For some couples struggling with fertility, it's simply not possible for the two partners to carry a pregnancy to term. But, keep in mind, it's pregnancy that's not possible. Parenthood — the ultimate goal — is still very much a possibility.
That's where considering a surrogate or gestational carrier comes in.
Surrogate versus Gestational Carrier: The Difference
Surrogacy may be a good option if you are not able to produce enough healthy eggs or if you have a medical condition that will not allow you to carry a pregnancy to term.
With a surrogate, a woman will pair one of her eggs with your husband's sperm and carry the child throughout the pregnancy, the US Office on Women's Health explains.
The baby will be biologically related to your husband and the surrogate, but you can declare parentage before the baby is born or adopt the baby afterwards, depending on the laws in your state.
With a gestational carrier, your egg and your husband's sperm are joined together to create an embryo. But another woman carries that embryo in her uterus and delivers the baby at birth. You and your husband are biologically related to the child. The gestational carrier is not.
The decision to go down this particular treatment path may not be easy for a number of reasons — biological, emotional, financial and legal. As with any fertility treatment option, it's important to do your research and really take time to consider what is best for you and your partner.
Six Questions to Help Guide the Decision-Making Process
Do you want to go with a known surrogate or gestational carrier, such as a family member, or do you want to go with person to whom you have no personal ties?
There are pros and cons to both options. You and your partner will need to decide which of these options you feel most comfortable with.
If you decide to go with a stranger contracted through an agency, be sure to ask for references you can contact first, suggests the National Infertility Association.
Regardless of which one you choose, the American Society of Reproductive Medicine recommends that both the surrogate and the parents have separate representation by lawyers with experience in this area.
Do you want your surrogate or gestational carrier to undergo genetic testing? What if a test comes back abnormal?
If you go with an unknown surrogate or gestational carrier, you may want to make sure that her medical history does not include conditions that could be passed on and potentially threaten the baby's health.
You also want to be sure that if your child does develop a medical condition that you and your partner are emotionally and financially prepared for it.
What type of relationship do you and your partner want to have with the surrogate or gestational carrier during the pregnancy and throughout the child's life?
There are all kinds of horror stories out there about surrogates popping up and suing for parental rights or child support. Whether they are true or not, this is something that you and your partner should determine with your surrogate or gestational carrier and your respective legal teams beforehand.
During the pregnancy you may want updates and ultrasound pics from your surrogate or gestational carrier — but is she okay with that? If the surrogate or gestational carrier wants updates on the baby after birth, are you okay with that or would it disrupt your family bond?
If you choose a surrogate, how will you respond if the child eventually wants to know her biological identity?
First, this involves deciding if you'll even tell the child how he was conceived. This is especially important if you do not plan to continue a personal relationship with the surrogate after the pregnancy.
After all, the surrogate is biologically related to the child. And the child may grow up wanting to know who his or her biological mother is.
How do you plan to tell others about taking this step toward building your family, if you want to tell them at all?
It could be awkward if you and your partner show up to the next family reunion with a baby. Be ready for questions, confusion and maybe even judgment.
That's why it's important to decide who in your personal circle you'll inform about this decision and how much information you'll share. Because they will ask.
How much will the medical and legal costs come to?
As much as you may want to focus only on the emotional anticipation of becoming a parent, it's important to spend time calculating the financial aspect of bringing your child into the world via surrogate or gestational carrier.
The ASRM suggests you agree upon the compensation for your surrogate or gestational carrier ahead of time.
Some of the Costs to You and your Partner
- A general fee for the surrogate or the gestational carrier
- The agency fee if you choose one
- Medical screenings for pre-existing conditions
- Prenatal care after the surrogate or gestational carrier becomes pregnant and gives birth
- Compensation for the surrogate or gestational carrier's time off work, particularly for bed rest and recovery from delivery
- Living expenses for the pregnancy, such as extra food, maternity clothes, travel to and from doctor's appointments, prenatal vitamins, etc.
- Legal costs for the surrogate or gestational carrier to have her own legal representation
All expected costs should be outlined in writing before any fertility procedures begin, advises the ASRM.
The process of choosing whether you want to go with a gestational carrier or surrogate can be difficult. Experts at Penn Fertility Care can share additional questions to consider on your journey to parenthood.