In this episode of The Surrogate’s Corner, host James Mahan speaks with Dr. Aimee, widely known as “The Egg Whisperer,” about the medical side of surrogacy. Dr. Aimee shares deep insights into the screening process, embryo transfer decisions, and how both surrogates and intended parents can better navigate the medical and emotional aspects of a surrogacy journey.
The Key Qualities Every Surrogate Should Have
Dr. Aimee explains that her top priority when screening a potential surrogate is simple: no drama. She looks for women who are emotionally and physically healthy, have low stress in their lives, and have previously experienced healthy pregnancies and deliveries. According to ASRM guidelines, surrogates should typically be between 21 and 42 years old, have had at least one full-term birth without complications, and pass both medical and psychological evaluations.
Every fertility clinic may have slightly different screening checklists, but the goal remains the same—to ensure the surrogate’s health and the safety of the pregnancy.
Why Reviewing Medical Records Comes First
Unlike some clinics that review surrogates after agency matching, Dr. Aimee prefers to review all medical records before contracts or payments are made. She personally reviews each candidate’s medical history and schedules a conversation to clarify any potential issues. This prevents intended parents from wasting time or money on a surrogate who may later be medically disqualified.
She notes that while agencies work hard, they aren’t medical professionals—so small but significant health details can easily be missed. Her approach allows for early detection of disqualifying conditions, saving everyone time, money, and emotional stress.
Dr. Aimee recommends that intended parents always have medical records reviewed before paying an agency, to avoid being financially tied to an unsuitable match.
The Reality Behind the Surrogacy Market
Contrary to what many intended parents are told, Dr. Aimee says the current market actually has more surrogates than intended parents. Agencies sometimes create a sense of urgency by mentioning long waitlists, but she urges parents to take their time and approach the process with clarity rather than desperation.
She believes intended parents should never feel pressured to pay upfront for a surrogate they haven’t fully vetted—comparing it to hiring a babysitter: “You don’t pay an agency for a babysitter you haven’t met yet.”
How Efficient Screening Improves the Process
Dr. Aimee’s efficient system has earned her strong relationships with agencies that appreciate her quick turnaround times. Her clinic typically reviews records within days, schedules calls within a week, and moves toward clearance promptly—avoiding the long delays seen in traditional clinics.
She emphasizes that her patients don’t do waiting lists, focusing instead on efficient and transparent coordination between surrogates, agencies, and intended parents.
Single vs. Double Embryo Transfers: What’s Safer?
When it comes to embryo transfers, Dr. Aimee strongly advocates for single embryo transfers whenever possible. She only recommends transferring two embryos in rare cases involving poor-quality embryos or limited options. Her stance is clear: “It’s safer and often more cost-effective to have two surrogates transfer one embryo each than one surrogate carrying twins.”
She highlights that twin pregnancies come with higher medical risks—bed rest, longer recovery times, premature birth, and even increased maternal mortality. Once surrogates fully understand the risks, most agree that a single embryo transfer is best.
Why Surrogates Should Ask About Embryo Quality
Dr. Aimee encourages surrogates to be proactive and informed about the quality and number of embryos available. She shares that some surrogates unknowingly agree to transfers involving poor-quality embryos—leading to failed cycles that unfairly affect their “record.” Surrogates should ask early how many embryos a family has and what quality they are, since that can influence both success rates and contract terms.
Success Rates and What to Expect
Dr. Aimee sets realistic expectations: while many first transfers succeed, not all do. With high-quality, genetically screened embryos, over 50% of first transfers are successful. Still, intended parents and surrogates should understand that outcomes can vary—and that failure is not always due to the surrogate.
The State of the Surrogacy Industry
Dr. Aimee believes the surrogacy industry has made progress in reducing stigma and promoting open discussions. More doctors are introducing surrogacy as an option earlier, helping families avoid years of failed IVF attempts. However, she sees room for improvement in emotional support and affordability.
She recommends joint psychological support sessions for surrogates and intended parents—both at the start and throughout the process—to help maintain trust and communication, especially if setbacks occur.
Addressing Costs and Agency Practices
The rising cost of surrogacy remains a major issue. Dr. Aimee questions why agencies often charge more than the surrogates themselves earn, despite not taking medical or physical risks. She supports innovative programs that aim to make surrogacy more affordable and believes the industry must find ways to reduce financial barriers for families.
Dr. Aimee’s insights offer a transparent and compassionate look at what makes a successful surrogacy journey—from thorough medical screening to open communication and smart decision-making. Her emphasis on safety, honesty, and efficiency serves as a model for improving the surrogacy experience for everyone involved.
