What is Gestational Surrogacy?

In gestational surrogacy, the child is not biologically related to the surrogate mother. The surrogate mother in such cases is known as the gestational carrier.^{(1, 2, 3)} In gestational surrogacy, the embryo is created through in vitro fertilization (IVF), with the use of sperm and eggs of the intended parents or donors.^{(4, 5)} The embryo is then transferred to the gestational surrogate mother. This type of surrogacy is also known as host surrogacy or full surrogacy. In the majority of the cases, at least one of the intended parents is genetically related to the child, but the surrogate is not.⁽⁶⁾ This is the main factor that makes the process of gestational surrogacy less legally complicated than other types of surrogacy since step-parent or second-parent adoption is not required in this.⁽⁷⁾

Many people today opt to choose gestational surrogacy. The following people may consider gestational surrogacy:

• Hopeful single parents
• People who are struggling with infertility
• Same-sex couples
• People who do not want a genetic link between their child and the surrogate
• Anyone who is unable to safely carry a pregnancy to term

According to the Southern Surrogacy agency, gestational carriers are now a more common form of surrogacy than traditional surrogates.⁽⁸⁾ This is because a traditional surrogate donates her own egg, so she technically remains the biological mother of the child. While this can go on to work out fine, but it can give rise to certain complex legal and emotional issues in the future. In fact, many states in the United States have strict laws against traditional surrogacy for these reasons.^{(9, 10)}

Since gestational surrogacy is the most common type of surrogacy in most countries today, most surrogacy procedures you read about usually refer to this type of surrogacy only. Typically, the gestational surrogacy process begins by finding a surrogate, completing the legal contracts and formalities, and then transferring the embryo to the surrogate mother.

The intended parents have the option of either finding a surrogate on their own and pursuing an independent surrogacy with the help of an attorney who specializes in assisted reproductive law. Or, as most intended parents choose, they can work with a full-service surrogacy agency that will help them find the right gestational carrier.⁽¹¹⁾

Once a potential surrogate match has been identified, the surrogate and intended parents will each with together with an attorney to discuss the legal risks and responsibilities of each party and also work out the surrogate compensation. Once everyone is in agreement over the terms of the agreement, the contracts will be signed, and a fertility clinic will get ready to carry out the IVF procedure and begin the embryo transfer process.⁽¹²⁾ An embryo will be created under laboratory conditions and then transferred to the surrogate using one of the following techniques:

• The eggs and sperm are taken from the intended parents to make sure that both intended parents are genetically related to the child.
• A donated egg will be fertilized with sperm from the intended father, in which case only the intended father will be genetically related to the child.
• Eggs from the intended mother are fertilized with donor sperm, in which case only the intended mother will be genetically related to the child.
• A donor embryo or an embryo created from using donor sperm and donor eggs is used, in which case neither of the intended parents will be genetically related to the child.

From here on, the surrogate will carry the baby. The rest of the procedure will be like any other pregnancy, and the intended parents will get to welcome their child once it’s born. They will also have full legal custody of their child once it is born.⁽¹³⁾

The exact process of gestational surrogacy may vary somewhat depending on your country’s laws, your individual circumstances, age, and other such factors.

The biggest question that faces intended parents when they decide to opt for gestational surrogacy is to find the correct surrogate to carry their child. Many people find a family member or friend who is willing to serve as a gestational surrogate. Most, though, turn to surrogacy agencies to find them a good match. Agencies carry out an extensive search procedure to find the right surrogate for you. They first screen candidates to make sure they meet the criteria associated with the entire process. They then cross-match your own requirements or wants to find the best surrogate for your family.

There are many nonprofit groups as well that help intended parents with finding a surrogate. For example, the Society for Ethics in Egg Donation and Surrogacy (SEEDS) was specifically created to review and maintain ethical issues that surround egg donation and surrogacy. The group maintains a member directory that helps intended parents find agencies in their neighboring areas that will help them.⁽¹⁴⁾

This does not mean that anyone can become a gestational surrogate. There are certain qualifications for becoming a gestational surrogate. These criteria vary from agency to agency but usually involve factors like:

• Age: Candidates should be between the ages of 21 to 45 years. The specific age range varies by location as well.
• Lifestyle: Surrogates should live in a supportive home environment, and the same will be confirmed during a home study carried out by the surrogacy agency. Drug and alcohol abuse are vital considerations that will be looked at.
• Reproductive Background: They should have carried at least one pregnancy, without complications, to term. However, they should also have had fewer than five vaginal deliveries and two caesarian sections.
• Tests: Potential surrogates will need to undergo a mental health screening, a complete physical examination which also includes screening for sexually transmitted infections. (STIs)

The intended parents will also have to meet certain requirements set forth by the surrogacy agency. These include:

They have to provide complete health histories.

They will need to undergo physical exams to make sure that they can successfully have the in vitro fertilization retrieval cycles.

Screen for infectious diseases will need to be done.

They will be tested for specific genetic diseases that could get passed on to a child.

Mental health counseling is also recommended to take care of issues like expectations from surrogacy, abuse, addiction, and other psychological issues.

The cost of gestational surrogacy depends on what type of technique is being used and where you live. Generally, the price for a gestational carrier may range between $90,000 to $130,000. This takes into account all the healthcare costs, legal fees, compensation, and any other situations that may arise. According to the West Coast Surrogacy Agency, the detailed costs of gestational surrogacy are as follows:⁽¹⁵⁾

1. Overall Compensation

   The basic pay begins from $50,000 for new surrogates and $60,000 for experienced surrogate mothers. There can be some additional charges involved here, including:

   • $5,000 if the pregnancy produces twins
   • $10,000 for triplets
   • $3,000 if a cesarean delivery has to be performed

   Intended parents may also incur costs for things like:

   • Lost wages
   • Monthly allowances
   • Health insurance

   The basic compensation cost may also include exceptional circumstances such as canceled IVF cycles, ectopic pregnancy, dilation and curettage, fetal reduction, and other such unexpected conditions.

2. Cost of Screenings

   Intended parents will need to pay approximately $1,000 for mental health screenings for themselves, the surrogate, and the surrogate’s partner (if any). Criminal background checks for the surrogate and the intended parties can cost anywhere between $100 to $400. Medical screening costs will also be undertaken by the intended parents and will depend on the recommendations of the IVF clinic.

3. Legal Costs

   There are several legal fees involved in the case of gestational surrogacies. These include drafting and reviewing a surrogacy contract ($2500 and $1000 respectively) to establishing parentage ($4000-$7000), and looking at trust account management, which may cost $1250. The total amount of legal fees can fall anywhere between $8750 to $11750.

4. Other Costs

   The other costs involved in gestational surrogacy vary by clinic and agency. For example, some clinics recommend intended parents and surrogates to undergo a 90-minute psychological counseling session per month and after reaching different milestones like embryo transfer. These sessions may cost around $2500. However, this may or may not be recommended by all agencies.

   The surrogate’s health insurance could be another additional cost. Health insurance comes to around $25,000, life insurance costs $500, and any hotel stays or travel fees due to IVF cycles will also need to be considered.

   Various situations like monitoring or lost wages due to pregnancy complications or IVF medications are some other costs that also have to be calculated.

While the option of surrogacy is never simple or straightforward, more and more people today are opting for this technique to have a family. It is a lengthy and costly process, but it is an option well worth investing in for those intended parents who want a family. If gestational surrogacy seems like the right option for your family, you can consider getting in touch with an agency near to your place to understand the procedure, costs, timeline, and any other considerations that may be important to you.

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Also Read:

• Artificial Insemination or Surrogacy: Which is Better?
• Ethical and Legal Issues of Surrogate Pregnancy
• Is Womb Transplantation A Good Alternative To Surrogate Pregnancy?