There are two ways a surrogate mother gets pregnant. In the first form, the surrogate mother’s egg cell is used to conceive the child. The sperm is donated by the male of the couple who opts for surrogacy.
In the other form, the surrogate mother only hosts the embryo. The embryo is created in the laboratory from the couple’s sperm and eggs.
Traditional surrogacy
This is a pregnancy where the surrogate is genetically related to the baby and becomes pregnant through artificial insemination. The sperms belong to the male of the couple.
Host surrogacy
When in vitro fertilization (IVF) is used either with the eggs of the intended mother or with donor eggs, the surrogate mother does not use her eggs and is genetically unrelated to the baby.
There are three stages to host surrogacy:
- Egg donation: The female intended parent or an egg donor undergoes special procedures to extract a few eggs.
- Fertilization: The eggs are fertilized with sperm in the laboratory, resulting in embryos.
- Embryo transfer: The embryo is transferred into the womb of the surrogate mother. It can be transferred to the surrogate either fresh or after having been de-frosted from storage.
- For a fresh embryo transfer, the cycles of the surrogate and the egg donor must be synchronized, and this is done using hormone medications.
- In cases where embryos have been frozen already and the de-frosted embryos are being transferred, the surrogate mother is provided with hormone medications to “ready” her womb lining.
A surrogate mother must meet all the clinical requirements to maximize her chances to get pregnant through in vitro fertilization (IVF) in as few attempts as possible, as well as have a healthy, uneventful pregnancy and undergo an uncomplicated delivery. Surrogates can be a person with a relationship to the intended parent(s), such as a close family member or friend. The surrogate should:
- Be a woman between the ages of 21 and 41 years.
- Have had at least one uncomplicated pregnancy and live birth.
- Have a positive outlook about being pregnant and is in an environment supportive of a surrogate pregnancy.
- Be of a reasonable weight and have healthy personal habits (non-smoker, non-drug user, healthy diet, and regular exercise).
What is surrogacy?
Surrogacy is an assisted reproductive treatment (ART) in which a woman (surrogate) carries a child in her uterus for another person. This is done when one is unable to carry a pregnancy themselves. For some women, using a surrogate is the only way of having a child. The reasons for choosing surrogacy could be:
- The female partner is unable or unwilling to deliver a baby safely.
- Any illness or a problem with the uterus.
- Surrogacy has become increasingly popular.
Surrogacy is usually recommended for patients who cannot carry the pregnancy to term due to:
- Advanced age
- Hysterectomy or uterus removed for any reason
- Small or abnormal uterus
- Repeated implantation failure or miscarriage
- Repeated IVF failure
- Any risk to life associated with pregnancy (heart disease, severe endometriosis, etc.)
Surrogacy benefits:
- Surrogacy allows an individual or couple to have a biological child even if the female partner is unable to carry a pregnancy to term.
- Surrogacy also allows the intended parents to be involved in their child’s life from conception, unlike adoption.
- Many states recognize surrogacy contracts and establish parentage to the individuals who intended to create the pregnancy (the intended parents).
Risks of surrogacy:
- The process of IVF can result in multiple pregnancies (twins, triplets) if more than one embryo is transferred. The Loma Linda University Center for Fertility strongly recommends that patients going through IVF (including surrogates) do a single embryo transfer.
- Both the intended parents and the surrogate must be on the same page regarding multiple pregnancies. These are high-risk pregnancies and can have a negative effect on the surrogate’s daily life and income.
- Different states have different laws regarding legal and natural parentage in a surrogacy situation. Hiring legal counsel familiar with surrogacy contracts can help all parties navigate the legalities and ensure that all bases are covered.
- Another risk of surrogacy is that the surrogate may become attached to the pregnancy as if it is her own and desire to keep the baby. This is rarely ever a problem if the surrogate is found through an agency because proper legal procedures and contracts are integral parts of that process. If a carrier is a family member or friend, it is important to still follow proper legal protocol regarding surrogacy contracts.
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