Why Women Choose Surrogacy


The need for a surrogate is fairly straightforward when it comes to gay male couples, but the choice may not be as obvious when an intended mother seeks out the help of a gestational carrier to grow her family.  There are a multitude of reasons a woman may choose to work with a gestational carrier. Here are just a few of them.

She Doesn’t Have a Uterus- Without a uterus, a fetus will have nowhere to grow. Some women may be born without a uterus, or may have had it removed due to a previous medical condition. In some cases of hysterectomy, a woman may have been able to have children prior to the loss of her uterus and may already have children. In other cases, she may have undergone medical treatments, such as for cancer, that lead to the loss of uterus before she was able to have any children.

Her Uterus Won’t Support Pregnancy- In some cases, a woman may need to use a surrogate due to abnormalities within her uterus. These abnormalities often present in the form of scar tissue or fibroids; thin bony strings that ultimately attach the walls of the uterus to one another. The scar tissue or fibroids can be the result of previous uterine trauma (pregnancies, D&Cs, or abortions) or naturally occurring. In these cases, it is incredibly difficult for the woman to carry a pregnancy to term. While she may be able to get pregnant, she will find that miscarriage is a very likely result.

Other Medical Conditions-Occasionally a woman will have other health issues that make pregnancy unlikely or, in some cases, impossible. Examples often include heart disease, kidney disease, diabetes, severe preeclampsia, or a history of breast cancer. Endometriosis is another medical condition that can lead some women to pursue surrogacy.

Advanced Maternal Age- Probably the most common reason for a woman seeking out a surrogate is that she is of an advanced age. Because a woman will ovulate her best eggs first, by the time her body nears menopause her remaining eggs may not have an optimal genetic makeup. This can lead to difficulty attaining pregnancy and higher rates of chromosomal abnormalities in births. This condition does not have to be linked to age, however. Often women in their 40s will begin experiencing similar conditions well before menopause sets in.

These are just a few reasons that a woman may choose to look into surrogacy for help in starting or growing her family. A doctor may advise a woman to consider surrogacy for any number of other reasons. Once the choice to use a surrogate has been made, the woman will also have to determine if she needs the help of an egg donor. In some cases these women may still be able to use their own eggs, while others will require an egg donation as well.

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors. She is the co-owner of Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019) as well as the children's book You Began as a Wish (Independent Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. She has two adult daughters.