Last Updated on November 20, 2019
What is Gestational Surrogacy?
When a woman becomes pregnant for someone else, using their sperm and eggs, she is considered a gestational surrogate. The process is technically called gestational surrogacy. Almost all gestational surrogacy occurs as part of an infertility treatment process.
In gestational surrogacy, the surrogate carries the baby for the intended parents. Using in vitro fertilization (IVF), fertility clinics transfer an embryo to the surrogate’s uterus. In a traditional gestational surrogacy situation, the intended parents contribute the sperm and the eggs. The surrogate becomes pregnant and carries the baby to term. However, the baby’s DNA comes from the intended parents, not the surrogate.
Gestational surrogacy allows couples who cannot become pregnant to have a baby, either due to multiple failed fertility treatments, or for many other reasons. However, it isn’t common. Less than 1% of IVF treatments involve the use of a surrogate mother. It comes with a number of pros and cons, and isn’t right for all intended parents. For some, however, gestational surrogacy creates a pathway to pregnancy when there are no other options.
This article explores how gestational surrogacy works, pros and cons, and what it costs. Depending on the cause of your infertility and likelihood of success with IVF, your fertility doctor may suggest that you consider it. This information will help you navigate your options and understand the process a little more.
Is Gestational Surrogacy Right For You?
Who benefits the most from gestational surrogacy? People choose surrogates for any number of reasons. In the case of infertility, certain intended parents benefit as it may be their only chance to have a newborn baby, outside of adoption.
Surrogacy may be right for you if you or your partner fit one of the following scenarios.
- When the uterus has been removed, but ovaries are still producing eggs.Sometimes, a woman cannot carry a baby because her uterus has been removed, but her ovaries are still healthy and active. Gestational surrogacy provides an ideal solution here, because it creates an opportunity for the woman to still have biological children.
- Inability to carry a baby to term. Gestational surrogacy helps women with uterine issues that cause multiple failed IVF treatments to have a newborn baby. For these women, it presents the best option to have a baby using their own eggs.
- When pregnancy could be fatal. Certain conditions or disorders make pregnancy extremely risky for women.
- Fertility issues due to age. a woman is older than 40 and has not been able to get pregnant or carry a baby to term after several tries.
Traditional/Full Surrogacy vs Gestational Surrogacy
Gestational surrogacy isn’t right for every woman or couple. For example, if a woman cannot produce any viable eggs of her own, she cannot use it. In that case, fertility specialists would recommend traditional surrogacy (also called Full Surrogacy). With this, fertility clinics use donor eggs from a surrogate mother, and she also carries the baby to term.
When single men and gay male couples use surrogacy to have a baby, they are using traditional surrogacy, not gestational surrogacy. Gestational surrogacy specifically involves using a surrogate mother’s uterus – a host uterus – to carry the baby to term, but the eggs and sperm come from the intended parents.
This is an important distinction, as many fertility clinics specialize in one or the other type of surrogacy, but not both.
Benefits of Using a Surrogate
Gestational surrogacy benefits intended parents in a number of ways. For most, surrogacy creates options where there were none previously. Or, it significantly reduces the risks associated with pregnancy.
Reduces risk when pregnancy could be fatal
Use of a surrogate – or carrier – reduces the risk of death of the mother or baby when pregnancy is considered very high risk.
Allows couples and individuals to have biological children
Gestational surrogacy allows future parents to create a baby from their own sperm and eggs. For this reason, and several others, many parents prefer to go this route than the traditional surrogacy route.
Increases Chances of Success
After multiple failed fertility treatments, some couples want to give up. But gestational surrogacy offers a window of opportunity to have a biological child using IVF. Surrogacy can dramatically increase the chances of a successful IVF treatment, especially when the intended mother suffers from issues with her uterus or failed pregnancies.
Gestational Surrogacy Process
Selecting a Gestational Carrier
Before fertility specialists do actual treatment or prescribe medications, intended parents must go through the process of selecting a surrogate. Some clinics partner with surrogacy organizations to make this process easier. Also, some US states have laws governing the process, so many people will need to hire a lawyer.
The fertility clinic will probably provide a lot of guidance about the selected surrogate, to ensure that she can carry a baby successfully. The doctor may perform an examination and discuss her medical history. If the intended parents choose to go through a organization, the chosen surrogate may have already completed those examinations.
Preparing for IVF
Once the intended parents choose a surrogate and have an agreement in place, the process begins similarly to any other IVF treatment. Except, with surrogacy, both the intended mother and the gestational carrier take medications to prepare. The fertility doctor prescribes medications to encourage the intended mother’s ovaries to produce multiple eggs. The surrogate will receive medications to suppress her cycle so the IVF process can be timed well.
Egg Retrieval and Sperm Collection
When the intended mother’s ovaries and follicles have produced mature eggs, the fertility clinic will schedule and perform egg retrieval. During this time, a doctor will retrieve the eggs from the intended mother’s ovaries using ultrasound technology and a hollow needle. On the same day, the clinic will collect sperm from the intended father.
Fertilization and Embryo Transfer
Later that day, the fertility clinic will begin the fertilization step, which involves mixing thousands of sperm together in a dish with an egg. The clinic will do this with every egg that was retrieved. In some cases, an embryologist may perform ICSI on the retrieved eggs. During ICSI, embryologists inject a single sperm directly into an egg to encourage fertilization.
2 to 5 days after fertilization, when embryos have divided and are ready for transfer, the clinic will schedule embryo transfer with both the intended parent(s) and the surrogate. On that day, the fertility specialist will transfer healthy and viable embryos into the surrogate’s uterus. Hopefully, the embryos will implant successfully and result in a pregnancy.
Pregnancy and Delivery
From this point on, the gestational surrogate and the parents-to-be communicate and interact with each other, usually under a particular agreement. The surrogate carries the baby, delivers the baby, and then the baby goes home with its biological parents.
IVF Success Rates with Surrogacy
Couples and individuals often choose gestational surrogacy with IVF because of the strong likelihood of success. Depending on the surrogate’s age, the age of the intended mother, fresh vs frozen eggs, ICSI, and a number of other factors, IVF success rates significantly increase or decrease. According to Attain Fertility, success rates with a gestational surrogate can be as high as 90% within three IVF cycles.
That said, intended parents must remember that IVF is not 100% successful even with a surrogate carrier. It can take multiple cycles of IVF to be successful, even when the odds are high.
Cost of Gestational Surrogacy
Unless the surrogate and parents know each other and agree to a free of charge, gestational surrogacy adds significantly to the cost of IVF treatment.
Intended parents can expect to pay as much as $30,000 more than the cost of IVF treatment alone. In addition, there may be agreed upon compensation. Every gestational surrogacy is unique, so the costs vary. Laws also play a big role in compensation and guidelines. That is why parents need to have a lawyer and/or understand the laws in their state.
Gestational Surrogacy Pros and Cons
While it’s the best alternative for some people, it is not feasible or ideal for others. The following list includes the upsides and downsides of using gestational surrogacy to have a baby.
|Increased likelihood of success||Very expensive|
|Reduces risk of dangerous pregnancy||Is not 100% successful|
|Allows parents to have biological children||Complicated, involves legal processes|
As with any fertility treatment, the potential upside – a newborn baby – generally overshadows the potential downsides, including cost and complexity. However, the choice to use a gestational carrier or not is a deeply personal one. Surrogacy involves a lot of emotions, and the decision to use a surrogate should not be made quickly or without information. A good fertility clinic will go over all of the risks, benefits, and choices with intended parents and help them make the best decision for their family.
Pct transfers using Gestational Carrier with IVF by clinics
(According to the latest CDC data published in April 2021 (Preliminary 2019 Data), the rate using Gestational Carrier)
|Clinic Name||Pct transfers using gestational carrier||Using gestational carrier <35||Using gestational carrier at 35-37||Using gestational carrier at 38-40||Using gestational carrier at 41-42||Using gestational carrier at ≥43|
|Avg = nan||Avg = nan||Avg = nan||Avg = nan||Avg = nan||Avg = nan|