Understanding Different Types of Surrogacy


With surrogacy, a woman carries a child to term and then relinquishes the baby to the intended parent(s) upon delivery. Within those parameters, there are two main types of surrogacy: traditional and gestational.

Traditional Surrogacy

This type is usually less costly, but it is also less common. In this method, the surrogate mother is impregnated with semen from the intended father or sperm donor and uses her own eggs. This means that the surrogate mother is genetically related to the child. The insemination procedure can be conducted at home using an insemination kit or it can be performed within a fertility clinic.

 Gestational Surrogacy

The more popular method, this procedure involves in vitro fertilization (IVF) with the eggs of the intended mother or those of an egg donor. This arrangement means that the surrogate mother is not genetically related to the child. Because this method is more complicated medically, it tends to be more expensive than traditional surrogacy. However, this method is also more effective.

There are three stages to gestational surrogacy:

Egg donation—either the intended mother or the egg donor undergoes an egg retrieval procedure.

Fertilization—the egg is fertilized with semen in the laboratory to create embryos.

Transfer—the fertilized egg, or embryo, is implanted into the surrogate mother’s womb. This is often referred to as an embryo transfer, or just transfer.

A fertilized egg may be transferred to the surrogate either when it is three to five days past fertilization, or after it has been taken from cryogenic storage and thawed. In order to prepare for a fresh embryo transfer, the intended mother or egg donor and the surrogate must take hormone pills at the same time to synchronize their cycles. In a situation where the embryos have been thawed, some fertility clinics recommend that the surrogate take hormone medication to prepare the lining of her uterus for the transfer.

The success rate of IVF depends on a number of factors such as the age and health of the woman providing the eggs. Both types of surrogacy are just as safe as traditional pregnancy, providing that the surrogate mother undergoes a thorough health screening.

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Dr. Kim Bergman

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 Fertility Counseling Services and 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 upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.