Substitute: types, purpose and process


A surrogate mother generally refers to a person who is pregnant with another person or partner. After birth, the intended parent (s) are listed as parents on the birth certificate and raise the child as their own.

In most cases, a surrogate mother refers to someone formally known as a "gestational carrier." Technically, a surrogate is someone who uses her own eggs for pregnancy, while a gestational carrier can use eggs from a donor or intended father. The latter is the norm today for many complex legal, psychological and ethical reasons.

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If you are looking to start a family and are considering surrogacy as an option, you are in good company. In the United States, the number of gestational carrier cycles increased from 727 in 1999 to 3,432 in 2013, resulting in 18,400 babies born worldwide (more than half of whom were twins, triplets, or higher-order multiples ).

If you are considering hiring a surrogate mother, start with this quick guide to the types of surrogates, why you can use them, and where to start.


There are two types of surrogacy: traditional and gestational. Surrogates may or may not receive additional financial compensation as well, although this depends on where you live and the legality of the arrangement.

Traditional surrogacy

In traditional surrogacy, also known as partial, natural, or direct surrogacy, the surrogate mother's own eggs are fertilized with sperm from the father or intended donor. This can happen in a reproductive medicine clinic through a process such as intrauterine insemination (IUI) , during which specially washed sperm are transferred via catheter directly to the uterus.

The key detail here is that the surrogate mother is genetically related to the child who is pregnant, which can have ethical and legal complications. For example, a surrogate mother may change her decision to release the child to the intended parent (s) and may challenge the surrogacy agreement.

Depending on where you live, this contract may or may not be considered legal. The risk is even higher if a sperm donor is used, since the child is not genetically related to the intended father or mother, but to the surrogate mother.

While traditional surrogacy may seem preferable because it can be less expensive compared to surrogacy, it is rare due to these concerns. In fact, according to the American College of Obstetricians and Gynecologists (ACOG), some surrogacy programs are no longer compatible with traditional surrogacy mechanisms.

Gestational surrogacy

On the other hand, gestational surrogacy is a more common option for those looking to start a family through surrogacy these days. It is also known as IVF surrogacy, foster surrogacy, or full surrogacy. In this type of device, the gestational carrier has no genetic link to the baby she is carrying.

Often times, the intended father or both parents will provide an egg or sperm for transfer to a surrogate mother using in vitro fertilization (IVF) . In other cases, a sperm donor, egg donor, or embryo donor may be used.

Laws on the type of surrogacy, compensation mechanisms, and contractual arrangements can vary significantly from state to state and from country to country. It is important to consult with an attorney before entering into any agreement.

Compensated and Compassionate Surrogacy

Cost is a factor that plays a large role in any surrogacy arrangement. With compensated surrogacy (previously called commercial surrogacy), the surrogate mother receives financial compensation in addition to the costs associated with the pregnancy.

Compassionate surrogacy (previously called altruistic surrogacy) does not imply additional financial compensation for the surrogate mother.

Again, the legality of this type of surrogacy arrangement depends on where you live. Be sure to speak with an attorney to learn about the requirements in your area before entering into a settlement or paying a potential surrogate.

In total, the cost of surrogacy can range from $ 60,000 to $ 150,000 or more, including agency and advertising fees, legal and medical expenses, compensation for surrogacy, and more, as estimated by surrogacy programs in the United States. .


There are many reasons why an intended parent (s) may want or need someone else to bring them a child. In general, according to ACOG, people who want to become parents but are unable to do so due to biological impossibility or medical contraindications are good candidates for gestational surrogacy.

Some common reasons for surrogacy include:

  • The expectant mother does not have a uterus , has a malformation or a medical condition in which pregnancy could endanger her life or the life of her child.
  • The intended parent (s) experience repeated IVF implantation failure or intractable pregnancy loss.
  • The intended parent (s) is LGBTQ + and that means having a genetically related child.
  • The intended father is a single person.


To start the surrogacy process, you can contact a potential surrogate or gestational carrier through people you know, such as friends or family, or through an agency.

Since surrogacy can be tricky when it comes to emotions, personal boundaries, legitimacy, and ethics, it's important to consider the pros and cons of any approach. Contacting your local reproductive health clinic or RESOLVE support group is a good start.

Your healthcare provider can help you with your future plans, including counseling, referral to an agency, finding a surrogate partner, additional medical and psychological screenings, hiring, and the path to conception, labor, and delivery.

Get the word of drug information

If you are considering using a surrogate mother to have a baby, there are many factors to consider. While surrogacy can be a rewarding and special experience, it is also difficult, time consuming, and expensive.

As with anyone who wants to have a baby, it is important to make sure you have the support you need to move forward. Be sure to speak with a fertility physician, an attorney experienced in reproductive family law, and a counselor before entering into an agreement. With their help, you can make sure that surrogacy is the right way for you and find the best gestational carrier to bring your baby into the world.

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