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Gestational Surrogacy


What Is Gestational Surrogacy?


Gestational surrogacy involves arranging for a woman to carry and deliver another couple’s baby. Although the use of donated eggs, embryos or sperm is not unheard of, the baby is most often genetically related to the intended mother and father. Depending on whether the intended parents pursue “traditional” or gestational surrogacy, a surrogate mother will either undergo in vitro fertilization (IVF) of one of her own eggs or have an artificially inseminated egg belonging to either the biological mother or a donor implanted in her uterus. The parents-to-be remain actively involved in every stage of the pregnancy, including being present at the birth to receive their child.

New York Fertility Institute has been working with gestational carriers to help families since 1997. 


Her Body, My Baby - New York Times Magazine

Learn more about this patients surrogacy experience with New York Fertility Institute




Who Is An Ideal Candidate For Gestational Surrogacy?

Woman Has No Uterus

Whether as a consequence of undergoing a hysterectomy or a birth defect, the lack of a uterus tragically robs many women who aspire to become mothers of the chance to conceive naturally. Through gestational surrogacy, a healthy woman whose ovaries continue to function normally can still become the parent of a biologically related child.

Woman Has Structural Abnormality, Fibroids Or Scars

Many women struggle to conceive due to structural abnormalities of the uterus that make it either difficult or potentially impossible for a fertilized egg to implant itself within the uterus.

Medical Condition Making Pregnancy Dangerous

Although still able to become pregnant, women diagnosed with certain medical conditions including preeclampsia, diabetes, various cancers and certain kidney or heart defects face potentially deadly risk factors by carrying a pregnancy to term due to the inherent immense physical toll childbearing exacts on the mother’s body.

Gay Men Who Use Eggs And A Surrogate To Carry Child

Many gay male couples have become parents through both traditional and gestational surrogacy. Those who opt for traditional surrogacy will choose one partner to donate the sperm that will artificially inseminate the egg of a surrogate who will eventually give birth to the child. If using a gestational surrogate, a donor egg will be used. Either way, as a matter of course, only one of the intended parents will be biologically related to the child.

What Are The Different Types Of Gestational Surrogacy?

Mother’s Ovum/Egg And Father’s Sperm

The most frequently used gestational surrogacy method requires a mother whose ovulation still produces viable eggs and a father who consistently yields a healthy volume of motile sperm. After retrieving and fertilizing the mother’s eggs with the father’s sperm using IVF techniques, the embryos are then transferred to the surrogate’s uterus for implantation. Some states forego the stepparent adoption process by allowing parentage to be established before birth and listing the intended mother’s name on the child’s original birth certificate.

Donor Ovum/Egg Or Donor Sperm

In the event of illness, advancing age limits the intended mother’s egg quality, intended parents can fertilize a donated ovum/egg to fertilize with the sperm of either the father or a donor. Although she may be genetically unrelated, some states may require that the mother then legally adopt the child.

Not Related To Surrogate

By either means of gestational surrogacy, the surrogate bears no relation to the child. Many fertility specialists, surrogates and intended parents regard this as the overall ideal approach, although traditional surrogacy tends to be less expensive due to the lack of required clinical fertility treatment.

How Is Gestational Surrogacy Done?

The gestational surrogacy process should begin with a fertility counselor’s consultation to weigh the journey’s pros and cons, evaluate the emotional ramifications and consider the ongoing relationship with a gestational surrogate during and after the pregnancy. Couples can then choose a gestational surrogate from among friends or relatives or screen candidates submitted by an agency with sound medical and psychological vetting safeguards. We strongly recommend hiring an attorney versed in the legalities of gestational surrogacy to craft an agreement that fairly protects the rights of everyone involved, including provisions for parental rights, legal custody, where the birth mother will deliver the baby, extent of future contact between parties, insurance, control over medical decisions throughout the course of the pregnancy and any compensation to the surrogate. It also bears noting that, while some states require that the surrogate sign away parental rights prior to the baby being born and the intended parents list their names on the birth certificate, others allow the gestational carrier to sign those rights away after giving birth.

Next, the embryo transfer process begins by using prescribed medications to sync the gestational surrogate. This is vital to ensure that the surrogate’s uterus will support an embryo once doctors have retrieved and fertilized the biological mother’s eggs. After stimulating the biological mother’s ovaries using gonadotropins to develop several eggs at once, a minor outpatient procedure will retrieve the ovum at the same time the biological father produces a sperm sample. Once the egg has been fertilized in a laboratory, the frozen embryos can be transferred to the uterus of the gestational surrogate. When an embryo implants, the pregnancy begins.

What Is The Difference Between Traditional And Gestational Surrogacy?

Aside from certain legal ramifications implied above, the difference between traditional and gestational surrogacy is fairly straightforward. Traditional surrogacy involves artificially inseminating the surrogate with the sperm of either the intended father or a separate donor, making the surrogate also the child’s biological mother.

In gestational surrogacy, an embryo created by artificially inseminating the intended mother or a donor’s egg with the sperm of either the intended father or a donor is implanted in the surrogate’s uterus. Thus, the birth mother has no biological relation to the child.

What Are The Challenges Of Gestational Surrogacy?

Gestational surrogacy is, with few exceptions, a legally and emotionally complex undertaking that demands substantial investments of time, patience and money.

A number of states honor gestational surrogacy contracts, but enforceability can vary. Whereas some states only honor agreements entered into by married couples, others prohibit parents from compensating their surrogate or impose restrictions on non-heterosexual participants. An attorney licensed in your state with experience navigating third-party reproduction agreements is a necessity to remaining thoroughly advised of your options.

In terms of the medical ramifications, prescribed fertility medications can come with some side effects to the gestational surrogate on top of a pregnancy’s normal discomforts and risks. Meanwhile, parents-to-be can anticipate heightened anxiety and suspense as they await the safe, healthy birth of their child. Many times, a couple’s loved ones also fail to understand why two people would choose such an exhaustive course to become parents. Finally, there’s the necessity of thorough psychological evaluation; couples have run into numerous legal snags over the possibility of a surrogate backing out and refusing to carry the baby or even giving birth and having more difficulty than expected relinquishing the baby.

How Long Can The Gestational Surrogacy Process Take?

The gestational surrogacy process is intensive. It can take months or sometimes years to connect with a willing carrier in ideal health, even when screening candidates through an agency. After reaching a finalized agreement and commencing treatment, a successful pregnancy may require three or four IVF cycles of four to six weeks each.

What Are The Qualifications To Become A Surrogate?

  • Sound mental and physical health
  • Have carried and delivered at least one child
  • All prior pregnancies carried to term with no complications
  • Be under 43 years of age – clinical cut-off ages may vary between facilities
  • Stable living conditions
  • No history of alcohol abuse or tobacco

How Successful Is Surrogacy?

Success rates for healthy births resulting from gestational surrogacy using the intended mother’s eggs inevitably decline rapidly with advancing age, plummeting from an almost 50-percent success rate on average across America for women 34 years of age and under to barely over 10 percent for women over 43 years old. That being said, your chances of having a child via gestational surrogacy are, at worst, just as strong as those of conceiving with traditional IVF procedures. At best, they’re actually slightly better.

What Are The Typical Surrogacy Fees?

Gestational surrogacy costs can often total more than $100,000 after all fees and expenses have been accounted for, including:

  • Average compensation, allowances and routine reimbursements
  • Agency fees covering the screening of potential surrogates
  • Maternity insurance coverage for either a stand-alone specialty policy or an addition to existing coverage
  • Cost of IVF
  • Securing egg or sperm donors, if necessary
  • Drafting and executing legal documents establishing parental rights
  • Psychological screening, home visits and support for your surrogate during the pregnancy
  • Travel

Pros & Cons Of Gestational Surrogacy


  • Opportunity for single parents, couples struggling with infertility and LGBT community members to experience the singular joys of parenthood
  • Maintains genetic link between intended parents and their child
  • Development of an emotionally meaningful bond between intended parents and their surrogate
  • Because the baby is not genetically related to its carrier, legal complications are minimized


  • Often cost-prohibitive and legally complex
  • Demands great trust for intended parents to relinquish control of the birth of their child to someone else
  • Invasive and exhausting fertility treatments and additional procedures, if the intended mother plans to use her own eggs
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New York City, NY 10028
Phone: 212-734-5555
Fax: 212-734-6059
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