Quick look at gestational carrier surrogacy & donation
Gestational carrier surrogacy is when a woman carries a pregnancy created through in vitro fertilization (IVF), a form of assisted reproduction, and gives birth to a baby for a person or couple. A gestational carrier is not genetically related to the resulting offspring.
Donation in fertility medicine refers to when people donate their own sperm, eggs or embryos to another person or couple to help those individuals achieve pregnancy.
Benefits of gestational carrier surrogacy & donation include helping a person or couple who would otherwise not be able to have a child to build their family.
Risks of gestational carrier surrogacy and donation are similar to the physical risks of IVF, but may also include mental and emotional health challenges caused by the complexity of parental definitions in these situations.
What is gestational carrier surrogacy?
Surrogacy in fertility medicine is when a woman gets pregnant, usually through assisted reproductive technologies such as IVF or intrauterine insemination (IUI), and gives birth to a child that will be raised by another couple or individual. Surrogates are generally used by individuals who are unable to carry a pregnancy and give birth to their own children.
There are two types of surrogates: gestational carriers and traditional surrogates. Positive Steps Fertility, along with most fertility specialists in the United States, only offers the gestational carrier method of surrogacy. It is important to use gestational carrier surrogacy instead of traditional surrogacy, where a woman becomes pregnant with her own eggs, usually through insemination with the male partner’s or donated sperm, and carries the pregnancy for another couple. (Using a separate donor and gestational carrier is completely fine.) The reason for not doing classic surrogacy is that in some situations, a classic surrogate could “run off” with a baby and legally it may be hard to get the baby back.
Gestational carrier surrogacy at Positive Steps Fertility
Women acting as gestational carriers are not biologically related to the children they give birth to. A gestational carrier becomes pregnant by having an embryo created through IVF placed in her uterus. The couple enlisting the gestational carrier (the intended parents), may provide their eggs and sperm for IVF to create an embryo so the resulting baby will have their genetics. The intended parents may also choose to use donated eggs, sperm or embryos with a gestational carrier.
A person or couple typically selects a gestational carrier based on her health history and personal attributes. Some people also ask family members or friends to act as their gestational carriers.
Intended parents and gestational carrier surrogates usually enter into a contract, which helps protect the rights of both parties. We recommend that all individuals seek out legal counseling before deciding to use a gestational carrier in order to better understand the laws that can affect the surrogacy process.
Gestational carriers can help:
- Women who are unable to carry a pregnancy to term because of uterine problems or uterine removal (hysterectomy).
- Women with conditions that would put their health and the health of their offspring at risk if they were to become pregnant.
- Women who have previously been unable to carry a pregnancy to term (recurrent pregnancy loss/miscarriage), though it is rare to need a gestational carrier for this.
- LGBT couples and single men who wish to have biological children.
Traditional surrogacy and why it is no longer used
Traditional surrogates get pregnant typically through the IUI form of artificial insemination. In an IUI, a doctor uses a catheter to transfer some of the intended father’s (or donor’s) sperm into a surrogate’s uterus so her egg, with her genes, can be fertilized and she can become pregnant. This means that traditional surrogates are genetically related to the children they carry.
Traditional surrogates are rarely used in modern infertility treatment, largely because IVF has made it possible for a woman to achieve pregnancy using eggs that are not her own (donated eggs), and to eliminate the genetic relation of a surrogate to the baby. This has important legal implications, as noted above.
Related Information: The IVF Process
How is donation used in fertility treatment?
Donation in reproductive medicine refers to a man donating his sperm, a woman donating her eggs or a couple donating their embryos for another person’s or couple’s use. The donated sperm, eggs or embryos are then used as part of assisted reproductive treatments, such as IVF or IUI, to help a person or couple get pregnant.
Men with healthy sperm can elect to donate their sperm to help another person or couple get pregnant. Sperm donors are screened for diseases, and their sperm is tested to improve safety. People may select an anonymous donor who donated his sperm at a sperm bank or ask a family member or friend to donate his sperm on their behalf.
Who should consider sperm donation
- Men or couples facing male infertility factors, such as poor sperm quality.
- Men who are at risk for passing on genetic conditions or diseases, including sexually transmitted diseases.
- Single women seeking to start a family on their own.
- LGBT couples (see below).
Egg donation is when a young, fertile woman chooses to donate her eggs for a couple’s or individual’s use in IVF. Using donated eggs is increasingly common, as women’s eggs deteriorate in quantity and quality as they age, particularly for smokers and women in their 40s. Poor eggs are a common cause of infertility.
People looking to use donor eggs generally select an anonymous donor by working with an egg donor organization and reviewing the donor’s physical characteristics, family and personal health histories and a description of her personality. Donor eggs may also come from a known donor, such as a family member or friend.
Women who elect to be donors are screened by fertility doctors to make sure they are healthy and to reduce the risk for inheritable diseases. Before an egg retrieval procedure, egg donors typically take ovulation induction medication. This stimulates egg production in the ovaries and allows a fertility doctor to retrieve multiple eggs, rather than just the normal single egg a woman ovulates on a monthly basis. Donated eggs can be used immediately in a “fresh” IVF cycle or can be cryopreserved (frozen and stored) for later use.
Who should consider egg donation
- Women or couples with female infertility issues related to ovulation or egg quality and quantity due to age, menopause, disease or other factors.
- Women who are at risk for passing on genetic conditions or diseases, including sexually transmitted diseases.
- LGBT couples.
After an IVF cycle, an individual or couple can choose to donate their unused embryos (fertilized eggs) to other patients who cannot create their own healthy embryos for pregnancy. Typically, embryos are cryopreserved until a person is ready to use them in an IVF cycle.
LGBT family building
Aside from medical issues, LGBT couples and single individuals who want to have biological children may need a surrogate or donor to achieve pregnancy. For example, gay couples may use an egg donor and one partner’s sperm (or a donated embryo) with a gestational carrier to have a child. Lesbian couples and single women may choose to use a sperm donor and artificial insemination to achieve pregnancy and have biological children, or consider having one woman donate the egg and the other carry the pregnancy.
Benefits of gestational carrier surrogacy & donation
Third-party reproductive services like gestational carrier surrogacy and donation benefit individuals and couples who are unable to get pregnant with their own eggs or sperm, or who cannot carry their own pregnancy.
Gestational surrogates, egg donors and sperm donors are typically paid for their time and effort. Outside of financial benefits, some people choose to become a gestational carrier or donor because they find value in helping others build their families.
Risks of surrogacy & donation
The health risks for the recipients of donor eggs, sperm or embryos are similar to the risks that accompany IVF, including an increased chance of multiple pregnancy (twins or more) if more than one embryo is implanted in a woman’s uterus. These procedures also carry risks associated with surgery, such as infection, pain, blood loss, damage to tissue and organs, and reaction to anesthesia. As with any infertility treatment, there is always a risk of miscarriage or the possibility that pregnancy will not occur.
Gestational carrier surrogates are at risk for infection and the typical complications that can accompany pregnancy and birth. Egg donors are at risk for ovarian hyperstimulation syndrome, which is caused by the fertility medications they take to induce ovulation, and infection caused by the egg retrieval procedure.
There are also financial, legal and emotional considerations that come with using a gestational carrier surrogate or a donor. We will thoroughly discuss these aspects with patients considering these options. Fertility treatments can also cause stress and financial strain, which can lead to mental health concerns.
Next steps: Explore surrogacy or donation at Positive Steps Fertility
Positive Steps Fertility welcomes all patients including LGBT and single individuals who are considering using a gestational carrier or donor to build a family. We will partner with you to find the right option for your diagnosis and concerns, and guide you through the process of selecting a donor or gestational carrier. We also offer resources that may help you find a donor or gestational carrier at a lower cost, without sacrificing a safe and thorough testing and evaluation process.
We are happy to answer your questions and help you on your fertility journey.