Surrogacy is an arrangement in which a woman carries a pregnancy for someone else. However, not all surrogacy is the same. In traditional surrogacy, the surrogate uses her own egg and is the baby’s biological mother. On the other hand, in gestational surrogacy, embryos are created through IVF using eggs and sperm from the intended parents or donors. The surrogate has no genetic connection to the child.

For first-time intended parents, understanding these two approaches is an important step in making informed decisions. Both paths share the same goal: helping you grow your family. This is a clear, compassionate guide to help you navigate the differences, so you can decide which path is right for you and your family.

What is Traditional Surrogacy?

Before modern science allowed for the creation of embryos outside of the womb, traditional surrogacy was the only way to conceive with a surrogate mother. This type of surrogacy has been practiced the longest. In traditional surrogacy, also referred to as “full” or “genetic” surrogacy, the surrogate is the egg donor and is genetically related to the baby she is carrying. The surrogate becomes pregnant, utilizing sperm from the intended father or donor through a process called intrauterine insemination (IUI). The surrogate carries the baby to term and since she is the biological mother of the baby, she signs her parental rights away right after delivery of the baby to the intended parents, who become the legal guardians.

Because the surrogate is also the biological mother, this pathway introduces emotional and legal complexities that can be challenging to navigate. Today, traditional surrogacy is extremely rare. Most agencies no longer offer it, since it often places additional stress on everyone involved.

What is Gestational Surrogacy?

Gestational surrogacy is the path most intended parents take and the one most agencies recommend. In this arrangement, the surrogate (or gestational carrier) carries a child created through IVF with the use of the intended mother’s or donor’s egg(s) and the intended father’s or donor’s sperm. It is then transferred to the surrogate’s uterus at the fertility clinic. The surrogate does not have genetic ties to the baby she is carrying.

This approach provides greater clarity and peace of mind for everyone. For intended parents, it can mean having a biological connection to their child. For surrogates, it allows them to support your path to parenthood without the emotional and legal complexities of being genetically related.

Genetic Differences Between Surrogacy Types

The most significant difference between traditional and gestational surrogacy lies in genetics.

With traditional surrogacy, the surrogate provides her own egg. She is not only carrying the pregnancy but is also the child’s biological mother. Because of this dual role, traditional surrogacy often brings greater emotional complexity. The surrogate may feel a stronger personal bond with the baby, and questions of parentage can become more complicated for intended parents. These factors are a big reason why traditional surrogacy is now rare and not supported by most agencies.

On the other hand, with gestational surrogacy, the surrogate has no genetic connection to the child she carries. The embryo is created using eggs and sperm from the intended parents, from donors, or from a combination of both. This means the child’s DNA comes entirely from the chosen source and not from the surrogate. For intended parents, this distinction often provides peace of mind, creating clear boundaries and simplifying legal parentage.

Many families also choose gestational surrogacy because it allows them the chance to have a biological connection to their child, even if they need an egg or sperm donor. For example, some couples are able to use one partner’s sperm or eggs, giving them a direct genetic link, while others find comfort in choosing donors whose traits or backgrounds resonate with their family story.

By removing the genetic tie between surrogate and child, gestational surrogacy creates a clear, secure foundation for everyone involved. It respects the surrogate’s role as a carrier, while protecting the emotional well-being of intended parents and ensuring that legal parentage is established from the beginning.

Medical Pathways Compared

The medical steps involved in surrogacy look very different depending on whether you choose traditional or gestational surrogacy. Understanding how each pathway works can help you see why most intended parents today choose gestational surrogacy with the support of an experienced surrogacy agency like Growing Generations.

TRADITIONAL

In traditional surrogacy, pregnancy is typically achieved through intrauterine insemination (IUI) at a clinic, or in some cases, through a home-based insemination process. Since the surrogate provides her own egg, IVF is not required. In terms of medical intervention, it might sound less complex, and it usually is on the surface.

However, simplicity often brings greater challenges later. Because the surrogate is genetically tied to the child, courts are cautious when granting parentage to intended parents. The American Society for Reproductive Medicine (ASRM) acknowledges these risks, strongly encouraging traditional surrogacy arrangements to be handled with great care because of the potential for emotional and legal complications. In addition, some states do not recognize traditional surrogacy contracts at all, leaving intended parents without legal protections.

GESTATIONAL

Gestational surrogacy follows a more advanced and carefully regulated medical process. It begins with in vitro fertilization (IVF), where eggs and sperm are retrieved from the intended parents or donors and combined in a lab to create embryos. Once healthy embryos are developed, one is transferred into the surrogate’s uterus under the supervision of a fertility specialist.

This pathway involves more medical steps, but it is highly structured and supported by strong ethical guidelines. ASRM sets clear standards around medical screening for surrogates, the number of embryos that can be transferred, and the informed consent process. These guidelines exist to protect everyone involved, ensuring the surrogate’s health is prioritized and that intended parents have the best chance of a safe and successful pregnancy.

Laws also play an important role in shaping which pathways are allowed. For example, in New York, the Child-Parent Security Act (CPSA) legalized compensated gestational surrogacy in 2021 but explicitly prohibited traditional surrogacy. This law reflects what many states now recognize: gestational surrogacy offers clearer protections and less emotional risk. The CPSA also requires detailed legal contracts, independent legal representation for both parties, and comprehensive medical and psychological screenings, aligning closely with ASRM recommendations.

For intended parents, this means that gestational surrogacy is not only the more common option but also the one most supported by medical and legal professionals across the United States.

Legal & Parentage Considerations

One of the most important differences between the two types of surrogacy is how parentage is established. In traditional surrogacy, the surrogate’s biological connection often means intended parents must complete an adoption after birth to be legally recognized. This process can be lengthy and emotionally difficult.

Gestational surrogacy, on the other hand, allows intended parents in many states to secure their rights through a pre-birth order. This ensures that their names are placed directly on the baby’s birth certificate, offering peace of mind long before delivery day. For families eager to focus on welcoming their child, this clarity makes a world of difference.

Cost Breakdown: Why Numbers Differ

Surrogacy is a significant emotional and financial investment, and the costs can vary greatly depending on the type of surrogacy you choose. Traditional surrogacy is generally less expensive on the surface because it does not require in vitro fertilization (IVF). Since the surrogate’s own egg is used, there is no need for egg retrieval, embryo creation, or embryo transfer procedures. The medical costs are lower, and fewer clinic visits are needed overall.

However, this initial cost savings often comes with increased legal fees and longer timelines due to the complexities of establishing parentage. Some intended parents also face added costs later if second-parent adoption is required to secure full legal rights.

Gestational surrogacy, by comparison, has a higher upfront cost because it involves a full IVF cycle. This includes egg retrieval (from the intended parent or a donor), fertilization in the lab, and embryo transfer into the surrogate’s uterus. These medical procedures require specialized fertility clinics, laboratory services, and highly trained staff. The cost also includes comprehensive medical screening for all parties, as well as medications for the surrogate to prepare her body for pregnancy.

Beyond the medical side, gestational surrogacy includes compensation for the surrogate, legal fees, insurance coverage, and support services throughout the journey. Although the total price tag can be higher, it reflects a carefully managed process that prioritizes safety, clarity, and the emotional well-being of everyone involved.

Pros & Cons for Intended Parents

Every surrogacy journey comes with unique considerations, and first-time intended parents need to understand both the advantages and challenges of each path. While both traditional and gestational surrogacy share the same goal, helping you welcome your child into the world, they differ in ways that can affect your experience medically, legally, financially, and emotionally. Here’s what to keep in mind:

TRADITIONAL SURROGACY

Pros:

• Typically less expensive since IVF is not required.

• The medical process is shorter and involves fewer procedures.

Cons:

• The surrogate is the biological mother, which can lead to emotional and legal complications.

• Parentage often must be established through adoption after birth.

• Many states do not legally recognize or allow traditional surrogacy.

• Rarely offered by reputable agencies due to the risks involved.

GESTATIONAL SURROGACY

Pros:

• The surrogate has no genetic link to the child, which provides clarity and reassurance.

• Parentage can often be secured before birth through a pre-birth order.

• Supported by most states and agencies, with clearer legal protections.

• Higher medical success rates due to advances in IVF.

Cons:

• The overall financial investment is higher because IVF and more medical services are required.

• The process involves more steps and a longer timeline due to fertility treatments and embryo creation.

Choosing a Surrogacy Type with Agency Support

At Growing Generations, our mission is to make your journey to parenthood as safe, supported, and joyful as possible. That’s why, like most reputable agencies, we focus exclusively on gestational surrogacy. This path protects intended parents, surrogates, and children alike, minimizing risks and ensuring that your experience remains centered on the joy of growing your family.

When you work with an agency, you’re not just choosing a medical or legal pathway; you are choosing a team that will stand beside you, guide you, and celebrate with you as you take each step toward parenthood.

Final Thoughts

Surrogacy is a remarkable way to grow a family, and both traditional and gestational surrogacy share the same beautiful goal: paving your path to parenthood. But for most intended parents, gestational surrogacy offers the clarity, safety, and peace of mind they need to move forward with confidence.

Every journey is unique. With the right support, the path ahead feels less overwhelming and more joyful. At Growing Generations, we are here to walk beside you every step of the way, from answering your very first questions to celebrating the moment you hold your baby in your arms.

If you’re ready to learn more about which surrogacy path is right for you, we invite you to connect with us today. Together, we can help you take the next step toward growing the family you’ve been waiting for.

If you miscarry or have an otherwise abnormal pregnancy, your doctor may recommend a dilation and curettage (D&C) procedure (as opposed to a natural miscarriage). A D&C can be a first-line treatment option for clearing the uterus or for instances where your body does not expel all tissue on its own. In this case, the procedure is necessary to stop bleeding and prevent hemorrhage. Like any surgical procedure, however, a D&C carries some risks. As a surrogate, it's essential that you understand the risks and benefits of this option.

 

WHAT IS A D&C PROCEDURE?

A D&C procedure usually takes just 10 to 15 minutes, but you may stay at the clinic or medical site for up to 5 hours. During the procedure, you’ll either be sedated using either a general anesthetic or given an epidural or local anesthetic. Your cervix will be dilated to allow a scalpel or vacuum into the uterus to remove tissue associated with pregnancy. This outpatient surgical procedure is generally routine and free of complications. However, as with all medical procedures, there can be risks. 

WHAT ARE COMMON D&C RISKS & COMPLICATIONS?

The most common complication of a D&C, according to the Mayo Clinic, is the perforation of the uterus. In this instance, a cutting object would inadvertently poke a hole in the wall of the uterus during the clearing of the pregnancy tissue. These perforations will usually heal on their own and only represent real concern if a blood vessel or secondary organ is damaged. 

Other potential D&C complications include:

• Damage to the cervix: It is possible for the cervix to be torn during the procedure. If this were to happen, your doctor would apply pressure to the cervix and then use stitches to repair the tear.

• Scar tissue or adhesions inside of the uterus: Known as Asherman’s syndrome, the development of scar tissue in the uterus happens in roughly 30 percent of D&C patients. This condition, which becomes more likely with each subsequent D&C, can lead to painful, absent or otherwise abnormal menstrual cycles. Additionally, it can lead to difficulty with future fertility, occasionally resulting in increased miscarriages or total infertility.

• Infection: While incredibly rare, infection can occur following the procedure. Infections are often detected by a fever or odorous vaginal discharge.

WHAT TO DO DURING D&C RECOVERY

You’ll want to pay close attention to your body after the D&C to ensure that you’re healing properly. You can usually return to your regular activities after a few days, but you may experience mild cramping and light spotting. You should wear a sanitary pad and take pain relievers if necessary. 

Your next menstrual cycle also might come early or late after the procedure. Be sure to call your doctor right away if you experience any of the following symptoms:

• Heavy bleeding

• Bleeding lasting longer than 2 weeks

• Fever

• Cramping lasting more than 48 hours

• Foul smelling discharge

• Pain that gets worse as the days progress

At Growing Generations, we understand that a miscarriage is a challenging and emotional event for both surrogates and the intended parents. We're here to support you through this difficult time. Reach out to us online at any time. 

Embryos are tiny, delicate things. Following the embryo transfer process, surrogates concerned about how to protect the embryo they're carrying may worry about how secure the embryo is once it's placed in the uterus. Is it possible for the embryo to "fall out" after it has been transferred?

IS IT POSSIBLE FOR AN EMBRYO TO FALL OUT AFTER TRANSFER?

The overwhelming fear is that walking, jumping, or even urinating could cause the embryo to simply slip out of the uterus. Doctors often prescribe bed rest following the transfer to allow the embryo time to “get settled” and implant, so it makes sense that undue movement could cause the embryo to become dislodged and slip out, right? Rest assured that this is highly unlikely. The idea has merit, in theory, but it is not plausible in reality. The uterus is a muscular organ. This means that it stays contracted and tight in its natural state. While the area inside of the uterus is called a “cavity,” it is not a literal empty space. The transferred embryo does not have open space in which to move freely or roll around. 

WHY EMBRYOS DON'T FALL OUT

Your body is prepared well for the embryo transfer with IVF medications. Nearly all IVF doctors will require your uterine lining to be thick enough for the walls to touch in the middle before proceeding with a transfer. This creates an environment in which the thick, sticky endometrial lining leaves no empty space. When the embryo is placed between the uterine walls and the muscle contracts, it will create a secure place for the embryo to bury itself deep within that thick lining and begin to grow. Visualize placing a poppy seed in the crease of your elbow and then folding your arm shut tightly by using your muscle. Now wiggle that arm as hard as you can. No matter how hard you try, that poppy seed will not fly out. 

An implanted embryo inside of a flexed uterus is much the same. No reasonable external physical activity—be it jumping, rolling over in bed, walking, or running—can cause a healthy receptive embryo to become dislodged once it has implanted into the endometrial lining. The bed rest period is meant to help you relax and encourage the embryo to implant and bury itself within the endometrial lining. 

While you should always follow doctor’s orders regarding bed rest, do not be afraid to get out of bed to use the restroom or stretch your legs. If you have questions about what activities are approved, both during bed rest and once you’re cleared to return to daily life, do not be afraid to ask your nurse or doctor.

READY TO LEARN MORE?

Please contact Growing Generations for more information about being a surrogate in our program.  

Often surrogates are curious which IVF doctor they’ll be paired with for their journey. Ultimately, the surrogacy doctor you will work with is chosen long before you receive the profile of the intended parents that you will be helping.

HOW IS A PHYSICIAN CHOSEN FOR MY SURROGACY JOURNEY?

When intended parents retain Growing Generations for surrogacy, they will have the option to either continue working with one of their own private practice IVF physicians or select one of our partner doctors.

Many couples do not have pre-established relationships with doctors when they retain us and will select one of our partner doctors. Growing Generations is very proud to work with doctors we believe to be some of the best IVF physicians in the US. Many of these doctors are industry leaders boasting some of the best success rates in their fields.

These doctors include:

• Brad Kolb, HRC Fertility

• Shahin Ghadir, Southern California Reproductive Center

Occasionally, we will encounter intended mothers who have tried to attain pregnancy on their own before turning to surrogacy and have developed a trusting relationship with their personal IVF doctor. We will allow them to continue working with their own IVF doctor in these cases.

WILL THE IVF DOCTORS BE NEAR ME?

That depends on a variety of factors, but most surrogates can expect to travel for some of their medical procedures. Often, the doctor you meet with during your medical screening process will be the one you wind up working with during your medical cycle and embryo transfer. However, sometimes your doctor will change depending on the doctor your intended parents have previously chosen. This is a normal part of the process and not a cause for concern.

Know that whichever doctor you’re working with, it’s one that Growing Generations has great faith in. You should always feel comfortable and informed when it comes to your health and the doctor that you’re working with. Each doctor has their own staff of third-party reproduction nurses who will be in regular communication with you during your medical phase. You should always feel comfortable reaching out to your nurse with any questions or concerns that you may have.

To learn more about the surrogacy and IVF process, contact Growing Generations.

Revised 5/15/18

Many surrogates find themselves wondering why their intended mother needs their help. One potential cause stems from prolonged or advanced polycystic ovary syndrome, PCOS for short. PCOS is often associated with pregnancy difficulties and infertility, leading many women to turn to surrogacy to build their families. 

WHO GETS PCOS AND WHY?

PCOS is actually quite common. Doctors estimate that as many as 8% to 13% of all women in childbearing years suffer from PCOS, and suggest that as many as half of those women may not even know they have it. 

Women suffering with PCOS produce too much of a typically male hormone called androgen. When it is too abundant, androgen prohibits the body from allowing a healthy egg to be released from the ovary into the fallopian tubes, sometimes leaving the woman unable to conceive a child.  Instead, the immature eggs turn into small cysts and are retained inside of the ovaries. These retained cysts will continue to contribute to steadily elevated levels of androgen in the body, serving only to fuel the cycle of PCOS further. 

PCOS Symptoms

PCOS is often characterized by missed or irregular periods, excess body hair, weight gain, and acne. Given that these are symptoms that are incredibly common for most women, many don’t mention them to their doctors for many years. The diagnosis itself can often take quite a while to attain, given that PCOS is only diagnosed as an “exclusionary diagnosis,” meaning it is only diagnosed after every other possible diagnosis has been ruled out. 

PCOS: PREGNANCY, MISCARRIAGE & SOLUTIONS

For women living with a PCOS diagnosis, the answers to their fertility can run the line from very hopeful to very grim. While some women may need minor hormone therapy to regulate their cycles and work to correct the abundance of androgen, others may experience infertility or miscarriage. Often, this latter group of women is left considering reproductive technologies and even surrogacy as the best way to create their families.

Helping these women build their families through surrogacy is deeply rewarding. (You can learn about other reasons to become a surrogate in our related blog post.)  Reach out to us online to learn more.

Yeast infections are common and impact millions of women every year. Even so, many women will experience their first yeast infection, or potentially her first outbreak of several yeast infections, in her surrogate pregnancy.

WHY ARE YEAST INFECTIONS MORE COMMON IN SURROGATE PREGNANCY?

According to the American Pregnancy Association, the second trimester of pregnancy represents the time in a woman’s life where she is most likely to experience a yeast infection. So why is there an increased likelihood of a yeast infection in surrogacy if you never experienced one during your own pregnancies? The link could be because several potential causes of a yeast infection occur all at once as a woman prepares to become a surrogate.

For example, some common causes of yeast infections include: 

• Hormonal changes related to pregnancy

• Starting hormone therapy treatments (including birth control pills, estrogen, or progesterone treatments)

• Taking antibiotics or steroids (a common component of your pre-transfer medical protocol)

• An increase of sugar in the diet (sweets are a common craving for pregnant women)

• An influx of vaginal intercourse (potentially before or after doctor ordered pelvic rest)

• Blood or semen in the vagina

Often characterized by an increase and change in appearance of your normal vaginal discharge and a persistent, insatiable itch, yeast infections are caused when the levels of yeast and acid in the vagina are out of balance. Both elements are present in your body normally, so the presence of bacteria is not the problem; it is the unbalance that presents the issue.

YEAST INFECTION TREATMENT DURING SURROGATE PREGNANCY

While yeast infections have no major risks or implications to the pregnancy, they can still be uncomfortable and problematic for you, especially if left untreated. Yeast infections during pregnancy can be difficult to control, so it’s best to get early treatment. 

Additionally, and unlike traditional pregnancies, yeast infections in IVF pregnancies and surrogacy may require a different form of treatment than your standard over the counter creams. This is because many IVF doctors do not want the creams or their plastic applicators introduced to your vagina in the early stages of your pregnancy. While some doctors may be OK with the creams with hand application only, other doctors may choose to call in a prescription to treat the infection orally.

We understand that it can feel embarrassing and invasive to tell your nurse about a potential yeast infection before simply self-treating with over the counter medications, but in the case of surrogacy, you should absolutely mention symptoms to your nurse, even if this is a multi-occurrence infection. 

Treatment is key, because if it is left untreated, the yeast infection can be transferred to the child you are carrying during birth, leading to a condition of the mouth called thrush.

Once you begin treatment you can expect to experience relief from the symptoms within 10 to 14 days, although most treatments will begin to offer relief from many of the symptoms within 48 hours. 

STEPS TO PREVENTING YEAST INFECTIONS DURING PREGNANCY

If you find that you are experiencing repeated yeast infections during your journey, you may opt to introduce the following natural prevention measures in order to try and stave off any future infections. 

• Wear loose clothing

• Wear cotton underwear

• Always wipe from front to back after using the restroom

• Limit sugar intake, as vaginal yeast feeds on sugar

If you have additional questions or concerns, try to focus on feeling comfortable mentioning this to your nurse or case specialist. Sending an email to approach the subject may offer you a bit more comfort than mentioning it in a call, but understand that both your case specialist and your nurse manage these sorts of issues every day, and they’re nothing to be embarrassed by.

Growing Generations is a premier surrogacy agency that provides intended parents, surrogates, and egg donors with exceptionaly attentive service. If you are interested in becoming a surrogate, contact us online or complete our surrogate application.