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The Complete Breakdown of Pregnancy via Surrogacy

There are many misconceptions about surrogacy as a form of assisted reproduction. Confusion over this type of arrangement is common and may prevent potential parents who could benefit from using a surrogate from exploring it further.

Traditional vs. gestational

There are two different kinds of surrogacy arrangements individuals or families can use depending on the specific situation.

A traditional surrogate is a woman who agrees to become pregnant with a man’s sperm and her own egg. The sperm will be injected into her body using artificial insemination. Therefore, the baby will be genetically related to the surrogate.

The biological relationship between the surrogate and the child can complicate legal issues of parental rights if the surrogate were to change her mind about relinquishing the baby. To avoid these complications, many states prohibit traditional surrogacy agreements. Some states may allow them only if there is no compensation to the surrogate beyond the payment of medical and legal expenses related to the surrogate agreement.

A gestational surrogate is more commonly known as a gestational carrier, or GC. In this arrangement, an egg is removed from the biological mother and then fertilized with the biological father’s sperm using in vitro fertilization (IVF) before being transferred to the GC’s uterus. Donor egg and/or donor sperm may also be involved, depending on the fertility issues of the intended parent/s. Therefore, the child is in no way biologically related to the carrier.

How are traditional surrogates or GCs selected?

The American Society for Reproductive Medicine (ASRM) is the governing body that makes recommendations to fertility clinics that perform both the artificial insemination and IVF procedures required for either traditional or gestational surrogacy. They have strict guidelines that regulate surrogate selection.

Most fertility clinics require that both types of surrogates:

  • Be at least 18 years old and younger than 43 (this maximum age varies by clinic)
  • Be in good physical health
  • Be in good mental health and able to understand all the legal and emotional implications of surrogacy
  • Have carried and delivered at least one child
  • Have no history of pre-term births or pregnancy complications
  • Have a stable living situation
  • Not smoke, drink or use illicit drugs

How do I find a GC?

In some cases, family members or friends offer to be GCs for the intended parents. In these cases, it is critical that all parties involved obtain legal advice from an attorney experienced in reproductive law before signing any contracts or agreements. A clear contract is essential to avoid potential conflict throughout the surrogacy process.

Most people find surrogates through agencies that match the intended parent or parents to surrogates. Finding a reputable agency is critical. When possible, talk with the agency’s former clients. If you are already working with a fertility clinic or attorney, ask for recommendations.

After a carrier is matched by the agency or clinic to the intended parent or parents and cleared medically by the fertility clinic, she will have to undergo psychological screening. The purpose of these evaluations is to determine that she is not being forced into the arrangement and that she understands the implications of the commitment she is making. The intended parents will also have a consultation with a mental health professional to review any potential issues that could arise.


  • Centers for Disease Control and Prevention. Infertility FAQs.
    Office of Women’s Health, U.S
  • Department of Health & Human Services
  • Infertility fact sheet.
    The Human Rights Campaign
  • Overview of the Surrogacy Process.
    American Society for Reproductive Medicine.

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