How Surrogacy Works: Answers to your Questions


Surrogacy numbers are on the rise, and the U.S. leads the way in terms of having the most favorite laws. For women and couples looking for an alternative way to have children for various reasons, surrogacy provides one more alternative. The process takes a lot of time to plan and implement, and outside of the legal issues involved, it required a lot of medical science expertise to make sure that each step is done right.

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Defining Surrogacy

In this process, the surrogate mother is the women in whose womb the fetus grows. This woman carries the pregnancy for the 9-month period, and it is her uterus that provides the nutrients that the fetus needs to develop from just an embryo all the way until birth. Surrogacy is an option when pregnancy is either medically impossible or too risky.

There are two main methods of surrogacy—traditional surrogacy and gestational surrogacy. In traditional, partial, or natural surrogacy, the surrogate mother provides her egg but gives up the legal rights of being a parent to the woman, man, or couple who require a child through surrogacy. The surrogate’s egg is fertilized either through artificial or natural insemination. The sperm used for this may belong to the father looking to have a child or to an outside donor. In the end, the baby born is biologically related to the surrogate mother and the man whose sperm was used, be it the father or a donor.

The other option is gestational, full, or host surrogacy. This differs from traditional surrogacy in that the surrogate mother acts as a host for the pregnancy but does not provide her egg for the process. This means that the child born is not genetically related to the host or surrogate mother.

The egg and the sperm to be used are fertilized outside the body in a process known as in-vitro fertilization (IVF). Once the embryo is formed, this is implanted into the surrogate mother’s uterus. She then carries the pregnancy normally. There are a number of sources for the baby’s DNA depending on who the parent or parents are and what they decide to do. Both the egg and sperm can come from the intended parents or from donors. This gives a number of possible combinations for the genetic parents of the embryo including an embryo from the intended parents, an embryo from two donors, and everything in between.

Risks and Challenges

Legal matters aside, surrogacy has some inherent risks and challenges. Firstly, finding the right surrogate can be an issue. Next, there have always been challenges with the success rate of IVF for parents looking at surrogacy as well as other alternatives for having a child. For the process to work, the embryo must properly attach and become implanted to the uterine lining of the surrogate or mother. This is why in many cases of IVF, multiple embryos are implanted to increase the chances of successful implantation, but it is impossible to predict what these are going to be accurately. There are also pre-implantation risks such that can produce unintended consequences.

Comparing gestational surrogacy and mothers who become pregnant through the donation of an egg, it has been found that gestational surrogates experience lower chances of hypertension during their pregnancies. This is because surrogate mothers are generally healthier and more fertile. Because of this, they also have lower rates of placenta abruptions during pregnancy. For the children born through IVF surrogacy, no difference in physical and mental abilities has been found compared with children born from natural conception. One difference here is that, for pregnancies from having multiple embryos implanted, there may be more complications such as preterm labor and delivery.

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