What Is Gestational Surrogacy and How Does This Remarkable Process Work?

In short: Gestational surrogacy is an arrangement in which a woman carries and delivers a baby conceived through IVF, using eggs and sperm from the intended parents, donors, or a combination. She has no genetic link to the child. It is the most common form of surrogacy in the U.S. and typically costs $50,000–$150,000 or more, with a journey lasting roughly 12–18 months.

Imagine wanting a baby more than anything, but your body just can’t carry one. This is the truth for many couples who seek hope through gestational surrogacy; this is the way they make their dreams come true. Gestational surrogacy is the most prevalent form of surrogacy in North America. If you have ever looked into it, chances are good that you were wondering about many things about it. Herein, you will find everything about the topic: definitions, differences from traditional surrogacy, the gestational surrogacy process, the content of a gestational surrogacy agreement, and the expenses involved.

What Is Gestational Surrogacy? 

In gestational surrogacy, a woman carries and delivers a baby that is not genetically hers, conceived through an embryo formed via In Vitro Fertilization (IVF).

Whether eggs and sperm are sourced from the intended parents, a donor, or a combination of all three, the woman carrying the pregnancy is not the source of genetic material. This is precisely what makes gestational surrogacy work. There will be no genetic relation at all between the child and the woman carrying the child, known as the gestational surrogate or gestational carrier.

This is the opposite of the conventional form of surrogacy practiced decades ago. This is why gestational surrogacy is now the norm in contemporary times.

Surrogate or Gestational Carrier? Same Person, Different Words

If you’re familiar with these two terms and have been wondering if they are used differently, then the answer to your question is no, at least in this scenario. These two terms are used interchangeably, and they mean the same thing. “Surrogate” is a layman’s term that will be used mostly by everyone. “Gestational carrier,” on the other hand, is a clinical or medical term and indicates that she is carrying the pregnancy and not providing the egg.

Hence, whether an agency refers to her as a surrogate or carrier, it all means the same thing. A woman carrying a baby who has no genetic connection to that child.

Gestational Surrogacy vs. Traditional Surrogacy

This is the comparison almost every new parent searches for, so let’s lay it out clearly.

	Gestational Surrogacy	Traditional Surrogacy
Genetic link to baby	None	Yes — her own egg is used
Conception method	IVF (embryo transfer)	Artificial insemination (IUI/AI)
Legal complexity	Lower	Higher
Legal status in the U.S.	Legal in nearly every state	Banned or restricted in many states
How common is it today	Most common form of surrogacy	Rare

By comparing gestational surrogacy and traditional surrogacy, the key factor lies in genetics. With traditional surrogacy, the surrogate woman uses her own egg, which makes her genetically related to the child. It increases the risks associated with a legal standpoint, as she may have legitimate claims to the baby’s custody. This is the reason why gestational surrogacy eliminates the risks, because the carrier does not use her egg. That is why gestational surrogacy is the preferred option.

Who Actually Needs a Gestational Carrier?

Reasons why individuals may need a gestational carrier include:

• Uterine problems, hysterectomy, or an abnormality that prevents safe or viable pregnancies
• Medical or psychological conditions make it unwise to carry a pregnancy
• Multiple miscarriages or unsuccessful rounds of IVF treatments.
• Single parents or same-sex partners with no access to a womb between the two of them
• To be genetically related to their baby while avoiding the risks of pregnancy

There is no one profile or “typical” intended parent. Same-sex couples, opposite-sex couples, and singles alike use gestational surrogacy to create their family.

The Gestational Surrogacy Process, Step by Step

The gestational surrogacy process breaks down into five clear steps, from finding a match to securing legal parentage.

Step 1: Find Your Match

Intended parents typically use surrogacy agencies that handle the matching process, screening, and organization. Some intended parents seek out their own carriers, perhaps through a personal acquaintance or relative. This is where you match with the surrogate who will carry your baby.

Step 2: Medical and Psychological Screening

Everything must be set before any step is taken. Firstly, both the surrogate mother and the intended parents undergo thorough health examinations. The surrogate mother must be physically fit, without previous difficulties during pregnancies, and emotionally ready for what lies ahead. Clinics typically prefer surrogates aged between 21 and 32 who have had at least one healthy birth and a limited number of prior C-section deliveries, though exact criteria vary by clinic. Blood samples are drawn for testing for any infection.

Step 3: The Gestational Surrogacy Agreement

This is one of the most crucial — and yet most often ignored — tasks. The gestational surrogacy agreement is the legal document that needs to be signed before you can start your journey. It usually includes provisions such as:

• Financial aspects of the procedure and payment terms
• Responsibilities of the carrier throughout the pregnancy
• Transfer of the child to their rightful parents upon delivery
• Provision for difficult situations, including possible complications and losses during pregnancy
• Legal parenthood and custodial rights of the surrogate parents

The gestational surrogacy agreement covers everyone’s interests in the procedure, starting from the carrier and ending with the child who needs parents. Most states insist on having the gestational surrogacy contract signed before commencing IVF treatments.

Step 4: IVF and Embryo Transfer

After signing the contract, the embryo is made in a laboratory through the use of either the eggs and sperm from the intended parents, a donor, or both. The embryo is then placed inside the womb of the surrogate. Once implanted successfully, the woman gets pregnant; otherwise, another implantation is done.

Step 5: Pregnancy, Birth, and Legal Parentage

The process goes on as usual from there. After birth, the legal custody of the child passes to the intended parents via a pre-birth or post-birth order.

Who’s Involved in a Gestational Surrogacy Journey?

It’s never just a two-person affair. An average arrangement may entail the following:

• Gestational carrier
• Intended parents
• Egg/sperm donor (where required)
• Surrogacy agency
• Fertility center and embryologist
• Attorneys representing both parties
• OB/GYN or midwife for pregnancy monitoring
• Mental health therapist

And that’s up to eight different people all working together on one single pregnancy, which is precisely the reason why proper guidance from an agency or an attorney is extremely important.

Altruistic vs. Commercial Gestational Surrogacy

And here’s a difference that almost every article leaves out. An altruistic gestational surrogacy agreement is when the surrogate doesn’t receive a flat fee for being pregnant. She will receive money to cover her expenses related to being pregnant, but no more than that. It usually happens when she is a good friend or a family member of the intended parents. Commercial surrogacy involves both a flat compensation fee and the money for expenses.

Neither one is better than the other. It depends on your relationship with your surrogate and the surrogacy services you use. There are countries and a couple of U.S. states where commercial surrogacy is prohibited.

How Much Does Gestational Surrogacy Cost?

This is the figure that everybody seeks but rarely finds stated plainly: the gestational surrogacy cost can be anywhere between $50,000 and $150,000 or more in the US. The factors behind this variance include the following:

• The fees paid to the surrogate ($20,000 to $50,000 based on experience and location)
• The fees paid to the agency for arranging everything
• Medical expenses — IVF cycles, monitoring, transferring the embryo, and prenatal care
• Legal costs, namely the cost of preparing the contract and obtaining a parentage order
• Expenses of using the donor eggs or sperm
• Miscellaneous expenses and insurance

Not all couples achieve success through one cycle of IVF, so many have to go for several attempts, each resulting in more expenses incurred. Costs are generally less when there are no monetary incentives involved.

Benefits of Gestational Surrogacy

Despite its complexities, gestational surrogacy offers a real solution to many individuals who want to have a family. It is useful when an individual is not able to carry a pregnancy to term. Most times, it will allow there to be some form of genetic link between the intended parents and the child.

This type of surrogacy is less prone to legal complications. This process can help single people have children. Furthermore, same-sex couples can benefit from this practice to have their genetic offspring.

Risks and Challenges to Know

There’s also something to be said about having realistic expectations. There are some potential problems:

• No promise that the transfer or pregnancy will be successful
• Heavy financial commitment with no money back if the cycle fails
• Emotional stress on both the surrogate mother and the intended parents during the waiting period
• Normal pregnancy problems associated with carrying a baby, such as high blood pressure or gestational diabetes
• More limited involvement in the pregnancy compared to what the intended parents may want

None of these constitute a reason NOT to go through with a gestational surrogacy arrangement, but they do warrant some forethought.

Is Gestational Surrogacy Legal?

There are different regulations for surrogacy in each country. Also, in the United States, there are variations in these regulations for different states. One of the positive things about gestational surrogacy is that it is legally less complex than traditional surrogacy.

This is because the surrogate has no biological relation to the child. Still, the laws may vary from one place to another. These include laws on payments, parentage orders, and surrogacy contracts.

Final Thoughts

Gestational surrogacy takes a lot of time. It involves aspects related to medicine, law, emotions, and finances. But for most intended parents, it may be their only route toward their dream family.

A competent surrogacy expert will help you go through the process smoothly. They can brief you on the details of the gestational surrogacy agreement. They will also help you get insight into screening procedures and realistic expenses. In essence, you will not be going through the process alone.

Frequently Asked Questions

Sources

1. Cleveland Clinic — Gestational Surrogacy.
2. New York State Department of Health — Gestational Surrogacy Fact Sheet. 
3. New York State Department of Health — Information for Gestational Surrogates and Intended Parents.
4. American College of Obstetricians and Gynecologists (ACOG) — Committee Opinion No. 660: Family Building Through Gestational Surrogacy.