6 Things to Know About Surrogacy

Considering surrogacy is a big decision and one that can feel overwhelming. It’s important to work with a surrogacy agency that’s professional, experienced, and understands the ups and downs that can come with the process. 

If you’re just now in the initial stages of thinking about surrogacy for your family, the following are six key things to know. 

1. How It Works

In a surrogacy arrangement, a woman agrees to carry a child for someone else. Once the baby is born, a birth mom will give guardianship and custody to the parent or parents. There are certain legal and medical steps that have to be followed. 

The intended parents will often undergo IVF, so the fertilization is happening outside of the body. Then, the embryo gets transferred to the uterus of the surrogate. 

In these situations where IVF is used, the surrogate is not legally or genetically related to the baby. The surrogate mother is paid for time and service by the intended parents. 

Surrogacy is becoming increasingly common, with more than 17,000 births taking place this way in the United States in 2019. 

A surrogate is paid for her time and the efforts of carrying a child by the intended parents. 

A gestational surrogate doesn’t have any genetic relationship to the baby she’s carrying. In the past, in traditional surrogacy arrangements, the surrogate would use her egg as well as carry the baby. 

2. Traditional vs. Gestational Surrogacy

This was briefly touched on already, but it’s often an area of confusion—there is a difference between traditional and gestational surrogacy. 

In gestational surrogacy, an egg donor can be used to create the embryo that a surrogate carries. Single men, same-sex couples, and couples where the woman can’t produce healthy eggs might require the help of an egg donor for gestational surrogacy. 

In traditional surrogacy, the surrogate is using her own eggs, so she’s both the donor and the carrier. 

In gestational surrogacy, IVF is used to create the embryo. IVF can also be used in surrogacy classified as tradition, but it’s more common for traditional surrogacy to involve intrauterine insemination. 

Traditional surrogacy has a lot of complexities as far as emotions and legality, so it’s less common. More agencies tend to specialize in gestational surrogacy. There are fewer options for parents choosing traditional surrogacy. 

3. Legalities

The laws are complex regardless of the particular type of surrogacy a family chooses. Some states that allow for gestational surrogacy prohibit traditional surrogacy. 

For people considering surrogacy, it’s important to work with an attorney who understands the laws in your state. 

With traditional surrogacy, more legal actions are required because the surrogate mother is genetically related to the child. 

There may be the need to go through the process of termination of parental rights and stepparent adoption proceedings if traditional surrogacy is used. 

4. Why Do People Use Surrogates?

There are many diverse reasons people will use a surrogate to have a child including same sex couples who want to start a family. 

Only one of those reasons is infertility. Infertility is a disease affecting the female or male reproductive system. It’s characterized by a failure to become pregnant after trying for 12 months or more to conceive. Around 11% of the population in the U.S. that is reproductive age is affected by infertility. An estimated 1 in 8 couples have difficulties getting and sustaining a pregnancy. 

As people age, fertility declines. 

Around one-third of infertility is because of the female partner, and the same is attributed to the male partner. Around one-third of cases of infertility are a combination of issues in both partners or are unexplained. 

There are many reasons for infertility. In females, Hashimoto’s disease is linked to infertility, for example, as are issues with a hormone called prolactin. If prolactin is high, it can point to deeper-level hormonal issues that can lead to infertility. 

5. Working with an Agency

You don’t have to work with a surrogacy agency, but since it can be a complex situation, the recommendation is that you do. 

A surrogacy team typically includes a lawyer, reproductive endocrinologist, insurance specialist, and psychologist. If you work with an agency, they can help you build your team. 

When working with a surrogacy agency, they should make sure carriers undergo all screenings before matching her with you, and you still, after that, want to make sure she’s the right fit. 

6. It’s an Expensive Process

Finally, there’s no way around the fact that surrogacy is expensive. There’s a lot of time and effort that goes into matching parents and surrogates. If you opt to use an egg donor, that’s also going to add to the costs. 

For most people, when all the costs are totaled, it’s into the six figures, so it’s something to plan for and consider.

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