What does surrogacy mother mean

What It Is and How Does Surrogacy Work

Written by Rebecca Buffum Taylor

Medically Reviewed by Jennifer Robinson, MD on November 04, 2021

There's still some controversy about using a surrogate mother to have a baby. The legal process is also tricky because it varies from state to state. Even so, whether it's because of fertility problems or other reasons, surrogacy is an option for you and your partner. Find out how it works and see if it's right for you.

What Is a Surrogate Mother?

There are two kinds:

Traditional surrogate. It's a woman who gets artificially inseminated with the father's sperm. They then carry the baby and deliver it for you and your partner to raise.

A traditional surrogate is the baby's biological mother. That's because it was their egg that was fertilized by the father's sperm. Donor sperm can also be used.

Gestational surrogates. A technique called "in vitro fertilization" (IVF) now makes it possible to gather eggs from the mother (or an egg donor), fertilize them with sperm from the father (or a sperm donor), and place the embryo into the uterus of a gestational surrogate.

The surrogate then carries the baby until birth. They don't have any genetic ties to the child because it wasn't their egg that was used.

A gestational surrogate is called the "birth mother." The biological mother, though, is still the woman whose egg was fertilized.

In the U.S., gestational surrogacy is less complex legally. That's because both intended parents have genetic ties to the baby. As a result, gestational surrogacy has become more common than a traditional surrogate. About 750 babies are born each year using gestational surrogacy.

Who Uses Surrogates?

If you're a woman, you may consider a surrogate for several reasons:

Medical problems with your uterus
You had a hysterectomy that removed your uterus
Conditions that make pregnancy impossible or risky for you, such as severe heart disease

You may want to think about surrogacy if you tried but couldn't get pregnant with a variety of assisted-reproduction techniques, such as IVF.

Surrogates have also made parenthood an option for people who might not be able to adopt a child, perhaps because of their age or marital status.

If gay men decide to use a traditional surrogate, one of them uses their sperm to fertilize the surrogate's egg through artificial insemination. The surrogate then carries the baby and gives birth.

A gay couple might also choose an egg donor, fertilize that donated egg, and then have the embryo implanted in a gestational surrogate to carry until birth.

Finding a Surrogate

There are several ways you can find a surrogate mother:

Friends or family. Sometimes you can ask a friend or relative to be a surrogate for you. It's somewhat controversial. But because of the high cost of surrogacy and the complex legal issues it raises about parental rights, a tried-and-tested family relationship can be simpler to manage.

The American Society for Reproductive Medicine accepts certain family ties as acceptable for surrogates. It generally discourages surrogacy, though, if the child would carry the same genes as a child born of incest between close relatives.

A surrogacy agency. Most people use one to arrange a gestational surrogate. There are about 100 agencies now operating in the U.S. They act as go-betweens.

An agency helps you find a surrogate and make arrangements. It also collects any fees that get passed between you and the surrogate, such as paying for their medical expenses.

How to Choose a Surrogate

Right now there aren't any regulations about who can be a surrogate mother. But experts agree on a few points about how to select one.

You should choose surrogates who:

Are at least 21 years old
Have already given birth to at least one healthy baby so they understand firsthand the medical risks of pregnancy and childbirth and the emotional issues of bonding with a newborn
Have passed a psychological screening by a mental health professional to uncover any issues with giving up the baby after birth
Sign a contract about their role and responsibilities in the pregnancy, such as prenatal care and agreeing to give you the baby after birth

Using a Surrogate

The American Society for Reproductive Medicine says surrogates should get a medical exam to check that they are likely to have a healthy, full-term pregnancy. The organization suggests they get tests that check for infectious diseases such as syphilis, gonorrhea, chlamydia, HIV, cytomegalovirus, and hepatitis B and C.

Surrogates should get tests to make sure they have immunity to measles, rubella (German measles), and chickenpox. Also, you may want to ask that they get a medical procedure to visually "map" the uterus, which can help the doctor check their potential to carry a pregnancy. Surrogate mothers should have their own doctor during pregnancy rather than use yours.

The cost of surrogacy can range from $80,000 to $120,000. A lot of different things go into the price, such as whether the surrogates have their own medical insurance or whether you need to buy a surrogacy-pregnancy policy for them.

Legal Issues With Surrogates

Parental rights aren't guaranteed after a surrogate pregnancy. The law continues to change as reproductive technology and the very definition of a "parent" changes.

There isn't a federal law on surrogacy and state laws vary. After a surrogate pregnancy in some states, you may still have to pass adoption proceedings to gain legal custody of the child. In other states, a "declaration of parentage" before birth lets you avoid having to "adopt" the baby.

To protect your rights as parents-to-be -- and the rights of the child you're hoping to have -- hire an attorney who specializes in reproductive law in your state. They can write a surrogacy contract that clearly spells out what everyone needs to do.

A contract like that may help if legal issues come up after birth. It can also outline agreements about a variety of possible scenarios with the pregnancy, such as what happens if there are twins or triplets.

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What Is a Surrogate Mother? Process, Types, Cost, More

What do Kim Kardashian, Sarah Jessica Parker, Neil Patrick Harris, and Jimmy Fallon have in common? They’re all famous — that’s true. But they’ve also all used gestational surrogates to grow their families.

As these celebrities know, there are many ways to have children these days. And as technology advances, so do the options. More and more people are turning to surrogacy.

While you may associate this practice with movie stars and the rich, here’s what you can expect — from the general process to the overall costs — if you think this route may be a good match for your family.

First comes love, then comes marriage, then comes baby in a baby carriage. The old song sure leaves a lot out, doesn’t it?

Well, surrogacy can help fill in some of those details for the 12 to 15 percent of couples experiencing infertility issues — as well as for others who want to have biological children and are in other situations.

There are many reasons people choose surrogacy:

Health issues prevent a woman from getting pregnant or carrying a pregnancy to term.
Infertility issues prevent couples from either getting or staying pregnant, like recurrent miscarriages.
Same-sex couples wish to have children. This may be two men, but women also find this option attractive because the egg and resulting embryo from one partner can be transferred and carried by the other partner.
Single people want to have biological children.

Related: Everything you need to know about infertility

The term “surrogacy” is generally used to describe a couple different scenarios.

A gestational carrier carries a pregnancy for an individual or couple using an egg that is not the carrier’s. The egg may come from either the intended mother or a donor. Likewise, sperm may come from the intended father or a donor. Pregnancy is achieved through in vitro fertilization (IVF).
A traditional surrogate both donates her own egg and carries a pregnancy for an individual or couple. The pregnancy is usually achieved through intrauterine insemination (IUI) with sperm from the intended father. Donor sperm may also be used.

According to the Southern Surrogacy agency, gestational carriers are now more common than traditional surrogates. Why is this? Since a traditional surrogate donates her own egg, she is technically also the biological mother of the child.

While this can definitely work out just fine, it can create complex legal and emotional issues. In fact, several states actually have laws against traditional surrogacy for these reasons.

Some people find a friend or family member who’s willing to serve as a surrogate. Others turn to surrogacy agencies — in the United States or abroad — to find a good match. Agencies first screen candidates to ensure they meet the criteria associated with the process. Then they cross-match your own wants/needs to find the best situation for your family.

Don’t know where to start? Nonprofit group Society for Ethics in Egg Donation and Surrogacy (SEEDS) was created to review and maintain ethical issues surrounding egg donation and surrogacy. The group maintains a member directory that may help you find agencies in your area.

The qualifications for being a gestational surrogate vary by agency, but they involve things like:

Age. Candidates must be between the ages of 21 and 45 years old. Again, the specific range varies by location.
Reproductive background. They also have to have carried at least one pregnancy — without complications — to term but have fewer than five vaginal deliveries and two cesarean sections.
Lifestyle. Surrogates must live in a supportive home environment, as confirmed by a home study. Drug and alcohol abuse are other considerations.
Tests. Additionally, potential surrogates must have a mental health screening, a complete physical — including screening for sexually transmitted infections (STIs).

Intended parents have certain requirements to meet as well. These involve:

providing complete health histories
having physical exams to ensure they can successfully go through in vitro fertilization retrieval cycles
screening for infectious disease
testing for certain genetic diseases that could be passed to a child

Mental health counseling is also recommended to cover things like expectations from surrogacy, addiction, abuse, and other psychological issues.

Related: The 30-day guide to IVF success

Once you’ve found a surrogate, achieving pregnancy differs depending on what type of surrogate you use.

With gestational carriers, the process looks something like this:

Choose a surrogate, usually through an agency.
Create a legal contract and have it reviewed.
Go through the egg retrieval process (if using intended mother’s eggs) or obtain donor eggs. Create embryos using intended father’s sperm or donor sperm.
Transfer embryos to the gestational carrier (surrogate) and then — if it sticks — follow the pregnancy. If it doesn’t work out, the intended parents and surrogate may pursue another IVF cycle.
The child is born, at which time the intended parents obtain full legal custody as outlined in the legal contract.

Traditional surrogates, on the other hand, are also donating their eggs, so IVF is usually not involved in the process.

Choose a surrogate.
Create a legal contract and have it reviewed.
Go through the IUI process using the intended father’s sperm or donor sperm.
Follow the pregnancy or — if the first cycle doesn’t work out — try again.
The child is born. The surrogate may need to legally terminate parental rights to the child, and the intended parents may need to complete a stepparent adoption in addition to any legal contract set up in earlier stages of the process.

Of course, this process may be slightly different depending on the state in which you live.

The costs associated with surrogacy depending on the type and where you live. In general, the costs for a gestational carrier may fall somewhere between $90,000 and $130,000 when you take into account the compensation, health care costs, legal fees and other situations that may arise.

The West Coast Surrogacy Agency, based throughout California, lists its costs in detail on its website and explains that these fees can change without notice.

Overall compensation

Base pay is $50,000 for new surrogates and $60,000 for experienced surrogates. There may be additional fees as well. For example:

$5,000 if the pregnancy results in twins
$10,000 for triplets
$3,000 for a cesarean delivery

You may also incur costs (that vary) for things like:

monthly allowances
lost wages
health insurance

Costs may also include special circumstances, such as canceled IVF cycles, dilation and curettage, ectopic pregnancy, fetal reduction, and other unexpected situations.

Screenings

Expectant parents will also pay around $1,000 for mental health screenings for themselves, the surrogate, and the surrogate’s partner. Criminal background checks for both parties cost between $100 and $400. Medical screenings will depend on recommendations by the IVF clinic.

Legal costs

There are actually quite a few legal fees involved, from drafting and reviewing a surrogacy contract ($2,500 and $1,000, respectively) to establishing parentage ($4,000 to $7,000) to trust account management ($1,250). The general total here is somewhere between $8,750 to $11,750.

Other costs

This varies by clinic and agency. As an example, West Coast Surrogacy recommends psychological counseling to its intended parents and surrogates at 90 minutes a month and after different milestones, like embryo transfers. In total, these sessions may cost $2,500 — however, this support may or may not be recommended by other agencies.

Other possible costs include the surrogate’s health insurance ($25,000), life insurance ($500), and hotel stays/travel fees associated with IVF cycles ($1,500). Parents may also arrange for private health insurance verification ($275).

Again, there are other miscellaneous situations, like IVF medications and monitoring or lost wages due to pregnancy complications, that may vary in cost.

What about traditional surrogates?

Your costs may be lower with traditional surrogacy because there’s no IVF involved. The cost of IUI is less and tends to have fewer associated medical procedures.

Does health insurance cover any costs?

Likely not, but it’s complicated. According to the ConceiveAbilities agency, around 30 percent of health insurance plans include verbiage that specifically states it will not cover costs for a woman for surrogacy. Around 5 percent do provide coverage, but the other 65 percent are a bit shady on the matter.

In short: There are many appointments, procedures, and then the birth itself to think about. You don’t want an unexpected and costly health insurance bill.

Most agencies will help you review the surrogate’s health insurance plan to determine coverage. They may also recommend that you purchase outside insurance for the surrogate using comprehensive surrogacy insurance programs through agencies like New Life or ART Risk Solutions.

There aren’t any federal laws surrounding surrogacy. Instead, the laws that apply depend on the state in which you live. Legal issues may arise when one parent is biologically related to a child and the other isn’t — even if the surrogate is not biologically related.

Traditional surrogacy — when the surrogate is also the biological mother — can be particularly complicated. Among other issues, you may need to secure what’s called a pre-birth order to be listed as a parent on the birth certificate when the baby is born. Some states may not allow this, even if they don’t have laws against traditional surrogacy. This means the non-biological parent(s) may need to go through adoption proceedings.

No matter the scenario, the American College of Obstetricians and Gynecologists recommends that the surrogate and the intended parents arrange for independent legal representation with lawyers who have experience with surrogacy.

Related: Lawsuit filed by surrogate mother raises new legal, moral issues

When planning surrogacy, everything may seem quite straightforward. However, it’s important to note that as with most things in life, there are opportunities for issues to arise and make things tricky.

Some considerations:

IVF or IUI isn’t a guarantee of pregnancy. Sometimes these procedures don’t work on the first or even subsequent tries. You may need several cycles to achieve pregnancy.
We don’t mean to be a Debbie Downer here. But another consideration is that even if pregnancy occurs, miscarriages are possible.
Just as with the traditional pregnancy-to-parenthood path, there is always a chance for health issues with the baby or complications with the surrogate or actual birth.
Pregnancy with IVF and IUI may result in multiples — twins or triplets.
While home studies and psychological evaluations are part of the screening process, they can’t guarantee that surrogates won’t engage in behaviors you may consider risky. (On the other hand, most surrogates carry babies out of a desire to bring the joy of parenthood to people who might not experience it otherwise.)

There are various ways that being a surrogate may make sense in your lifestyle. You may find the money appealing or feel fulfilled giving a couple something they may not be able to achieve without your help.

Still, it’s a big decision. The Family Inceptions Agency outlines a few things to consider before applying to be a surrogate.

You’ll need to meet all the minimum requirements — including those regarding age, health status, reproductive history, and psychological status — that may vary by agency.
You’ll need to be OK with giving up control during the pregnancy. While it’s your body, what happens during the pregnancy isn’t entirely up to you. This involves things like testing that you may not choose for yourself but that the intended parents may wish to undergo.
You’ll also need to think about the process itself. Getting pregnant via IVF takes a number procedures and medications. Consider how you’ll feel about taking injectable and oral drugs and hormones.
You’ll want to consider if your own family is complete. Do you want more children? Understand that with each pregnancy and with advancing age, more risks for complications can arise that might impact your fertility.
You’ll need to get input from the rest of your family as well. How does your partner feel about surrogacy? What about your children?

There aren’t necessarily right or wrong answers to questions you need to ask yourself — these are just things to consider. Surrogacy can be a wonderful process and gift.

Related: Infertility after donating eggs

While surrogacy may not always be simple or straightforward, more and more people are choosing this route.

In 1999 there were just 727 gestational carrier cycles reported in the United States. In 2013, this number jumped to 3,432, and it continues to climb each year.

It’s an involved process but certainly one worth investigating. If surrogacy seems like it might be a fit for your family, consider contacting an agency near you to go over the timeline, costs, and any other considerations that may be specific to your journey. There are many ways to become a parent — and this is one of them.

Surrogacy

There are situations in which a woman cannot carry a child on her own. In such cases, married couples can resort to the method of surrogate motherhood, in which a surrogate mother bears a child that is genetically alien to her.

Surrogate motherhood refers to assisted reproductive technologies and involves the participation of three persons in the conception at once. Firstly, the genetic father takes part in the conception, who provided the sperm for fertilization and agreed to acknowledge his paternity after the child is born. Secondly, we are talking about a genetic mother who provided her egg for fertilization and agreed to play the role of mother after the birth of the child. Thirdly, the surrogate mother herself is involved in the procedure, which can be a woman of childbearing age who has agreed, as a rule, on a compensatory basis, to bear and then give birth to a child for genetic parents.

This method of treatment lies in the fact that the embryo is obtained from the egg and sperm of a married couple, but another woman, a surrogate mother, is responsible for carrying the child. A surrogate mother does not have a genetic connection with the child she is carrying, and, therefore, is not able to transfer any of her traits to him, for example, the color of her skin, eyes, hair. The main requirement for a surrogate mother is expressed in physical health and a responsible attitude to the accepted role. Immediately after birth, the child is taken by the biological parents.

Who may need a surrogate mother?

In modern Russia, surrogacy is a method of treating pathologies associated with infertility. Surrogate motherhood is considered an extreme measure used in the treatment of severe forms of infertility. The help of a surrogate mother is addressed if the eggs of the biological mother can be fertilized, but the woman herself is not capable of bearing and giving birth to a child. The reasons may be related to an abnormality of the uterus or its complete absence, severe general diseases, the risk of rejection of transplanted donor organs, and the removal of malignant tumors.

Who can be a surrogate mother?

A familiar woman or an anonymous one can take the role of a surrogate mother. Mandatory conditions include the presence of at least one child of your own. In addition, the surrogate mother must be in good health, and her age cannot exceed 35 years. Another requirement is that a surrogate mother cannot bear a fetus that is derived from her egg.

THERE ARE CONTRAINDICATIONS. IT IS NECESSARY TO CONSULT WITH A SPECIALIST

The materials posted on this page are for informational purposes and are intended for educational purposes. Site visitors should not use them as medical advice. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your doctor!

What is surrogate motherhood? | Eternal questions | Question-Answer

07.10.2013 19:47

Olga Zvonova

Estimated reading time: 5 minutes

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Category: Women's Health

How Russian law regulates surrogacy

Who can become a surrogate mother?

Surrogacy is a fairly new reproductive technology in which conception occurs outside the body of a surrogate mother, and then the fertilized eggs are transferred to her uterus. In this case, the procedure implies the conclusion of an agreement between the biological parents and the surrogate mother.

According to Russian law, not all women can become a surrogate mother, but only between the ages of 25 and 35, who have at least one healthy child and who have received a medical certificate of a satisfactory state of health. The future surrogate mother must give written consent to medical intervention. At the same time, the law specifically states that she cannot be an egg donor at the same time.

For married women, there is a chance to become a surrogate mother only with the written consent of the spouse.

Read also: Surrogacy, or a woman as an incubator for someone else's child >>

Surrogacy: procedure

Both spouses and a couple who have not registered their relationship, as well as a single woman or a single man without a partner.

Let's take a closer look at the steps that spouses who want to have a child with the help of a surrogate mother need to go through.

Find a surrogate mother. This can be done on your own or you can seek help from a clinic and/or profiling organization.
Get tested. Spouses can go to any clinic that provides relevant services and undergo their own examination and examination of the future surrogate mother.
Conclusion of the contract. A civil law contract is concluded by spouses with a surrogate mother to compensate for all costs associated with the bearing and birth of a child. At the same time, the child cannot be the subject of the contract, therefore the rights to it cannot be subsequently transferred to donor parents. All disputes regarding the termination of the contract and the establishment of motherhood are considered in court.
In vitro fertilization (IVF). This is a procedure for removing an egg from a woman's body and fertilizing it with sperm in the laboratory. Then the embryo is placed in the uterine cavity of a surrogate mother for further development.
Diagnosis and monitoring of pregnancy. After IVF, the surrogate mother is under the supervision of doctors in the hospital for the first 3-5 days, and after 12-14 days pregnancy can already be diagnosed.
Management of pregnancy. Doctors monitor the course of pregnancy, and donor parents are obliged to comply with all clauses of the contract and provide the pregnant woman with appropriate conditions and assistance.
Birth of a child and registration of parents. After the birth of a child, parents have the right to register it with the registry office as their child. It should be noted that this is possible only if there is a certificate from a medical institution that the surrogate mother has given her consent to this. Otherwise, parents do not have the right to register a child under their last name.
Deprivation of parental rights. It is possible to deprive a surrogate mother of parental rights only by a court decision. This procedure is mandatory for donor parents if they want to have parental rights for a child born by a surrogate mother.
Rights and freedoms of the child. A child born from a surrogate mother has the same rights and freedoms as other children. In addition, upon reaching the age of 18, such a child has the right to apply for the restoration of the parental rights of a surrogate mother.

Surrogacy is regulated in Russia by the Family Code of the Russian Federation, the Federal Law “On the Basics of Protecting the Health of Citizens in the Russian Federation”, the Federal Law “On Civil Status Acts” and Order No. 107n of the Ministry of Health of the Russian Federation dated August 30, 2012 “On the procedure for using assisted reproductive technologies , contraindications and restrictions to their use.

Rights of a surrogate mother

A surrogate mother, signing an agreement with donor parents, actually undertakes to provide services for bearing and giving birth to a child. Therefore, the transfer of the child into the hands of the parents is possible only with her written consent.

From the moment the child is born, the surrogate mother has parental rights to this child, and her rights can be deprived only by a court decision. In addition, the surrogate mother has the right to sue for the restoration of parental rights later, if she deems it necessary.

Which celebrity has used the services of a surrogate mother?

Many Russian stars in the past resorted to the help of a surrogate mother to carry a child. In early October, it became known that Alla Pugacheva and Maxim Galkin had twins Elizabeth and Harry. The services of a surrogate mother were used by singer Philip Kirkorov, singer Alena Apina with her husband Alexander Iratov, president of the Russian Fitness Aerobics Federation Olga Slutsker, and also, according to media reports, singer Valery Leontiev.

Some foreign celebrities also used the services of a surrogate mother: film director George Lucas with his wife, British singer Elton John, singer Michael Jackson, actresses Sarah Jessica Parker and Nicole Kidman.