Surrogacy is an arrangement where a person agrees to carry and give birth to a child for another individual or couple. The person who carries the pregnancy is known as the surrogate or gestational carrier. The people who will raise the child are known as the intended parents. Surrogacy is used when pregnancy is not medically possible or when individuals choose this path for personal or family reasons.

Types of surrogacy

Surrogacy is commonly divided into two forms that reflect how conception occurs.

Gestational surrogacy

Gestational surrogacy involves the transfer of an embryo created through in vitro fertilization into the uterus of a gestational carrier. The carrier has no genetic connection to the child. This is the most widely used form of surrogacy in the United States and in many other countries due to clearer parentage pathways and medical predictability.

Traditional surrogacy

Traditional surrogacy involves conception using the carrier’s own egg with sperm from the intended father or a donor. The child is genetically related to the carrier. This approach is uncommon in the United States because it presents complex legal and psychological considerations.

Reasons people choose surrogacy

Individuals and couples explore surrogacy for various reasons. These include medical conditions that prevent pregnancy, a prior hysterectomy, repeated pregnancy loss, prior infertility treatment, or severe medical risks associated with carrying a pregnancy. Surrogacy is also chosen by single individuals and by LGBTQIA+ parents who seek a path to parenthood that aligns with their personal or family goals.

Medical process

Surrogacy involves a sequence of medical steps that support both the intended parents and the surrogate.

Screening

Gestational carriers complete a series of evaluations that may include medical history review, laboratory testing, obstetric record review, psychological consultation, and a uterine assessment by a fertility specialist.

Embryo creation

Embryos are created through in vitro fertilization using the intended parents’ gametes or donor gametes. The embryos are then prepared for transfer.

Embryo transfer

A fertility specialist transfers a single embryo into the gestational carrier’s uterus. Clinics increasingly recommend a single embryo to reduce risk of multiple pregnancy.

Pregnancy care

The surrogate receives prenatal care through her own obstetric provider. Fertility clinics oversee early pregnancy, then transition care to the obstetric provider once the pregnancy is confirmed to be stable.

Risks and considerations

Surrogacy carries medical risks similar to any pregnancy. These may include gestational diabetes, gestational hypertension, cesarean delivery, or conditions such as placenta previa. Risks may be higher when more than one embryo implants. Surrogacy also involves emotional and ethical considerations for both the surrogate and the intended parents, including expectations, communication, and support throughout the journey.

Legal aspects

Laws surrounding surrogacy vary by region. Some areas have clear statutes that support gestational surrogacy agreements, while others rely on case law or do not enforce surrogacy contracts. Intended parents and surrogates work with reproductive law attorneys to establish parentage through pre birth orders or post birth orders depending on local practice. Legal steps also account for marital status, genetic relationship to the child, and recognition of single parents and LGBTQIA+ parents.

Surrogacy around the world

Global surrogacy laws differ significantly. Some countries permit compensated gestational surrogacy, others allow only altruistic arrangements, and some prohibit the practice entirely. These differences result in international travel for fertility treatment and parentage procedures. Families often seek regions with established medical programs and clear legal protections.

Ethical considerations

Ethical discussions around surrogacy focus on consent, autonomy, and the well being of the surrogate and the child. Professional guidelines emphasize voluntary participation, independent legal representation, psychological support, and transparent communication between all involved parties.

Cost considerations

Surrogacy involves expenses related to medical care, legal representation, surrogate support, and agency coordination. Surrogacy Costs vary by region and by clinic protocols. Programs that include screening, matching, pregnancy management, and legal guidance often have higher total costs but provide clearer support structures for both parties.

Frequently asked questions