Gestational Carriers – Surrogates

In the U.S. alone, approximately 850 gestational surrocycles are performed each year via carrier procedures. A woman who carries another woman’s embryo is called a gestational carrier. Many times, the gestational carrier has no genetic relationship to the recipient couple or the resulting baby.


How is a traditional surrogate different from a gestational carrier?

A surrogate is someone who donates an egg, which is fertilized with the male partner’s sperm in the laboratory setting. The gestational carrier is someone who carries the fetus, but the egg is placed in her uterus. The carrier only offers a nurturing environment for the fetus. The egg and sperm come from the intended parents via in vitro fertilization.


What can I expect before the IVF and gestational carrier process?

The Federal Drug Administration (FDA) requires the fertility center to test the biological tissue of the embryo for infectious diseases. The fertility clinic does this in a laboratory setting, using strict guidelines before in vitro fertilization takes place. The gestational carrier will sign a detailed legal contract relinquishing all rights to the baby upon delivery, and she is in no way legally responsible for the support and welfare of the child in the future.


How is in vitro fertilization done?

The intended parents first undergo a cycle of IVF. First, the woman’s ovaries are stimulated using injectable hormones. This involves injections of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which produce one or more eggs. To measure the development of the follicles (sacs around eggs), transvaginal ultrasounds are used.


Once the eggs reach maturity, the fertility specialist retrieves them using transvaginal oocyte retrieval. Once in the laboratory, the intended father’s sperm is injected into the eggs using intracytoplasmic sperm injection (ICSI), and the embryos then develop.


What happens during the gestational carrier procedure?

The gestational carrier’s uterus is prepared to carry the embryo using hormones (progesterone and estrogen). When hormone levels are appropriate, the embryo(s) are transferred to the carrier’s uterus. This is done using a thin, small catheter inserted up the cervix. The gestational carrier will maintain the fetus until delivery occurs.


Why would a gestational carrier be used?

Many women cannot carry the baby to term. Gestational carriers are used when:

  • The recipient woman does not have a uterus due to previous hysterectomy (cancer, severe endometriosis, or fibroids).
  • The intended mother has a serious medical condition that will be aggravated from pregnancy.
  • The woman has scarring of the uterus or a uterine condition related to previous surgery or infections.


What type of counseling will I receive?

Before seeking the services of a gestational carrier, the fertility specialist recommends extensive psychological assessment and counseling. This is used for both the intended parents and the gestational carrier.


Are there any benefits to using a gestational carrier?

Use of a gestational carrier is part of a detailed clinical fertility treatment. This process has many benefits, such as:

  • High success rate
  • Laws supporting this process
  • Experienced fertility specialists coordinating it
  • Has good results for both parties


What type of legal documents and paperwork are required?

The fertility center arranges a detailed legal agreement between the intended parents and the gestational carrier. We recommend that each of the parties maintain separate legal counseling. In addition, the specified laws regarding surrogacy contracts and parental rights vary from state to state.


Will the gestational carrier be screened for communicable diseases and health issues?

The fertility clinic has strict protocols regarding gestational carriers. The woman serving in this role is tested for certain diseases, such as herpes simplex virus, hepatitis B and C, human immunodeficiency virus (HIV), toxoplasmosis, syphilis, and cytomegalovirus. Per regulations of the American Society of Reproductive Medicine, the carrier also undergoes a comprehensive physical exam, uterus assessments, and she cannot use drugs, tobacco, or alcohol.