Your fertility plan should be too.
With fertility treatment, using a gestational carrier or (surrogate) is an option for individuals or couples who are unable to carry a pregnancy to term, including single male patients or gay couples.
A GC is a woman who enters into a legal agreement to have an embryo(s) created through IVF transferred into her uterus, and to carry and deliver the resulting child(ren) on behalf of the couple or individual who cannot carry a pregnancy – known as the intended parent(s).
In this arrangement, the GC is not genetically related to the resulting child(ren). Intended parents who need a gestational carrier can use their own sperm and eggs in IVF or use a donated egg, sperm, or embryos.
In the United States, gestational carriers (who don’t use their own eggs) are the preferred option as opposed to traditional surrogacy (in which the woman uses her own eggs), since the legal arrangements are more straightforward.
Traditional surrogacy is a legal arrangement in which a woman will be inseminated with sperm from the intended parent to attempt to become pregnant on behalf of the intended parent(s). The surrogate’s own egg(s) are fertilized, and therefore the surrogate is biologically and genetically related to the baby she carries.
According to ASRM, this type of surrogacy carries a higher legal risk due to the potential for conflict over the nature of binding agreements signed prior to the surrogacy process or at birth, since the surrogate is genetically involved.
Fertility Specialists Medical Group requires that in any gestational carrier arrangement, the intended parent(s) and the GC seek counseling from a mental health professional familiar with the complex psychological and emotional issues related to a gestational carrier arrangement.
We also require legal counsel for both parties before the medical process begins to ensure all parties are in agreement regarding parenting rights and compensation.
Many factors come into play when deciding to use a GC. Women who are unable to safely carry a pregnancy to term may opt to use a gestational carrier, often due to conditions such as:
Other candidates for using a gestational carrier include:
The gestational carrier is compensated for the risk she assumes and the service she provides by carrying a pregnancy.
Some patients choose to have a friend or family member be their GC, which can reduce costs significantly.
Our doctors can screen and test friends or family members who consider being gestational carriers.
Gestational carrier agencies around the country offer programs for intended parents to meet potential GCs. Agencies typically recruit, screen (basic), and legally represent all potential GC candidates.
There are a number of agencies in the San Diego area. Please click on the links below to learn more about each agency. Other agencies can be found via the internet.
Both the intended parents and the gestational carrier undergo physical examinations to make sure they are healthy enough for their respective procedures.
According to the Centers for Disease Control and Prevention (CDC), gestational carriers have a higher rate of multiple births (twins or more) and preterm labor when compared with non-gestational carrier pregnancies. This is largely due to transferring more than one embryo per IVF cycle.
For the safety and health of both the woman and resulting child(ren), the physicians at Fertility Specialists Medical Group recommend transferring only one embryo when possible for all IVF cycles (including for gestational carriers), which is known as elective single embryo transfer (eSET).
Partnering with a gestational carrier involves considerable legal issues and potential risks. Those wishing to have a child using a gestational carrier should seek advice from lawyers who are experienced in third-party reproduction.
Traditional surrogacy carries even more of a legal risk than using a gestational carrier because the surrogate is genetically related to the child. Many states have outlawed the use of traditional surrogates. While traditional surrogacy is still legal in the state of California, due to the legal complexity, gestational carriers are still preferred, and used exclusively at FSMG.
Using a gestational carrier can be emotionally and psychologically challenging for both the intended parents and the woman carrying their child(ren). Counseling by professionals who are experienced in providing support can be very beneficial.
While not a medical risk, the cost of using a gestational carrier can be daunting for some. We recommend patients talk to our financial counselors if they are considering using a gestational carrier.