Using a Surrogate Mother: What You Need to Know
Using a surrogate mother -- surrogacy -- is still somewhat controversial. But it is one more option people have for having a baby through new reproductive technologies.
What Is a Surrogate?
There are two kinds of surrogate mothers.
Traditional surrogates. Artificial insemination first made surrogacy possible. A traditional surrogate is a woman who is artificially inseminated with the father's sperm. She then carries the baby and delivers it for the parents to raise. A traditional surrogate is the baby's biological mother. That's because it was her egg that was fertilized by the father's sperm. Donor sperm can also be used for a traditional surrogacy.
Gestational surrogates. In vitro fertilization (IVF) now makes it possible to harvest eggs from the mother, fertilize them with sperm from the father, and place the embryo into the uterus of a gestational surrogate. The surrogate then carries the baby until birth. A gestational surrogate has no genetic ties to the child. That's because it wasn't her egg that was used. A gestational surrogate is called the "birth mother." The biological mother, though, is still the woman whose egg was fertilized.
In the U.S., gestational surrogacy is less complex legally. That's because both intended parents have genetic ties to the baby. As a result, gestational surrogacy has become more common than a traditional surrogate. About 750 babies are born each year using gestational surrogacy.
Who Uses Surrogates?
A woman might decide to use a surrogate for several reasons:
- She may have medical problems with her uterus.
- She may have had a hysterectomy that removed her uterus.
- There may be conditions that make pregnancy impossible or medically risky, such as severe heart disease.
Other women choose surrogacy after trying unsuccessfully to get pregnant with a variety of assisted-reproduction techniques (ART), such as IVF.
Surrogates have also made parenthood an option for people who might not be able to adopt a child. Reasons could include:
- Their age
- Their marital status
- Their sexual orientation
For instance, when gay men use a traditional surrogate, one of them uses his sperm to fertilize the surrogate's egg through artificial insemination. The surrogate then carries the baby and gives birth. A gay couple might also choose an egg donor, fertilize that donated egg, and have the resulting embryo implanted in a gestational surrogate to carry until birth.
Finding a Surrogate
There are several ways to find a surrogate mother:
Friends or family. Some people ask a friend or relative to be a surrogate for them. Doing so is somewhat controversial. But given the high cost of surrogacy and the complex legal issues it raises about parental rights, a tried-and-tested family relationship can be simpler to manage. The American Society for Reproductive Medicine accepts certain family ties as acceptable for surrogates. It generally discourages surrogacy, though, if the child would carry the same genes as a child born of incest between first-degree relatives.
A surrogacy agency. Most people turn to a surrogate agency to arrange a gestational surrogate. There are an estimated 100 agencies now operating in the U.S.The agencies act as go-betweens. An agency helps would-be parents find a suitable surrogate, makes arrangements, and collects any fees passed between parents and the surrogate, such as reimbursement for her medical expenses.