SURROGACY 101

Surrogacy 101

An article that was recently presented by the American Society of Reproductive Medicine described the remarkable story of a gestational carrier mother who gave birth to 10 children in the past 13 years: two sets of triplets, one set of twins, two single births in addition to 4 children of her own.

What is a gestational carrier?

A gestational carrier, also known as a surrogate, is a woman who has agreed to carry a pregnancy for another person. The baby results from fertilization of an egg and a sperm derived from the intended parents or from egg/sperm donors.

At times, a gestational carrier also provides the egg. Such a case is referred to as traditional surrogacy. In traditional surrogacy the gestational carrier has a biological connection to the baby. While traditional surrogacy is possible and available in the US, the traditional surrogacy can at times carry more emotional/legal complexities due to the biological/emotional connection of the surrogate mother to the baby.

Why do women decide to become a gestational carrier?

Women who decide to become gestational carriers come from a variety of cultural, familial and socioeconomic backgrounds. Their individual motivation also may be diverse. Some women simply enjoy being pregnant, others have witnessed the suffering which goes along with infertility and feel it is their duty. All surrogates however, share a common desire to help another person have a baby. Usually, the surrogate is compensated for her services.

How do I find a gestational carrier?

There are different ways to find a gestational carrier. Most gestational carriers are found through agencies that specialize in surrogacy. The agency is responsible for the recruitment and initial screening. Gestational carriers can also be found in some fertility centers as well as in independent web sites. At times a gestational carrier can also be a friend or a family member.

What is important to know about the gestational carrier and how do I know if the gestational carrier is a good match?

Surrogate selection is usually accomplished with the help of a reproductive endocrinology and infertility specialist.

1. The first step is to contact a fertility center and make an appointment with a fertility specialist. The fertility specialist can help you in the initial selection of the surrogate. It is very important to work with a fertility specialist that has experience in surrogacy. The fertility specialist can also refer you to agencies that provide surrogates.


2. The initial contact with the agencies usually is free of charge. The agencies will provide the intended parent with a list of available surrogate based on the specific search criteria. It is highly recommend consulting with the fertility specialist while reviewing the potential surrogate profiles.


3. Once a surrogate is chosen the next step is an informal meeting with the surrogate, this can also occur via phone or skype. The informal conversation allows both sides to get to know each other and also to address some important issues of the surrogacy process (how many embryos to transfer, how many babies is the gestational carrier comfortable carrying etc..). These issues are later confirmed and addressed in a legal contract. At the conclusion of the conversation, if both parties agree, the gestational carrier is scheduled to undergo a medical screening with the fertility specialist.


4. The medical screening includes a thorough history and physical examination as well as a medical description of the surrogacy process. The physical focuses on the pelvic anatomy, as well as imaging studies of the uterus and screening for sexually transmitted diseases. In addition, the gestational carrier also undergoes a psychological evaluation. Once the gestational carrier passes the medical / psychological screening the intended parent and the surrogate can begin working on the legal contract.

Legal contract: the contract is a legally binding agreement between the intended parent and the gestational carrier. The legal contract include many important details pertinent to the fertility treatment (ex. how many embryo to transfer), pregnancy (prenatal screening, amniocentesis, termination of pregnancy if needed etc) and delivery (which hospital to deliver, cesarean section etc..) . Once both parties agree and sign the contract the surrogacy journey begin.

Overall the surrogacy process can be a very exciting and rewarding endeavor for both parties. By making the right decisions early, such as working with an experienced fertility specialist and choosing the right surrogate, intended parents improve their chance for success.