Twiblings via gestational carrier or surrogate

Having a child via gestational carrier, a process commonly referred to as surrogacy, can be complex for one pregnancy. But George and his husband were hoping to have two babies at the same time — “twiblings.” Between finding an egg donor, a reputable clinic, two gestational carriers, and managing everything there is to do when preparing for two new additions to a family, George and his husband had a lot on their hands. Here’s how they did it.

Podcast Transcript

Show notes

George Arison, founder and CEO of Shift, had twiblings via gestational carrier. 

Men Having Babies is a Facebook group that George and his husband referenced for a number of resources. 

Gifted Journeys is the egg donation and gestational carrier agency George and his husband used to search for an egg donor.

Northwest Surrogacy Center is the agency that helped George and his husband connect with a gestational carrier. 


Marie (00:00): The first time George saw the word twiblings it was in a New York Times article about a couple that had two kids at the same time via two different gestational carriers. Before I explain twiblings, let me clarify that gestational carriers are commonly referred to as surrogates. A gestational carrier becomes pregnant via in-vitro fertilization in order to carry a fetus to term on behalf of another person or a couple who are unable to become pregnant themselves. Twiblings are two babies that are genetically related and born at the same time, but come from two different gestational carriers, so kind of twins, kind of siblings. When George saw that New York Times article, it piqued his interest. It encapsulated exactly the way he hoped to one day form a family with a husband. George is the founder and co-CEO of a company called Shift and he says that the process of having his kids sometimes felt more involved than starting a company. Today he's going to talk about his and his husband's gestational carrier journey and everything it entailed.

Marie (01:19): This is Baby Steps, a podcast from Carrot Fertility about the many diverse paths that people take in the pursuit of parenthood. I'm your host, Marie McCoy-Thompson. Okay. So let's start with you. Where are you from? What do you do?

George (01:39): I'm originally from Georgia, the country. I was the first Soviet kid allowed to leave the Soviet Union to go to US prep school and was very fortunate and lucky and also had a lot of help with my family in Vermont that had lived with my family in Georgia. This is all like early 90s let's say. This kind of stuff didn't happen. This is pre days of the internet and such, so you're communicating with the US with a fax machine and a telex machine and only one fax machine that's publicly available in Georgia can send faxes to the US. It's that level of kind of weirdness. But I was-

Marie (02:09): You would go to the one fax machine and maybe wait in line and-

George (02:14): You didn't have to wait in line because the cost was so exorbitant that most people couldn't use it. It was 10 Soviet rubles a page, which at that currency exchange was $10 to send a page.

Marie (02:26): Wow.

George (02:26): It was like you'd have to fill in every spot on the page with stuff to send. That's how I applied to prep schools, got in and I've been here pretty much the rest of my life as a student and then working and so forth. Did go back to Georgia for about a year and a half in 2013, 2014 to help run a political campaign.

Marie (02:49): After those two years back in Georgia, George returned to the US and made a career for himself. In his most recent venture, he founded Shift a virtual dealership for and selling cars. You talked about sort of your professional trajectory. At what point did you meet your husband?

George (03:08): I met Robert in 2015. We hit it off very, very fast. I think after four dates he wanted to move in with him. But to go backwards before the four dates on the very first date we spend a ton of time talking about children, the reason being that we both really want kids, I probably maybe even more than he did-

Marie (03:28): How old were you at this point?

George (03:31):I was like 37.

Marie (03:32): You knew who you were, you knew you wanted a family, you were ready.

George (03:36): Yeah. Robert's view also was like when you know, you know. That's why he was so ready to move in after four dates.

Marie (03:43): What did you like about him from the get go?

George (03:46): Well Robert is really, really smart, which for me matters a lot. And I think we were very aligned in what we wanted our lives to be like longterm and that was really good as well.

Marie (03:56): Were you aware as soon as you started talking with him about it what your different options were for having kids?

George (04:02): I've had a lot of friends who've gone through various ways of having children among my gay friends. Five or six had done surrogacy in some way. As I had kind of heard about this for a long time, for me having a biological child was a very important emotional thing and so I had dreamed of this idea of my husband and I were going to have kids who are siblings genetically because they have the same genetic mom and then each one of our ... the sperms for the other half of DNA for a really, really long time, before any of my friends actually had done that. And then a bunch of my friends did do that and so I knew that it was possible. That was very much the direction that I wanted to go in.

Marie (04:45): Why is that and why did you decide that you wanted to have your two kids at the same time?

George (04:49): Robert and I love this concept of twins and people we know who had twins, it's just the relationship is so special. I have a colleague who works for me who is a twin and he texts his sister like 10 times a day and look, their siblings were very close as well, but the fact that you grow up together and in twins cases are actually in the womb together, is really amazing. There's also a lot of research that points to the fact that twins are oftentimes super kids because they are able to feed off each other and they always have a friend together. Setting your children up to have that was kind of cool. I think the reality is that this process of having a gestational carrier and egg donor and IVF and all this stuff that's involved, which we can go through is extremely costly and so having twins reduces the costs substantially if you want to have two children, right? That's just the reality.

Marie (05:45): One thing that I thought I loved that you said was the idea of super kids coming from twins. I think that's so ... It sounds like that's something that fits your personality of being someone who would think about that so far in advance that even before you're thinking of having kids, it's how do I set my kids up for the best possible chances of success in life.

George (06:07): Yes, that's very much how I think. For better or for worse.

Marie (06:10): For better. I mean your kids are so lucky I think to have someone who's been so considerate of them from before they were even conceived. George and his husband knew they wanted to have twiblings and then it was a matter of getting the gestational carrier process moving forward.

George (06:36): There's three big buckets of things that need to happen. One is you need to find an egg donor and choosing to find a surrogate or, in our case, two surrogates and thirdly, you to decide which clinic you're using to do this whole process and then this all is covered in a box of law that has to be done in a very careful way.

Marie (06:58): Would you say that this finding the egg donor is step one?

George (07:01): Yes. Finding the egg donor is definitely step one. A lot of people will use a relative or someone they know for an egg donor or you can go and find an anonymous egg donor and there are agencies where you can pick. There's no kayak so to say of this process, right? You have to go to each agency at a time and look in their databases to see what's available. It's a lot of work to navigate that process. There's a company or two that you can use to like say, "Hey these are my criteria. Go look for me." They kind of do that work. But we actually got fired by one of those agencies because our criteria were allegedly too complicated.

Marie (07:36): What were your criteria?

George (07:38): I thought they were super basic. We had a list of ... and so for us the most important thing about our egg donor was academic abilities let's say like, because I think both Robert and I really care about the education and knowledge.

Marie (07:50): Did you have any other criteria?

George (07:52): No. I mean secondary criteria, but those are the two that determined criteria.

Marie (07:58): They found an agency called Gifted Journeys that had been recommended to them and through that agency they were able to narrow down their search for an egg donor. It was Robert who ultimately found the first person who seemed like the right fit.

George (08:13): He was actually on a plane and flying on a business trip to Africa and was going through some profiles and saw this woman who met and way exceeded the criteria that we had laid down and got really, really excited about her. We then moved very, very fast to sign her up. It's good that we did because literally within hours of us contacting the agency, four or five other people contacted the agency as well. It was really fortunate that we were early in the process. There were things in her past and background and what she'd done in life and where she was from which were for both of us there was some connection that made it really special. She did something so amazing for us and we were really, really grateful for what she did.

Marie (08:58): George and Robert found their egg donor. They had also been concurrently looking for the clinic that would be right for them. How did you choose your clinic?

George (09:11): Really Robert made that choice. We met with the doctors and then he kind of ... Rob is a doctor, so it was up to him.

Marie (09:18): That's pretty convenient.

George (09:19): Yeah, it's very convenient. I don't think you need to be a doctor to do this, but it was a lot easier to do this if you are a doctor. We met with a bunch of different clinics and one of them was Spring Fertility and we really liked the folks there and they're just an amazing clinic.

Marie (09:33): For someone who isn't a doctor going through this process, what would you recommend looking for in a clinic?

George (09:38): I think outcomes is really important, so having you walk through outcomes that they have and being very honest about the data.

Marie (09:45): Their track record essentially.

George (09:45): Yeah, exactly. You actually want outcomes history on your type of a case, right? Because different situations require different type of care.

Marie (09:54): What are the different types of situations?

George (09:57): If you have a woman in her late 30s or early 40s trying to have a baby, it's a very different type of a situation versus if you are a gay couple using a gestational carrier who is probably sub 35 in age and has an egg donor who is probably below 30 in age. Those are just two very different circumstances and so statistics that combine everybody's data together are not helpful for you. I don't want this to come off in any way cavalier and it's really important for me for this not to come off ... because actually, I'm really conscious of how expensive this is and how that creates so many obstacles for people to have babies and I'm happy to talk about that because there's so much we can do to make it actually be cheaper that we should be doing.

George (10:36): But the reality is there are things that ... on which I think it makes sense to save money and there are things in which it doesn't make sense to save money. Sometimes when you see super discounted LASIK surgery, I'm not going to go have a super discounted LASIK surgery. It's just like the risk on that seems a little bit too high. This is one of those, I think, a super discounted IVF process, probably not one I would do. That's another thing I would watch for is this a clinic that has a lot of people coming there and or is it desperate for customers because I don't think you want to be at a clinic that is desperate for customers, but you do want to be at a clinic where the doctor is going to pay attention to you and so that's another thing that really matters.

Marie (11:12): Cost and the feel that you get from a clinic are some important factors. While finding the right clinic and the right egg donor, George and Robert were looking for their gestational carriers as well. They went through an agency called Northwest Servicing that had been recommended to them.

George (11:30): Our situation is a little bit unique because we're trying to do two different pregnancies at the same time, so we need two gestational carriers at once, which was going to make it a longer our search process. Ideally, we wanted them to at least be some vicinity of each other would be really, really nice. We actually had a fairly strong preference for gestational carriers within reasonable driving distance of San Francisco, because we wanted to be fairly involved in the process. Robert traveled to see each one of our carriers every three weeks.

Marie (12:01): Wow.

George (12:02): He was very, very involved in every doctor's visit, et cetera, which was incredible because it tells you the kind of dad he's going to be maybe our kids are very, very lucky to have him as a father. We were told it was going to take what six months to find carriers for us. It's a three to six month process. It ended up taking 15 months to find carriers and so we had our embryos ready in January 2018 and then we waited for another nine months before we actually had our gestational carriers to be able to start working on transfers.

Marie (12:32): George and Robert had already had their egg donor go through the egg extraction process at the clinic.

George (12:39): You go through a process at the clinic to be tested as well. We would go through a bunch of tests. You freeze your sperm, they test that as well. The sperm motility is the thing that's tested, how likely it is to actually inseminate well. And then when the donor does the egg donations, at that point you can decide on what you want to do, right? And so in our case, we want to take all the viable eggs and inseminate them with mine and Robert's sperm 50/50. Obviously embryo freezing has been happening for out longer than egg freezing, so the success rates on it are much higher, which is why it made sense to freeze the embryos. We were very lucky because we actually had a ton of eggs available to us and so we have a lot of embryos still available for more kids if we end up deciding we want to have more children.

Marie (13:27): How many did you end up with?

George (13:27): We started out with 38 eggs and we ended up, I think, with 12 or 14 embryos that were good post genetic testing embryos. I think nearly 50% of the embryos we sent off to genetic testing were not viable, but the remainder were and that's how we ended up with, I think it was 12 embryos or maybe 14, something like that.

Marie (13:58): While the embryos were frozen at the clinic it was time for George and Robert to go meet their gestational carriers. What was it like meeting them?

George (14:09): It's great. I mean it's actually quite formalized because the way this works is the surrogacy agency has a representative present at the meeting and then they have a list of questions that they want you to cover.

Marie (14:19): What kinds of questions?

George (14:20): Why you want to have kids, why you want to be a gestational carrier, how you think about approaching the process. What are the things that you'll really care about in the process? What do you not care about in the process? How do you envision the relationship being during the pregnancy? Did you plan on going to doctor's visits or do you not want to go to doctor visits? Those types of questions and then some questions about the future, like what happens in the future. Do you want to be in touch? Do you not want to be in touch? If that person is married, you meet the spouse and then you meet the children, all that kind of stuff.

Marie (14:51): That's a lot of information that you're processing all at once, but it sounds like both of your meetings went well and you liked the answers that you heard.

George (14:59): And then you go through some legalese on this whole thing with actually signing contracts and agreements on the surrogacy and concurrently with that they go through their medical testing.

Marie (15:10): At this point, the gestational carriers had to prepare their bodies for the embryo transfer, which involved self injections and hormonal medication.

George (15:19): And that's actually probably the hardest thing about this whole thing for the gestational carriers because they have to go through ... They have to do a lot of shots before the transfer and that's fairly challenging and painful and the shots continue after as well. It's kind of brave for them to be able to do this.

Marie (15:34): Then it's time for the transfer of the frozen embryos to the gestational carriers. For Robert and George, they were able to transfer both embryos on the same day, so the gestational carriers had the same transfer date.

George (15:48): Yeah, it's pretty amazing. It was one of the most incredible things I've ever seen. There's a book that we read to our kids about this kid who experiences a bunch of different animals and plants telling her that she's tiny and then a bunch of them telling them that she's huge depending on the size of the animal that she's interacting with it. Anyway, so we read this book and at one point in the books it's like she's talking to the moon and the moon tells her, "You are like microscopic." And so I usually end up stopping at that point and telling the kids like, "Yeah guys, like you are microscopic too." Like, "I saw you when you were like literally microscopic five cells that were transferred into the beginning of this thing," so it's pretty incredible.

George (16:33): Amelia was transferred first and I cried a lot when the whole thing was happening and then at the clinic everyone thought we were done. And so then it's like, "Oh great, we'll talk to you in a few days." And we were like, "No, we have another one happening." That had never happened at the clinic where they had done two transfers back to back. And so then we came back in and did the second transfer with Luca and it was pretty incredible.

Marie (16:54): Yeah. What's going through your mind as you're watching it?

George (16:56): I mean, just to be honest, the fact that we are so fortunate to live in a time and in a country where this is possible. The fact that in America a gay couple can do this, but mass majority of the population is going to be supportive and happy about it is really amazing. The speed by which the acceptance and tolerance of this has been coming through is really incredible. I remember my second or third year in the US, Ellen kissed another woman on The Ellen Show, the comedy show, not the TV show that she now does and it was a huge thing. They had to give an apology. That was only like 25 years ago. To go from there to where we are today is really, really incredible.

Marie (17:46): I'm imagining you in this room watching this happen, just the confluence of time that brought you to this moment and circumstance and science and-

George (17:58): All of it.

Marie (17:59): ... social progress, a lot had to happen.

George (18:02): It's pretty awesome.

Marie (18:08): After the transfers, George and Robert went on their Christmas vacation to Thailand. They had a great time relaxing, but were also anxiously awaiting news from their gestational carriers.

George (18:21): Robert had bought some pregnancy test kits for our surrogates and given to them in advance. We get a text message from Amelia's surrogate that had the test result and it worked. And so we woke up like 6:00 in the morning and saw this text message, which was completely incredible. I think we both started crying, et cetera, and then we couldn't stand it, so we had to text our first gestational carrier like, "Hey, can you like try to take a test?" Then she took a test, but it was inconclusive result. But then as the day progressed it became clear that her result was good as well. Robert is a pathologist by the way, so there was a lot of research going into how do we read a pregnancy test going all through this time period. And so by that evening we knew that both of them had worked and then they go in to do a blood test, which is more accurate. Over the next couple of days it became clear that they were both pregnant and that was that.

Marie (19:17): That's amazing.

George (19:18): But then like it's risky because a lot of pregnancies fail even after they take. I was always like, "Yeah, I mean, we're now going to have two kids." Robert was always very cautious like, "Look, a lot of things can happen between now and when the babies are born," so it was always this balance between being super excited and being nervous about what might happen still.

Marie (19:39): He was there for all the appointments along the way to sort of ensure that-

George (19:39): Yeah. Robert did an amazing job going to almost all the appointments. I think there was literally one appointment each that he missed, but every other one he was there. I think the ultrasounds are really, really powerful to see and so that was really awesome.

Marie (19:54): Were you able to see any of the ultrasound experiences?

George (19:57): Yeah, so I went to one and I saw each one and then I would usually get the videos of them so I knew what was going on, but yet we as a couple saw almost every ultrasound that happened.

Marie (20:06): What's that like?

George (20:08): I mean it's pretty crazy because the kid looks like a kid, especially by 16, 20 weeks. It's really incredible. One of our wedding pictures, my face looks really like what Lucas' face looks like. Robert has this picture of ... overlaid this wedding photo and the baby foot next to each other joking that these are the twins. Pretty awesome to see the development.

Marie (20:37): George and Robert were thrilled to be able to witness the ultrasounds of both of their children. The whole gestational carrier process had been such a powerful experience, but George also acknowledges that it's an experience that's not within reach for everyone because of the finances involved in making it happen. You mentioned that there's so much that people could do theoretically to make this process cheaper.

George (21:05): A few things that immediately come to mind, if you are a straight couple and you have to go through IVF, you can deduct most of your medical expenses from your taxes because likelihood is extremely high that it would meet the threshold of deductions in terms of percentage of your income. The reason is because the medical stuff is being done to you. One of the people in the marriage is the one who's going to be treated. For a gay couple, you can't because the person being treated and where the money's being spent is not part of the tax filing couple, which is crazy and this actually went all the way to a Circuit Court of Appeals and the case was lost. There is no reason that the medical part of it shouldn't be tax deductible and I would actually argue that even the surrogacy costs should be tax deductible. At the bare minimums meeting the same threshold as a straight couple who's using IVF treatment can deduct it. That's one very basic one.

George (21:58): Second is insurance. One of our surrogates did not have insurance and we had to buy insurance for her, so then we're using post tax dollars to buy insurance. Whereas it'd be awesome if we'd been able to put her on our own insurance, which I think would have been totally reasonable. That's another thing that's super simple to do if we could.

George (22:15): Thirdly, I would say simplifying the legal framework for some of this stuff would make the legal costs be less as well. You're not going to eliminate these costs. There's a lot involved, but there's a lot that you can do to reduce them and those three come to mind. We are really lucky to be able to afford this and be able to do this the way we did. We're very, very fortunate and I count my blessings in that regard, but very minimal regulatory changes or tax changes could make things a lot better.

Marie (22:41): Definitely. And with all the legalese that's involved, do you think that anyone who's going through this process essentially needs to have a lawyer?

George (22:48): Oh yeah. You have to have a lawyer and the agencies will push you to have a lawyer because there's a lot of contracts that need to be signed, et cetera.

Marie (22:54): Can I ask you how much it cost for you?

George (22:57): I think most surrogacy processes when there's an egg donor involved and a surrogate involved and IVF treatments in the range of like on the low end 80 and the high end $150,000 per child.

Marie (23:09): Per child? Yeah. Certainly cost prohibitive for a lot of people as you mentioned. And-

George (23:14): And, of course, it's amazing that now more and more companies are able to offer benefits.

Marie (23:18): With all the costs taken into account and all the prenatal appointments completed and all the months of anticipation dwindling down to their gestational carriers' due dates, the day finally arrived when Robert woke up to a very, very early morning text. It was from one of their gestational carriers, the one who was carrying their son. She said that the baby was on its way.

George (23:50): Robert wakes me up and we're kind of in a scramble rushing to four and a half, five hours away from where we live to her and kind of terrified on the one hand. Like, "Oh my God, what if the baby's born before," and so forth. We were driving really fast. Unfortunately nobody was on the road because it was 3:00 in the morning. We actually got pulled over. The police officer was very nice to let us go, but Robert had never been pulled over in life. And so this was like-

Marie (24:18): What did you say? Did you tell him where-

George (24:18): We were like, "We have baby coming." He got a little confused by the whole thing because he's like, "Wait, why are you having a baby in really Northern California when you're in San Francisco," et cetera. But it worked out. And so then we arrived there and actually we're still pretty far from Luca being born. Luca's his head was massive, so he took a while to come out, which they ultimately had to do a C-section with him. We were there for a long time waiting and it was very stressful for the surrogate as birthing process was going and going and going and his face was facing up not down, which made it even harder. That's why they eventually had to resort to a C-section and then he was eventually born at the end of the day. Seeing him for the first time was pretty amazing actually.

Marie (25:01): What was that moment when you met him?

George (25:03): Pretty incredible. Robert always says, "Everyone tells you you're going to have this love at first sight and you really do." I don't think you can really describe what that's like when it happens or what it will be like for somebody else. But for us, it was really amazing to hold them. Unfortunately Luca had to go into the NICU after 24 hours because some of his glucose levels were a little bit off and so he end up being stuck in NICU for about six days, which would have been normally fine. Actually the nurses at the NICU are amazing.

George (25:36): Our second baby's about to be born kind of more Southern California, many hours away, but we can't leave because he's in the NICU. There's all of this, what are we going to do about this? Eventually we decided to leave and send my mom up to be with him. She stayed with Luca and then we made it down to where Amelia was born and Amelia's birth was much more, actually had to be induced because it went past the due date and then it was a very simple process. Born within 24 hours of induction or maybe 30 hours of induction. Amelia was born and it was just really incredible to see her. And I mean both times like because you take them and you put them on you naked right away as soon as you can. It's like this really special feeling with the kids to do that. She was like super calm, really happy baby and then we went home within 24 hours or something. It was really awesome.

Marie (26:32): And now you have two babies.

George (26:33): Yeah. Now we have two babies.

Marie (26:35): After a pretty involved process.

George (26:38): Yeah. It's pretty amazing. We are so grateful for the gifts that both our surrogates gave us. It's like just incredible and you can never be thankful enough for what they did, even after the birth. One of them was unable to produce milk, partly because it was a C-section, but the other one is making milk and so she's sending milk almost every week. That's really incredible, so appreciative of that.

Marie (27:09): George and Robert both have the sincerest gratitude for the gestational carriers and the egg donor who helped bring his children into the world. Baby Steps is a podcast from Carrot, the leading global fertility benefits provider for employers. To demonstrate how Carrot helps its members, I'm here with Adam who is the head of Carrot's Care Navigation. Hi Adam.

Adam (27:43): Hello.

Marie (27:45): I'm going to read a question that Adam has received from a Carrot member and Adam is going to walk through how he would help that person. Here's the question from a Carrot member. I'm looking for information on fertility and gestational services. I'm looking for an egg and a womb and of course checking if my sperm is viable. Thoughts?

Adam (28:05): This one's pretty complicated and to really help this member, we had to break it out into various sections so that they understand all of the working components to their journey. First off, the member is inquiring as to whether their sperm is viable as part of the gestational carrier journey. We advised this member to go to a fertility clinic close to them that was eligible so that they could have a fertility check. Through this fertility check, their doctor will perform some semen analysis and some other tests just to make sure that their sperm is viable as part of the gestational carrier journey. The second component of this journey is that they're going to need to obtain some donor eggs. Generally, fertility clinics have their own egg donor program and we usually advise the member to talk to their fertility clinic that they're seeking care with to see what options they have for them.

Adam (28:58): Typically, a clinic's donor egg selection will be smaller than an agency or a cryobank. Some intended parents find that checking their clinic's donor egg pool first is more convenient and then find a donor agency after that if the clinic's pool is not large enough. Other intended parents may just want to skip that and just go straight to an agency or a cryobank. Ultimately, the choice is up to the member and we help them either way. Another thing that's top of mind for members is cost. With donor eggs, there are varying costs depending on where you receive them from and what type they are. For example, if you received the donor eggs from an agency, a clinic or a cryobank, there's varying costs. Similarly, if you obtain fresh or frozen eggs, the cost also varies, so what we try to do is share all of the costs so that the member knows before they head into their journey what it entails.

Adam (29:55): The next component of this path is that ultimately this member's going to need a gestational carrier, often referred to as a surrogate. There are two paths that this member can take when finding and working with a gestational carrier. The first one is the independent route where they generally manage the whole process and we're happy to help guide them along that path. The second option is that they work with an agency and the agency generally does all the heavy lifting. They coordinate everything and they really guide the member as they form their family. Finally, we have some additional in-house resources that we provide to members such as this one. We have an in-house gestational carrier, subject matter expert who can help them understand the nuances of an independent route versus a agency route. They can also help them understand the costs and various other logistics.

Adam (30:52): Alternatively, we do partner with a couple gestational carrier agencies. Through these partnerships. Our members have free consultations at their fingertips where they can talk to the agency for 60 to 180 minutes and they can also help them understand the gestational carrier journey, similar to our in-house subject matter expert.

Marie (31:14): Thanks so much, Adam. To learn more about Carrot, visit Baby Steps is produced and edited by me, Marie McCoy-Thompson and also edited and mixed by Jim Metzendorf, who is both incredibly cheerful and incredibly productive. Our original music is by Power Duo, Chris Ploeg and Chili Corder. Our artwork is by the inimitable Allie Packard. This has been an All Turtles production. Thanks for listening.