Nodal Q&A with Intended Parent and Fertility Consultant Ashley Gildin Spitzer

Ashley Gildin Spitzer is both an intended parent and a parent via IVF. After three years of fertility treatments, she had her two rainbow babies in 2021—a baby girl she carried and a baby boy born with the help of a surrogate. They were born just four months apart. Ashley is very well versed in both the fertility and surrogacy patient experiences, having personally completed five egg retrievals and six embryo transfers, as well as having worked with two different surrogates. She has consulted with multiple fertility clinics and fertility immunologists in the NYC area and has navigated every realm of the fertility workup. 

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Ashley—who is an advisor to Nodal—is familiar with the process, timeline, litigation, and nuances of surrogacy, having utilized an agency and finding a surrogate independently. She can provide a thorough overview of the process, what to look for in a surrogate, how to select an agency to work with, and how to structure compensation and birth plans.

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Ashley also understands how it feels to get pregnant after so much heartbreak and loss finally, and what it means to have someone else carry your baby. We are so excited to feature her here today.

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Caroline: Tell me a bit about how your family-building journey allows you to help others who are going through something similar.

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Ashley: When I talk to people, I really can say, "I've been in your shoes." I understand how long, emotional, and draining the process can feel, especially because so much of fertility treatments and surrogacy is a lot of hurry up and wait. Many of the timelines are just out of your control, so it's a true lesson in patience, and in trust, in the delegation. 

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And that’s because you want to ensure you do things right and not rush. Time feels like your worst enemy when you're going through it. People think, "But if I do this with this, I can save myself a few weeks or a month or so." In the end, in the grand scheme of things, the few weeks and months will not make any difference once your child is born.

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C: So, how do you coach people through that?

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A: I always tell people to go with the path of least regret. You don't want to ever feel like you're rushing something. Because then you get into a transfer cycle, and you're like, "We should have waited." Or, “Her lining wasn't really that ideal. Why did we push this?” Or, “Maybe we should have given her another month to reset.” I really relate to the people I speak with. And surrogacy—it's a complicated matter.

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C: OK, so waiting is a big part of the journey, and we understand the emotional implications that can result from that. What are some practical ways to navigate the process that can help circumvent some of the unpreventable aspects of the journey?

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A: I think it's just important to have all your ducks in a row and be as organized as possible. So that when timelines do change, for better or worse, you know what’s next. For example, with our surrogate, her lining got thicker much quicker than they anticipated for our transfer. Therefore, our transfer was moved up by five days. Thankfully, we were prepared and made sure she had all the meds that she needed already, and we weren't then scrambling at the last minute to make sure, "Oh, does she have her progesterone oil and her estrogen patches, et cetera?" That would have then changed things.

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You have to be on top of your stuff and organized. Because if you miss a date or a point in the cycle in order to schedule appointments, that will set you back weeks or months. So I think that's probably the biggest thing I tell people.

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Related: What to Expect from the Surrogacy and Intake Process

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C: What helped you stay on top of that process?

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A: I tried to do everything possible to make the numerous processes as easy as possible for our surrogate to navigate. I created my own calendar that I would send her every month with all the meds and the directions, so she wouldn’t bear the burden of deciphering the clinic's convoluted piece of paper that was more than confusing. 

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Also, key to the process was having great lawyers on either side who advised us throughout the process. You want all important topics discussed and agreed upon before moving to contract, including possible termination, vaccinations, who will be in the hospital room, and, of course, communication. It's just so important to make sure anything really important to you and the surrogate is voiced over from the get-go. That way, you're not second-guessing anything before the transfer or once your surrogate is pregnant with your child. Because by that time, you have to be ready to relinquish control. You really have to trust that the surrogate understands your wishes and you understand theirs. They must trust that the intended parents will hold up their end of the bargain, support them, and communicate with them.

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‍C: You’re making me think about what it means to find the right match. Can you talk about why the matching process is important? 

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A: It is so important to find the right match, which leads back to the idea of trying not to rush. You both want to go into the process really just knowing that you are choosing each other. Obviously, there's no way to know that it's going to work for sure, but you want to go into the journey with full confidence that you're working with a person who’s going to give you the best chance.

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C: In your experience, what are some common misconceptions around infertility that are still very difficult for you to digest?

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A: People really don't realize how common infertility is. And it is not just something women experience. There are tons of men out there who have low sperm count, low morphology, or no sperm. And often, that burden still falls though on the woman.

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Infertility is a real, life-altering, physically, mentally, and emotionally taxing thing to experience. It can really impact a woman, especially those who have unexplained infertility and are just constantly looking for answers. It's so draining. As much as there have been amazing scientific advancements in fertility labs, and IVF in general, there is still so much unknown.

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C: This sounds like so much to navigate. How was your experience guided by a support team?

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A: As an intended parent, having a support system outside your immediate family is crucial. Unfortunately, there are women who do not have the support of their immediate family, and I can't imagine how hard that is for them. I also had a therapist I spoke to biweekly, which was another source of strength and support for me. 

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As for surrogates, many agencies do have weekly or monthly support groups for surrogates. But I think it's also very important to ensure a surrogate's family is on board and that their partner is supportive if they have one. 

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As a fertility consultant with Fertility Together, I have helped a number of women navigate the fertility journey and provide them with this crucial level of support. When I help people vet surrogates, I always ask, do they have support? Do they have people that can help watch their children while they're going to appointments or things like that? Just because you don't need any extra added stress while you're going through all this.

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Related: How to Create a Support Team, According to an Expert

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C: Can you share your thoughts on an agency versus an independent journey?

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A: I think that if the monetary cost of working with an agency will prohibit you from exploring surrogacy, you should 100% pursue an independent journey. That being said, you need to be educated. You need to do your research. You need to have resources. And you need to be very organized and on top of your game. 

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You might want to consider reaching out to other people—I've done it in the past to learn from their experiences. An independent journey also requires a very, very good lawyer who's really going to almost act as a bit of your agency and guide you. You need counsel who's experienced with surrogacy, somebody who will help you set up your escrow, and who will just really look out for your best interest in terms of accepting a match or working on surrogate compensation—things like that.

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In the case of someone very new to surrogacy, I do think an agency can do a great job at explaining the ins and outs of surrogacy, helping to answer a lot of the overall informational questions. Obviously, they do a lot of the legwork usually in terms of finding you a match. Agencies can be extremely essential in acting as a third party who ensures that rules are being followed or that expectations are put into place, helping to ask some of the harder questions, as well as helping to make a birth plan.

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If you don't have the bandwidth or the energy to devote yourself to the independent journey fully, then an agency can help to guide you and handle tasks for you that you do not have the ability to take on.

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But if you are the hands-on type and want to want to be the one who's vetting the surrogate or really making all those decisions (and you're extremely resourceful, and you've done your research), I think you are perfectly suited for an independent journey. 

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The thing is—there's no right or wrong answer. It’s about what works best for you.

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C: One more? You’re an advisor to Nodal. What made you get behind this company?

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A: I think that there's just so much room for improvement in this surrogacy process across the board. There's a need for more transparency. There's a need for more guidelines to be put in place about who can be a surrogate and who is qualified. And even with intended parents, making sure that background checks are done in a legitimate manner. 

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Nodal's doing such a great job at finding qualified surrogates, doing thorough background checks, and educating surrogates on the process, so they are fully informed about what they're signing up for. Surrogacy is a beautiful thing, but surrogates are putting their body on the line. Nodal is giving surrogates more options and offering a platform with more transparency, all while offering intended parents an opportunity to lower costs and the option to decide between an independent or agency journey. It’s a matching process that works for both parties. 

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Nodal is the guide surrogacy has been waiting for.

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