Gestational surrogacy

Meet Growing Generations & Mitera, Carrot partners making donor-assisted reproduction safer

Anyone who has started on a gestational carrier (GC) journey knows that the process is complicated. GCs carry pregnancies that they’re not genetically related to on behalf of a couple or individual, and there are many medical, legal, and financial steps to take along the way. That’s why Carrot is pleased to partner with experienced agencies like Growing Generations, which has helped bring more than 3,500 babies into the world since its founding in 1996, and medical screening experts like Mitera

We talked with Growing Generations and Mitera about advice for those starting a GC journey, how to find a GC agency that’s right for you, and how they’re making donor-assisted reproduction safer through high-quality screenings.

Tell me a little bit about Growing Generations, Mitera, and how you work with Carrot.

One important part of working with GCs is the medical screening process, which makes sure a GC can become pregnant and carry a healthy pregnancy. Growing Generations has partnered with Mitera to provide intended parents with medical and obstetrical screening services for the gestational carrier they’re working with, genetic screening for egg donors, and consultations for intended parents with maternal fetal medicine (MFM) physicians. MFMs are physicians that pursue advanced training after completing a residency in OB/GYN and have specific expertise in high-risk pregnancies, including the medical, obstetrical, and fetal complications of pregnancy. 

What is the screening process like for gestational carrier candidates working with Growing Generations?

Growing Generations’ GC education and screening process is structured to help ensure safety for our GCs and the babies they carry. While there are many requirements for becoming a GC, the basic ones are having had at least one healthy pregnancy, being physically and mentally healthy, being financially stable, and being able to commit to the timeframe for the process (18 to 24 months from application to delivery). 

The screening begins with a qualification and application process, followed by an educational phone or video consultation with a member of Growing Generations’ GC admissions team. Next, the GC will speak to a member of Mitera’s maternal fetal medicine team for a review of their past obstetrical history. This helps to identify any areas of increased risk for the GC’s pregnancy. The GC will also complete a medical screening with an in vitro fertilization (IVF) physician, psychological testing and evaluation, and a criminal history background check. 

How does Mitera provide care that is different from the average gestational carrier screening process or medical screenings done in the past?

Mitera’s MFMs are specifically trained in high-risk pregnancy and are highly qualified to identify increased risk factors based on a review of obstetrical history. This review of obstetrical histories has traditionally been completed by IVF doctors. Growing Generations believes that adding this second layer of review by a highly trained physician is in alignment with Growing Generations’ commitment to safety and quality. 

Do you see Mitera and other MFMs being used more often for this type of care in the future?

Assisted reproduction professionals have a collective interest in taking reasonable steps to ensure healthy pregnancy outcomes. Given the national accessibility of Mitera’s services, we anticipate that many GC agencies and IVF practices will integrate Mitera or other MFM services into their care models.

What should intended parents know before starting on a gestational carrier journey?

As you will soon learn, kids rarely do what you expect them to. GC journeys are not so different. There are simply too many independently-moving cogs for your actual journey to mimic the one you’ve been imagining and hoping for that can set you up for disappointment.

Instead, come to the process with an open heart, an open mind, and a lot of patience. This will help you enjoy your experience when things get frustrating. If a pregnancy attempt fails or if there is a delay in progress, understanding that this process more closely resembles a marathon than a sprint will help you keep your head up.

Finally, take pride in your choice to use GC services to grow your family. It’s a great big endeavor that can be intimidating to many, but you’re doing it. You’re taking on this adventure because you’re the type of parent who will do anything for their children, and for that, you should be proud.

What should intended parents look for in a gestational carrier agency?

We encourage intended parents to consider three areas:

  • Business basics: For the most part, GC agencies are not regulated, so it is important to understand how long an agency has been in business, whether they carry adequate professional liability insurance, and what kind of infrastructure they have to support you through a process that can last 18 months.
  • GC-specific areas: Most intended parents want to know how quickly they will be matched with a GC. An equally important question is what level of screening will your potential GC have before you’re introduced? Have they worked with prospective parents like you? Can they refer you to an attorney, doctor, and psychologist if needed?  What is their specific role from the time you sign on until the time you arrive home with your baby?
  • Just a feeling: You’re going to be working with your GC agency for a significant amount of time. It’s important that it “feels” right, so listen to your gut.

What advice do you have for LGBTQ+ people looking to start a family through gestational carrying or egg donation?

Starting a family through GC or egg donation means relying on a team of people to help you become a parent. Ensuring that the team you chose is affirming, knowledgeable, and sensitive to the unique issues and decisions LBGTQ+ folks face can make a huge difference. LGBTQ+ competency in the family creation space has come a long way, but there’s still work to be done so, as I said earlier, trust that “gut feeling.” 

From your perspective, how have fertility benefits and the family-forming space changed over the years?

Growing Generations has been helping people become parents through GC services and egg donation since 1996. Over the course of our 25-year history we’ve created, contributed to, and witnessed many innovations and evolutions in the family-forming space. Ten years ago, one or two families per year would have access to very limited benefits; an intended mother might be lucky enough to have her egg retrieval covered by her insurance if she lived in New Jersey, a state with mandated IVF coverage, or an intended father would submit his medical screening expenses to insurance and receive a partial reimbursement. These cases were few and far between, the coverage represented a tiny fraction of overall expenses, and the parents often went through a complicated approval and claims process. 

In the last two years, we have seen an explosion in the number of prospective parents with access to fertility and family-formating benefits. Each week we talk with prospective parents who have family-forming benefits provided by an employer. For those who don’t have benefits, we encourage them to advocate for themselves with their employer’s human resources department. We even find that some intended parents are pleasantly surprised to find out they have benefits they weren’t aware of. 

If you’re a fertility care or family-forming service provider interested in supporting Carrot members, or you would like to learn more about working with Carrot, please contact us at

Continued reading

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Funding the cost of gestational surrogacy

Finding community and optimism during gestational surrogacy journeys

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