Surrogacy & Gestational Carriers

Surrogacy & gestational carriers overview

• In fertility medicine, a surrogate is a woman who carries a pregnancy for another individual or couple.
• A traditional surrogate carries the pregnancy using her own egg that is fertilized with the sperm of the intended father.
• A gestational carrier (GC) is a woman who carries a pregnancy using the egg and sperm of the intended parents, which are implanted into the GC after in vitro fertilization (IVF).
• Gestational carriers are nearly always preferred in order to minimize genetic relation of the child to the surrogate; if the intended mother’s eggs are not viable, a donor’s eggs may be used.
• A surrogate is typically compensated for her effort, time and expenses.

Who should use a surrogate?

Surrogacy is recommended for women who have functioning ovaries but may have a medical condition that makes carrying a pregnancy very difficult or impossible. Common medical conditions of women seeking surrogates are the absence of a uterus, recurring miscarriages, uterine abnormalities or a medical condition that could put both mother and baby at risk.

If donor eggs must be used and the intended mother cannot carry a pregnancy, then a couple may decide to use a gestational carrier so that the child is genetically related to the intended father.

Gay partners may also choose to use a surrogate in order to have a child that is genetically related to one of the partners.

How should you choose a surrogate?

Surrogates can be a person with a relationship to the intended parent(s), such as a close family member or friend. The surrogate may also be located through an agency or through the fertility clinic.

The criteria for choosing a surrogate include:

What is involved in the surrogate process?

Once a surrogate is chosen, she undergoes thorough health screenings and tests to ensure that she is healthy. This workup includes:

After the surrogate, either traditional or gestational carrier, is chosen, all parties involved must consent to the arrangement. This typically involves legal contracts specifying terms of the surrogate arrangement, payment for the arrangement and rights and responsibilities of the intended parents and the surrogate.

It is important to detail expectations, such as amount of contact between parties throughout the pregnancy and what type of diet the surrogate should have. These details are often overlooked and tend to cause conflict between the surrogate and the intended parents.

Preparing for pregnancy

Once all contract agreements are reached, the steps for achieving pregnancy are similar to the steps of the egg donation process. The surrogate and intended mother will be placed on medications to coordinate their menstrual cycles. This process could take a few weeks to two months.

Once the two women’s cycles are in sync, the intended mother will be stimulated for egg retrieval. When the intended mother has mature eggs available, egg retrieval will be performed.

The eggs retrieved from the intended mother are fertilized with the intended father’s sperm in the laboratory. Fertilized embryos develop in the lab for three to five days prior to implantation in the surrogate.

Once the best embryo is chosen, it is placed directly into the surrogate’s uterus. A simple blood test about nine days after the procedure will either confirm or deny pregnancy.

Once pregnant, the surrogate will be monitored until about the eighth week of pregnancy. Then her care will be transferred to her Ob/Gyn. She will update the intended parents throughout the pregnancy, as detailed in their contract.

Once the surrogate gives birth, the baby will be taken home from the hospital by the intended parents.