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Surrogacy 101 - What is Surrogacy?

a blog by Grey Fox, August 23, 2013

Do you live on Mars? No? Under a rock? No? Then you've probably heard about Jimmy Fallon and his wife welcoming their baby girl via surrogate. Lots of people have already dissected that news byte so I won't rehash it here.

But what is surrogacy and why would you do it?

First off, people do NOT use (I really hate employing the word "use" followed by a person but I have yet to identify a better word) a surrogate because they don't want [insert whatever pregnancy symptom you'd prefer to avoid, such as stretch marks, here]. No reputable doctor would consent to that.

Surrogates, or gestational carriers, are needed when there is no viable womb available to gestate a fetus. Examples are:

  • gay male couples (clearly no wombs there)
  • a woman with no uterus (again, obvious)
  • a woman with any kind of uterine disease or anomaly
  • a woman who may not have a diagnosed uterine issue but who has failed to become pregnant after several embryo transfers
  • a woman who has a history of miscarriages or pre-term birth thought to be due to factors other than egg/sperm quality or genetics (i.e. uterine or cervix issues)

Basically anyone who doesn't have a uterus or who has one that doesn't appear to work correctly is a good candidate for surrogacy.

Types of Surrogacy

There are two main types of surrogacy - traditional and gestational.

A traditional surrogacy is one in which the woman carrying the child has contributed her own egg. This type of surrogacy is not as common as it once was for many reasons. IVF is now a bit more mainstream and affordable (comparatively) than it used to be (traditional surrogacies can use IUI and not require IVF). And there have been some legal challenges about who is the rightful mother in these situations. Anyone remember Baby M?

A gestational surrogacy is one in which the woman carrying the child has no genetic relationship to the baby. Some people feel that using the term "gestational carrier" is somehow demeaning or dehumanizing but it is really just a more accurate description. Despite the surrogate not being genetically related to the child, the child may or may not be the biological child of one or both of the intended parents. Use of donor egg/sperm has no bearing on this title but it can result in a legal quagmire if not properly outlined in the surrogacy contract and depending upon what state laws may or may not exist for these situations. It's no secret that laws have not been keeping up with science lately.

In either case, the surrogacy could be deemed as a compassionate surrogacy or as a compensated surrogacy. The differentiation there is largely a legal matter and reflects whether the woman carrying the child will be compensated beyond her own expenses - will she be receiving a fee for her services beyond her expenses or is she volunteering her body (with expenses paid)?

In most cases a compassionate surrogacy is the result of an existing relationship between the gestational carrier and the intended parents such as a sister or other family member or a long time friend. Compensated surrogacy is often achieved by going through an agency that facilitates vetting the surrogates and matching them to intended parents. But it's also possible to set up either type of surrogacy without going through an agency.

Stay tuned for my next post which dissects the COST of surrogacy.

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