What Is Gestational Surrogacy? Definition and Process

Gestational surrogacy is an exciting opportunity to grow a family for people who biologically or physically cannot have children on their own. Gestational surrogacy has become the most common form of surrogacy in America. Hundreds of families benefit from the process every year, yet it is often misunderstood.

What is gestational surrogacy? Is there a difference between traditional vs. gestational surrogacy? How does it work? Let’s explore these questions and see how the gestational surrogacy process works. 

A Simple Explanation of Gestational Surrogacy

In gestational surrogacy, a woman carries and delivers a baby on behalf of another person or couple, and she has no genetic connection to the baby. Instead, the embryo is created through in vitro fertilization (IVF) using an egg and sperm from the intended parents or from donors. The embryo is then transferred and implanted into the surrogate’s uterus, where it grows and develops just like any other pregnancy.

With gestational surrogacy, no genetic relationship exists between the surrogate and the baby. The surrogate’s role is to carry the pregnancy and give birth on behalf of the intended parents, who will raise their child. When comparing traditional vs. gestational surrogacy, genetics is the fundamental distinction. In traditional surrogacy, the surrogate’s own egg is used, and she is genetically related to the baby. A gestational surrogate has no genetic relationship with the child whatsoever. 

Because gestational surrogacy involves no biological link between the surrogate and the child, the process is more legally straightforward—and emotionally clear—for everyone involved. 

“Is It Hard to Give the Baby Up?”

A common first question about gestational surrogacy is often: “is it hard to give the baby up?” While carrying a pregnancy for someone else is undoubtedly an emotional experience, surrogates who carry for another family enter into the process knowing this pregnancy is carried for another family in order to make the dream of a family’s first child or sibling possible. Many surrogates often talk about the joy they have experienced having and raising their own children, and feel motivated to be a surrogate in order to support and witness that joy in someone else’s life. A gestational surrogate makes it possible for someone who cannot carry a pregnancy to have a child they are biologically related to (depending upon the source of the egg or sperm), who is wholly their own. 

There is the dictionary’s gestational surrogacy meaning, and then there is the living reality of the process. What is gestational surrogacy? It is a powerful, compassionate partnership that helps hopeful parents grow their families through medical science and human generosity.

How Gestational Surrogacy Works Step-by-Step

The gestational surrogacy process involves several key milestones—each designed to protect the health, rights, and well-being of everyone involved:

Application and Qualification 

Gestational surrogacy is typically entered into with the assistance of a qualified surrogacy agency. With an agency, intended parents and surrogates must each complete a thorough screening process that includes a background check and psychological evaluation. This helps ensure that every party is fully prepared for the gestational surrogacy process.

Matching Intended Parents and Surrogates

An ethical surrogacy agency, such as NW Surrogacy Center, matches surrogates and intended parents based on their shared values. No match is made until and unless both sides are happy with the pairing.

During a proposed potential match, the family’s chosen fertility clinic reviews and provides their recommendations (and hopeful approval) of the potential surrogate’s medical records.

Legal Agreements

Gestational surrogacy is safeguarded by clear legal agreements that spell out all expectations and responsibilities between the surrogate and the intended parent(s). The legal contract is prepared by a qualified attorney experienced with surrogacy law, and it covers every aspect, including the surrogate’s compensation, the parents’ rights, and how to handle sensitive issues such as medical risks or pregnancy complications. The intended parent(s) and surrogates each have their own legal representation through this process.

Medical Screening

A gestational surrogate undergoes in person medical screenings with the intended parent(s)’ fertility clinic to verify that she can safely carry another pregnancy. She then takes fertility injections to prepare her body for the embryo transfer, following an IVF cycle designed by the fertility clinicians that culminates in an embryo transfer.

Embryo Transfer via IVF

In gestational surrogacy, the intended parents’ egg and sperm—or a donor’s— are used to create the embryo. Through IVF, the embryo is transferred to the surrogate’s uterus in a simple outpatient procedure. Some intended parents attend the embryo transfer with their surrogate to mark the occasion and provide support, while others might attend via a video call or send text messages of support from afar. Transfer day is both exciting and surprisingly quick – and it kicks off a phase of waiting for the next 2-3 weeks until lab tests and ultrasounds confirm if the transfer was a success.

Pregnancy and Delivery

Once the pregnancy is confirmed, the surrogate receives the same prenatal care as any expectant mother. Throughout the gestational surrogacy process, the intended parents and surrogates may remain in close contact. The parties reconvene with their attorneys mid-pregnancy to complete legal parentage proceedings that articulate that the surrogate has no legal guardianship rights or responsibilities and that the intended parent(s) is/are the legal and sole guardian(s) responsible for baby upon birth. After the delivery, the baby goes home with their parents.

Many surrogates and families share the labor and delivery experience, if the surrogate is comfortable laboring with others around here. Some intended parents may feel nervous about intruding or disrupting, but many surrogates have expressed that it’s important to them for parents to be in the delivery room to welcome their little one right away. Labor and delivery is an understandably intense process, and other surrogates appreciate being able to labor independently in the quiet of their own labor and delivery room. These discussions about how everyone imagines delivery day are typically supported proactively by an attentive surrogacy agency during the very beginning of the surrogacy journey in a Match meeting, and again during a third trimester check-in leading up to the due date.

The gestational surrogacy process is complex. But with expert support, it becomes a beautiful, life-changing experience for everyone involved.

Gestational vs. Traditional Surrogacy: What’s the Difference?

Surrogacy always involves someone being pregnant and carrying a baby for another person or couple. What distinguishes traditional vs gestational surrogacy is genetics. The surrogate uses her own egg in traditional surrogacy, so she is both the genetic and birth mother of the child. The pregnancy is typically achieved through intrauterine insemination (IUI) and uses the intended father’s sperm or a donor’s. Because the surrogate is genetically related to the child, the process can involve more complex emotional and legal issues—especially around parental rights.

There is no genetic link between the surrogate and the child in gestational surrogacy. Using DNA from the intended parents or donors, the embryo is created with in vitro fertilization (IVF) and then transferred to the surrogate’s uterus. Gestational surrogacy is now widely preferred to traditional surrogacy throughout the U.S. due to the greater clarity it provides, both legally and emotionally. 

Who Uses Gestational Surrogacy and Why?

Gestational surrogacy offers individuals and couples who cannot have a child on their own the chance to realize their dreams of parenthood. It helps individuals and couples facing a wide range of medical, biological, or social challenges become parents.

Some intended parents have struggled with infertility for years. Others may experience secondary infertility or have medical conditions, such as a history of cancer, recurrent pregnancy loss, or uterine abnormalities, that make pregnancy unsafe or impossible. Gestational surrogacy is also a powerful option for same-sex male couples, single men, and others who cannot become parents biologically without a surrogate’s help.

Legal and Medical Considerations to Know

Rigorous medical screening and clearly articulated legal agreements are essential to protect everyone involved in gestational surrogacy. Every gestational surrogate must undergo complete physical and psychological evaluations designed to determine her readiness for the process. An experienced surrogacy attorney draws up legal contracts to establish legal parentage, outline expectations, detail compensation, and ensure a smooth process. Because surrogacy laws vary by state, it’s vital to work with a reputable agency that understands the legal landscape.

During screening, potential surrogates are supported by an excellent screening coordinator, and at the time of matching, intended families and surrogates are assigned a dedicated case manager to walk with them from initial match to welcoming baby. At NW Surrogacy Center, we support our intended parents and surrogates through every step of the journey with compassion, clarity, and expert support.