Infertility plagues one out of every six couples and can be devastating to accept. The physical and emotional loss of not being able to carry your own baby can be hard to overcome. However, there are still many options available to help you realize your dream of becoming a parent. Surrogacy is one of those options. There are two different kinds of surrogacy, traditional and gestational.
Traditional surrogacy
Traditional surrogacy (here is a concise explanation of about surrogacy definitions and jargon) is the process of a woman being artificially inseminated with the father’s sperm, who then carries the fetus to term. Because her egg was used in the process, she is genetically related to the child, and is considered to be the biological mother. She will give up her parental rights after birth to the intended parents, who will raise the child as their own. It is possible for a sperm donation to be used, making the child not biologically related to either of the intended parents.
Couples who use traditional surrogacy usually do so because of their inability to have children. Infertility can be caused by several factors, including diseases like endometriosis and Polycystic Ovary Syndrome, failure to ovulate, hormone imbalance, and age. When these cannot be overcome, many couples prefer to have someone else carry their child rather than adopt one that is not related to them. It is also not unlikely for couples who carry certain genetic diseases to choose surrogacy so that they do not pass the disease to their children.
Advantages of traditional surrogacy;
- Artificial insemination is a relatively inexpensive procedure, making it easier to do multiple times if necessary.
- If the first effort does not succeed, a second effort can be made within weeks instead of months.
- The surrogate usually does not need to take fertility medication.
Disadvantages to this type of surrogacy;
- Because the intended mother is not the biological mother, she will typically need to adopt the baby through a step-parent adoption process.
- There are no federal laws regarding surrogacy, and many states have differing laws, making it possible for the birth mother to back out of the agreement once the child is born.
- Some surrogate mothers have a difficult time separating themselves from the baby after birth, causing emotional pain.
Gestational surrogacy
Gestational surrogacy is a process in which a woman carries and delivers a baby that is not biologically related to her. Usually, the egg comes from the intended mother and the sperm comes from the intended father, though donor sperm, donor eggs, and donor embryos are sometimes used. This process is done when eggs are harvested from the mother, fertilized with sperm from the father, and placed into the uterus of the surrogate using in vitro fertilization, or IVF.
This type of surrogacy is not very common, for reasons which are probably related to the high cost. Couples who choose this type often do so because of the same reasons as traditional surrogacy, namely there are fertility issues or other diseases or conditions present. However, using a gestational surrogate is much more personal because the child will be related to both intended parents and not to the surrogate. The intended parents are generally very involved throughout the entire pregnancy and birth.
Advantages of gestational surrogacy include:
- Even if you are unable to conceive or carry a child to term, you can still raise your own biological child.
- You are able to be intimately involved in the details of the pregnancy.
- Because the process is so thorough, your doctor will be able to guarantee the health of your surrogate before conception.
Disadvantages of this type of surrogacy:
- Because the intended mother and surrogate are both required to take fertility medication in order to sync their cycles, there may be side effects and discomfort related to the medication.
- The process is legally complex and very expensive. You are generally in charge of many of your surrogate’s expenses, including medical insurance and sometimes even some of her living expenses. If you decide to go through an agency, you will also be responsible for all of the agency fees.
- Most states do not have laws regarding gestational surrogacy, so you will probably need to work with an attorney to make sure that everything is taken care of legally.
- IVF is a more expensive procedure, and it does fail from time to time.
IVF failure
It is possible for the IVF to fail when going down the road of gestational surrogacy. It is a difficult setback to deal with because you have to decide if you are able to emotionally and financially invest in another round of IVF. If you decide to go ahead with another round, you will need to wait several weeks, at the discretion of your doctor. There are several reasons why the IVF could fail:
- Egg and sperm quality
- If HCG, or Human Chorionic Gonadotropin, injections are done at the wrong time or if the injection does not react correctly with the follicle, fertilization may not be able to take place.
- Suboptimal endometrial growth, or an endometrial lining that is too thin
- Weakness in the embryo that leads to failed implantation
Sometimes there are no explainable reasons for IVF failure. However, your doctor will be able to review the process and discuss the situation with you, as well as his or her opinion on estimated success rates for future IVF procedures.
Joanne Bubrick is the program administrator for the Center for Surrogate Parenting for the California office. Joanne has been with CSP since 1997.
