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Gestational Carrier Guide

What is a Gestational Carrier?

Many couples who consider expanding their family with the help of a surrogate first ask: what’s the difference between a traditional surrogate and a gestational surrogate?

It’s important to understand how these two kinds of surrogacy differ.

The gestational carrier definition is as follows: a woman who chooses to carry a child from conception through delivery for another individual or couple, but has no biological relation to the child she is carrying, is a gestational carrier (GC).

Also known as a gestational surrogate (GS), the woman does not use her own eggs to become pregnant, but instead undergoes IVF, using embryos that have been created from the expectant parents’ eggs and sperm.

It is also possible for a gestational carrier to become pregnant through the use of donor eggs or sperm; regardless of how the embryos are created, a woman is considered a gestational surrogate if she is carrying a baby to whom she is not biologically related.

Some couples who have difficulty getting pregnant because of a fertility condition, or cannot become pregnant naturally because they are in a same-sex relationship, consider gestational surrogacy as an avenue to having a biological child.

Also known as intended parents, these couples are often able to successfully have children with a surrogate’s help.

Gestational Carrier vs. Surrogate Mother

Generally, surrogates fall into two categories: gestational carriers and traditional surrogates. The major difference between these two types of surrogates comes down to DNA.

Traditional surrogate mothers carry a baby for another person or couple, either for pay or out of generosity.

In traditional surrogacy, the surrogate mother uses her own eggs to become pregnant, with the help of either donor sperm, or that of the intended father.

That means a traditional surrogate mother is biologically related to the child she is carrying, though she agrees that she is not the child’s mother, and at birth gives the baby to the intended parents.

Gestational carriers follow much of the same surrogacy process, though they are not biologically related to the child.

Intended parents can choose between a variety of options when it comes to creating embryos that are later implanted in the gestational carrier’s uterus; they may choose to use their own egg and sperm, donor sperm and eggs, or a combination of the two.

In general, gestational carriers and traditional surrogates follow much of the same process for bringing a healthy baby into the world.

But, one of the largest differences between the two surrogacy options is cost.

In fact, some couples choose to go with traditional surrogates because of the reduced price tag; because gestational carriers require both egg and sperm, couples must choose to undergo IVF to harvest eggs for fertilization or use donor eggs.

Both options can push the cost of gestational surrogacy higher than traditional surrogacy, where there is no need to harvest eggs.

Reasons to Consider Gestational Surrogacy

So, if gestational surrogacy often is a bit more expensive, why do people choose it? There are several strong reasons many couples have in mind when they choose gestational surrogacy, including:

Concern for a healthy pregnancy: While some women are able to get pregnant, they may have health issues that make it difficult or unsafe to carry a pregnancy to term.

These women may still want to have a biologically related child, and gestational surrogacy allows them to do so without risking their health or that of the baby.

They worry about parental rights of surrogates: One of the most common questions asked about the surrogacy process is “Can a gestational carrier keep the baby?”

Because traditional surrogacy means the baby is biologically related to the birth mother, some families worry that the surrogate may not want to give up the baby after birth.

For this reason, some families seek out gestational surrogacy as a way to ease their worries.

The emotional toll of surrogacy and future relationships: Many people who have children through surrogacy go on to have relationships with their surrogate or gestational carrier.

While it’s common, it’s not required, and for some families that aren’t interested in keeping in touch, gestational surrogacy is a better fit.

In addition, it can be difficult for some intended parents to undergo surrogacy knowing that the biological mother of their child is the surrogate.

For this reason, gestational surrogacy is an option that helps quell difficult emotions.

Success Rate for Gestational Surrogacy

You should know that gestational surrogacy statistics are pretty favorable — and many individuals and couples who seek out gestational surrogacy are able to grow their families.

According to the Centers for Disease Control (CDC):

  • “Gestational carrier cycles had a higher rate of implantation, pregnancy, and live births when compared to non-gestational carrier cycles,” says the CDC, meaning that gestational carriers were regularly successful at becoming pregnant in comparison to couples who choose to undergo in vitro fertilization (IVF) instead of surrogacy.
  • In addition, between the years of 1999 and 2013 (most recent data), gestational carriers in the U.S. had 13,380 deliveries, totaling 18,400 babies. More than half of those pregnancies involved twins, triplets, or multiples.

But what are your chances of having a successful surrogacy experience?

There’s no hard and fast data on how often surrogates safely make it through a full-term pregnancy, but some surrogacy agencies suggest that success rates in the United States are as high as 75 percent, and that after successful embryo transfer, 95 percent of surrogates go on to deliver a healthy baby.

The Gestational Surrogacy Process

While the fine details of the gestational surrogacy process will change from agency to agency, in general, the process is pretty straightforward:

Step 1: Locate a gestational surrogacy agency

Many people considering gestational surrogacy reach out to a surrogacy agency to learn more about surrogacy and begin the process. During this step, intended parents learn more about the cost of surrogacy, the process, and their responsibilities.

Step 2: Start the search for a gestational carrier or screen carriers suggested by the agency

Some couples have a specific surrogate in mind, such as a close friend or family member who has volunteered to carry their baby.

Other couples do not, so finding prospective surrogates is a top priority. Most agencies will work to help match you with a gestational surrogate, and you’ll be able to meet the surrogate to determine if you are a good match.

Step 3: Drafting and signing surrogacy contracts

Preparing and signing the necessary surrogacy forms and contracts is crucial since it protects both the surrogate and intended parents in case of a dispute or issue.

Whether you choose to go with a surrogacy agency or to pursue surrogacy privately, know that it is incredibly important to have your surrogacy contracts reviewed by a legal expert.

Step 4: Undergoing medical examinations and the IVF process (if needed)

After a surrogate is selected and all the paperwork is complete, the medical portion of the process begins.

Intended parents who plan to use their own eggs and sperm will need to undergo health screenings, as will the gestational surrogate. From there, the IVF process will begin so that the intended mother’s eggs can be harvested.

Step 5: Prepare for and undergo egg or embryo transfer

Prior to implantation of a fertilized egg (or transfer of an embryo), the gestational surrogate will likely begin a course of fertility medications that raise her chances of success. The actual implantation process is relatively quick and painless.

Step 6: Confirming a pregnancy and enjoying the pregnancy process

Normally around two weeks following egg or embryo transfer, the surrogate will visit with a doctor to determine if she is pregnant, or if the transfer process has failed.

If successful, she and the intended parents will begin the pregnancy journey together, which includes regular check-ins and shared medical appointments.

Step 7: Delivery of the baby and creating a family

The surrogacy experience ends with the baby’s delivery. After the GC and baby are both considered healthy, they are discharged from the hospital, with the gestational carrier heading home and the baby joining the intended parents.

If you’re wondering, “How long does surrogacy process take,” know that most intended parents are able to match with a surrogate within four to six months.

Considering that pregnancy is a long 40 weeks, the entire process can take up to a year and a half, from matching to delivery.

Finding a gestational carrier

There are generally two ways to find a surrogate: through gestational carrier agencies, or privately.

Agencies can be a great tool at locating and screening potential surrogates, and their experience can help walk you through the process to avoid pitfalls.

This can be especially important for intended parents who are pursuing surrogacy for the first time and aren’t sure of what all is involved.

Other intended parents choose to locate private surrogates, often as a way to reduce the cost of surrogacy by bypassing an agency. In this scenario, intended parents may choose to place ads in papers, magazines, and online to help find a surrogate.

Some may reach out to the best fertility clinics in their area to determine if they have partnerships or relationships with surrogates. And in other cases, intended parents may have a friend or close family member volunteer to be their surrogate.

Choosing a gestational carrier

Choosing the person who will carry your child is an important task. When it comes to deciding on a surrogate, you’ll want to keep these things in mind:

  1. Do you get along with the GC, and do you foresee her being the person to carry and deliver your child? Would you want to have a relationship with this person after your child is born?
  2. What kind of lifestyle does the GC have — is she active? What are her nutritional habits? Does she have any health issues that could impact the pregnancy?
  3. What experience does the GC have? How many times prior has she been a surrogate?
  4. Are you able to meet the budgetary needs and expenses of the surrogate?
  5. Do you and the surrogate see eye-to-eye on all aspects of the pregnancy and contract, such as situations where you may need to terminate the pregnancy?

Gestational Carrier Eligibility and Requirements

While surrogacy requirements may slightly differ from region to region, as well as among agencies, you should know that there are some common requirements for potential GCs.

If you’re looking for a gestational carrier or considering how to become a gestational surrogate, here are common requirements you should know:

  • Must meet the gestational carrier age limit, usually between 21 and 39 years old
  • Usually must have safely given birth to at least one child (with no complications), who is currently in their care
  • Meet certain financial requirements (often showing that you have enough resources at your disposal to comfortably carry a baby to term without relying on government assistance)
  • Must have a healthy body weight
  • In the U.S., must be a legal citizen who is eligible to work
  • Must have a letter from their OB/GYN clearing them to be a surrogate, as well as a clean medical history

While these are general guidelines, surrogacy agencies may choose to have additional eligibility requirements for potential surrogates.

Medical and psychological tests required

In addition to meeting certain requirements, gestational carriers may also be required to undergo certain kinds of testing.

Many agencies require GCs and surrogates to undergo a mental health evaluation to determine if they will be able to handle the emotional rigors of surrogacy.

Other tests, such as sexually transmitted infection (STI) and general health screenings are often required by agencies.

You should know that while there are federal health regulations that require certain kinds of STI and health screenings for egg and sperm donors, FDA regulations for gestational carriers do not exist, but these screenings are still highly recommended by many pregnancy and gynecological health organizations.

Legal Implications of Using a Gestational Carrier

A large part of the gestational carrier process is the legal components that identify who the intended parents are, and who has rights to the baby during pregnancy and after birth.

For this reason, it is important to have a gestational carrier agreement.

Gestational carrier contract

With a gestational carrier agreement, you and your surrogate will outline a variety of responsibilities.

Your responsibilities may be ensuring the surrogate has access to medical care, helping with living expenses such as groceries, and attending all medical appointments, while covering the cost of her medical expenses.

The surrogate’s responsibilities usually revolve around a positive lifestyle that will ensure your baby is born healthy. The gestational carrier agreement will also outline who the baby’s legal parents are.

Insurance coverage

Because many insurance agencies will not cover surrogate pregnancies, your surrogate will rely on you for assistance with her medical costs.

For this reason, the gestational carrier agreement will outline how medical bills will be covered, and who (usually the intended parents) will cover hospital and medical costs.

Court order declaring parentage

In an effort to protect themselves and their unborn child, many intended parents seek out a court order declaring parentage.

Intended parents can file a pre-birth court order that legally declares them to be the child’s parents, and gives them the right to put their name on the child’s birth certificate.

It can also make it easier to have insurance coverage for the baby, and gives them the right to make all medical decisions for their unborn (and born) child.

Cost Considerations for Gestational Surrogacy

One downside that many families face with gestational surrogacy is the cost.

Gestational surrogate costs often range between $75,000 and $150,000. While the gestational carrier price is often only between $30,000 and $60,000, the remaining amount often includes agency fees, medical expenses, IVF costs, and more.

And because health insurance often doesn’t cover a gestational carrier’s expenses, those medical bills are often paid out of pocket by intended parents.

One way couples look to reduce the cost of surrogacy is to locate a friend or family member who will volunteer to carry their baby — in fact, the cost of surrogacy with a family member can be as little as several thousand dollars in medical bills.

Pros and Cons of Gestational Surrogacy

Like any big life choice, there are pros and cons to gestational surrogacy. Some of the most positive points of surrogacy include:

  • Being able to have a child who is biologically related to you
  • Still being able to participate in and enjoy the journey of pregnancy
  • Bonding with the surrogate mother, which can create a larger, loving support network for your child’s life

Still, there are some downsides to gestational surrogacy:

  • The costs can be staggering
  • The surrogacy journey can be emotionally difficult at times knowing that someone else is carrying your child
  • There’s limited control over the pregnancy, which can be difficult for some intended parents to accept

Ethical considerations

Surrogacy does carry some major ethical questions. Many people wonder if it is ethically alright to have another person carry a child that they will not raise, considering the strong emotions involved.

Another major dilemma questions whether it is ethical to pay someone for use of their reproductive system, or if surrogacy is a form of exploitation of lower-income women who may seek out surrogacy as a way to support their families.

So, is surrogacy ethical? Each family and gestational carrier who considers surrogacy must decide this for themselves.

Medical risks

Because pregnancy is strenuous on the body, it is important to recognize that even a surrogate who has had healthy pregnancies may encounter medical issues.

Common medical risks that a surrogate may encounter include:

  • Loss of pregnancy
  • Loss of fertility (especially after a C-section or carrying multiples)
  • Pregnancy-related health conditions, such as gestational diabetes or high blood pressure

Is Gestational Surrogacy Right For Me?

If you’re wondering if gestational surrogacy is right for you and your family, consider these points:

  1. Can I afford the cost of gestational surrogacy?
  2. What kind of relationship do I want to have with a surrogate during and after pregnancy?
  3. How do I feel about the legal process of surrogacy — am I comfortable with it?
  4. Can I handle the emotions that come with gestational surrogacy?
  5. Have I weighed the pros and cons of surrogacy, and considered other fertility options?