Surrogacy is the process in which a woman carries and delivers a child for another individual or couple.
While surrogacy can be used for many reasons, it is most frequently used for individuals or couples experiencing infertility who are having difficulty bringing a child into the world.
Interestingly, there are a few different types of surrogacy.
In gestational surrogacy, the surrogate is not genetically related to the child she delivers. This is accomplished using in vitro fertilization (IVF) technology. In gestational IVF surrogacy, eggs from the intended mother or egg donor are removed from their ovaries, fertilized by sperm from the intended father or sperm donor in a lab, grown for 3-7 days, and then placed into the surrogate’s uterus.
The remainder of this article will take a deep dive into this beautiful family-building process, including what it is, who may benefit from it, what steps are involved, how you can find a gestational carrier/surrogate, how gestational surrogates are screened, the cost, and more.
What is Gestational Surrogacy
Gestational surrogacy is the process in which a woman carries and delivers a child that she is NOT genetically related to for another individual or couple.
Gestational surrogacy may also be called IVF surrogacy or host surrogacy and is commonly contrasted with traditional surrogacy.
In gestational surrogacy, the woman who carries the pregnancy is technically called a gestational carrier or gestational surrogate but may still be referred to simply as a surrogate for simplicity’s sake.
The person(s) the gestational surrogate carries the pregnancy for are called the intended parent(s).
Who is Gestational Surrogacy for?
Gestational surrogacy is commonly used as a way for a couple or individual who is infertile, unable, or otherwise not wanting to carry a pregnancy themselves to grow their family.
For example, a couple may consider gestational surrogacy if they have experienced many pregnancy losses, stillbirths, or several unsuccessful IVF cycles. Similarly, it could be used by those who do not have a uterus – either due to a hysterectomy or congenital/inherited causes.
Gestational surrogacy is also commonly used by single and gay men looking to grow their families.
Certain medical conditions make pregnancy risky, potentially life-threatening, or otherwise impossible, making gestational surrogacy a great option. Such conditions and situations may include:
- Uterine malformations
- Certain heart conditions
- Cystic fibrosis
- Severe diabetes
- History of preeclampsia
Social surrogacy, though less common, occurs when there is no medical need for surrogacy and has been made famous by celebrities and other wealthy pop families.
Finding a Gestational Surrogate
There are several ways to find a gestational surrogate, including talking to family members and friends, searching classified ads and Facebook groups, and working with professional surrogate agencies.
Surrogacy arrangements set up without an agency’s assistance are referred to as independent surrogacy. While independent surrogacy may be possible for some, finding a suitable surrogate, screening them, juggling surrogacy’s legal and emotional complexities, managing fertility treatment, and more is no easy task.
As such, most fertility clinics recommend that their patients exploring gestational surrogacy work with a gestational surrogacy agency.
Gestational surrogacy agencies like Surrogate Steps specialize in recruiting and screening potential surrogates and have strict requirements with many possible disqualifications to ensure only the most qualified women are presented to the intended parents they work with and can save a lot of money down the road.
Some surrogate agencies also handle lots of the logistical and legal work surrounding surrogacy.
How Common is Gestational Surrogacy
Gestational surrogacy is a relatively new medical offering that relies on IVF technology and has grown in popularity over the few short decades it has been around.
According to the CDC, the number of gestational carrier cycles increased from 727 (1.0% of all assisted reproductive technology cycles) in 1999 to 3,432 (2.5%) in 2013 and a high of 9,195 (5.4%) in 2019. Since then, gestational surrogacy has become even more popular, reaching a high of 9,195 (5.4%) or embryo transfer cycles in 2019.
Between 1999 and 2013, those 30,927 gestational carrier cycles resulted in 13,380 deliveries and the birth of 18,400 infants. Birth data is a few years behind, but with nearly 10,000 gestational carrier cycles each year in the past few years and a 41% success rate, approximately 3,000-5,000 infants are being born annually via gestational surrogacy today.
Who’s Eggs Are Used In Gestational Surrogacy
In gestational surrogacy, the surrogate’s eggs are not used to create the pregnancy, meaning the surrogate is not genetically related to the child.
This makes it possible for the intended mother’s eggs to be used, though depending on why the intended parents are pursuing surrogacy, they may also use donor eggs.
If the intended mother’s eggs are used, the surrogate baby will be genetically related to the intended mother.
However, using the intended mother’s eggs is not possible for all intended parents due to the critical role egg quality plays in a successful pregnancy and the fact that many pursuing gestational surrogacy have issues with egg quality or no eggs at all.
Donor eggs and sperm are available through some fertility clinics and donor egg/sperm agencies.
Gestational Surrogacy Cost
The cost of gestational surrogacy can vary widely and depends mainly on the surrogate compensation, agency fees, pregnancy and medical expenses, the cost of the IVF needed for gestational surrogacy, and more.
Regardless of the exact details, gestational surrogacy is usually an expensive process, in the $75,000-150,000 range.
Gestational Surrogacy Process
Gestational surrogates are impregnated through in vitro fertilization (IVF).
In gestational surrogacy, eggs from the intended mother or egg donor are removed from their ovaries, fertilized by sperm from the intended father or sperm donor in a lab, grown for 3-7 days, and then placed into the surrogate’s uterus.
If we take a step back and examine the entire surrogacy process for intended parents, the process often includes many of the following steps:
- Exploring Agencies: Every agency has its unique approach, resources, level of expertise, cost, and more. Exploring multiple options can ensure you work with a reputable agency that fits your needs.
- Agency Consultation: During an agency consultation, the agency will usually ask questions to understand the intended parent’s preferences for their surrogate and allow them to ask their own questions and learn more about the surrogate process with them.
- Sign Agency Agreement: The agency agreement lays out the intended parents’ and agency’s terms and expectations.
- Pre-Match Surrogate Screening: Knowing the intended parent’s preferences, the agency will look for surrogates within their database or recruit a new surrogate that fits the intended parent’s criteria.
- The Match: The match includes the sharing of profiles between the IP and surrogate and, if they both agree, having a virtual or in-person meeting and independently confirming with the agency that they’d like to work together.
- Clinical Medical Screening: Once the intended parents have approved the surrogate, the surrogate will go through a fertility evaluation by the IP’s fertility clinic.
- Final Agency Screening: A comprehensive psycho-social evaluation including a psychological assessment, home study, and criminal background check
- The Gestational Carrier Agreement: An agreement between the intended parents is drafted, negotiated, and signed by both parties.
- Escrow Formation: The intended parents must fund an escrow account, which is used to pay the surrogate and necessary surrogacy expenses.
- Establishing Pregnancy: The embryo transfer and pregnancy tests to confirm the pregnancy.
- The Pregnancy & Recognizing the Intended Parents as the Legal Parents: During the surrogate pregnancy, the intended parents will have the opportunity to be in regular contact with their surrogate and work with the agency and legal to be recognized as the legal parents of the child upon birth.
- The Delivery: Depending upon what is agreed upon, the IPs are usually present in the delivery or wait nearby. In most cases, the intended parents can cut the umbilical cord, hold the baby, and begin bonding with their new child immediately after the healthcare team delivers and examines the baby.
If working with a reputable surrogate agency, the intended parents will be discharged home from the hospital with a new member of their family, signifying the end of the surrogacy process and the beginning of a beautiful new chapter.
Legal Concerns of Gestational Surrogacy
Surrogacy laws are governed by the states and differ greatly throughout the US. In fact, surrogacy may even be illegal, depending on the type of surrogacy or if the surrogate resides in a particular state.
Fortunately, laws governing gestational surrogacy are more favorable for intended parents than laws surrounding traditional surrogacy.
Even though there are fewer potential legal hurdles with gestational surrogacy, it is still a very complex matter that requires legal guidance, a formal agreement prior to commencing the surrogacy, and many other important legal processes that must be completed in order to secure parental rights.
Forming a sound gestational carrier agreement is a critical aspect of ensuring a successful surrogacy. A gestational carrier agreement is a contract between the intended parents and a gestational carrier (and her partner/spouse).
The agreement details each party’s rights, obligations, intentions, and expectations in connection with the surrogacy.
A gestational carrier agreement typically addresses topics like the location of delivery, future contact between the parties, parental rights, custody issues, control over medical decisions during the pregnancy, intended parents’ presence during delivery, payment of medical bills, liability for medical complications, health, and life insurance, and more. Financial considerations, including the carrier’s compensation and reimbursements, including lost wages, child care, legal fees, maternity clothes, and more, are also addressed in the gestational carrier agreement.
Traditional vs. gestational surrogacy
Traditional and gestational surrogacy are the two main types of surrogacy.
While surrogacy itself is a rather complex process to carry out, the distinction between traditional and gestation surrogacy is quite simple.
In traditional surrogacy, the surrogate mother is the biological mother of the surrogate baby.
In gestational surrogacy, the surrogate mother is NOT the biological mother of the surrogate baby.
While at its core, this may sound like it impacts only what the surrogate baby might look like, strict laws surrounding surrogacy have important consequences regarding the intended parent’s ability to obtain legal parent rights and emotional challenges.
Due to this, gestational surrogacy is far more common and the only type of surrogacy Surrogate Steps, along with most other surrogate agencies, assist with.
Bottom Line about Gestational Surrogacy
Gestational surrogacy is a beautiful, yet surprisingly modern, family-building solution.
Compared to traditional surrogacy, gestational surrogacy has a number of key legal and emotional advantages, making it the preferred and by far the most popular form of surrogacy today.
While the legal and emotional advantages of gestational surrogacy are real, there are still significant challenges to finding a reliable and highly qualified surrogate and navigating the logistical and legal hoops involved, which makes working with a reputable agency important.
If you’re considering gestational surrogacy and need help finding a surrogate or a professional guide along the way to ensure the success of your surrogacy, we are here and happy to help and encourage you to request a free consultation.