For individuals and couples struggling with infertility, the natural next step is to explore different assisted reproduction technology (ART) methods. IVF is an option most families look into once it is established that conceiving naturally is not possible. Although IVF has made great strides in the past few decades, yet for many it is not a viable alternative due to a variety of reasons such as maternal age, poor egg or sperm quality and a multitude of other possible reasons. In cases like these, surrogacy is an option that can potentially help infertile couple and individuals achieve the dream of having biological children.
Surrogacy itself though is slightly tricky as the legalities involved vary from country to country and even within the US, each state has its own set of unique laws governing surrogacy.
Surrogacy normally takes either of the following two forms:
In traditional surrogacy, a woman (the carrier or surrogate) gets inseminated artificially using the father’s sperm. In this scenario, the woman carrying the baby is the biological mother of the child as she uses her own eggs to carry the pregnancy.
This is an increasingly popular form of third party reproduction where a gestational carrier or surrogate, carries the embryo formed in a lab through IVF using the father’s sperm and the mother’s eggs. In gestational surrogacy, the GC is simply carrying the child for the couple and as such is not biologically related to the child. Donor eggs or donor sperm can also be used in gestational surrogacy.
With the increasing popularity and general acceptance of this form of surrogacy, thousands of families resort to gestational surrogacy each year all over the world for the purpose of family building. If you are considering gestational surrogacy, it’s important to be acquainted with the process you would be involved in and the people you will be working closely with throughout your surrogacy journey.
1. Gestational Carrier
A gestational carrier, or surrogate, is a woman who has consented to carry a surrogate baby. These compassionate women are motivated and driven by the bigger picture of helping out a family achieve their dreams of family building. More often than not they have families and kids of their own and have had the experience of carrying uneventful, healthy and normal pregnancies. Whether you choose to pursue surrogacy independently or with the help of a surrogacy agency, it’s absolutely critical to find a gestational candidate that you are comfortable with. Not only would you be expected to work closely with her throughout the pregnancy but also because she would eventually be carrying your biological child for you, so it’s important that you find the perfect fit.
2. Surrogacy Agency
Since the process of surrogacy is extensive and a lot is at stake both financially and emotionally, most families decide to hire the services of a surrogacy agency to help them navigate the intricacies of it. A surrogacy agency essentially helps you right from the beginning of your decision to find a surrogate, right up till the very end when you hold your baby in your arms. From helping you find the right gestational candidate to ironing out the legalities (such as establishing parental rights) and getting you connected with the best possible fertility experts, a surrogacy agency is your one stop shop for all your surrogacy needs.
3. Fertility Doctor/Reproductive Endocrinologist
A fertility specialist or reproductive endocrinologist is tasked with starting the IVF process for the surrogate mother. As such, the RE thoroughly assesses the medical history and overall health of the gestational carrier in order to ensure she’s in good shape to carry a surrogate pregnancy. The RE simultaneously works closely with the Intended Parents as well, obtaining their lab work prior to starting the IVF process. Your fertility specialist is supposed to explain in detail how the entire process would work, including fertilization of the eggs, implantation of the embryo and the resulting pregnancy. Once a successful pregnancy is confirmed, the surrogate then graduates to a regular obstetrician/gynaecologist usually at the 9th or 12th week mark.
4. Reproductive Attorney
Reproductive attorneys are specialized legal counsels who have years of experience studying and dealing with family building laws. These fertility lawyers work to protect the legal rights of the Intended Parents in establishing parental rights of the child. The legal aspects of surrogacy begin right from the start where different surrogate applications are being analyzed to check where the surrogate resides and where she’s supposed to give birth. Once a match has been found, the Intended Parents and surrogate would both sign off on the gestational carrier agreement stating that the child born as a result of this arrangement would lawfully belong to the Intended Parents, and the gestational carrier consents to forfeit any rights to the child. This is integral before you even start with the medical process as any fertility clinic would first require legal clearance before accepting any surrogacy arrangements.
5. Mental Health Professional
Surrogacy can get pretty taxing for both the IP’s as well as the gestational candidate herself. A mental health professional is fundamental to any surrogacy arrangement as they not only ensure that the both the intended parents are mentally prepared to anticipate the challenging yet exciting process of having someone else carry your child, but also that the gestational carrier is psychologically ready to carry a surrogate baby in terms of the potential emotional attachment issues that may arise during and after the pregnancy.
Once the embryo implantation is successful a pregnancy is confirmed, the surrogate is transferred to a regular Ob/Gyn in place of the IVF/Fertility healthcare team, to manage the remaining part of the surrogate pregnancy. Obstetrician–gynecologists should be mindful of the rather unique aspects of a surrogate pregnancy and how it differs from regular pregnancy in terms of the different parties involved. It is important to make sure that both the IPs and the surrogate are equally involved at each step of the pregnancy.