Surrogacy

Surrogacy explained

Surrogacy is becoming more common as more people worldwide struggle to conceive a child. However, the services of a surrogate mother are not only for couples dealing with infertility. For gay couples, single men, some trans people, and women who cannot safely carry a child to term, a surrogate can be the only option to have a baby.

Introducing surrogacy

While paid surrogacy is legal in a handful of countries, most surrogates choose to offer this service based on a deep sense of compassion and a desire to help others have a family. It’s a beautiful and loving act, but one that comes alongside many complex legalities.

Are you considering using the services of a surrogate to have a baby? Perhaps you are thinking about acting as a surrogate for a stranger or trusted loved one?

The laws around surrogacy are complex and often hard to navigate – read ahead to learn more about this deeply altruistic act.

What is a surrogate mother?

A surrogate mother is a woman or any other AFAB (assigned female at birth) person who carries a child for another person or couple. Some surrogates do not like the use of the word “mother” as part of their role.

What is the difference between traditional and gestational surrogate mothers

There are two types of surrogate mothers: traditional and gestational.

Traditional surrogate – With traditional surrogacy, the child is conceived with the surrogate’s own eggs and the sperm of the father. In some cases, donor sperm is also used. The surrogate then carries the baby for the parents and relinquishes all parental rights, despite being the biological mother. A traditional surrogate may become pregnant via intercourse, at-home insemination, IUI (intrauterine insemination), or IVF.

Gestational surrogate – With gestational surrogacy, eggs are retrieved from the mother or a donor and fertilised via IVF. The embryo or embryos are then transferred into the surrogate’s uterus, and she carries the baby (which she is not genetically related to). While she is not the biological mother, some documents may refer to her as the “birth mother.”

Who uses the services of a surrogate?

Many different types of people choose to seek surrogacy services:

Couples dealing with infertility
Infertility is an increasingly common medical condition that is estimated to affect at least 1 in 7 couples. Infertility, defined as the inability to conceive naturally after more than one year of regular intercourse, occurs for a wide array of medical reasons. While infertility is often attributed to either the male or female partner, in many couples, no definitive cause is ever found.
Women with medical conditions that prevent them from safely carrying a baby
Certain medical conditions can make it dangerous for a woman to carry a baby to term, including heart disease and past cancers.
Women who have had their uteri removed or damaged from past medical treatments
Some women have had their uteri removed due to an extremely painful condition called endometriosis or past uterine cancer. Chemotherapy can also reduce uterine volume, making it impossible to carry a baby to term.

Gay couples who want to become fathers
Gay men or AMAB (assigned male at birth) people who wish to have a baby together need to seek the services of a surrogate. In some cases, gay couples each fertilise one egg and both are transferred into a gestational surrogate in order to have ‘twins.’
Single men who want to become fathers
More and more single men and AMAB people are making a choice to become single fathers, working with surrogates in their home countries and abroad to start their families.
Transgender people who do not have a functioning uterus
Some transgender men have a full hysteroscopy as a part of their transition, or hormone therapy damages their uterus. Transgender women do not have uteri. As a result, many transgender people seek the services of a surrogate to have their own biologically linked children.
Transgender men for whom pregnancy would cause dysphoria
Some transgender men still have a functioning uterus, but the act of going off their hormone therapies and becoming pregnant causes them to experience unbearable dysphoria. These men seek the services of a surrogate to carry their biological child, and in some cases, they can use their own frozen eggs (retrieved before medical transitioning).

How to Find a Surrogate

Depending on your home country, there are a few different ways to find a gestational surrogate.

Friends and family – Some people choose to have a close friend or family member act as their gestational surrogate. This is a good option that can help you avoid high costs, confusing laws, and concerns about parental rights. Of course, for traditional surrogacy, the surrogate must be someone unrelated to the sperm donor/male partner.

A surrogacy agency – Depending on the country in which you live, you may be able to find a gestational surrogate via a surrogacy agency. They will help you find the person, make arrangements, decide on compensation for expenses, and settle on payment (if legally allowed).

Your fertility clinic – Fertility clinics can often help you connect with a potential gestational surrogate.

While most countries do not have regulations about who can be a surrogate, you should make an ethical choice and look for a surrogate who:

Is 21 or older
Has had at least one healthy baby, so they understand the difficulty of parting with a baby they’ve just delivered
Has had a past healthy pregnancy without any major complications
Has passed a psychological screening process by a qualified mental health professional, such as a psychologist
Is willing to sign a contract that lays out the specificities about their responsibilities
Is willing to undergo a full medical exam, including tests for infectious diseases that could be passed to the baby
Has had all recommended vaccinations, including vaccines for Covid-19

Remember, if you live in the United States or another country without universal healthcare, you may need to seek special coverage for your surrogate from your private insurance company.

Surrogacy Laws in the US

Laws around gestational surrogates and traditional surrogates vary from state to state, and include differences in allowed compensation, sexual orientation, and marital status. Experts advise anyone entering into a surrogacy agreement in the UK seek the services of a lawyer who specialises in fertility and custody laws.

Under US law, a Declaration of Parentage must be completed to ensure that the Intended Parent is listed on the birth certificate. Your legal counsel can advise you on all necessary and recommended steps.

Lots of our readers want to know – “can I drink alcohol while taking Clomid?” While Clomid doesn’t interact negatively with alcohol, do remember that alcohol can decrease your chances of pregnancy and reduces IVF success. Some women do report dizziness from Clomid, and alcohol can increase this effect. It’s also a good idea to speak with your GP or chemist to ensure that none of your other medications interact negatively with alcohol.

Surrogacy Laws in the UK

While it is legal to use a surrogate in the UK, the laws and rules are not in favour of the parents. Please note that the surrogacy agreement cannot be enforced by the courts, which can make many potential parents nervous about the process. You are allowed to pay for their reasonable expenses, but you must not pay them for their surrogacy.

A surrogate is the child’s legal parent at birth, and if they are married or in a civil partnership, their spouse is the child’s other parent (unless they did not agree to the process). This is unusual; most countries do not consider the surrogate to be the legal parent.

If you use a surrogate in the UK, legal parenthood must be transferred by adoption or parental order after the baby is born. The intended parents have no legal claim to the child in the event that a disagreement about the custody occurs – the matter will need to go to court, and a judge will decide.

You can try to mitigate some of this concern by entering into a surrogacy agreement with your surrogate, detailing how you want the arrangement to proceed. However, this agreement is not enforceable in court.

Travelling for Surrogacy

Based on the complexities detailed, many people choose to seek a surrogate in another country. However, this can be a controversial process, as some women have reported being financially coerced into surrogacy, drawn by the relatively large amount of money they can earn. Some people criticise this as exploitative, so ensure you work with a reputable agency.

Some countries that allow legal surrogacy ‘for hire’ include the US, India, Ukraine, Russia, Mexico, Georgia, and Thailand. Remember, some countries will not legally allow surrogacy for unmarried couples, single people, transgender people, or gay people. It’s a smart idea to seek legal counsel in your own home country to ensure that the process goes smoothly.

Depending on your home country, a baby born abroad may require a visa to travel home with you. Again, your lawyer will be able to advise you on this matter.