What is surrogacy? How is surrogacy different from gestational carrier? Who needs a surrogate?
I will answer all these questions and more in this episode of InfertilityTV
In order to have a successful pregnancy,
you must have a viable embryo and a person with a healthy uterus who can carry the pregnancy and
eventually deliver the fetus. Some people with fertility problems have issues which
make it harder for them to create healthy embryos. Others have healthy embryos but
are unable to carry and have a successful delivery. Some people have both problems.
Using the technology of IVF, people with both types of problems can benefit. A surrogate
mother as a person who provides her eggs for making the embryo and her uterus for
carrying the pregnancy to term. This is a good option for people with problems making healthy
embryos and people who are unable to carry a pregnancy to term. A gestational carrier
provides the use of her uterus only. This is a better option for people who
can make healthy embryos themselves but are unable to carry and deliver.
Both surrogates and gestational carriers provide the use of their
uterus. Only surrogates also provide their eggs.
Who are the people that need someone to carry a pregnancy for them? There are several groups
that may need a gestational carrier. First, we have women who don’t have a uterus. Some women
may have been born without a uterus. Others may have had their uterus surgically removed
at some point during their lives. This is known as a hysterectomy. Trans women and same sex male
couples would also need a gestational carrier or surrogate. There are some people who have a
uterus that did not develop properly. Because of these uterine abnormalities, their uterus
is unable to allow an embryo to implant or to sustain a pregnancy until full term. A third
group are people who were born with a normally developed uterus but developed some problem with
their uterus later on. Examples of this type of problem may include the development of scar
tissue in the uterus or growths such as uterine fibroids. A final group who may need a gestational
carrier are people who have a normal uterus but who have a medical condition that makes
becoming pregnant or carrying a pregnancy to term risky for either them or the developing fetus.
Ideally, a gestational carrier should be someone who is healthy, has had one or more
previous pregnancies and was able to deliver a full term baby and has no current medical
or social issues that would make them a poor candidate to carry a pregnancy for somebody else.
You will need to have a legal contract that specifies what will happen. For example,
the contract might say that an embryo made from your eggs and your partner’s sperm will
be implanted into the uterus of the carrier. She will carry and then eventually deliver but
at the moment of birth, you and your partner will become the legal parents instead of the
woman who gave birth. You should try to include as many situations as possible
in a surrogacy or gestational contract. This might include a requirement for the carrier
to see a doctor for prenatal care to what would happen if the fetus had abnormalities
and you wanted to terminate the pregnancy. The less you leave to chance, the better
In the United States, there are some states that have laws that make it easier for people to use a
surrogate or carrier. Illinois and California are examples of states that make it easier on
couples who need this treatment. Other states have passed laws that ban surrogacy contracts.
Nebraska and Louisiana are examples. There are many different variations in other states.
Some states don’t have any explicit laws regarding surrogacy either way. Some will
allow surrogacy but only when the surrogate or carrier is not compensated for her services.
If you are somebody who is considering using a surrogate or gestational carrier,
you should definitely consult with a reproductive
attorney in your state and the state where the surrogate or carrier lives.
Bottom line is that for some people, using a gestational carrier or a surrogate may be
the best or only way to have a child. It is a complicated legal process and is expensive.
From a medical point of view, it is no more complicated than any other type of IVF treatment.