Gestational Surrogacy

Building Families Through Gestational Surrogacy: A Journey of Hope and Connection


Through advancements in reproductive technology, Gestational Surrogacy offers a pathway that transcends biological barriers, fostering dreams of creating a family.

Gestational Surrogacy

There are numerous reasons why individuals and couples turn to gestational surrogacy. The most common are:

– Same-sex male couples
– Men who are single parents
– Women with previous hysterectomy
– Medical conditions making being pregnant too risky

The intended parents’ eggs or donor eggs are fertilized with sperm through In Vitro Fertilization (IVF). One of the resulting embryos is then transferred to the surrogate, who carries the pregnancy and delivers the child.

You can select a surrogate from one of the many Surrogacy Agencies available. To assist you in selecting a surrogate, please refer to the Gestational Surrogacy Guidelines (PDF).


Finding a Gestational Surrogate

Finding a surrogate is the first step in initiating the Gestational Surrogacy treatment.

There are many gestational surrogacy agencies, several of them in the San Francisco Bay Area. Each has a pool of pre-screened surrogates from which you can make your selection.

The surrogacy applicants are typically young women in their twenties and thirties with a low risk for disease transmission and substance abuse.  Most of them have decided to become a surrogate based on a combination of financial incentives and an altruistic desire to help infertile couples.

Once you have selected your surrogate, the agency will instruct her to contact Bay IVF directly to set up her initial consultation.

Your surrogate does not have to live locally or even in the US.

Gestational Surrogacy separates the genetic material of the intended parents from the surrogate.

Gestational Surrogacy Treatment Process

1 — Ovarian stimulation (Intended Mother or Egg Donor)

The treatment is always individualized to maximize the probability of a successful outcome. You will receive your personalized ovarian stimulation calendar.

2 — Egg retrieval procedure

The egg retrieval procedure is performed at our Clinic. The procedure typically takes only a few minutes, and we use conscious sedation for comfortable analgesia.

4 — Culture of embryos

Evidence of fertilization can be seen the next day, approximately 16 hours after insemination. The fertilized eggs are then transferred into a growth medium and continue to be cultured in our laboratory.

3 — Fertilization of eggs

On average, eight to fourteen eggs are retrieved during the egg retrieval procedure. Once identified, the eggs are combined with sperm and placed in petri dishes filled with culture medium.

5 — Embryo cryopreservation

All normally developing embryos are cryopreserved (vitrified).

6 —Embryo storage in liquid nitrogen

Following the cryopreservation process, the embryos are transferred to a liquid nitrogen storage chamber in our Clinic. Theoretically, there is no limit on the length of storage.

7 — Subsequent Frozen Embryo Transfer

Once you decide to use your cryopreserved embryos, one or two embryos will be thawed and transferred into the surrogate’s uterus.

Below is an example of a Gestational Surrogacy treatment cycle. Your individualized protocol may take less or more time to complete.

Gestational Surrogacy Procedure

Ovarian stimulation (Intended Mother or Egg Donor)

There are various forms of ovarian stimulation protocols, each with multiple modifications. Your treatment is always personalized to maximize the likelihood of success.

The optimal protocol for your treatment is selected based on your reproductive history and your pre-treatment evaluation.

Ovarian stimulation takes approximately ten days. During this time, your progress is monitored by estradiol (estrogen, E2) and progesterone blood levels and ultrasound examinations.

Ovarian stimulation should result in the development of several eggs in each ovary. The ultrasound image shows a stimulated ovary. Each of the several follicles (dark circles) contains a microscopic egg.

Egg Retrieval Procedure

The egg retrieval procedure is performed at our Clinic. We provide comfortable, conscious sedation analgesia.

The egg retrieval is a quick and relatively painless procedure that takes about five minutes to complete. Here’s what happens during the procedure:

Administering Pain Medication

  • Dr. Polansky administers pain medication and relaxation drugs through the IV line, inducing a state of twilight anesthesia.
  • Most patients will fall asleep during the procedure, while some might remain awake and view the egg retrieval on an ultrasound screen.

Egg Retrieval Process

  • Under ultrasound guidance, Dr. Polansky retrieves eggs from the ovaries using a thin needle passed through the top of the vagina.
  • The needle aspirates the follicular fluid containing the eggs. The process is usually completed within minutes.
  • Embryologists then examine the follicular fluid under a microscope to identify eggs.

Fertilization of Eggs

On average, eight to fourteen eggs are retrieved during the egg retrieval procedure. Once identified, the eggs are placed in petri dishes filled with culture medium.

The composition of the culture medium resembles the fluid secreted by the Fallopian tubes, facilitating the development of eggs and embryos (fertilized eggs) in our laboratory environment, simulating the conditions in the Fallopian tubes.

On the day of egg retrieval, the male partner provides a semen specimen through masturbation. The highest quality sperm are extracted from the semen and combined with the eggs three hours after retrieval. This in vitro fertilization process takes place over several hours in the evening following egg retrieval.

If the male partner has never caused pregnancy or if his test results indicate significant male infertility, Intracytoplasmic Sperm Injection (ICSI) is performed. In ICSI, a single sperm is directly injected into an egg, significantly increasing the probability of successful fertilization for selected patients.

Culture of Embryos

Fertilization is usually observed the day after insemination, approximately 16 hours later. A normally fertilized egg (zygote) will exhibit two pronuclei representing the genetic material from the egg and sperm. The fertilized eggs are transferred to a growth medium and continue to be cultured in our laboratory.

The following day, embryos should divide into 4 cells, and by the day after, they should reach 8 cells.

By the fifth to seventh day after the insemination, the embryos should develop into the blastocyst stage, consisting of 80 or more cells.

This picture shows an advanced stage of blastocyst development. Notice the central fluid-filled cavity. The cells within the blastocyst have already differentiated into the inner cell mass (at seven o’clock) that will give rise to the fetus and the trophectoderm cells that will form the future placenta.

At this stage, the embryos are still microscopic, invisible to the naked eye.

Blastocyst cryopreservation

Embryos that develop normally are cryopreserved. Preparation for the freezing process involves removing water from within the embryos and replacing it with a cryoprotective substance to prevent ice crystal formation during vitrification and subsequent thawing.

The embryos are then flash-cooled to -196°C (-321°F). Such rapid freezing (vitrification) prevents damaging water crystal formation.

Liquid nitrogen storage

Following the cryopreservation process, the embryos are transferred to a liquid nitrogen storage chamber in our Center. Theoretically, there is no limit on the length of storage.

Subsequent Frozen Embryo Transfer

Once you decide to use your cryopreserved embryos, typically, only one embryo will be thawed and transferred into the surrogate’s uterus.

A large majority of the embryos will survive the cryopreservation and thawing process. The implantation rate of the thawed embryos should be the same as the “fresh” embryo implantation rate.

If your surrogate is successful, her pregnancy becomes indistinguishable from conception through intercourse, and her obstetrical care should be no different than if she were to conceive without any treatment.

Bay IVF Early Pregnancy Heartbeat

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Prerequisites for Gestational Surrogacy

Only a few treatment prerequisites are needed before the start of your treatment. They assess the egg and sperm quality and ensure that embryos can be accurately placed in the surrogate’s healthy uterus.

Intended Mother’s age

The probability of a successful Gestational Surrogacy treatment becomes exceedingly low by age 44. The intended mother must be 43 and 11 months or younger when the Gestational Surrogacy treatment begins. Patients who are 44 and older should strongly consider a combination of Donor Egg IVF and Gestational Surrogacy as the most effective treatment option to achieve a successful pregnancy.

Pathogen testing

This testing is required by the State of California and the FDA. You, your partner (if applicable), and the surrogate must be tested for Hepatitis B-Surface Antigen, Hepatitis C-Antibody, HIV I&II, HTLV I&II (male partner only), RPR, Chlamydia, Gonorrhea, and Cytomegalovirus (CMV).

Ovarian Reserve Assay – ORA (Intended Mother or Egg Donor)

ORA assesses the likelihood of producing normal-quality eggs. It involves measuring Follicle Stimulating Hormone (FSH), estradiol (estrogen, E2), and Anti-Mullerian Hormone (AMH) blood levels.

These test results are used to optimize ovarian stimulation.

Antral Follicle Count (Intended Mother or Egg Donor)

The number of antral follicles (small fluid-filled sacs within the ovaries seen on ultrasound) in unstimulated ovaries is related to the quality of the eggs. Ideally, there should be approximately 20 antral follicles in both ovaries combined.

Uterine measurement and saline ultrasound (Surrogate)

It is important to determine the length of the uterus in order to ensure the correct placement of embryos.

A saline ultrasound is utilized to rule out the presence of intrauterine polyps or fibroids.

Semen evaluation

The male partner’s semen will be evaluated at Bay IVF to determine the best laboratory method for semen preparation for egg insemination.

Intended parents’ genetic testing (optional)

All prospective parents should consider genetic screening for hundreds of the most common genetic diseases. Please inform us during your initial appointment at Bay IVF if you would like to have your blood sample sent for genetic screening.

IVF diet and lifestyle

Environmental factors have a significant impact on reproductive health. Please review the IVF Diet and Lifestyle document (PDF) for a comprehensive list of environmental reproductive health recommendations and a source for dietary supplements.

The surrogate undergoes rigorous screening and medical evaluations, ensuring her physical and mental well-being.

FAQ — Find Answers to Your Queries

Here are some of the most commonly asked fertility-related questions. A more comprehensive FAQ selection is available on the FAQ page.

Do medications used in the IVF treatment have any side effects?

Most patients should expect minimal, if any, side effects from the medications used in In Vitro Fertilization. You should be able to continue with your everyday activities during the treatment.

How long does it take to complete a cycle of IVF?

It typically takes approximately 6 to 8 weeks from the start of your treatment to the egg retrieval and embryo transfer.

Is the egg retrieval procedure painful?

Your egg retrieval should be a very comfortable experience as we use effective pain and relaxation medications. Most patients will sleep through the 5-10 minute egg retrieval procedure. Some may experience mild menstrual-like cramping.

What is ICSI, and how does it affect my embryos?

n the Intracytoplasmic Sperm Injection (ICSI) procedure, a single sperm is directly inserted into the center of an egg. ICSI has been widely used since 1993, and approximately 2 million babies have been born worldwide without significant side effects through the use of ICSI.

I am over 40. Should I plan to do PGT?

You may consider adding Preimplantation Genetic Testing (PGT) to your In Vitro Fertilization or Donor Egg IVF treatment. If you choose to do so, it eliminates the need for amniocentesis. While adding PGT to these treatments has not been proven to improve the chances of a successful outcome consistently, it can help reduce the risk of miscarriage.

How many embryos should we transfer?

We adhere to the recommendation of the American Society for Reproductive Medicine that most patients should consider transferring only one or two embryos. While we will always provide guidance, the ultimate decision of whether to transfer one or two embryos will be up to you.

Is bed rest recommended after an embryo transfer?

From a conception standpoint, it is not recommended to rest immediately after embryo transfer. Recent studies have shown that remaining active and moving around after the transfer can increase the probability of implantation. Therefore, it is advised to start moving around immediately after your transfer.

I am from the LGBTQ+ community. Can I have my treatment at Bay IVF?

Yes! We take pride in being one of the first fertility clinics in Northern California to offer In Vitro Fertilization services for lesbian partners. Our clinic is LGBTQ+ friendly and experienced in both lesbian IVF and Reciprocal IVF.

Meet Your Doctor

  • Dr. Polansky received his medical diploma from Charles University in Prague, the Czech Republic, in 1978.
  • After completing his OB/GYN residency at Jewish Hospital in Saint Louis, MO, he graduated from the Reproductive Endocrinology and Infertility (REI) fellowship at Stanford University in 1985.
  • In the same year, he co-founded the Stanford IVF Clinic.
  • Dr. Polansky obtained board certification in Obstetrics and Gynecology in 1986 and became REI subspecialty board certified in 1988.
  • In 1987, he left Stanford University and established Nova IVF.
  • In 2011, he founded Bay IVF, where he provides advanced fertility treatments with a holistic approach, utilizing state-of-the-art techniques.
  • Dr. Polansky personally performs ultrasound examinations, egg retrievals, embryo transfers, and ovarian and endometrial stimulations for his patients.
  • He is deeply committed to his patients and freely shares his cell phone number, ensuring accessibility and availability 24/7.

Frank Polansky, M.D.

Initial Appointment Questions

When you call to schedule your consultation, one of our Front Office Coordinators will ask you a short series of questions regarding your reproductive history.

  • Your name
  • Your date of birth
  • Your height
  • Your weight
  • Do you know which treatment you plan to have?
  • How many times have you been pregnant?
  • For each of your pregnancies, what was the conception date? (month and year)
  • What was the outcome?
  • Were the pregnancies with your current partner?
  • If known, what is the cause of your infertility?
  • What is your average cycle length? (number of days between onsets of your periods)
  • Are you currently taking any medications? If yes, which ones?
  • Are you allergic to any medications? If yes, which ones?
  • Your partner’s name (if applicable)
  • Your partner’s date of birth (if applicable)
  • What is the length of your relationship with your current partner? (years and months)
  • When was the last time either of you used any contraception?
  • Is the male partner currently taking any medications? If yes, which ones?
  • Is the male partner allergic to any medications? If yes, which ones?
  • What is the total number of pregnancies the male partner has ever caused?
  • Has the male partner ever caused a pregnancy without the ICSI (Intracytoplasmic Sperm Injection) procedure?
  • Has the male partner had a vasectomy or vasectomy reversal?
  • If available, for each Semen Analysis, please give the date (day, month, and year), volume, concentration (sperm count), percentage of motile sperm, and percentage of morphologically normal sperm.
  • Have you ever had any treatment for, or problems with, your lungs, heart, blood and blood vessels, breasts, digestive system, genito-urinary system, thyroid disease, diabetes, or neurological disorder? (female partner only)
  • For each X-ray of your uterus and Fallopian tubes (hysterosalpingogram), laparoscopy, hysteroscopy, or laparotomy, please give the procedure date (day, month, and year) and the findings.
  • If available, for each FSH, LH, estradiol (estrogen, E2), and AMH (Anti-Mullerian Hormone) test you have had, please give the date of the test (day, month, and year) and the result.
  • Have you done any intrauterine inseminations (IUI)? If yes, how many?
  • Have you had ovarian stimulation with injectable medications?
  • For each IVF treatment you have had, please provide the following information if available: Date (month and year), the dose of medications to stimulate your ovaries, your highest estrogen level, number of ovarian follicles that developed, number of eggs retrieved, whether ICSI was done, number of embryos available, number of embryos transferred, number of embryos frozen, and the treatment outcome.
  • Have you ever smoked cigarettes? If yes, how many cigarettes a day during the last three months? (Please remember that you must not smoke during your treatment.)

This is Erica

She will be providing you with exceptional support throughout your treatment journey at Bay IVF.

Listen to a typical conversation between Erica and a new patient.
  • Your name
  • Your date of birth
  • Your height
  • Your weight
  • Do you know which treatment you plan to have?
  • How many times have you been pregnant?
  • For each of your pregnancies, what was the conception date? (month and year)
  • What was the outcome?
  • Were the pregnancies with your current partner?
  • If known, what is the cause of your infertility?
  • What is your average cycle length? (number of days between onsets of your periods)
  • Are you currently taking any medications? If yes, which ones?
  • Are you allergic to any medications? If yes, which ones?
  • Your partner’s name (if applicable)
  • Your partner’s date of birth (if applicable)
  • What is the length of your relationship with your current partner? (years and months)
  • When was the last time either of you used any contraception?
  • Is the male partner currently taking any medications? If yes, which ones?
  • Is the male partner allergic to any medications? If yes, which ones?
  • What is the total number of pregnancies the male partner has ever caused?
  • Has the male partner ever caused a pregnancy without the ICSI (Intracytoplasmic Sperm Injection) procedure?
  • Has the male partner had a vasectomy or vasectomy reversal?
  • If available, for each Semen Analysis, please give the date (day, month, and year), volume, concentration (sperm count), percentage of motile sperm, and percentage of morphologically normal sperm.
  • Have you ever had any treatment for, or problems with, your lungs, heart, blood and blood vessels, breasts, digestive system, genito-urinary system, thyroid disease, diabetes, or neurological disorder? (female partner only)
  • For each X-ray of your uterus and Fallopian tubes (hysterosalpingogram), laparoscopy, hysteroscopy, or laparotomy, please give the procedure date (day, month, and year) and the findings.
  • If available, for each FSH, LH, estradiol (estrogen, E2), and AMH (Anti-Mullerian Hormone) test you have had, please give the date of the test (day, month, and year) and the result.
  • Have you done any intrauterine inseminations (IUI)? If yes, how many?
  • Have you had ovarian stimulation with injectable medications?
  • For each IVF treatment you have had, please provide the following information if available: Date (month and year), the dose of medications to stimulate your ovaries, your highest estrogen level, number of ovarian follicles that developed, number of eggs retrieved, whether ICSI was done, number of embryos available, number of embryos transferred, number of embryos frozen, and the treatment outcome.
  • Have you ever smoked cigarettes? If yes, how many cigarettes a day during the last three months? (Please remember that you must not smoke during your treatment.)

This is Nisha

Your invaluable resource for effortlessly managing your appointments at Bay IVF.

Listen to a typical conversation between Nisha and a new patient.

Your Initial Visit at Bay IVF

Attending a new patient appointment at a fertility clinic can be stressful. Our primary objective is to ensure that your initial visit is friendly and relaxing. We encourage you to ask questions at every step of the process.

1 — When You Arrive

You will be welcomed by one of the clinic receptionists. One of our nurses will measure your height and weight and take your blood pressure

2 — Meet Your Doctor

Dr. Polansky will ask you a series of clarifying questions and then provide you with a summary of the factors contributing to your infertility

4 — Exam Room

One of the nurses will escort you to an examination room. Your examination will begin with listening to your lungs and heart

3 — Ask Your Questions

You will then have a discussion with him about the most suitable reproductive treatment(s) for you. During this time, you will have the opportunity to ask any questions you may have

5 — Ultrasound of the Ovaries

The next step is a pelvic ultrasound to examine the uterus and ovaries. This ultrasound will help determine the number of antral follicles present within the ovaries

6 — Financial Part

Following that, you will have a discussion with one of the financial advisors regarding the financial aspects of your treatment, including potential treatment financing options

8 — Support 24/7

If you have any questions after leaving the clinic, please feel free to reach out to us via phone call, text, or email. Open and discreet communication is an integral part of the care we provide at Bay IVF

7 — What About Time?

Your entire visit is expected to last approximately one hour

Schedule Your Initial Consultation With Dr. Polansky

Online (free) or In-Person

Call or Text Us: 650-322-0500

You can also complete the form below to request your initial consultation

    Next Step: One of our coordinators will call you for information about your reproductive history and to schedule your appointment.

    We look forward to meeting you at Bay IVF and, when your treatment is successful, celebrating your new pregnancy!