How Does Surrogacy Work?

How Does Surrogacy Work?

It’s not unusual for people who decide to spend their lives together to want to start a family. Once that lifelong bond has been established, it’s only natural to want to continue the cycle of life, and add even more to an existing relationship by raising a child with the same love, values, and beliefs in a family setting.

Unfortunately, not everyone can choose to start a family traditionally, with a mother carrying a growing embryo to maturation, resulting in birth, and a new baby in the family. Same-sex couples, for example, may not have a uterus available in either partner to grow a baby. And in other cases, there may be very strict medical reasons for not having a natural childbirth, as it could put the child and/or mother at serious health risk.

This doesn’t mean that it’s impossible for these intended families to have a chance. It does mean, however, that a more concerted, planned, concentrated effort is required. Surrogacy, where another woman agrees to carry a baby to term, give birth to it, and then allow that child to unite with his or her intended parents, is one likely alternative. But how does this work? There are a few things that need to be considered.

IVF Or Not?

One of the first big questions that should be addressed when thinking about surrogacy is whether this will be a gestational or traditional surrogacy. A traditional surrogacy means that the surrogate mother will be using her own eggs as part of the surrogate process. This means that the male genetic material may either come from one of the intended family members, or a donor. Biologically, however, the surrogate mother will be the genetic mother of the child as well.

In gestational surrogacy, the surrogate mother is providing her uterus for growing the baby, but all the genetic material is coming from the intended family, through a process known as in vitro fertilization. Here, the mother and father both have their sperm and eggs samples collected and then fertilized in lab conditions. Optionally, one or both of the parents may also elect to use donors. The fertilized egg is then implanted into the surrogate mother who carries the baby to term.

This first choice is important since a traditional surrogacy means the intended parents may want to be more selective about the surrogate mother. Now her genetic characteristics will determine the health of the child.

Picking A Surrogate

Once the intended family knows what type of surrogacy they are looking for, it’s time to select and work with a surrogate mother. This can occur in one of two ways. The intended parents can either find someone they know and trust, then ask that woman to take on the role of a surrogate mother. Alternatively, the couple can go to an established, experienced, surrogate motherhood clinic, and go through an extensive support, screening, interview, and selection process.

Depending on the personal situation, either alternative is just as valid. However, picking a surrogate should also—for the rights of everyone involved—also involve some kind of finalized legal documentation. With a surrogate motherhood clinic, these legal and administrative requirements may be addressed “in-house” as part of the service. But for families that privately pick an individual, there may be a need to seek additional legal assistance.


If IVF has been selected as part of the process, then samples will need to be taken for this step. These samples may either be “freshly harvested” from the parents, or they may be retrieved from a cryobank if one or both intended parents had materials stored away in advance.

In either case, the in vitro fertilization will take place, and in some instances may also undergo pre-implantation genetic diagnosis to ensure no genetic conditions or disorders have surfaced. Parents may also have a pick of a few different “viable” eggs for implantation.


Once the embryo is implanted, nature takes its course. The surrogate now carefully monitors her health and lifestyle to ensure a safe developmental period for the baby. Depending on the type of surrogacy chosen, intended parents may be supporting a selected surrogate as she carries the child to term, or the clinic may oversee her overall health and well-being as part of the service.

Birth & Citizenship

Once a child is born and united with his or her parents, there’s the question of parenthood and citizenship. Parents who choose to go to a clinic in a country like Georgia, with well-defined laws about surrogacy, will have much of these legal considerations taken care of, as well as any questions of citizenship when the family returns to their country of origin. Families to that choose to have an independent surrogate situation will need to negotiate these variables on their own, depending on their country of residence and personal situation.