Surrogacy & Donation

Surrogacy & donation overview

  • Surrogacy involves a third-party woman who carries and delivers a child for a couple or parent after becoming pregnant through an in vitro fertilization (IVF) process that uses eggs, an embryo and/or sperm from the parent(s), or from a donor.
  • Surrogacy is an option for women who cannot carry a pregnancy due to certain health conditions.
  • “Gestational surrogacy” involves the implantation of an embryo produced by the recipient parents via IVF and is the preferred form of surrogacy (compared to “traditional surrogacy,” which involves artificial insemination and uses the surrogate’s own eggs).
  • Donation involves a third party’s donated sperm, egg(s) or embryo(s) that the couple or parent uses in IVF treatment.
  • Surrogacy and donation are types of “third party reproduction.”

What is surrogacy?

By definition, a surrogate is a substitute for another. A surrogate in fertility treatment refers to a third-party woman carrying and delivering a child for another parent or couple using the couple’s or donor’s sperm, eggs or embryos to achieve that pregnancy. Surrogacy is referred to as “third party reproduction.”

“Traditional surrogacy” involves impregnating the surrogate mother by artificial insemination. However, the preferred method of surrogacy is known as “gestational surrogacy,” which involves implantation of an embryo created by the recipient parent(s) through IVF into the surrogate mother.

A child born via gestational surrogacy does not carry genetic material from the surrogate mother. A child born through traditional surrogacy inherits genes from the surrogate mother because her eggs (carrying her genes) are fertilized by the male recipient parent’s sperm. Because of this, traditional surrogacy is discouraged, as it can become more complex emotionally and legally.

The surrogate mother can be a family member, a friend of one of the parents, or another woman located through a surrogacy agency. Aside from medical treatment, surrogacy is an arrangement that involves social, ethical and legal issues, with specific legal agreements usually stipulating the details of the surrogacy.

What is donation?

In fertility, donation refers to

  • a third-party male providing sperm
  • a third-party female providing eggs
  • or a third-party couple providing embryos

Donated sperm can be used in artificial insemination and donated eggs and/or embryos can be used in IVF in order for a recipient parent or couple to achieve pregnancy. Generally, donation is used in fertility treatment because the recipient(s) are unable to achieve pregnancy using their own sperm or eggs.

In male or female donations, the donor may remain anonymous or may be known by the recipient. Donors may be family members, friends or people contacted through outreach or an agency.

Sperm donation can involve artificial insemination of the donated sperm into the uterus of the recipient female, or it may involve adding the sperm to the female’s eggs outside of the body in an IVF treatment. In either case, the donated sperm is carefully inspected for genetic quality and sperm health, and is generally frozen and quarantined for a period of time to allow for re-testing at a later date before it is used in fertility treatment.

Egg donation has increased substantially since the first pregnancy through egg donation in 1984. Eggs may be donated for free, usually by a family member or friend, or may be purchased, usually through an agency. Donated eggs are fertilized through IVF using the male partner’s sperm (or donated sperm) to create embryos, which are then implanted into the uterus of the recipient mother.

Embryo donation uses an embryo from a third party (another woman’s egg that has been fertilized by another man’s sperm) that has been created through the IVF process. The embryo is then implanted into the recipient mother.

Identifying, screening and selecting donor sperm, eggs or embryos should involve a thorough process carried out under the supervision of your fertility doctor. Rigorous scrutiny can help ensure the success of the donation.

Who should consider surrogacy or donation?

  • A parent or couple who have not been successful achieving pregnancy using their own sperm and/or eggs
  • A person or couple who is at elevated risk of passing along genetic defects to the child
  • Women who have entered menopause
  • Women whose ovaries don’t function properly

What are the risks of surrogacy & donation?

Surrogacy and donation carry medical, emotional and legal risks. Medically, the risks are similar for the normal process of IVF.

Due to the complex feelings and values many people have regarding parenting and genetic relationships, surrogacy and donation can have emotional issues for recipients and donors, both male and female. Your Loma Linda Fertility physician can refer you for counseling related to surrogacy and donation.

Individuals involved in complex legal issues surrounding surrogacy, as well as donation to a lesser extent, should seek appropriate legal advice and guidance to minimize legal risks inherent in such contractual relations.