – Update
    • “Today Allison had an appointment at the clinic. Everything went well. Attached are the ultrasound pictures from today. Baby is measuring a couple days ahead and his heartbeat is 168bpm. Her last appointment at RFC is tentatively scheduled on 5/22. Once we have a confirmed time I will then keep you posted.”
  • 5/10 OIF – Oscar ACA Exit 2024
    • “I was informed yesterday that Oscar insurance will be exiting ACA by January of 2024. I have asked ArtRisk insurance agent for advise, they responded that there should be no issues since Allison’s EOD is in December. However, they do suggest to get a policy in January in case of any complications and we should apply for a continuation of care. Thus, let me know your thoughts or if you’d like, I can also help you set up a consultation with the insurance agent for more details.”
  • 5/22 RFC – Update
    • “Congratulations. We graduated Allison and she is going to continue her care with her OB office. She is so great and hope all goes well. Baby is doing well, heartbeat was 168 and Cindy got some picture of Allison. I am sure she will send you them.”
      • “37.78 was her progesterone. She is going to stop injecting and only do vaginal for about 2 more weeks.”
  • 5/22 OIF – Update
    • “Today was Allison’s graduation appointment. Everything went great. She’s measuring 10 weeks and 4 days. The baby surely is growing fast! We were able to throw a little surprise graduation celebration for her. She was really touched. Please find the pictures below. And I plan on going to her OB appointment with her on June 7th when she gets to meet her OB for the first time.”

2023Q3

  • TBD

2023Q4

  • TBD