Surrogacy as the last throw of the dice

Surrogacy is seldom the first choice on the journey to build a family. Often people come to surrogacy after trying and exhausting other options such as intrauterine insemination (IUI), in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). In some cases medical issues, such as absence of a uterus, impaired uterus, or a chronic health problem, make it impossible or unsafe for the intended mother to carry a child. Sharing a pregnancy with a carrier (the woman carrying the child) may be the right option for you if involvement with the pregnancy and prenatal care, genetics and being present for the birth of your child are important.

Until recently, stories in the popular press were about traditional surrogacy, where the surrogate is inseminated with sperm from the infertile woman’s husband, and the carrier is genetically linked to the child. Today, most couples who build their families through surrogacy choose gestational surrogacy, also known as gestational care. In gestational care, the intended mother or an egg donor provides the egg and the intended father or a sperm donor provides the sperm. The resulting embryo is transferred to the gestational carrier, who has no genetic connection to the child.

After three miscarriages and years of infertility, Sharon didn’t give up her dream of having children. Once it became clear that pregnancy wasn’t a viable option, she and her husband Dan became interested in surrogacy, where they could both be genetically connected to the child. They also investigated adoption and resolving without children.

Sharon: “All my life I expected that I would have children. After years of failed infertility treatment, my husband and I had almost given up. We didn’t have the energy or emotional stamina to keep trying. I thought adoption was my only alternative until our doctor suggested that we consider gestational care. As hard as that was to hear, I realized I could have a genetic child and be very close to the pregnancy even if I wasn’t carrying the child myself. It was so exciting to be at that first ultrasound and see my child’s heartbeat! It has turned a very painful beginning into a very hopeful future.”

Dan: “What a nightmare this has been for both of us, especially for my wife. After each miscarriage, what we took for granted began to seem like it might not happen. I have seen the pain in my wife’s eyes as she has come to terms with the fact that she is unable to carry a baby. I have always supported my wife but have also realized my own deep desire to have a child who will carry on the traits of my family. It may sound selfish, but I wanted to have a child who might be blessed with my mom’s musical talents or have my dad’s sparkly eyes. For me, surrogacy is as close as we can come to having our child in the “usual” way.”

Before deciding to use a surrogate, you (and your partner) should consider the following questions:

Are you ready to move on from current infertility treatments?

How do you feel about someone else carrying your child?

Are both partners ready to do this?

How will you explain the pregnancy and birth to others and eventually to your child?

It is important that you and the carrier speak to a mental health professional specializing in infertility about these and other concerns. A mental health screening can help ensure that all parties have considered all matters. It will also help to determine if you and your carrier are compatible.