Understanding the Different Types of Surrogacy

At its root, surrogacy is the process whereby a woman (the surrogate) carries and delivers a child for another individual or couple (the intended parents).

Interestingly, there are a few different types of surrogacy with important distinctions and implications.

While the original practice of surrogacy has been around for thousands of years, with references in biblical texts and ancient Babylonian law, other types of surrogacy have only been made possible through modern medical inventions.

In this article, we will explore the various types of surrogacy, discuss their pros and cons, and more.

Different Types of Surrogacy

From a biological and medical standpoint, there are two main types of surrogacy: traditional and gestational.

• Traditional Surrogacy: In traditional surrogacy, the surrogate’s own eggs are used, and she is thus genetically related to the child she delivers.
• Gestational Surrogacy: In gestational surrogacy, another woman’s eggs are fertilized in an IVF procedure, grown in a lab for 3-7 days, and then deposited in the surrogate uterus.

While traditional vs. gestational is the most essential distinguishing line between the different types of surrogacy, two other common “types” of surrogacy are often mentioned.

• Altruistic Surrogacy: The surrogacy arrangement in which the surrogate is not financially compensated for their role.
• Independent Surrogacy: An independent surrogacy is an arrangement without a surrogate agency’s expert support, guidance, and management.

Altruistic and independent surrogacies could be either traditional or gestational surrogacy and thus may be better viewed as subcategories of surrogacy.

Now that we have a basic understanding of the various types of surrogacy let’s take a deeper dive into each.

What is Traditional Surrogacy?

Traditional surrogacy is the process in which a woman carries and delivers a child (created from her own eggs) for another individual or couple. Because the surrogate’s own eggs are used, she is the biological mother and genetically related to the child she delivers.

Traditional surrogacy is the oldest form and has been practiced for thousands of years. Before IVF was invented in 1978, traditional surrogacy was the only type of surrogacy.

Because the child is genetically related to the surrogate, a formal adoption must often occur after the child’s birth to recognize the intended parents as legal parents.

A traditional surrogate pregnancy can be established via many different methods, including:

• Intercourse (rarely practiced today due to other less intimate ways)
• Intravaginal/Intracervical Insemination (performed at home – a relatively common way of achieving a traditional surrogate pregnancy)
• Intrauterine Insemination (performed at a doctor’s office – a fairly common method of achieving a traditional surrogate pregnancy)
• IVF (usually not used for traditional surrogacy due to the cost)

While traditional surrogacy works for some, it presents significant challenges:

• Emotional challenges: It is often difficult, if not unthinkable, for a surrogate to give up a biological child. Additionally, the process whereby the intended parents become the legal parents usually takes place after birth, so the intended parents may not be able to bond with their child immediately.
• Legal Challenges: A multitude of legal challenges can arise due to the biological connection between the surrogate and the child, including:
  • the surrogate refusing to give up the child or complex adoption proceedings
  • the surrogate being left to pay for all costs associated with the pregnancy and child
  • traditional surrogacy may be illegal in some states

Due to the emotional difficulty of a traditional surrogate giving up a genetically related child after birth, the legal challenges for the intended parents to be recognized as the legal parents, and the suitable practice of gestational surrogacy being readily available, traditional surrogacy is rarely practiced today.

What is Gestational Surrogacy

Gestational surrogacy is the process in which a woman carries and delivers a child for another individual or couple that she is not genetically related to.

Gestational surrogacy relies upon IVF technology and is today’s most popular form of surrogacy.

In gestational surrogacy, eggs are surgically removed from the intended mother or egg donor, fertilized with sperm from the intended father or sperm donor, grown in a lab for 3-7 days, and transferred into the surrogate’s womb.

The first gestational surrogacy was successfully carried out in 1985, just seven years after the first IVF baby was born.

Compared to traditional surrogacy, gestational surrogacy has a host of advantages.

Emotional advantages of gestational surrogacy:

• easier for the surrogate to hand over the child to the intended parents
• easier for intended parents as the child can often be genetically related to one or both intended parents
• less stress for intended parents, knowing they can be recognized as the legal parents prior to the birth
• less stress for intended parents, knowing the courts are more likely to uphold their parental rights should difficulties arise

Legal advantages of gestational surrogacy:

• stronger parental rights for intended parents
• ability to establish legal parenthood prior to birth
• legal in more states

Due to the emotional and legal advantages of gestational surrogacy, it is today’s most widely used form and the only form practiced by most surrogate agencies, including Surrogate Steps.

What is Altruistic Surrogacy?

Altruistic surrogacy is the practice of surrogacy in which the surrogate is not monetarily compensated. This is in contrast with most surrogacy arrangements today in which the surrogate receives financial compensation for their time, effort, and role as a surrogate.

While altruistic surrogates do not get financial compensation, it is common for the intended parents to pay for the surrogate’s medical expenses and some other necessary pregnancy items.

As you might expect, altruistic surrogates are typically family or close friends with the intended parents.

As mentioned above, an altruistic surrogacy can be either a traditional or gestational surrogacy.

Interestingly, all surrogacies in some countries (like Canada and Australia) must be uncompensated altruistic surrogacy arrangements.

What is Independent Surrogacy?

An independent surrogacy is a surrogacy arrangement not organized or supported by an expert surrogacy agency. Much like altruistic surrogacy, independent surrogacy is often performed by a surrogate who knows the intended parents well.

While independent surrogacy may seem reasonable, it comes with substantial and high stress levels trying to work through complex insurance issues, medical decisions, important legal proceedings, and more.

If one so chooses to pursue an independent surrogacy arrangement, keep in mind that working with a reproductive attorney is strongly recommended.

Bottom Line About the Different Types of Surrogacy

All surrogacy arrangements are one of two types depending on whether the surrogate’s eggs are used (genetically related) to create the child they carry and deliver.

In traditional surrogacy, the surrogate’s own eggs are used. In contrast, the intended mother’s or donor’s eggs are used in gestational surrogacy. Naturally, having a genetic separation between the surrogate mother and baby offers significant financial and legal advantages.

Altruistic and independent surrogacies are non-biologic classifications and can either be traditional or gestational.

No matter where you are in the process of growing your family and exploring surrogacy, we are here and happy to answer any of your questions and encourage you to contact us or request a free intended parent consultation.