Six Facts to Know About Surrogacy

Whether you're contemplating surrogacy as an intended parent or surrogate, or simply aiming to better understand this evolving domain of third-party reproduction, here are facts you should know about surrogacy.

1. Two main types of surrogacy exist

There are generally two kinds of surrogacy: traditional and gestational. In traditional surrogacy, the same person is both the egg donor and the gestational carrier, making her the biological mother. In gestational surrogacy, the surrogate carries a pregnancy but has no genetic link to the child. Gestational surrogacy is more commonly used today. 

2. Surrogacy laws vary widely by state and country

Surrogacy laws are not uniform and can differ dramatically from state to state in the U.S. and among different countries. Some states have permissive laws, while others may criminalize surrogacy agreements. 

The American Society for Reproductive Medicine (ASRM) has a comprehensive guide to surrogacy laws across the United States. The guide outlines the surrogacy laws for each state, including whether surrogacy is legal, the type of surrogacy arrangements permitted, the eligibility criteria for intended parents and gestational carriers, and any specific legal requirements, such as pre-birth orders or post-birth adoption procedures. 

Read more: What Do I Need to Know About Surrogacy Laws?

3. Nearly 5% of IVF embryo transfers are to a gestational carrier

In 2020, the latest year where we have data, 4.7% of embryo transfer cycles used a gestational carrier. That’s up from 2% in 2013.

Considering that 2% of annual births in the U.S. are from IVF, that would mean roughly 4,000 births each year are to gestational carriers.

4. Gestational carriers must pass strict requirements

The American Society for Reproductive Medicine (ASRM) has established recommended requirements for surrogates. These requirements are designed to ensure the health and well-being of both the carrier and the baby. Key requirements include:

• Age criteria: Surrogates must be legally adult, with a preferred age range of 21 to 45 years. In certain cases, carriers older than 45 years may be considered, but all involved parties must be fully informed about the increased pregnancy risks associated with advanced maternal age.
• Previous pregnancy success: It is essential for a surrogate to have experienced at least one successful pregnancy prior to becoming a gestational carrier for another couple. This criterion helps to gauge the surrogate’s ability to carry a pregnancy to term.
• Limit on previous deliveries: A surrogate should not have had more than five total deliveries in the past, and no more than three of these should have been cesarean sections. This limitation is to reduce health risks associated with multiple pregnancies and deliveries.
• Stable family environment: The surrogate must have a supportive and stable family setting. This support system is crucial in helping her handle the added stress and responsibilities that come with being pregnant as a gestational carrier.
• Psychological screening: Undergoing psychological evaluation is mandatory for all surrogates. This screening ensures that the surrogate is mentally and emotionally prepared for the unique challenges of gestational surrogacy.

These guidelines are in place to safeguard the interests and health of both the gestational carrier and the intended parents, and to promote a successful and healthy surrogacy arrangement.

5. Surrogacy is expensive

The cost of surrogacy can run you anywhere from $100,000 to $200,000 in the United States — depending on where you live, who your gestational carrier is, and just exactly what fertility services you need along the way. 

Read more: Can Someone Break Down the Costs of Surrogacy?

6. There are many reasons someone may need a gestational carrier (and being a celebrity is not one of them)

There are many reasons someone may need a gestational carrier to have a baby, including:

• Same-sex male couples or single men: those who wish to have a biological child but require a surrogate for gestation
• Absence or problems with the uterus: women who are born without a uterus or have uterine abnormalities that prevent a healthy pregnancy.
• Severe health risks: conditions like severe heart disease or other serious illnesses where pregnancy could be life-threatening.
• History of recurrent miscarriages: individuals who have experienced multiple miscarriages due to unknown or unresolvable causes.
• Post-hysterectomy: women who have had a hysterectomy due to cancer or other medical conditions.
• Previous pregnancy complications: a history of severe complications during pregnancy that pose a risk in future pregnancies.
• Immune system disorders: conditions where the body's immune system adversely affects pregnancy.

Despite the headlines of celebrities (Paris Hilton, Kim Kardashian, Rebel Wilson) going the surrogacy route – simply being rich or famous is not a reason for needing a gestational carrier, and most fertility doctors do not allow non-medically necessary cases. 

Read more:

• Navigating the Legal Landscape: A Guide to Egg Donation & Surrogacy Laws for Gay Dads
• What Should I Know Before I Get Serious About Surrogacy?
• What Do I Need to Know About Surrogacy Laws?
• Surrogacy Questions Gay Dads Should be Asking
• Surrogacy: Coping With The Grief Of Not Carrying Your Child