What is Surrogacy?

two fathers having fun at the park with their daughter

The advancement of science and medicine has allowed for new and innovative family building options. Surrogacy is a family building option for couples who cannot successfully carry a pregnancy.

Gestational Surrogacy

A gestational surrogate is a woman who is able and agrees to carry a pregnancy for another person. The intended mother provides her genetic material via her egg (or occasionally from an egg donor), the intended father provides his sperm (or a sperm donor), and through in vitro fertilization, an embryo is created. This embryo may then be transferred to the gestational carrier. While the baby will share a biological connection with this woman, she will not be the genetic mother of the baby.

Traditional Surrogacy

In traditional surrogacy, the woman uses her own egg to become pregnant, which is fertilized by the intended father. Most commonly, this is performed through intrauterine insemination (IUI), but in vitro fertilization (IVF) may also be used, especially if the intended parent(s) wish to perform genetic testing on the embryos prior to transfer. This means that the surrogate has a genetic relationship to the embryo.

Who Uses Surrogacy?

The American Society for Reproductive Medicine states that gestational carriers may be used when there is a clear and definitive medical indication that prevents the intended couple from carrying a child. Examples of some such conditions include:

  • Significant uterine anomalies or the absence of a uterus
  • Major medical conditions that would cause significant risk to either the mother or the fetus in pregnancy
  • Biologic inability to carry a child (e.g. same-sex male couple or single male)
  • Patients with a history of multiple unexplained IVF cycles or other suggestion of an unidentified endometrial factor
Finding a Surrogate

Most people locate gestational carriers/surrogates through fertility clinics, websites, lawyers, and private agencies. Some people find a gestational carrier who is a family member. Most agencies require that potential gestational carriers already have at least one uncomplicated pregnancy and delivery, are healthy medically and emotionally and are not motivated solely by financial considerations.

What to Consider with Surrogacy

Surrogacy involves many legal, ethical, and financial considerations. Usually, intended parents pay the surrogate for her medical expenses; there are also significant legal expenses. Costs can start at $80,000 and go up to $120,000 or more. Legal contracts are required before the process begins to protect the rights and responsibilities of the intended parents, gestational carrier, and intended child. Both the third party and intended parents should have separate legal counsel. Check with your company if you have surrogacy reimbursement policy.