A father and mother with their baby

What is Surrogacy? A Guide for Intended Parents

Surrogacy offers a pathway to parenthood for those who face challenges with traditional conception and pregnancy. As modern family dynamics evolve, surrogacy plays a crucial role in helping individuals and couples fulfill their dreams of raising a child. But, what is surrogacy exactly? I will delve into the types of surrogacy, why people opt for this method, and the important legal and emotional considerations involved.

Types of surrogacy

Surrogacy can be broadly categorized into two types: traditional surrogacy and gestational surrogacy.

Traditional surrogacy involves the surrogate mother being artificially inseminated with the sperm of the intended father or a donor. A surrogate mother (also called surrogate or gestational carrier) is a woman who will carry the fetus for the intended parent (the person who wants to have a child through surrogacy). In this arrangement, the surrogate is the biological mother of the child because her own egg is used in the process. So, if you choose traditional surrogacy to have your child, the child will be genetically related to the surrogate and you, a male parent. Despite its historical precedence, traditional surrogacy has become less common in the world due to complex emotional and legal issues regarding the biological link between the surrogate and the child. In Mexico, traditional surrogacy is not legal.

On the other hand, gestational surrogacy has gained popularity due to advances in reproductive technologies such as in-vitro fertilization (or IVF, a type of assisted reproduction technology where a sperm fertilizes an egg under microscope in a laboratory outside of the uterus). In gestational surrogacy, the surrogate carries a pregnancy created by the egg and sperm of the intended parents or donors, meaning she has no genetic ties to the baby. This is accomplished by transferring an frozen embryo into the surrogate’s uterus using a technique called frozen embryo transfer. This type of surrogacy significantly reduces the emotional and legal complexities since the surrogate is not biologically related to the child she carries. In most countries where surrogacy is not illegal, including Mexico, only gestational surrogacy is allowed.

Why do individuals choose to do surrogacy?

Individuals and couples turn to surrogacy for various reasons. For many, medical conditions that make pregnancy risky or impossible, such as absence of a uterus, recurrent pregnancy loss, or severe complications in previous pregnancies, are primary factors. Additionally, surrogacy is a vital option for same-sex couples and single individuals seeking to have biological children. The decision to pursue surrogacy is often supported by a deep desire for a genetic connection to the child, especially when other methods such as adoption or fostering do not meet this criterion.

As I talked to more people who were looking to pursue surrogacy, I got to understand their motivation in using surrogacy to have a child. Some of their reasons were medical reasons while others were because of their sexual orientation. There are several reasons why people consider surrogacy instead of natural pregnancy or IVF followed by pregnancy carried by themselves.

1) Medical reasons

There are many medical reasons that prevent a woman from carrying a pregnancy to term. These include conditions like uterine abnormalities, recurrent miscarriage, severe health issues that make pregnancy unsafe (such as heart disease or severe diabetes), and a history of preterm labor. Additionally, women who have had multiple C-sections may be advised against attempting to carry another pregnancy due to the risk of uterine rupture. Women who have been treated for certain types of cancer may also be unable to carry a pregnancy if their treatments have affected their fertility or general health. In such cases, surrogacy offers a hopeful alternative for individuals and couples who wish to have a child genetically related to them.

2) Age

If you or your partner is aged 35 years or older, carrying a pregnancy entails higher risks to you or your fetus. As maternal age increases, so does the likelihood of complications such as gestational diabetes, high blood pressure, and pre-eclampsia, as well as chromosomal abnormalities in the fetus like Down syndrome. Older pregnant individuals are also more likely to experience difficulties during labor and delivery, which can necessitate a cesarean section. Moreover, the chances of miscarriage and stillbirth are higher in this age group. Given these increased risks, some couples or individuals might consider surrogacy as a viable option to expand their family, allowing them to have a biological child with a reduced risk of pregnancy-related health issues.

3) Sexual orientation

It used to be that people who are LGBTQ+ were precluded from having a biological child. Many people in the LGBTQ+ community give up having their own genetic children until they learn about surrogacy. For individuals who are LGBTQ+, surrogacy opens up the possibility to parent a child that shares their genetic material. Advances in reproductive technologies and more inclusive legal frameworks have made it increasingly feasible for LGBTQ+ individuals and couples to pursue surrogacy. This option not only allows them to fulfill their dreams of parenthood but also to do so in a way that connects them biologically to their child. Surrogacy agencies today are often equipped with supportive services that understand and cater to the unique needs of the LGBTQ+ community, helping navigate the intricacies of the surrogacy experienced by LGBTQ+.

4) Being single

Some people are not in a romantic relationship and don’t have any long-term partners. They might not be looking for a long-term relationship or marriage, and they might not want to wait for a long-term relationship before having a child. I see this often in older individuals who are turning a significant age marker – turning 30, entering late 30s, or just becoming 40 for example. These individuals may have accumulated some savings or have achieved career advancement, feeling confident that they can raise a child on their own without a partner.

Who will be involved in surrogacy?

Surrogacy is a complex undertaking involving many individuals. It involves people in different professions and different supportive roles. It will also most likely involve different people in your life. Let’s take a look at who will be in your surrogacy journey and how they can help you.

  • You: You are the most important person. You will do the research and you will make the final decisions, and you will be responsible for your decisions, good or bad.
  • Your partner: Your significant other will be the second most important person because he or she will have your best interest at heart. Other professionals in your journey will help you and may even give you emotional support when you need it, but at the end of the day, they are in a business to provide services for monetary compensation. You should have full support from your partner, and in my opinion, if your partner doesn’t fully support your decision to do surrogacy, you should wait and talk to your partner more thoroughly.
  • Your family and friends: Like your partner, your family and friends can support you throughout your journey. Whether you want to disclose your surrogacy journey to your family members or friends is a personal choice because there are people who are opposed to surrogacy due to personal or religious beliefs. Also, during your journey, you might make more friends as you meet fellow intended parents. I’ve become friends with people who were also undergoing surrogacy, and their support has been invaluable to my own journey.
  • Your agency contacts / coordinators: They are the first contact you have to the world of surrogacy. Your agency’s patient coordinator will communicate with you, answer your questions, arrange meetings with other medical and legal professionals, and generally be a liaison between you and other stakeholders. If you pursue surrogacy in a foreign country like Mexico and if you don’t speak the local language, the service of your coordinator will become invaluable.
  • Your fertility doctor: He or she is the doctor at the fertility clinic in Mexico that will be taking care of your case. Specifically, the doctor and their team will perform medical examinations and procedures for egg retrieval (if you are using an egg donor), IVF procedures, embryo transfers, and other medical procedures to help your surrogate become pregnant.
  • Your OB/GYN: He or she is the doctor who will take care of the pregnant surrogate, conducting routine prenatal check-ups, performing ultrasounds to monitor the fetus’s development, and managing any issues that arise during the pregnancy. He or she may also be there to deliver the baby. In some cases, the fertility doctor and OB/GYN are the same person.
  • Your lawyer: Your lawyer who specializes in surrogacy cases will help you draft a contract between you and your chosen surrogate to protect both of their interests. He or she will also help you register the birth of your child and, if necessary, initiate a court action (Amparo) to have your parentage officially recognized in the form of your name on your child’s birth certificate.
  • Your immigration / family lawyer in your home country: Sometimes, an intended parent has to adopt the child born through surrogacy if legal parentage cannot be established after birth in Mexico. Then, the intended parent may need the help of a lawyer in their home country to adopt the child. An intended parent may also need the help of a lawyer to understand the legal status of a child born through surrogacy in their home country, to change the last name of the child if it contains the surrogate mother’s last name, among other things.
  • Other intended parents: You can gain a surprising amount of information from your fellow intended parents doing surrogacy in the same place as you are. They carry information that is up-to-date from on-the-ground. For example, they can tell you their experience with their agency, and you can use it to gain insight about an agency that you are considering.

What steps are involved in surrogacy?

Broadly speaking, 5 steps are involved in gestational surrogacy. But, there is also a very important step – step 0: research, research research.

0) Research about surrogacy in Mexico or another country you want to pursue surrogacy in

You will be spending a significant amount of money (at least $50,000 USD) and time (at least 18 to 24 months of commitment), so you’ll want to do a thorough research before starting this process. It will be a rollercoaster of emotion as you go through ups and downs of surrogacy journey, so you’ll want to make sure you are committed and ready for the process, have enough financial resources and buffer funds, and be mentally prepared.

Research about what will be involved in the surrogacy process, which destination is right for your specific situation, what kind of cost is involved, and what kind of timeline you should be expecting. Knowing these things will allow you to pick the right destination, agency, and program.

1) Choose an agency or a clinic

The first step is to find an agency or a fertility clinic that you want to work with. This involves doing a thorough research on surrogacy agencies and comparing various programs offered by the agency of your choice. Each agency offers different programs, so you have to compare them and ask questions to find out which program is the best for you. Remember that agencies are definitely not made equal, and each agency will have its strengths and weaknesses.

2) Create or ship embryos

Intended parents who don’t have any embryos have to start from creating embryos. If you and your partner have healthy sperms and eggs, you may create embryos with the help of in-vitro fertilization (IVF). If the male’s sperm quality is not high, your clinic may perform intracytoplasmic sperm injection (ICSI) where a doctor chooses the best sperm to inject into an egg. If you don’t have healthy sperms, you may need a sperm donor, and if you don’t have healthy eggs, you may need an egg donor. Your agency or clinic should be able to arrange these donors for you.

If you already have embryos, you can have them shipped to your fertility clinic where embryo transfer will take place. Note that you’ll need to use the service of a qualified shipping company with proper license. BabySteps Couriers is one company that can ship frozen embryos across borders for you.

3) Match a surrogate and doing embryo transfer

Once the embryos are available, a surrogate has to be matched to you. Typically, your agency will look for a suitable surrogate, examine them medically, give a medical clearance, and present the surrogate profile to you. When you give a go-ahead of the surrogate, she will be prepared by a fertility doctor for embryo transfer, which is the procedure for transferring one or two frozen embryos to the uterus of the surrogate. Note that not all embryo transfers result in pregnancy. The chance of successful embryo transfer is about 50% – 70% per transfer.

4) Surrogate becomes pregnant

When your surrogate becomes pregnant, you are half way there! Your surrogate will attend regular ultrasound checkups and monitor her health closely to ensure the pregnancy progresses smoothly. At this stage, the surrogate’s well-being and the development of the fetus are the most important issues. The surrogate will follow a care plan developed by her doctor, which includes a balanced diet, adequate rest, and appropriate exercise. Regular communication between the surrogate and the intended parents is important, too, so that you can maintain a transparent and supportive relationship throughout the pregnancy.

5) Birth of your child and exit process

Delivery can be done via natural birth or planned C-section. In Mexico, planned C-sections are quite common, but as an intended parent, you should have a say in which mode of delivery you want. After the baby is born, you will have to go through a process known as the exit process. This is when you, with the help of a lawyer, register the birth of your child, obtain a passport for your child, and if necessary, initiate a court proceeding known as Amparo process to amend the birth certificate of your child to include you and/or your partner’s name and remove your surrogate’s name. Usually (but not always), the birth certificate issued by the hospital will have your name (if you are a male parent) as the father and the surrogate’s name as the mother. If you are a female intended parent, the birth certificate might list only the surrogate’s name. This may present legal issues down the line, so many new parents choose to amend the birth certificate to include their names.

Navigating the legal landscape of surrogacy is essential for protecting the rights and responsibilities of all parties involved. Legal agreements in surrogacy are complex and vary significantly by country and even by state or region within countries. These contracts cover parental rights, custody issues, and financial arrangements, among other things. It is imperative for intended parents and surrogates to engage legal counsel experienced in reproductive law to ensure a clear and binding agreement is in place. Read my other blog articles about the legal aspects of surrogacy in Mexico to gain more insight.

Emotionally, surrogacy can be a rollercoaster for both the surrogate and the intended parents. It involves intricate emotions and significant psychological engagement, requiring ongoing support throughout the process. Many surrogacy arrangements include counseling services for all parties to help manage expectations, navigate emotional challenges, and provide a smooth process for everyone involved.

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