Surrogacy at a glance
- A surrogate, or gestational carrier, is a woman who carries a pregnancy for another individual or couple because the intended mother is not capable of carrying a healthy pregnancy herself.
- A gestational carrier (GC) is usually compensated for her efforts in carrying the pregnancy and for any expenses she incurs while pregnant.
- Due to emotional and legal complexities, all parties involved in a surrogacy must obtain psychological and legal counseling.
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What is surrogacy?
Surrogacy is a process in which a woman carries a child for another woman or couple. There are two different types of surrogacy: gestational carrier and traditional surrogacy.
A gestational carrier (GC) is a woman who carries the pregnancy using the egg and sperm of the intended parents or a combination of donor egg and sperm. She has no genetic relationship to the child, so this option is generally preferred.
A traditional surrogate carries the pregnancy using her own egg and the sperm of the intended father. She is genetically related to the child, so this option is not often recommended.
Many gestational carriers are compensated for time, effort and living expenses incurred during pregnancy. The amount paid can range from $20,000-40,000 depending on the experience of the surrogate. This is called commercial surrogacy.
Another option is a compassionate gestational carrier, in which carriers are only reimbursed for expenses. Expenses can include rent, food, clothing and medical bills.
Why use a gestational carrier?
A gestational carrier is used when a woman is unable to carry a healthy pregnancy to term. This could be due to a number of reasons, including:
- The absence of a uterus (due to a hysterectomy or being born without a functional uterus)
- Various uterine abnormalities
- Recurrent pregnancy loss
- Medical conditions that can put both mother and child at risk during pregnancy and delivery.
Male same-sex partners may also choose to use a gestational carrier in order to have a child who is genetically related to one of the partners. Many couples are now pursuing this option.
How does one choose a gestational carrier?
A gestational carrier can be chosen a number of ways. The intended parents may choose to find a carrier through an agency in order to have no personal ties. Sometimes, a close friend or family member of the intended parents may offer to carry the child.
A gestational carrier should meet the following criteria:
- Is between the ages of 21 and 41
- Has previously had an uncomplicated pregnancy and given birth to at least one child
- Has a positive outlook on having another pregnancy, and her family should accept her surrogacy situation
- Has a healthy/reasonable weight
- Should have healthy personal habits (diet, exercise, non-smoker and non-drug user)
- Should have reliable transportation to and from various medical appointments.
These rules apply to traditional surrogacy as well.
What happens after a gestational carrier is chosen?
Once a gestational carrier is chosen, she must undergo a screening and workup to ensure that she is a viable candidate. Tests included in the screening and workup are:
- Health questionnaire
- Review of medical and gynecological records
- Physical examination
- Psychological counseling
- Transvaginal ultrasound or x-ray of reproductive organs
- Infectious disease testing.
After the gestational carrier has completed the necessary tests, all parties involved must consent to the arrangement. This typically involves legal contracts specifying all rights and responsibilities of the carrier and the intended parents.
The following steps are similar to the egg donation process. The carrier will be given medications to suppress her menstrual cycle and develop a receptive uterine lining while the intended mother is stimulated for IVF egg retrieval. It is important that the menstrual cycles of the two women are aligned. When the ovarian follicles of the intended mother are mature, the egg retrieval procedure will be performed to remove the eggs from the mother’s ovaries.
The eggs are then fertilized in a laboratory with the intended father’s sperm. Fertilized embryos must develop in the lab for three to five days. Once the embryos are viable, they are implanted into the gestational carrier’s uterus.
If a pregnancy occurs, the gestational carrier will be monitored at our fertility clinic until approximately her 8th week of pregnancy. She will then receive care for the remainder of her pregnancy from her OB/GYN.
The amount of contact and communication between a carrier and the intended parents during the pregnancy varies from situation to situation. The expected amount of contact and updates about the pregnancy are usually detailed in the contract.
After the carrier delivers the baby, the child leaves the hospital as the legal offspring of the intended parents.
What are the pregnancy rates when using a gestational carrier?
Success rates for GC IVF vary considerably and are largely dependent on the age of the woman providing the eggs. Most GC IVF cycles performed with donated eggs have pregnancy rates that are 50 percent or more in the first cycle. There are often frozen embryos remaining, so the cumulative success can be 80 percent from one egg retrieval.
What are the costs for a gestational carrier IVF cycle?
The cost for the medical management of a GC IVF cycle is considerably higher than the price for infertility-related IVF. Additional costs involved with carriers include legal fees, psychological counseling and, of course, the fee for the GC. Fees in the U.S. often exceed $75,000.
What are the risks of using a gestational carrier?
While a gestational carrier pregnancy has all the same medical risks and complications of any other pregnancy, there are a few risks that are unique to the surrogate birth.
- IVF treatments, which are the most commonly used method to impregnate a gestational carrier, may result in multiple pregnancies (twins, triplets etc.) if more than one embryo is implanted. We encourage single embryo transfer, especially if using a donor egg.
- In rare cases, a gestational carrier may become attached to the pregnancy and threaten to keep the child. Using a carrier found through an agency, as well as filing the proper legal paperwork, helps prevent this from becoming an issue.
- In the state of Georgia, the person giving birth to a child is legally recognized as the child’s mother. The carrier must formally abandon parental rights to that child.
What are the legal issues to consider?
Georgia is a carrier-friendly state. We can connect you with an attorney who has a specialty in surrogacy.
What are the psychological concerns?
For the vast majority of carriers, the surrogacy experience is positive. The top items that can make the experience negative for the carrier are:
- A lack of closeness between the carrier and intended parent(s)
- The feeling that the carrier is not respected by the intended parent(s)
- Depression after surrendering the child.
Many of these issues can be talked through during counseling sessions.
Children born to surrogate mothers often have a normal parent/child relationship with their intended parents.
Parents of children born through a surrogate often exhibit the same parenting styles and connection to their child as parents with children born naturally or through egg or sperm donation.
In some cases, mothers who did not disclose to their child that they were born through a surrogate may feel some distress about not being honest with their child. Family counseling with a therapist who specializes in adoption and surrogacy may help the mother navigate her feelings.
What are the benefits of using a gestational carrier?
The process of using a gestational carrier allows a woman or couple to experience the joys of parenthood and a child biologically related to them, which they could not accomplish otherwise due to the inability to have a normal pregnancy. Using a carrier also allows the parents to be involved in the conception of their child, which can be a powerful emotional aspect of parenthood for many people.
Many women who have been a GC describe the process as especially meaningful. The gift of a child is the most precious gift one can provide to a couple struggling with infertility.
Servy Massey Fertility Institute is well versed in using gestational carriers for many different situations. We offer access to specialized attorneys, psychologists and other professionals needed for this process.
Contact us if you have any questions or think you may be a candidate for using a gestational carrier.
What are the benefits of being a gestational carrier?
- Gain a sense of self-fulfillment from giving the greatest gift humanly possible to another family.
- Receive a base fee plus expenses.
- Build a life-long relationship with grateful intended parents.