The First Gestational Surrogate
The first gestational surrogate who carried to term a child to whom she was genetically unrelated gave birth in 1985. This birth marked a major milestone in family building, allowing those for whom a woman with a healthy uterus was not available to make a baby related to one or both of the intended parents. Today in the United States, approximately 8,000 gestational surrogacy cycles are performed each year to help loving families who would not otherwise have been able to have a baby.
Traditional Surrogacy and Gestational Surrogacy
There are two forms of surrogacy. The first, traditional surrogacy, occurs when a woman is inseminated with the intended father’s sperm. This form of surrogacy is now uncommon. Most surrogacy today refers to gestational surrogates like the one in 1985. This second approach uses in vitro fertilization (IVF) where the surrogate is implanted with an egg from the biological mother, fertilized with sperm from the biological father. The surrogate, called the birth mother, then carries the child to term for the intended, genetically related parents.
Surrogacy for Single Men and LGBTQ Couples
Single men or gay male parents often use surrogates (either traditional or with an egg donor) to make a baby with one of the parent’s DNA — though technology may in the next decade enable two men or two women to contribute DNA to the same embryo. Families where one partner is trans and either taking hormone therapy or born without a uterus might also contract with a surrogate.
Medical Conditions that Cause Infertility
Various medical causes could result in parents born with a uterus being unable to carry a child to term. These include:
- Absence of a uterus or abnormalities with the uterus
- Medical conditions like severe heart disease, which make pregnancy impossible or risky
- A past hysterectomy to remove the uterus for health reasons
Mothers over the age of 35 may consider contracting a surrogate as well, as the risk of complications during pregnancy increases thereafter. A surrogate could ensure a healthier baby and safer gestation.
Families may also face unexpected infertility issues which are resistant to treatments like IVF, hormone therapy, or other approaches meant to help biological parents become pregnant and deliver a baby. In these cases, gestational carriers could carry a child having one or both of the parent’s DNA.
How to Find a Surrogate
Before deciding on surrogacy, it is important to know how the surrogate herself will be chosen. A friend or family member may volunteer to be the gestational carrier. This is a less expensive option and gives the parents more access to the surrogate, but pregnancy is an emotionally fraught time for everyone involved and could strain personal relationships between the intended parents and the surrogate.
Surrogacy agencies are the most common choice, providing expertise on surrogate selection, finding and screening the surrogate, legal, financial and medical aspects of surrogacy and providing counseling and navigation for what is a complex journey for the intended parents and a contracted gestational surrogate. The total cost for a surrogate, including finding and screening the surrogate, other informational and contractual arrangements, fertility treatments, embryo creation, and surrogate compensation and support, is usually at least $100,000 and often much higher in the United States.
Health Insurance and Fertility Benefits
Health insurance plans may or may not cover gestational carriers. If they do, it is usually through dedicated programs such as ARC Fertility which provide coverage for multiple methods of family building. Parents interested in exploring surrogacy to create the family they want should talk to their employers about choosing ARC Fertility to provide comprehensive fertility coverage companywide.