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How Does Surrogacy Work? The Basics for Anyone Considering 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. 

What is surrogacy?

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. Members of the LGBTQ community and single individuals who wish to be parents can also pursue parenthood via surrogacy.

Traditional vs. Gestational Surrogacy

Until the 1980s, the only way to have a child via surrogacy was through what’s called “traditional surrogacy.” With traditional surrogacy, the surrogate is inseminated with the sperm of the intended father, and her own egg is used. Obviously in this case, the child would be genetically related to the surrogate. As you can imagine, this has the potential to create all sorts of legal and emotional complications.

While some people do choose traditional surrogacy these days, gestational surrogacy is far more common. 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 preferred, so that’s what we’ll use from here. With this form of surrogacy, the carrier is not genetically related to the child. In most cases, agencies in the US will only work with gestational surrogacy agreements, avoiding the potential complication of traditional surrogacies. 

How are Embryos Created for Surrogacy?  

Going way back to basics, to create a baby, you need an egg and sperm. With gestational surrogacy, these reproductive cells are joined together in a lab through IVF. Where the cells come from, though, depends on each intended parent’s unique situation. 

Embryos can be created from the eggs and sperm of both intended parents. This is most common in the case of a serious medical issue that prevents a woman from carrying a baby. For example, a woman who has cancer or a heart condition may be medically unable to safely become pregnant. 

In many cases, intended parents use donated eggs, donated sperm, or both. Same-sex male couples, for example, could use donated eggs and sperm from one of the intended parents. A single woman could use her own eggs plus donated sperm.

Another option is to use donated embryos. There are several embryo donation agencies or banks in the US that connect intended parents with frozen embryos. Usually these embryos are leftover from donors’ previous IVF cycles and are no longer needed for the donors’ family building. 

After determining the best method for creating embryos, the next step is to have them transferred to the carrier via IVF. If the pregnancy is successful, the GC will carry the baby to term, at which point, the intended parent(s) receive full parental rights. 

The Surrogacy Process: an Overview

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. 

Surrogacy is not a quick process, but it is well worth the wait! 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. Each path is great — the independent journey can save you money, but you’ll also be assembling your own team and searching for your GC on your own. A tool like Surrogacy Roadmap can help you navigate the process on your own. As you prepare, you’ll want to think about your goals and expectations, and you’ll need to nail down your budget.

Phase 2: Legal and Medical Screening. 

During this stage, you’ll be selecting and screening your gestational carrier, ironing out all the legal and medical details, and making all necessary financial arrangements. Your carrier will be screened extensively for medical, psychological, and past pregnancy issues. You’ll also work with an attorney to draft a Gestational Surrogacy Agreement (GSA) that establishes your relationship to the carrier, your rights as a parent, and the details of compensation for your surrogate. 

Phase 3: Embryo Transfer and Pregnancy. 

After you receive medical and legal clearance to proceed, it’s time to have a baby! The clinic will prepare the carrier’s cycle schedule, and she’ll take medications to prepare her uterus for transfer. If the transfer is successful, then you have nine months to wait for the baby to arrive! During this time, you and your carrier will maintain close communication, per your GSA, and she will receive prenatal care, first with the fertility clinic and then with her OB/GYN. 

Ready to learn more about the surrogacy process? Do you enjoy podcasts?

Dive deeper into the journey of surrogacy by tuning into the Fertility Cafe podcast, specifically Episode 02 | Surrogacy 101 – When it Takes a Village to Start a Family. Download the episode or search “Fertility Cafe” on your favorite podcast app!

How do you go about finding the right surrogate for your family?

This is such an exciting time for you as a hopeful parent, but it’s understandably daunting. How do you find the right person? What factors do you need to consider in your search? Where do you even begin? Read our blog on the topic: How Family Inceptions Can Help You Find the Right Surrogate

Not quite sure an agency is right for you?

Not everyone wants to use a surrogacy agency for their journey. And that’s ok! We recommend checking out Surrogacy Roadmap – a DIY guide to independent surrogacy.

Have you done your research and are ready to talk to someone on the Family Inceptions team?

Reach out today to start your journey. 

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Eloise Drane
Eloise Drane, Founder

"I believe that we are all placed on this earth for a purpose. Each one of us has a specific calling in this world and although it is different for everyone, we are here to serve one another. My purpose is to help women who wish to become surrogates and egg donors and the hopeful parents who wish to partner with them. I feel very lucky to be living my purpose."