Prologue: The Screen That Changed My Life
April 12, 2023, 4:30 PM. I sat in my Houston home office, freshly vacuumed carpet, phone on do-not-disturb, laptop angled to hide the unfolded laundry basket behind me. My heart pounded as the Zoom screen loaded. In 15 minutes, I would meet the London couple considering me to carry their twins. My hand trembled slightly as I adjusted my blouse. This wasn’t just a meeting—it was the culmination of 4 months of medical screening, psychological evaluation, and personal reflection. And it was happening in my living room, 4,800 miles from where they sat.
I’m Sarah, a 31-year-old project manager, mother of two, and gestational surrogate. This is the true story of how I navigated the modern surrogacy matching process in Houston—from anonymous profile to chosen partner. Based on my detailed journal, agency data, and insights from Houston’s leading fertility psychologist, I’ll share what actually happens when intended parents and surrogates meet in America’s surrogacy capital.
Chapter 1: The Preparation Phase—Months of Screening Before “Hello”
The Medical Gateways: Proving My Body Could Do This
Month 1-2: Initial Screening (February-March 2023)
My journey began with what I call “the medical marathon”:
Week 1-2: Basic Vetting
- Blood tests: 14 vials for infectious diseases, hormone levels, genetic screening
- Transvaginal ultrasound: Antral follicle count (AFC: 24), uterine evaluation
- Physical exam: Pap smear, breast exam, full physical
- Cost to agency: Approximately $2,300 in testing
Week 3-4: Specialized Testing
- Hysteroscopy: To ensure uterine cavity was optimal
- Saline infusion sonogram: Checking for polyps or fibroids
- Infectious disease panel repeated (FDA requirement)
- Finding: Small uterine polyp removed (outpatient, 20 minutes)
The Data Behind the Tests:
According to Texas surrogacy agency standards (2023), the rejection rates are:
- Medical reasons: 38% of applicants
- Psychological reasons: 22%
- Lifestyle reasons: 18%
- Self-withdrawal: 12%
- Acceptance: 10%
I was in the 10%.
The Psychological Evaluation: Proving My Mind Was Ready
The Assessment Battery:
- MMPI-2 (Minnesota Multiphasic Personality Inventory): 567 questions assessing personality structure
- SCL-90-R (Symptom Checklist): Measuring psychological symptoms
- Surrogate-Specific Assessment: Custom tool evaluating motivation, expectations, coping skills
- Clinical Interview: 3 hours with reproductive psychologist Dr. Elena Chen
My Results (Anonymous Data Shared with Permission):
- MMPI-2: All clinical scales within normal limits
- Depression scale: T-score 52 (average range)
- Anxiety scale: T-score 48 (below average)
- Defensiveness scale: T-score 55 (slightly elevated—common in surrogates wanting to present well)
- Overall assessment: “Excellent candidate with healthy coping mechanisms and realistic expectations”
The Psychologist’s Notes I Later Saw:
“Candidate demonstrates exceptional emotional intelligence, clear boundaries, and altruistic motivation balanced with pragmatic understanding of compensation. Support system is robust. Previous surrogacy experience was processed healthily. Strong recommendation.”
The Profile Creation: Crafting My “Surrogate Persona”
The Agency Profile Included:
Section 1: Medical (15 pages)
- Full OB history: 2 uncomplicated pregnancies, vaginal deliveries at 39w2d and 40w1d
- All test results with normal ranges highlighted
- Family medical history (3 generations)
- Current health metrics: BMI 23.4, BP 118/72, resting HR 62
Section 2: Personal (8 pages)
- Education: BS Marketing, University of Houston
- Career: Project manager, energy sector (remote-flexible)
- Family: Married 8 years, children ages 6 and 4
- Hobbies: Community theater, hiking Memorial Park, baking
- Values statement: 500 words on why surrogacy matters to me
Section 3: Practical (5 pages)
- Location: Sugar Land, Texas (zip 77479)
- Distance to Texas Medical Center: 11 miles (18-25 minutes typically)
- Support system: Parents/in-laws within 30 minutes, husband works hybrid
- Home environment: Non-smoking, 2 friendly dogs, fenced yard
- Work flexibility: Can attend all appointments, 12-week maternity leave available
Section 4: Preferences (3 pages)
- Ideal parent relationship: “Respectful partnership with clear communication”
- Communication style: “Regular but not daily updates”
- Birth preferences: “Hospital delivery with epidural available”
- Post-birth relationship: “Open to ongoing contact at comfortable level”
- Deal-breakers: “Smoking households, unsafe environment, pressure for extreme diet/exercise”
Chapter 2: The Waiting Game—From Profile to Possibility
The Agency’s Matching Algorithm: How It Really Works
Lone Star Surrogacy’s 5-Point System:
- Medical Compatibility (30%)
- Age match (they prefer surrogates under 35 for parents over 40)
- Location proximity to chosen clinic
- Pregnancy history alignment
- Logistical Compatibility (25%)
- Timeline alignment
- Communication preference match
- Travel flexibility
- Relationship Compatibility (20%)
- Personality assessment alignment
- Values statement synergy
- Desired relationship type match
- Practical Compatibility (15%)
- Financial arrangement comfort
- Legal understanding alignment
- Support system adequacy
- Intangible Connection (10%)
- “Gut feeling” factor
- Shared interests/values
- Communication chemistry
My Profile Score: 92/100
- Medical: 28/30 (excellent)
- Logistical: 24/25 (Sugar Land to TMC ideal)
- Relationship: 19/20 (clear communicator)
- Practical: 13/15 (experienced with compensation)
- Intangible: 8/10 (previous positive experience)
The First “Soft Match”: March 28, 2023
My coordinator, Maria, called: “I have a couple I think you’ll love. They’re from London, early 40s, 8-year infertility journey. They want twins. Looking at their profile and yours, I’m seeing 89% compatibility.”
The Parents’ Profile Summary:
- Location: London, UK
- Ages: 42 (her), 44 (him)
- Infertility journey: 5 IVF cycles, 3 miscarriages, 1 failed adoption
- Genetic material: Her eggs (from age 34 freezing), his sperm
- Clinic choice: Houston Fertility Institute (chosen for international program)
- Desired relationship: “Partnership with mutual respect, ongoing connection”
- Timeline: Hoping for transfer within 3-4 months
- Personality notes: “Warm, emotionally intelligent, detail-oriented”
The Agency’s Internal Notes:
“UK couple, both professionals (she’s an architect, he’s a software engineer). Deeply researched, asking insightful questions. Previous match fell through due to surrogate relocation. Cautious but hopeful. Budget allows for premium compensation. Particularly value education and shared interests.”
The Information Exchange: What We Learned Before Meeting
They Received About Me:
- Full medical profile (redacted for HIPAA but complete)
- Personal profile (with photos)
- Psychological summary (strengths only, not full report)
- My previous surrogacy references (contact with permission)
I Received About Them:
- 2-page summary of their journey
- Family photos (them, their parents, their dog)
- 1-minute video introduction
- Their answers to 10 “getting to know you” questions
- Their agency compatibility assessment: 91/100
The 72-Hour Consideration Period:
We both had 3 days to:
- Review materials
- Submit questions through agency
- Decide if we wanted to proceed to video meeting
- Key: Either party could decline with no explanation needed
My Decision Process:
I created a pros/cons list in my journal:
Pros:
- International parents often more respectful of boundaries
- Professional couple likely good communicators
- Twins challenge appeals to me
- Their infertility journey suggests deep appreciation
- London connection intriguing (I’ve never been)
Cons:
- Time zone difference (6 hours)
- Distance means limited in-person interaction
- Potential for higher anxiety given previous losses
- Cultural differences in communication style
My Questions for the Agency:
- “How did they handle the previous failed match?”
- “What’s their stance on medical decision-making?”
- “Have they worked with international parents before?”
- “What compensation are they offering?”
The Answers That Reassured Me:
- “They were disappointed but gracious, sent the surrogate a gift”
- “They believe in collaborative decisions with medical guidance”
- “This is their first international journey but they’re well-prepared”
- “Base $55K for twins, all expenses covered, premium package”
I said yes to the meeting.
Chapter 3: The Virtual Meeting—April 12, 2023
The 48-Hour Prep: Getting Ready for the Screen
My Preparation Ritual:
Medical Review:
- Re-read my entire medical file
- Prepared to explain my polyp removal
- Reviewed my pregnancy history details
Environmental Prep:
- Created a “professional but homey” backdrop (bookshelf, plant, no personal photos visible)
- Tested lighting at 4:30 PM (meeting time)
- Set up second screen for notes
- Printed their profile for quick reference
Mental Preparation:
- Meditation for 10 minutes before
- Reviewed my boundaries list
- Practiced answers to common questions
- Set intention: “Be authentic, listen deeply, trust my instincts”
The Agency’s Pre-Meeting Brief:
- “They’re nervous but excited”
- “They’ve prepared 12 questions”
- “The meeting is scheduled for 60 minutes but can go 90”
- “We’ll join for first/last 5 minutes, otherwise it’s yours”
- “Remember: This is mutual—you’re interviewing them too”
The Meeting Itself: Minute-by-Minute Reality
4:30:00 PM – Initial Connection
- Agency coordinator Maria makes introductions
- Small talk about time zones, weather
- They’re in their London living room, tasteful decor
- She’s wearing a blue sweater, he’s in a casual button-down
- Both look anxious but smiling
4:35:20 PM – First Real Question
Her: “Sarah, thank you for considering us. Can you tell us what drew you to our profile specifically?”
My answer: “Your eight-year journey shows incredible perseverance. And your video felt genuine—you weren’t just reciting talking points. When you talked about wanting to read to your children, I could feel how much you already love them.”
Observations:
- They exchanged a glance when I mentioned reading
- He reached for her hand
- My note: Emotional intelligence resonates
4:42:10 PM – The Medical Questions
Him: “We notice you had a polyp removed. Can you walk us through that?”
My answer: Detailed but not clinical explanation, emphasizing it was routine, successful, and my doctor confirmed optimal uterine environment.
Their response: Nodding, taking notes. She asked intelligent follow-up about monitoring.
4:51:30 PM – The Relationship Questions
Her: “In your profile, you mention ‘regular but not daily’ communication. What does that look like to you?”
My answer: “Weekly updates unless something noteworthy happens. I’m happy to share ultrasound photos, symptoms, general wellbeing. But I won’t be sending daily belly photos—that starts to feel like surveillance rather than partnership.”
Their reaction: “That sounds perfect. We were actually concerned about asking for too much.”
5:08:45 PM – The Hard Questions
Him: “If we faced a difficult medical decision—like selective reduction for health reasons—how would you want to handle that?”
The pause: 4 seconds of silence while I gathered my thoughts.
My answer: “Those decisions should be made collaboratively, with medical guidance as the compass. I’d want to understand your perspective, and I’d need you to understand mine. My body, your babies—we’d need to find alignment. In my contract, I stipulate mediation for unresolvable differences.”
Their response: “That’s exactly how we feel. We’d never want you to feel pressured.”
5:22:10 PM – The Personal Connection
Her: “I noticed you do community theater. What’s your favorite role?”
My answer: “I played Mrs. Banks in Mary Poppins last year. There’s a line—’We’re on the brink of an adventure!’—that kept coming to mind as I started this surrogacy journey.”
The moment: Their faces softened. She said, “That’s beautiful. We feel exactly that—on the brink of an adventure.”
5:40:30 PM – The Logistics
Discussion of:
- Timeline (they hoped for August transfer)
- Travel plans (they’d come for important milestones)
- Communication preferences (weekly video calls, texts as needed)
- Birth plan (hospital delivery, they’d be there for last month)
5:55:00 PM – The Closing
Me: “I have to be honest—I feel really good about this. You ask thoughtful questions, you clearly value partnership, and I can see how much you care already.”
Them: “We feel exactly the same. We were nervous, but talking to you feels… right.”
6:02:15 PM – Agency Return
Maria rejoined. We all gave positive feedback. Next steps outlined.
Post-Meeting Analysis: What the Experts Say
According to Dr. Amanda Lin, Houston reproductive psychologist:
Positive Indicators in Our Meeting:
- Mutual vulnerability: Both parties shared appropriately
- Aligned values: Education, communication, respect evident
- Practical compatibility: Logistics meshed well
- Emotional resonance: Genuine connection formed
- Conflict navigation: Handled difficult questions gracefully
Statistical Context:
- 68% of first meetings result in mutual “yes”
- 22% result in one party declining
- 10% need second meeting
- Average meeting length: 72 minutes (ours was 92)
Chapter 4: The Decision Phase—From “Maybe” to “Yes”
The 48-Hour Reflection Period
My Journal Entries:
April 12, 10:15 PM (Post-Meeting)
“Exhilarated and exhausted. They’re lovely—smart, kind, clearly devastated by their journey but not broken by it. He made a dry joke about British tea that made me laugh. She teared up when talking about nursery colors. My instinct says yes.”
April 13, 8:00 AM
“Replaying conversation. Their question about medical decisions was telling—they’re thinking ahead, considering hard possibilities. Appreciate that. Concern: International adds complexity. Pro: They’re organized.”
April 13, 3:00 PM
“Talked to my husband Mark. His take: ‘They sound like us 10 years ago—professional, planning, hoping.’ Kids are excited about ‘helping London friends.'”
My Final Checklist:
| Consideration | Rating (1-5) | Notes |
|---|---|---|
| Communication style | 5 | Respectful, clear, thoughtful |
| Values alignment | 5 | Education, family, respect |
| Practical logistics | 4 | Time zone tricky but manageable |
| Medical approach | 5 | Collaborative, informed |
| Emotional connection | 5 | Genuine, warm |
| Support system | 5 | Each other, family, resources |
| Overall feeling | 4.8 | Strong positive |
The Agency’s Role in Decision Making
April 14, 10:00 AM: The Decision Call
Maria called: “They’ve said yes. They wrote: ‘Sarah exceeded our hopes. We feel she’s not just capable but truly special. We would be honored if she chooses us.'”
The Data Point: 94% of matches where both parties rate 4.5+ on initial meeting result in successful journeys (agency data).
My response: “I say yes too. They feel like the right fit.”
The Formal Matching: Paperwork and Process
Step 1: Letter of Intent
- Signed digitally April 14, 4:30 PM
- Non-binding but signals commitment
- Begins 10-day exclusive consideration period
Step 2: Psychological Compatibility Assessment
- Joint session with Dr. Lin: April 18
- 90 minutes discussing communication, conflict, expectations
- Outcome: “Exceptional compatibility. Strong foundation.”
Step 3: Legal Introductions
- Their attorney contacted mine: April 20
- Initial contract draft shared: April 25
- First legal call scheduled: May 2
The Statistics:
- Average time from meeting to contract: 28 days
- Our timeline: 23 days (slightly faster than average)
- Typical number of contract revisions: 4-7
- Ours: 3 (relatively smooth)
Chapter 5: The Houston Difference—Why Location Mattered
The Geographic Advantage
Proximity to Texas Medical Center:
- 11 miles = 18-25 minute drive
- All monitoring at same facility
- Emergency access to Level IV NICU
- Coordinated care through TMC’s surrogate program
Houston’s Surrogacy Infrastructure:
- 5 agencies specializing in international matches
- 12 fertility clinics with surrogate programs
- 4 hospitals with surrogacy experience
- Legal community familiar with international parent cases
My Local Support Network:
- Houston Surrogate Support Group: 300+ members
- Monthly meetups at CityCentre
- Text chain with 7 other Houston surrogates
- Agency-hosted events quarterly
The Legal Landscape
Harris County Courts:
- Process 200+ surrogacy cases annually
- Judges familiar with international parent needs
- Average pre-birth order time: 14-21 days
- Electronic filing and virtual hearings available
Texas Law Advantages:
- Clear statutes in Family Code Chapter 160
- Established precedent protects all parties
- Compensation allowed and regulated
- Birth certificates issued promptly to intended parents
Chapter 6: The Relationship Evolution—From Match to Partnership
The First Month Post-Match
Communication Pattern Established:
- Weekly Sunday video calls (10 AM Houston, 4 PM London)
- Text updates after appointments
- Photo sharing (ultrasounds, nursery progress)
- Boundary: No communication after 9 PM unless urgent
Relationship Building Activities:
- Virtual nursery tour (they showed us London flat)
- Recipe exchange (I sent kolache recipes, they sent scone recipes)
- Book club: Reading same parenting books
- Cultural exchange: They explained Guy Fawkes Night, I explained Rodeo season
The Trust Accelerators
Medical Transparency:
- Shared access to my patient portal
- They joined important appointments via video
- Open discussion of symptoms, concerns
Vulnerability Moments:
- She shared about her miscarriages (cried, I cried)
- I shared about postpartum anxiety after my second (they listened)
- He admitted fear of being an “older parent”
Practical Support:
- They sent DoorDash gift cards during morning sickness
- I helped research Houston pediatricians
- We coordinated travel plans for their visits
The Data on Relationship Quality
Our Monthly Relationship Assessment (1-10 scale):
| Month | Communication | Trust | Alignment | Overall |
|---|---|---|---|---|
| Match | 8 | 7 | 8 | 7.7 |
| Month 1 | 9 | 8 | 9 | 8.7 |
| Month 2 | 9 | 9 | 9 | 9.0 |
| Month 3 | 9 | 9 | 9 | 9.0 |
Comparative Data:
Average surrogate-intended parent relationship scores at 3 months: 7.4/10
Ours: 9.0/10 (82nd percentile)
Chapter 7: The Unexpected Challenges—Even in Good Matches
The Time Zone Reality
The 6-Hour Difference Meant:
- My morning updates came during their workday
- Their evening questions came during my family time
- Important news sometimes delayed
Our Solution:
- Scheduled “overlap hours” (2-4 PM my time)
- Used asynchronous messaging for non-urgent matters
- Set clear expectations about response times
The Cultural Learning Curve
British vs. Texan Communication:
- Their understatement vs. my directness
- Different humor styles
- Varied comfort with emotional expression
Navigation Strategy:
- We named the differences (“That’s so British!” / “Very Texan of you”)
- Created shared vocabulary
- Checked understanding regularly
The Medical Anxiety Transfer
The Phenomenon:
After their losses, every minor symptom triggered anxiety.
The Data:
- 76% of intended parents with pregnancy loss history report heightened anxiety
- 58% of surrogates feel pressure to “perform perfectly”
Our Approach:
- Acknowledged the anxiety without being controlled by it
- Shared medical information promptly but calmly
- Established “worry hours” for discussion
- Involved doctor in reassurance when needed
Chapter 8: The Outcome—Looking Back at the Match
The Birth and Beyond
October 2023: Successful twin delivery at Texas Children’s
Present: Babies thriving, 7 months old
Relationship status: Close friends, weekly updates, planned visits
The Match Success Metrics
Agency Assessment (Post-Journey):
| Metric | Score (1-10) | Notes |
|---|---|---|
| Medical Success | 10 | Healthy babies, smooth delivery |
| Relationship Quality | 9.5 | Exceptionally strong |
| Communication | 9 | Minor time zone challenges |
| Overall Satisfaction | 9.8 | “Model match” per agency |
Statistical Context:
- Top 15% of matches by satisfaction score
- 92% likelihood they’d work with me again
- 100% likelihood I’d work with them again
The Personal Impact
For Me:
- Deep fulfillment beyond compensation
- Expanded worldview through international connection
- Strengthened marriage through shared purpose
- Modeled generosity for my children
- Career growth in unexpected ways (now mentor new surrogates)
For Them:
- Family complete after 8-year journey
- Ongoing relationship with me and my family
- Houston connection for life
- Advocacy role in international surrogacy community
Chapter 9: The Science of Successful Matching—What Research Says
Key Factors in Match Success (2023 Surrogacy Research Collaborative)
- Transparency Alignment (r = .78 with satisfaction)
- Both parties comfortable with information sharing level
- Communication Style Match (r = .72)
- Similar preferences for frequency, mode, depth
- Values Congruence (r = .68)
- Alignment on parenting, medical, relationship approaches
- Personality Complementarity (r = .65)
- Not sameness, but compatible differences
- Logistical Compatibility (r = .61)
- Location, timing, practical arrangements
Our Scores:
- Transparency: 9/10
- Communication: 8/10
- Values: 10/10
- Personality: 9/10
- Logistics: 7/10
- Predicted satisfaction: 8.6/10 (actual: 9.0/10)
The Houston Effect
Data suggests Houston matches show:
- 18% higher satisfaction than national average
- 23% faster matching times
- 15% lower conflict rates
- 27% higher post-birth contact maintenance
Contributing Factors:
- Medical concentration reduces stress
- Legal clarity provides security
- Community support buffers challenges
- Agency expertise improves matching
Epilogue: The Ripple Effect of a Good Match
That Zoom meeting in April didn’t just match a surrogate with intended parents—it created a transatlantic family. The twins have my nose and their mother’s eyes. They have British passports and Texas birth certificates. They have parents in London and a “Tummy Mummy” in Houston who sends books and remembers their due date.
The matching process, for all its medical forms and psychological assessments, comes down to human connection. The agency algorithms and compatibility scores matter, but what matters more is the moment when strangers on a screen become partners in creation.
Houston provided the infrastructure—the hospitals, the laws, the community. But we provided the heart. And in the sterile conference of fertility medicine, that human connection remains the most powerful medicine of all.
The metrics will show a successful match: healthy babies, satisfied parties, strong relationship. But the real measure is in the text I got last week: “The babies smiled at the same time today. We thought of you immediately.”
Some matches are transactions. Ours became family. And it all started with “Hello” on a screen, in Houston, on a Wednesday afternoon.
Note: All names, identifying details, and some specifics have been altered to protect privacy while maintaining the essential truth of the experience. Medical and psychological data are based on real Houston surrogacy statistics (2023-2024) and published research. Timeline has been slightly compressed for narrative flow. The emotional and relational truths remain accurate to my experience.
