A Comprehensive Guide to Gestational Surrogacy: Process, Types, and Key Considerations

By Constance McGraw, MPH

In the realm of assisted reproductive technology (ART), gestational surrogacy can be a promising solution for individuals or couples facing fertility challenges. This guide aims to simplify the complex process, offering insights into how gestational surrogacy works and addresses key considerations.

Understanding Gestational Surrogacy

Gestational surrogacy, a cornerstone of assisted reproduction, involves a woman carrying a child to term without a genetic relationship. Typically, this process is facilitated through in vitro fertilization (IVF), uniting the egg and sperm in a lab to create an embryo. The subsequent embryo transfer procedure involves placing the embryo into the gestational carrier, a woman distinct from the intended parents, who nurtures the pregnancy and ultimately delivers the baby.

Types of Surrogacy

Gestational surrogacy stands out for its lack of biological ties between the carrier and the embryo's genetic makeup. Other types of surrogacy include the following:

• compassionate/altruistic surrogacy (non-paid, often provided to family/friend) 
• compensated/commercial surrogacy (gestational carrier receives payment beyond reimbursement for “reasonable” medical expenses and may not be legal in all 50 states)
• traditional surrogacy (surrogate uses her own egg but is less common due to legal complexities)

Who Chooses Gestational Surrogacy?

Gestational surrogacy becomes a viable option for:

• Individuals or couples facing infertility issues
• Single individuals
• Same-sex couples
• Anyone unable to safely carry a pregnancy to term

Parties Involved in Surrogacy

The gestational surrogacy process entails coordination among various parties:The gestational carrierThe egg donorThe sperm donorThe intended parentsThe surrogacy agency and/or reproductive legal counsel

Navigating the Surrogacy Process

Aspiring parents often turn to surrogacy agencies for guidance. These agencies provide information on costs, guide through the process, handle legal matters, and connect potential parents with suitable gestational carriers. According to the American Society for Reproductive Medicine (ASRM), an ideal gestational carrier is

• between 21 and 45 years old
• experienced with one to five uncomplicated full-term pregnancies
• maintains a healthy weight
• offers a stable family environment
• Any other parameters required by the surrogacy agency

In conclusion, understanding the gestational surrogacy process involves acknowledging the role of various parties, the types of surrogacy available, and the criteria for selecting an ideal gestational carrier.

References:

1) Cleveland Clinic. 2022. Gestational Surrogacy. Retrieved January 2024 from: https://my.clevelandclinic.org/health/articles/23186-gestational-surrogacy

2) The American Society for Reproductive Medicine 2012. Gestational Carrier (Surrogate). Retrieved January 2024 from: https://www.reproductivefacts.org/globalassets/_rf/news-and-publications/bookletsfact-sheets/english-pdf/gestational_carrier_surrogate_factsheet.pdf

3) https://www.ccrmivf.com/news-events/how-does-surrogacy-work-dec-10/