Understanding the Different Types of Surrogacy

When a woman carries a baby for another person or couple, she is commonly referred to as a surrogate. But often that term is incorrect. There are different ways that a woman may come to carry a pregnancy for someone else, and the terminology used should reflect those important differences. For instance, the person or people seeking to have a baby with assistance are referred to as the “intended parents” to reflect all parties’ understanding that they, not the carrier, will be the child’s parents.

Most of the time, the proper term for a woman carrying a pregnancy for someone else is “gestational carrier.” To understand why, let’s unpack the different types of surrogacy and what’s involved. There are two types of surrogacy: traditional surrogacy and gestational surrogacy. When people think about surrogacy, they may imagine traditional surrogacy. In reality, gestational surrogacy is far more common.

At one time, surrogates were commonly referred to as “surrogate mothers.” In fact, that is a term many people still use and search for online, but it is inaccurate. The person carrying the pregnancy has gone into the surrogacy process planning to have a baby for the intended parents, and knowing that she herself will not be the child’s parent. But using the term “surrogate mother” to refer to her implies, incorrectly, that she will have a parental relationship with the child.

Traditional Surrogacy

In traditional surrogacy, the woman carrying the pregnancy is genetically related to the child, because her eggs make up part of the child’s genetic makeup. (It is possible for the pregnant woman to be genetically related to the child but not be a traditional surrogate, such as when a family member of one of the intended parents carries the baby.)

With a traditional surrogate arrangement, in vitro fertilization (IVF) is typically not required; the surrogate’s eggs are fertilized via some form of artificial insemination, such as intrauterine insemination (IUI), intravaginal insemination (IVI), or intracervical insemination (ICI). Intrauterine insemination is the most common and effective, but the other methods may be more convenient or cost-effective.

The male intended parent usually provides the sperm in traditional surrogacy. If IUI is being used, the sperm go through a special washing procedure before being placed in the surrogate’s uterus. Using a sperm donor can give rise to legal problems in traditional surrogacy, because the resulting baby will be related genetically to the surrogate, but to neither of the intended parents. Therefore, the intended parents will need to legally adopt the baby. Also, if the surrogate changes her mind about giving the baby to the intended parents, the intended parents may be unable to enforce the surrogacy contract.

At one time, traditional surrogacy was the only option for parents who wanted to ask another person to carry a pregnancy for them. As assisted reproductive technology (ART) has evolved, gestational surrogacy has become a better option for most intended parents.

Gestational Surrogacy

In gestational surrogacy, the person carrying the pregnancy (the “gestational carrier” or “gestational surrogate”) does not provide any of the baby’s genetic material. Other terms used to refer to this type of surrogacy are full surrogacy or host surrogacy.

Gestational surrogacy may offer the intended parents the opportunity to have a child that is genetically related to both of them. It is common in gestational surrogacy for the intended parents to supply the egg and sperm; the egg is fertilized using in vitro fertilization (IVF). One or more embryos that result from the process are then transferred to the gestational carrier.

There are other possible genetic combinations: an egg or sperm may be taken from one of the intended parents, and fertilization may take place using donor sperm or a donor egg. Other options include using both sperm and egg from donors, or transferring an donated embryo to the carrier. (Depending on the state or country, laws may require the baby to be genetically related to at least one of the intended parents.)

There are a number of reasons intended parents may seek the help of a gestational carrier. The intended parents may be a gay male couple who want a child, or a single man who wants to become a father. The intended mother may have uterine malformations or be missing a uterus, making it impossible for her to carry a pregnancy, or may have had repeated unexplained IVF implantation failures. The intended mother may have other health conditions, such as autoimmune conditions that cause repeated pregnancy loss. Even if an intended mother is able to become and stay pregnant, she might have a condition that could make pregnancy a serious health risk.

There are some basic requirements for women who want to act as genetic carriers. They must generally be in good health and at a healthy weight; have carried a healthy pregnancy to term in the past (and raised or be raising the child) with no complications; have no more than 3 c-sections, be between the ages of 21 and 40; not be receiving government assistance; and be willing to attend doctor appointments and required procedures both before and during pregnancy.

If you have questions about the types of surrogacy, becoming a traditional surrogate or gestational carrier, or want to expand your family through surrogacy, we invite you to contact Brinkley Law Firm to schedule a consultation.