How Does Surrogacy Work?

Surrogacy refers to a contract in which a woman carries a pregnancy for another couple. It may be used to help overcome infertility in a female partner, or by a gay couple who would like to use their own sperm for a pregnancy.

What is Surrogacy?

Surrogacy refers to any arrangement where the woman carrying a pregnancy is not the mother of the child. There are two types, gestational surrogacy, and traditional surrogacy. The difference is based on whose egg is used. 

Traditional Surrogacy

Traditional surrogacy is also called straight or partial surrogacy. The woman who will carry the pregnancy is inseminated with sperm from the intended father, or a sperm donor. In this case, the surrogate will be the biological mother of the child.

If there is no female partner in a couple, or if the female partner has serious fertility problems affecting her eggs and uterus, a traditional surrogate would likely be used.

Gestational Surrogacy

Gestational surrogacy is more complicated. In this case, the surrogate’s egg is not being used. Instead, she is implanted with an embryo formed from the parents’ gametes, from donor gametes, or from some combination. The surrogate is not biologically related to the child at all.

Gestational surrogacy requires in-vitro fertilization (IVF) because an embryo is being transferred into the the surrogate. This makes it a significantly more expensive and complex procedure than traditional surrogacy.

Gestational surrogacy may be used if a female partner has healthy eggs, but has problems with her uterus that make it difficult for a pregnancy to succeed. Another use could be a gay couple who is using donor eggs from a woman unable to carry the pregnancy.

While gestational surrogacy typically is the less common choice of the two, more and more people are turning to it. According to the Society for Assisted Reproductive Technology, in 2004, 738 babies in the U.S. were born via gestational surrogacy, whereas in 2011 this number had risen to 1593.



Why Use a Surrogate?

If males want a biological child without a female partner, then surrogacy is their only route.

However, for many surrogacy is a last resort when dealing with serious infertility problems. The decision to use a surrogate is also likely based on the type of fertility problems a woman is having. If a woman has a healthy uterus, but problems with her eggs, she might consider an egg donor instead.

Women may choose to use a surrogate if they do not have a uterus, or if they have a problem with the uterus that makes it impossible to carry a child. 

What is the Surrogacy Process?

If you are considering surrogacy, you will first want to check what the laws and regulations are in your area, then locate a trusted surrogacy agency or attorney in your area. Each country has a different set of laws and regulations regarding surrogacy arrangements.

You may also choose to work with a surrogate independently, but due to the emotionally and legally sensitive nature of the process, it is highly advisable to have a professional agency and/or attorney working closely with you and the surrogate through the entire process.  

Once you have found a surrogacy network/clinic in your area, you can work with them to choose the type of surrogacy that you would like to proceed with. You will need to figure out whether you will be using donor sperm or eggs. The surrogacy process is very expensive, and there is no guarantee of a successful pregnancy. You will want to fully test both gametes for any fertility problems. Learn more about our sperm DNA test.

If you do not already have a surrogate chosen independently, an agency can help you find an appropriate match which the intended parent(s) will get to know. You will also be drafting a legal contract with the surrogate and your respective lawyers.

After the legal contracts are signed, fertilization and embryo transfer takes place and when the pregnancy is confirmed, you will likely continue to meet with and support the surrogate throughout the pregnancy. 

How  Much Does Surrogacy Cost?

Using a surrogate is typically an expensive process that will most likely cost at a minimum $60 000, with costs over $100,000 being common as well.  This is because there are a variety of costs involved, including surrogate compensation, surrogate medical expenses, various clinic and agency fees, and management and legal fees. Gestational surrogacy is typically more expensive because it involves additional IVF costs.

Depending on where you live, you may be able to find financial support for family planning. Some companies are starting to offer fertility financing loans, and depending on your location, you may also be able to find assistance through family planning grants.  

Kristin Brogaard, PhD

Kristin Brogaard, PhD is Co-founder and CSO of Inherent Biosciences, a molecular diagnostics company at the intersection of epigenetics and AI. Dr. Brogaard is an experienced molecular biologist, study director, and operations manager for early stage biotech startups. She received her PhD in Molecular Biology from Northwestern University developing novel epigenetic technologies. She subsequently worked with Dr. Leroy Hood, a pioneer in personalized medicine technologies, first as a post-doc and then as a colleague launching a novel scientific wellness start-up, Arivale. Dr. Brogaard has broad business experience that includes launching and scaling the health startup, Arivale. Additionally, Dr. Brogaard was the Director of Program Management at Arivale managing all strategic projects with a highly qualified team of program and project managers.

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