What is Gestational Surrogacy and How it Works

What Is Gestational Surrogacy and How Does It Work?

Gestational surrogacy is a form of assisted reproduction in which a woman (the surrogate mother) carries and gives birth to a baby to whom she has no genetic connection.

The embryo is created through in vitro fertilization (IVF) using:

• the intended parents’ eggs and sperm, or

• donor eggs and/or donor sperm.

The embryo is then transferred to the uterus of the gestational surrogate, who carries the pregnancy and delivers the baby for the intended parents.

From a medical, genetic, and legal perspective, the surrogate is not the biological mother of the child.

How Gestational Surrogacy Works – Step by Step

1. Medical evaluation of intended parents
   Fertility assessments and selection of genetic material (own or donor).

2. Selection of a gestational surrogate
   The surrogate undergoes strict medical, psychological, and social screening.

3. IVF and embryo creation
   The embryo is created in a laboratory using IVF techniques.

4. Embryo transfer
   A healthy embryo is transferred into the surrogate’s uterus.

5. Pregnancy and monitoring
   The surrogate receives full medical care throughout pregnancy.

6. Birth and legal parentage
   The baby is born and legally recognized as the child of the intended parents, according to the laws of the country where the program is conducted.

Difference Between Gestational and Traditional Surrogacy

Although both involve a surrogate carrying a pregnancy, gestational and traditional surrogacy are fundamentally different.

Gestational Surrogacy

• The surrogate has no genetic link to the child

• The egg comes from the intended mother or an egg donor

• Legally clearer and safer for intended parents

• Widely accepted in modern surrogacy programs

• Used in countries like Ukraine, the USA, Mexico, Colombia, Czech Republic

➡️ This is the most common and recommended form of surrogacy today.

Traditional Surrogacy

• The surrogate uses her own egg

• She is both the genetic and birth mother

• Pregnancy usually occurs via artificial insemination

• Higher legal and emotional risks

• Heavily restricted or banned in many countries

➡️ Rarely used today due to complex legal and ethical issues.

Key Differences at a Glance

Why Gestational Surrogacy Is Preferred

• Clear separation between genetics and pregnancy

• Stronger legal protection for intended parents

• Reduced risk of custody disputes

• Ethically and medically well-regulated

• Allows use of donor eggs or sperm if needed

Who Can Choose Gestational Surrogacy?

Gestational surrogacy may be an option for:

• Couples with medical infertility

• Women without a uterus or with contraindications to pregnancy

• Same-sex male couples

• Single men

• Intended parents after failed IVF attempts

The primary thing needed to be known how do surrogacy types differ as surrogacy can be:

1. Gestational.
2. Traditional.

The principle distinction is that the woman in traditional surrogacy program is a mother of baby from the biological point of view because the fertilization is done inside the woman’s body. On the contrary, gestational surrogacy it is performed outside the human body. This way of overcoming the infertility was the only option for couples who didn’t have an opportunity to use ART, as they didn’t exist yet.

Surrogacy involves two parties — a woman who will be carrying pregnancy and the intended parents. Eggs and sperm are taken from the intended parents for the fertilization by ICSI or PICSI and the blastocyst created as a result is transferred. Considering the actual fertilization is done in a specially equipped laboratory, surrogate does not take any part in these procedures and has no genetic connection to a baby she is going to carry.

In some circumstances the traditional surrogacy is used these days, and they are quite rare.
Traditional surrogacy often goes along with complications connected with the legal part and the psychological point of view. Countries which allow surrogacy adhere to the gestational type. At the same time, there is a big number of countries which do not recognize surrogacy at all.

How does gestational surrogacy work?

Gestational surrogacy as a process demands a comprehensive strategy and a thorough work where several equally important matters must be taken into account. First, couple needs to decide if to work independently or to find assistance. As a rule, intended parents, tend to hire agencies who can keep every detail in mind and offer them the best options among those available. They can take charge of recruiting surrogate and matching procedure, you will just let them know what qualities are crucial for you and what type of person you would love to have as your gestational carrier.

Agencies will also offer you several reputable clinics. Normally, agencies propose only those who have already proven to have high pregnancy success rates and who are easy to collaborate with. This means they have mutual effectively completed programs in the past which adds up confidence in this sometimes scary journey. All surrogates are being recruited and medically evaluated in these clinics while agencies are coordinating and organizing this process. In other words, agencies become your right hand which facilitates your surrogacy program and protects your interests.

If you decide to use agency’s services, your program will start from signing the agreement with them and once you agree on the clinic you may move to the medical part of your path — the creation of embryos. For this purpose intended mother goes through an ovarian stimulation with the eventual egg collection. This set of procedures is needed to obtain as many eggs as possible for the fertilization.

During the ovarian stimulation woman makes shots of hormones every day, mostly in the morning hours. The intake of these hormones leads to the growth of all the follicles which woman’s body produces during one menstrual cycle. The stimulation takes approximately from 9 to 12 days and ends up with an egg collection. This is the minimally invasive surgery in which the doctor inserts a very thin needle into your ovaries to collect your follicles.

Intended parents prefer embryo the egg collection,ICSI, embryo culture and embryo transfer to be in the same place. The only exception is when the clinic located far from the IP’s place of residence. In cases like this the embryo creation takes place in another country and then the biological material is transported. There are specific companies which work at the shipping of the bio-material in special tanks with liquid nitrogen.

In a number of instances intended mother or father are unable to produce eggs and/or sperm or their material is unsuitable for the fertilization due to the quality. In such cases help from a donor is required. Please, note that surrogacy cannot go along with double donation in some countries and the embryo needs to be connected with at least one parent. Egg and sperm donation can be anonymous or non-anonymous, depending on the country. Judging from the place where you’re seeking for your surrogacy journey, the matching differs.

The fertilization can be done byICSIorPICSI. Embryologists select a single sperm and insert it inside eachoocyte. Then everybody is waiting 5 days to see how many will grow into good qualityblastocysts.Blastocystis an embryo developed until the 5th or 6th day of culture and has a potential to result in pregnancy. It is preferable to transferblastocystsof a satisfactory or good grading (according to the Gardner’s classification), especially in surrogacy programs to maximize odds for success.

The subsequent move on your way to successful surrogate pregnancy is the genetic testing of embryos. This stage is often omitted due to specific indications to carrying out this test, such as advanced age and hereditary diseases. However, the strong desire of certainty in transferring healthy embryo can be a sufficient ground. Bear in mind that PGD or PGS will extend time needed to wait before the embryo transfer. The average waiting time is one month. If you have doubts about PGD, your IVF specialist will give recommendation based on medical history.

When embryos are ready, fertility doctors start the preparation of the uterine lining for a transfer. It is necessary for a surrogate to take hormonal pills for three weeks (sometimes injections) to stimulate the growth of the endometrium. At that period she is visiting her doctor for ultrasounds and once her uterus is ready the embryo is warmed and transferred. The embryo transfer is painless and short so it doesn’t cause a lot of discomfort. In two weeks the blood test is performed and the pregnancy is confirmed.

Eight things to know about gestational surrogacy

Gestational surrogacy is frequently a perplexing and challenging path for both intended parents and a surrogate. For this reason we have prepared eight aspects of the gestational surrogacy that to keep in mind while seeking for surrogacy chances.

1. The legal side of your program; it’s better to be informed about the reproductive law of the country where you’re pursuing the program and the country of residence. The best option is to hire attorneys in both countries.
2. Your desire to use agency’s services or not. In case you decide to organize the program on your own, be prepared that it requires a lot of time and effort.
3. The health of your surrogate — be sure to ask about the number of cesarean sections as the bigger the number is, the higher is the chance of complications.
4. The number of probable attempts with one surrogate; do not forget to agree with your surrogate the number of attempts she is willing to make in case of need.
5. Thenumber of embryos you want to transfer. This question should be agreed when you’re selecting a surrogate as not every woman wants or can carry twins.
6. ThePGD — it is done only on fresh embryos, that’s why you should decide if you want to have it before embryos are vitrified.
7. Themoving of a surrogate, make sure you or your agency organizes this service in the middle of pregnancy, it is better when surrogate lives close to the hospital.
8. The payment — if you use agency you have to know if monthly compensations and final one is included or it is paid extra for.

Gestational surrogacy has proven to be an effective choice for people who cannot carry pregnancy. Even though it is often demanding and difficult, every couple who has gone through it says every move was worth this never-ending happiness.