The Science of Making Babies

GESTATIONAL (CARRIER) SURROGACY

Remember Phoebe on the TV show “Friends”? She was a gestational surrogate for her brother and his wife. She carried triplets for them! Those babies were the creation of her brother’s sperm and his wife’s eggs and therefore not directly genetically linked to her. That’s how gestational surrogacy works. The surrogate is only used to carry the pregnancy and the baby is not genetically connected to the surrogate. The baby is the combination of genetic material from you and your male partner. In essence, you are only borrowing the surrogate’s uterus. That’s why this process is sometimes referred to as uterine borrowing. Because the surrogate is carrying and delivering the child, a legal contract that states the baby belongs to you and your partner is still necessary.

Gestational surrogacy may be an option if you have normally functioning ovaries but do not have a uterus. You may lack a uterus because you were born that way or perhaps you’ve had a prior hysterectomy. This type of surrogacy may also be indicated when you possess untreatable scarring or other such abnormalities within your uterus. Another reason to choose gestational surrogacy could be if you have a medical condition where pregnancy would be dangerous to you (severe heart disease is one example).

The procedure for gestational surrogacy is carried out using IVF techniques previously discussed. In fact, the only difference is that the transferred embryos are placed into the surrogate’s uterus instead of your own. That means ovulation stimulation and egg retrieval for you and sperm collection and preparation for your partner.The surrogate’s hormonal cycle must be synchronized with yours and her uterus must be prepared with hormones for it to be receptive to embryo implantation. The surrogate will carry the resulting pregnancy and turn the baby over to you once it has been delivered.

Gestational surrogacy is considered more complicated than traditional surrogacy because it requires IVF to create the embryos. Despite this, gestational surrogacy is more commonly used in the United States because it is considered to be legally and psychologically more acceptable to all parties.

SELECTING A SURROGATE

No matter which type of surrogacy arrangement you choose, you will need to select your surrogate. The surrogate may be someone you know, such as a close friend, a sister, or another relative, who is willing to carry the pregnancy for you. Sometimes the surrogate is someone you don’t know but who has been identifi ed through an agency. These agencies specialize in recruiting surrogates, prescreening them, and then matching them with the intended parents. Following are some criteria that you should consider when selecting your surrogate. You’ll note that these criteria are similar to those used in selecting an egg or embryo donor. However, in the case of the surrogate, she must have a normal uterus and must have delivered a full-term infant in the past.

• She should undergo a diagnostic test to prove that she has a normal uterus.
• She should be at least 21 years old and already have delivered a full-term infant in the past.
• She should be healthy, not have any underlying medical conditions, and be able to pass a thorough physical examination.
• She should be tested and found to be negative for infectious diseases and STDs.
• She should have her blood drawn and tested, and her blood type should be noted.
• She should undergo a complete psychological evaluation.

LEGAL AGREEMENTS

Be sure you have a legal contract with your surrogate. Surrogacy agreements are usually rather complicated, so have a reproductive law attorney advise you. The most important feature for you is that the surrogate and her partner revoke all parental rights to you and your partner. In most cases, the surrogate will have a separate legal counsel who will represent her rights and interests.