My Journey with Cushing’s disease
At 30 years old, I was fit, healthy and naturally a size 8–10. I knew my body well, which is why, when it started to
The journey to parenthood can be taken via multiple pathways, from natural conception and IVF to working with surrogates. There is no one-size-fits-all, and modern science allows many people to become parents who would not previously have had the opportunity to do so.
At Female Health & Fertility, we often look at the different forms of assisted reproduction and how to choose the best IVF clinic for you. In this article, we will look at one very specific option for parenthood: surrogacy.
Often seen as a pathway for “the rich”, with celebrities like Chrissy Tegan, Kim Kardashian and Sara Jessica Parker being among the famous people in the last few years to talk candidly about their surrogacy journeys, surrogacy is often an overlooked route. However, in the past few years, the number of people teaming up with surrogates has quadrupled in the UK alone, with people from all walks of life choosing surrogacy for many reasons, from wanting to start a same-sex family to health issues which make conception and birth challenging.
The journey to parenthood is a deeply emotional and personal experience, and it can be frustrating when the “natural way” isn’t working. When fully understood and approached ethically with the right support resources, surrogacy can be a truly wonderful route to parenthood.
Surrogacy is where a person goes through pregnancy and gives birth to a baby on behalf of another person or couple. When ethically approached, this process usually involves the parents-to-be developing a close relationship with the surrogate throughout the process. This allows them to be present and experience the journey to parenthood as a supportive team.
As mentioned above, there are many reasons why people opt to choose a surrogate over IVF, natural conception, and even adoption, including:
Infertility and/or Medical Conditions: For people who have been told they are infertile, have experienced multiple miscarriages, or have been trying to get pregnant and are unable to, surrogacy offers a chance to have a baby that is still biologically theirs, using their own eggs and/or sperm. Conditions like endometriosis, PCOS and many more can make carrying to term difficult. Meanwhile, for women who have had to undergo a hysterectomy or have MRKH syndrome, pregnancy is not physically possible. Surrogacy allows intended parents to overcome these complications.
Same-Sex Couples: As a male same-sex couple, working with a surrogate allows the use of one partner’s sperm in the process, ensuring the child is related biologically to one of the parents. It also allows male couples to experience the milestones of pregnancy and to be involved in the birth of their child.
Single Parents: For those looking to start their journey to parenthood alone, whatever their gender, surrogacy offers an interesting opportunity. The parent will have their sperm or egg fertilised and placed into the surrogate to carry to term on their behalf.
For couples or individuals who cannot carry a baby themselves, sharing the journey to parenthood with a surrogate allows them to still be involved in the pregnancy and birth of their child.
There are two different types of surrogacy and choosing which one is right for you is usually based on your needs, medical history, or even relationship status.
Also known as host surrogacy, this is where the eggs of the intended mother or an egg donor are used, so there is no genetic connection between the baby and the surrogate.
Also known as straight surrogacy, this is when the surrogate’s own egg is fertilised with the sperm of the intended father.
When it comes to choosing the right option for you, it is recommended that you speak with a fertility clinic, surrogacy agency and legal counsel that specialises in surrogacy—allowing you to fully understand the process as well as your and the surrogate’s legal rights once the baby is born.
It is important to note that, in most locations, at least one of the intended parents must be genetically related to the baby in order to proceed with a surrogate. Also, in some locations, traditional surrogacy is not permitted. There is also a list of countries where surrogacy in any form is illegal.
Costs vary depending on the country you are in; for example, in the UK, you are not allowed to pay for a surrogate. However, you will be expected to reimburse them for any reasonable expenses they may incur during the process, including but not limited to: medical bills, travel, counselling, maternity clothes, loss of earnings and any clinic treatment.
Like IVF, surrogacy is an expensive process and clinic costs currently come in around £10,000 to £15,000 or more in the UK, depending on the route you go down (creating embryos, egg donation, embryo transfer, etc.).
In countries like the UK where surrogacy is altruistic, it can also challenging to find a surrogate. This leads to many UK citizens pursuing surrogacy abroad. Costs vary greatly depending on the location you choose.
In the US, commercial surrogacy is legal and this means costs are very significant. Surrogacy can cost around $170,000 depending on the state in which you choose to work with a surrogate. Intended parents need to cover agency fees, medical costs of the surrogate, legal fees, surrogate compensation and more.
Locations such as Mexico, Cyprus and Georgia have become popular over recent years as more affordable options. When selecting any location it is highly important to ensure your agency or clinic is working ethically and surrogate exploitation is not taking place. Making the right choice goes far beyond understanding the costs involved.
Surrogacy is not a simple process, but there are many ways you can find a surrogate to work with. You may find that a family member or close friend comes forward and offers to be your surrogate. The benefit of this is already having a close relationship that allows you to trust your surrogate and to be in close contact with your surrogate throughout the process.
If you do not have someone to help you in your social network, surrogacy agencies are an option for connecting with potential surrogates in your own country and abroad, with many requiring you to create a profile about yourself, your relationships and your interests.
Some agencies will actively match you with a surrogate, while others operate on the basis of a surrogate approaching you if they are interested in your profile. Either way, it is always recommended that you meet and chat with any potential surrogate before you all decide on teaming up together. Some agencies can also put you in contact with egg or sperm donors who match specific criteria.
When choosing to go abroad for surrogacy, it is worth noting there may be additional legal and financial obligations in your surrogacy journey to take into account before you start the process. There may also be immigration rules and requirements that you need to follow. It is vital that you feel comfortable with the agency and their staff and that you feel positive about their approach.
As you start researching potential agencies, always consider the following criteria: their reputation, costs, the services included throughout the process; such as mental health support for you and the surrogate, the rate of success, and the overall client experience. Ask lots of questions and ensure you feel comfortable that the agency is transparent about their practices.
For the best chances of success, currently, the average age for surrogates is between 21-42, with women who are below the age of 35 seen as the most practical option to avoid health problems or complications during pregnancy.
Many agencies prefer surrogates to be fairly young, have a specific BMI and a history of carrying to term, and have no previous complications during pregnancy or birth.
It is recommended that you make your own personal requirements and views clear from the beginning. Every agency is different and every intended parent is unique, as is every surrogate: what might be a great match for someone else might not feel like the right match for you.
Every journey is different. Some couples or individuals will come to surrogacy having already made embryos from previous IVF treatment. Others will be starting from the very beginning. To give you some idea of what the surrogacy path might look like, you can expect the process to include some or all of the following elements:
Once the child is born, there are several steps you will need to go through as well. These can be complicated and vary depending on the location, but here is a very brief overview:
Whether you choose to work with a surrogacy agency or have a close friend or family member as your surrogate, understanding the legal side of the process is crucial for protecting all parties throughout the journey.
To begin with, you will need to enter a surrogacy agreement as mentioned above; this agreement will set out the obligations of all parties to the intended outcome and include how many embryos will be transferred, who will be attending hospital appointments, views on termination, the expenses you intend to pay and more.
Depending on the country you live in, you may also need to apply for a Parental Order once the child is born; this is because in countries like the UK, no matter if you have chosen the traditional surrogacy or gestational surrogacy route, the surrogate will legally be recognised as the parent of the child (regardless of whether they share any genetic link to the baby). Once a Parental Order is in place, the surrogate will no longer have parental rights or obligations to the child. You must also apply for a new British birth certificate with the new parents listed.
Other legal complications can arise when determining who the second parent is. In the UK, if the surrogate is married, their partner automatically becomes the second parent until a Parental Order is granted. If the surrogate is single, the sperm donor will automatically be the second parent if he wants to be the father. However, to avoid this complication, the surrogate can nominate a second legal parent, such as the biological mother who has provided the eggs or the non-biological father. This consent needs to be given by the surrogate before the eggs, sperm, or embryo is transferred. It is also important to note that, if you use donor eggs or sperm, the donor has to have agreed their eggs or sperm can be used for surrogacy.
If you choose to go abroad surrogacy, there are also the additional legal requirements of getting a birth certificate and passport to bring the child back into your country. The Parental Order process and legal rights will also vary from country to country. A specialist lawyer will be able to advise accordingly.
When it comes to the success rate for surrogacy, the age of the surrogate can play a role, with some studies finding that women under the age of 35 have a 60% chance of success.
However, the success rate can also depend on the age of the egg donor, the surrogate’s ability to get pregnant, egg quality, the quality of the father/donor’s sperm, as well as the success rates of the fertility clinic you use for IVF and IUI treatment.
To wrap up, surrogacy is one of many exciting ways that people living in today’s world can become parents. However, before agreeing to work with a potential surrogate, you must do your due diligence to ensure the process is the right fit for you. From understanding the budget needed, to finding the right agency or destination, to creating a surrogacy contract, to the medical procedures involved, taking your time to understand the process will save you time, money, and emotional turmoil.
Working with a reputable agency can help you find your perfect surrogacy match. You can also work legal professionals and consultants who are aware of the processes and the legal requirements to protect all parties. Surrogacy is a complicated path, which can take many twists and turns, but it can be a wonderful solution for those hoping to become parents who are unable to go through pregnancy.
My Surrogacy Journey: A non-profit agency with pathways in the UK, USA, and Mexico City. Developed following founders’ Michael and Wes’ own experiences with surrogacy.
Surrogacy UK: A UK non-profit run by a team of surrogates who are dedicated to ethical surrogacy and a “friendship first” approach.
FCLV. The Cost Of US Surrogacy. The Fertility Center of Las Vegas. fertilitycenterlv.com/fertility-treatments/price-us-surrogacy
HFEA. Surrogacy. Human Ferilizatilization and Embryology Authority. hfea.gov.uk/treatments/explore-all-treatments/surrogacy/
Patel, N. H., Jadeja, Y. D., Bhadarka, H. K., Patel, M. N., Patel, N. H., & Sodagar, N. R. (2018). Insight into Different Aspects of Surrogacy Practices. Journal of human reproductive sciences, 11(3), 212–218. doi.org/10.4103/jhrs.JHRS_138_17
Pereira H. (2022). Children of Single Fathers Created by Surrogacy: Psychosocial Adjustment Considerations and Implications for Research and Practice. Children (Basel, Switzerland), 9(11), 1644. doi.org/10.3390/children9111644
Saxena, P., Mishra, A., & Malik, S. (2012). Surrogacy: ethical and legal issues. Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine, 37(4), 211–213. doi.org/10.4103/0970-0218.103466
We hope you enjoyed this article. To help us to create more content like this, please consider visiting our Shop.
At 30 years old, I was fit, healthy and naturally a size 8–10. I knew my body well, which is why, when it started to
If you’ve had more than one loss, you may already have had chromosome testing, a karyotype or carrier screening, and still no answer. Here is
I am 36 years old, and I have spent a large part of my life trying to understand my own body and trying to become
