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Surrogacy, also known as gestational care, is a family building option for those who want a child with genetic ties and have not had success with other “first-line” assisted reproductive technology (ART) treatments. Surrogacy, in which a woman carries and gives birth to another woman’s baby, has a long history, dating back as far as the Old Testament story of Sarah and Hagar.
Traditional Surrogates and Gestational Surrogates
There are two types of surrogacy — traditional and gestational — that are practiced today.
In traditional surrogacy, a woman, called a “surrogate mother,” carries an embryo that was created with her own egg and the sperm of a man who, with his partner, wants a baby. Traditional surrogacy can be accomplished either by intrauterine insemination (IUI) or by in vitro fertilization (IVF).
In gestational surrogacy, the surrogate, called a gestational carrier, gives birth to a baby created with an egg and sperm from the "intended parents," or the embryo can be created from a donor egg or donor sperm. The majority of surrogates today are gestational carriers.
With gestational surrogacy, IVF is used to fertilize the eggs in a laboratory. If the fertilization is successful, a fertility doctor transfers some or all of the resulting embryos (often two or three) into to the surrogate’s uterus. If all goes well, the gestational carrier delivers the baby and immediately relinquishes him or her to the parent(s).
IVF, which came into practice in 1978, transformed surrogacy into a popular practice today.
Who Uses Surrogacy?
Candidates for surrogacy are:
- Couples and single women who have had multiple miscarriages or difficulty conceiving and/or carrying a fetus to term. Surrogacy enables them to have a child genetically related to one or both.
- Gay male couples who want a child with a genetic connection to one partner.
- Couples or single women in which the woman has no uterus or a congenital anomaly of her uterus but has intact ovaries.
What to Consider with Surrogacy
Surrogacy involves many legal, ethical and financial considerations. Usually, potential parents pay the surrogate a fee for carrying the child, along with her medical expenses. Costs can start at $20,000 or more, up to $120,000. Legal contracts are required before the process begins to protect the rights and responsibilities of the parents, surrogate, and intended child. Both the third party and intended parents should have separate legal counsel.
Finding a Surrogate
Most people locate gestational carriers/surrogates through fertility clinics, websites, lawyers and private agencies. Most agencies require that potential surrogates already have had a child/children of their own, are healthy medically and emotionally, and are not motivated solely by financially considerations.