Growing your family isn’t always as easy or as straightforward as you might hope. There are many reasons a person may consider alternative family building options such as adoption, surrogacy, or other assisted reproduction techniques like IVF. For LGBTQ couples, single men, and those who cannot become pregnant for any number of reasons, adoption and surrogacy are two paths that are often compared. There are several differences in adoptions vs. surrogacy to be aware of, including genetics, cost, preparation, and legal matters. Let’s explore each of the differences below.
Understanding The Concept Of Adoption
According to ChildWelfare.gov, adoption is the “social, emotional, and legal process in which children who will not be raised by their birth parents become full and permanent legal members of another family while maintaining genetic and psychological connections to their birth family.”
There are several different types of adoption. Domestic adoption involves children and adoptive parents from the United States. International adoption is when parents adopt a child from another country. Children can also be adopted through the foster care system after the birth parents’ rights have either voluntarily or involuntarily been terminated.
Adoptions can be either open or closed. In open adoption, the adoptive family and the birth parent(s) agree to some level of contact. Identifying information is shared among the involved parties, and association is maintained to some degree, from exchanging letters and phone calls to in-person meet-ups.
There are many reasons why a child may be available for adoption. Some birth mothers make the choice after they become pregnant unexpectedly, often because they feel unable or unwilling to care for a child. Others have their legal parental rights revoked by the court system due to negligence, abuse, or inability to provide a safe and stable home environment. These children are typically placed in the foster care system and can be adopted once parental rights are eventually revoked.
Adoption is a complex process both legally and emotionally. While it is a wonderful option for many families, it’s not the right choice for everyone. Another option to consider is family building via gestational surrogacy.
Understanding The Concept Of Surrogacy
Although surrogacy has been around in some form for centuries, the practice has evolved over time. Today, surrogacy is a significantly advanced and viable way for a person to have a child. Rapidly advancing technology makes surrogacy easier than ever for intended parents.
The formal definition of surrogacy is a method in which a woman agrees to carry a pregnancy for someone else who will be the child’s parent or parents after birth. It’s used when the intended parents are unable to carry a child on their own, often due to medical issues. LGBTQ individuals & couples, and single individuals who wish to be parents can also pursue parenthood via surrogacy.
We go much deeper into this topic elsewhere, but in general, an entire surrogacy journey can take up to 15-18 months. If you need to seek an egg and/or sperm donor, you can expect an additional 3-4 months.It helps to visualize the process, so let’s break it down into three phases:
Phase 1: Preparation.
During the preparation stage, intended parents either consult with a surrogacy agency that will walk them through the process, or they begin their independent journey.
Phase 2: Legal and Medical Screening.
During this stage, intended parents match with their gestational carrier/surrogate. If you are working with an agency, they’ll handle the matching as well as all of your legal, financial and medical details. Prospective surrogates will be screened extensively for medical, psychological, and past pregnancy issues. Intended parents work with an attorney to draft a Gestational Surrogacy Agreement (GSA) that establishes the relationship to the carrier, applicable rights as a parent, and the details of compensation for the surrogate.
Phase 3: Embryo Transfer and Pregnancy.
After everyone receives medical and legal clearance to proceed, it’s time to have a baby!
With gestational surrogacy, IVF (in vitro fertilization), is used to create an embryo that’s then transferred to the surrogate. In the reproductive technology industry, the term gestational carrier (GC), or simply carrier, is used to refer to the woman who serves as a surrogate. With this form of surrogacy, the carrier is not genetically related to the child. Embryos are created using donor eggs and/or sperm, either from the intended parents or from another donor. Gestational surrogacy allows one or both intended parents to be genetically related to their child.
In researching surrogacy, you may come across the term “traditional surrogacy.” This is a practice that has fallen out of favor in the United States. In traditional surrogacy, the surrogate mother uses her own eggs to become pregnant and carry a child for the intended parents. This biological connection causes many layers of legal and emotional complication, which is why it is not regularly practiced in the U.S. Advancements in the reproductive technology field have made traditional surrogacy unnecessary since embryos can be created using donor eggs and IVF.
You can read more about how gestational surrogacy works in this in-depth article: What is Surrogacy?
For some intended parents, the question of genetics is of the utmost importance. If having a biological child is important to someone, then gestational surrogacy is the more likely choice. Except in very unique circumstances, an adopted child comes from a different family and is not genetically related. The exception to that would be the case of a kinship or relative adoption; for example, a person who adopts their grandchild, cousin, niece or nephew, should the child’s parents be unable or unfit to care for them.
In gestational surrogacy, the surrogate who carries the child has no genetic link to the baby. Instead, she carries an embryo that was created using donor material or that of one or both intended parents. Because the intended parents have the opportunity to use their own genetic material to create the embryos, this is a popular choice for those who wish to have a biological child. It’s also the only way for a gay male couple to have a biological child. When one or both intended parents are genetically related to the child, legal matters can go much smoother, especially in certain states and jurisdictions that are less favorable to surrogacy contracts.
With adoption, the birth mother has a biological connection, which can make the situation more legally and emotionally complex. Unless and until her parental rights are terminated by a court, she has the right to change her mind and keep the child. Courts tend to heavily favor biological parents, so in the case of a dispute, intended parents often find themselves disappointed.
Cost And Preparation
Both adoption and surrogacy are costly endeavors. There are legal costs, medical costs, professional fees, and in the case of surrogacy, compensation for the surrogate. Costs can increase depending on the intended parents’ personal circumstances and choices. For example, if they need donor eggs, sperm, and a gestational surrogate, their overall cost will be much higher than a couple who can use their own eggs and sperm. A couple wanting to adopt an infant from overseas will have a much higher cost than someone who fosters a child to adopt.
Overall, gestational surrogacy costs $100,000-200,000, sometimes more. Costs vary depending on the amount of compensation provided to the surrogate. Typically, a surrogate receives a base compensation of $30,000-$60,000 for her extensive dedication to all of the mental, physical, and emotional demands of surrogacy. Intended parents can cut costs by pursuing an independent surrogacy without an agency, seeking an altruistic/compassionate surrogate or by finding a surrogate whose personal health insurance covers some or all of her prenatal care. Read more: Three Significant Ways to Lower the Cost of Surrogacy.
Surrogate expenses generally include the following:
- Your surrogate’s base compensation. Compassionate/altruistic surrogacy arrangements average $10,000-20,000, whereas compensated surrogacies average $25,000-60,000.
- Monthly allowance to cover miscellaneous expenses
- Maternity clothing allowance
- Childcare and/or housekeeping costs
- Travel compensation
- Lost wages due to complications, bed rest, etc.
Adoption costs vary greatly depending on the type of adoption you pursue. International adoption costs between $25,000-$50,000. This is the highest cost option due to agency fees, travel costs, legal fees, and more.
Domestic adoption through a private agency costs between $20,000-$30,000. Costs include agency fees, background checks, legal fees, and medical expenses for the birth mother. Laws prevent birth mothers from receiving any compensation related to the adoption of a child, which is one reason adoption is significantly less expensive than gestational surrogacy.
Adoption through the foster care system or adoption of a relative is the least expensive option. In these cases, you usually only pay for some legal fees and the cost of background checks and a home study. This type of adoption can be completed for just a few hundred dollars in most cases.
Another consideration: Families who adopt become eligible for special tax credits and reimbursement from federal and state governments. No such incentive exists for surrogacy, although there are some grant and loan programs available from private entities and non-profit organizations. In some cases, if the intended parents have high medical costs associated with their own egg retrieval or other aspects of IVF, those medical expenses may be tax deductible.
There are significant differences in the matching process in adoption vs. surrogacy. In adoption, the birth mother is the one who ultimately chooses the intended parents. Prospective parents can specify certain preferences; for example, race, age, medical history and potential substance exposure, and desire for contact in the future. For the most part, the decision is left to the birth mother.
In gestational surrogacy, the matching process is a mutual undertaking. The intended parents and potential surrogates all complete a detailed profile. Once the parents review surrogate profiles and select someone to meet, the surrogate must also agree that there is mutual interest. After meeting, all parties must agree that they’d like to move forward with a surrogacy arrangement. The surrogate is selecting the parents just as much as the parents are selecting her. Most of the time, these matches are facilitated by an agency like Family Inceptions.
The legal process varies in adoption vs. surrogacy. With adoption, the birth mother, and in some states, the birth father, must sign a written agreement to relinquish parental rights. Those rights must then be terminated by a court. All of this occurs after the birth of the child, and at any point, the birth mother and/or father have the right to revoke consent and keep the child.
In gestational surrogacy, the entire process is governed by a legal contract signed during the early stages. All expectations and obligations are clearly outlined before any steps are taken to move forward. The surrogate has no biological connection, therefore she has no right to claim the child. Except in the small number of states where surrogacy contracts are illegal, this means that the intended parents run no risk of complications regarding parentage.
In either case, adoption or surrogacy, it’s crucial to consult with an attorney who specializes in the type of arrangement you are pursuing.
Certainty Or Assurance
In considering adoption vs. surrogacy, intended parents should ask themselves how tolerant they are of uncertainty. For many, the path to parenthood has been rocky already, with lots of ups and downs. By the time someone reaches the point of considering surrogacy or adoption, they have tried many different paths without success. For those that are ready for a child and are unwilling to tolerate some uncertainty, surrogacy is the better path. Here’s why:
With surrogacy, you and the surrogate enter into a legally binding contract after completing an intense and comprehensive screening process. The surrogate has undergone psychological examinations to determine her motivations, commitment, and understanding of the process. The prospective parents have completed an extensive application and pre-screening process and have invested in the help of an agency and/or other professionals. Once the surrogacy agreement is signed, the process moves forward with a level of certainty that doesn’t exist with adoption. Of course, there are still unknowns with surrogacy. Will the embryo transfer result in a successful pregnancy? How many attempts will be required before achieving a live birth?
The adoption process is much less certain. The birth mother, and sometimes the birth father, can change their minds at any time. Adoptive parents can’t be certain of the type and quality of prenatal care or of the birth mother’s daily habits that could cause harm to the fetus. With surrogacy, prenatal care and tolerance of high-risk activities while pregnant are all clearly outlined in the contract. Experiencing an adoption disruption can be an emotionally draining experience.
Medical Process In Surrogacy
Surrogacy involves a complex series of medical interventions in order to achieve a planned pregnancy. With adoption, there is no need for extra medical interventions unless there is a complication at birth and the adoptive parents have agreed to pay the birth mother’s medical expenses.
The medical process of surrogacy has several steps. First, there is the need to obtain genetic materials: the egg and sperm. During egg retrieval, either of the intended mother’s own eggs or with a donor, the patient undergoes an outpatient procedure where the doctor inserts a thin catheter to retrieve eggs from the uterus. The eggs are then combined with donor sperm or sperm procured from the intended father. This is done in a lab by a skilled embryologist who then monitors the cells as they develop into blastocysts, and ultimately an embryo. This process is called in vitro fertilization (IVF). Read more about the egg retrieval process here: A Comprehensive Guide to the IVF Egg Retrieval Process
The surrogate must take fertility medications in the weeks leading up to the embryo transfer to prepare her body. The embryo is then placed in her uterus during an outpatient procedure, where it will hopefully implant and develop into a fetus. Throughout this process, the surrogate is monitored by the fertility clinic.
As you consider adoption vs. surrogacy, it’s important to think about the type of relationship you’d like to have with the involved parties. What level of interaction do you want between your child and his or her birth family or surrogate family? How will that play into the way you talk about your child’s origin as they grow up?
Open Or Semi-Open Adoption Arrangement
There are three types of adoptions when it comes to the level of relationship between the birth parents and the adopted family: closed, open, or semi-open adoptions.
In a closed adoption, no identifying information is exchanged, and there is no relationship between the birth and adopted families. Depending on local law, a child may be able to obtain records about his or her adoption when they turn 18. This is becoming less common now, considering the prevalence of genealogy kits and an overall better understanding of how important it is for a child to understand their origin.
Open adoptions give all parties the opportunity to remain in contact on a regular basis. Identifying information is exchanged, so the adoptive parents and birth family can make a plan to communicate and keep in touch. Contact can include in person, via telephone or video calls, through the exchange of letters, and so on, depending on what everyone agrees to. Open adoptions are increasingly popular as more people see the advantage to having an open dialogue and awareness of where one comes from.
Semi-open adoptions are a sort of middle ground between closed and open adoptions. With a semi-open adoption, some identifying details are shared between families, for example geographical location or first names. Any contact is facilitated by a third party, such as agency staff who passes along photos or messages. The goal is for the birth mother to maintain some awareness of the child’s well being and growth while also maintaining privacy.
Staying In Touch With The Intended Parents
The type of relationship between surrogates and their intended parents can vary from business-like to best friends. Early in the process, intended parents and prospective surrogates specify the level of contact they hope to have both during the pregnancy and after the child is born, and they are matched accordingly. The relationship is also defined in gestational surrogacy contract.
Some surrogates and intended parents like to keep in touch after the child is born, often exchanging cards and annual updates or remaining connected on social media. Not everyone chooses to stay in contact, though, so it is very much a personal choice with surrogacy.
Mother Screening or Prenatal Care
Prenatal care and advanced screening of the mother are handled very differently in adoption vs. surrogacy. With surrogacy, every step is planned, monitored, and controlled. With adoption, intended parents have little to no control over what happens prior to birth. Still, there are certain screenings that take place in an adoption.
Prenatal Care For Surrogacy
Surrogate mothers receive top-notch prenatal care and are required to limit exposure to high risk activities or harmful substances as outlined in the surrogacy contract. All potential surrogate applicants undergo extensive medical screening, both during the application process and after being matched. Medical clearance is granted to a surrogate by the fertility clinic only after they determine that she is healthy and likely to have a successful pregnancy.
Intended parents are aware of, and sometimes present for, all of the prenatal care. You’ll often receive updates from the surrogate following her regular appointments. Depending on distance and the facility’s policies, you may be able to be present for ultrasounds and other procedures. Intended parents are usually present for delivery as well.
Mother Screening For Adoption
Birth mothers do undergo some medical screening, although it’s not nearly as extensive as the screening done for surrogates. Often, birth mothers are asked to self-disclose their medical and social history, as well as their drug or alcohol use. If she is working with a professional agency, they may require a drug screening, although many are hesitant to do so for fear of offending a birth mother.
Agencies will also provide professional counseling to make sure she understands the process and can cope with the decision. The birth mother will also be asked to disclose what type of prenatal care she has received, although there is no legal requirement that she receives care. There is no expectation that the intended parents be informed of test results, procedures, etc. If the birth mother allows it, some adoptive parents can be present at the hospital during delivery, but that’s not always the case.
Advantages and Disadvantages
The way you choose to build your family is highly personal and dependent on your own circumstances and values. Both surrogacy and adoption are wonderful ways to grow your family. Each has its own set of advantages and disadvantages you will need to consider.
There are many advantages to choosing surrogacy:
- Surrogacy allows one or both intended parents to have a biological relation to the child.
- There aren’t many surprises with surrogacy: everything is planned and governed by a legal contract.
- Surrogacy is likely to result in a successful pregnancy. Surrogate mothers have all had healthy pregnancies in the past.
- There is opportunity for forging a special bond and relationship between the surrogate and intended parents.
- Intended parents and surrogates have a mutual level of control and autonomy during the matching process.
There are also some disadvantages to surrogacy:
- Surrogacy is expensive, costing $100,000 or more.
- There can be legal complications depending on what state or locality has jurisdiction over the contract.
- Intended parents may feel far removed from the pregnancy, as some surrogates live a considerable distance away.
- The interpersonal connection between the surrogate and intended parents can be rocky, especially if any steps are skipped in the drafting of a contract.
Adoption has many advantages when compared to surrogacy:
- The cost of adoption is lower than that of surrogacy.
- The child is already in utero or has been born, so there is no uncertainty about achieving pregnancy as in surrogacy.
- Adoptive parents are providing a loving, stable home to a child who needs it.
There are some disadvantages to adoption you should consider:
- The birth mother has the right to change her mind.
- You have to be chosen by the birth number, meaning the decision is not as mutual as in surrogacy.
- There can be many unknowns regarding the birth mother’s medical & family history as well as her prenatal care.
Which Is Best Suited For Your Family?
Surrogacy and adoption are both worth considering when you are choosing how you’d like to build your family. At the end of the day, whether you choose adoption or surrogacy, you are pursuing the dream of becoming a parent. The most important outcome is a healthy, happy child who is raised by loving parents.
How you get there is a personal choice, and in many ways, it depends on your unique personal circumstances and values. At Family Inceptions, we believe everyone deserves to become a parent if they desire to do so. We are thankful that there are so many pathways to parenthood for those who need a little help getting there. If you would like to explore how surrogacy can be an option for you, please reach out to our team today.
Still weighing your options? Family Inceptions founder Eloise Drane has devoted an entire episode of the Fertility Cafe podcast to exploring this very topic. Listen to our podcast: Adoption v. Surrogacy: What to Consider No Matter What Path You Choose