Gestational surrogacy is an arrangement where one woman carries and delivers a baby for a couple or another woman. The woman who carries the baby is called a gestational carrier or surrogate. The recipient parents are called intended parents. Surrogacy is a controversial form of assisted reproductive technology (ART). Because of the sensitive nature of this process, many states prohibit compensation other than payment for legal and medical expenses.
Types of Surrogacy
Couples using assisted reproductive technology can choose from one of two types of surrogacy. These are:
- Traditional surrogacy – A surrogate mother is artificially inseminated using the intended father’s sperm or the sperm from an anonymous donor. After insemination, the surrogate carries the baby to term. If the intended father provides the sperm, the child will be genetically related to him.
- Gestational surrogacy – A donor egg can be used, or the egg can be removed from the intended mother. The egg is fertilized using either donor sperm or sperm from the intended father. After fertilization, the resulting embryo is transferred into the surrogate who carries the baby to term. The child is then related to the woman who donates the egg as well as the intended father, but not the surrogate.
Finding a Surrogate
To reduce the cost of surrogacy, many couples ask a family member or friend to serve as their surrogate. We recommend that both the surrogate and the intended parents obtain legal advice before signing any contracts or making any agreements. A legal document can prevent potential conflicts during the surrogacy process. Because finding a surrogate is not always that easy, our agency will match you with possible surrogates. When choosing a fertility clinic, it is necessary to research surrogacy and understand how surrogates are screened. Questions prospective parents should ask include:
- Do we meet with the surrogate?
- Does the agency evaluate the home environment of the surrogate?
- Do you do reference checks and criminal background evaluation?
- Do you screen surrogates for health and mental stability?
Most fertility clinics require surrogates to meet certain general qualifications. She must be/have:
- In good mental and physical health
- Carried and delivered at least one child in the past
- A history of full-term pregnancies free of complications
- Less than 43 years of age
- In a stable living environment
- Drug and alcohol free
Gestational Surrogacy Success Rates
When a woman uses her own egg for gestational surrogacy, the chances of delivering a healthy baby are about the same as using traditional in vitro fertilization (IVF). According to recent national data on gestational surrogate cycles using the intended mother’s eggs, the chances of cycles resulting in live births are:
- 50% for women age 34 and younger
- 38% for women age 35 to 37 years
- 28% for women age 38 to 40 years
- 23% for women age 41 to 42 years
- 11% for women age 43 and older
Candidates for Surrogacy
Using a gestational surrogate will be a good choice if you:
- Do not have a uterus
- Are unable to carry the pregnancy safely
- Have problems maintaining a pregnancy
- Are a single man or gay couple
- Have failed on other fertility treatments
Using a gestational surrogate is a complex and emotionally challenging process. If you choose to use this form of ART, be prepared to commit much money, time, and patience to the process. Only a few states allow gestational surrogacy contracts, and some states require the couple to be married. Because most states don’t have specific laws governing the surrogacy process, it is important that you work with an attorney who has expertise in the areas of third party reproduction.