How Does Surrogacy Work? All You Need to Know

Andrew Mackay

Andrew Mackay - Medical Content Writer

Posted Jan 11, 2021

Happy couple smiling and sitting on the sofa holding baby.

Surrogacy has come a long way in recent years. Facing the difficult prospect of infertility can be daunting. Thankfully, this reproductive method has allowed hundreds of aspiring parents to start a family of their own. Attitudes around the surrogacy process are changing, making the method more affordable and accessible.

But surrogacy can still be a complicated procedure to try and get your head around. In fact, one of the most common questions among prospective parents is “how does surrogacy work?” In this article, we’ve aimed to create a clear, step-by-step answer to this. We’ve also addressed other common questions around what exactly surrogacy is and who is eligible, and some important points to watch out for.

What Is Surrogacy?

Simply put, surrogacy is a method whereby a woman — referred to as the surrogate mother — carries and gives birth to a baby for another person or couple — referred to as the intended parent(s) or ‘IP(s)’. In most cases, once the baby is born it’s given to the IPs, with the surrogate mother having no further obligations towards it, however this might not always be the case depending on specific agreements. As it’s such a sensitive situation, surrogacy arrangements are commonly supported by previously agreed legal framework between the IP and the surrogate mother.

Surrogacy is a popular option among couples who are struggling with infertility. This can include male infertility issues, however, it’s a common solution in cases where a woman has either already faced multiple miscarriages, or where the risks of going through a pregnancy are too high.

Surrogacy also provides same-sex couples — both male and female — with a safe and effective way to start a family. It can also be undertaken by people who are single and looking to have children.

How Does Surrogacy Work: The Two Main Types

Explaining how the surrogacy process works can be complicated. It’s important to first understand the two main types of surrogacy that are available.

Full Surrogacy (Also Known as Host or Gestational Surrogacy)

The first method, full surrogacy, is the most commonly undertaken option. It involves the use of an egg from the IP or from a donor. This means that there’s no genetic connection between the surrogate mother and the baby. Embryos from the IPs can be created from both sides (i.e. an egg from the mother combined with the male sperm from the father). Alternatively, the embryo can consist of one half of the IPs genetics, plus either a donor egg or donor sperm.

Partial Surrogacy (Also Known as Straight or Traditional Surrogacy)

As the name suggests, partial surrogacy is the more traditional method. It involves the fertilisation of the surrogate mother’s egg using the sperm of the intended father. This was widely used before technological developments allowed for the creation and fertilisation of embryos outside of the womb. Of course, this method means that it’s the surrogate mother, rather than the intended mother, who is genetically-related to the baby. This can make the legal framework more complicated for this type of surrogacy, which is the main reason as to why it has become less widely used as reproductive medicine has developed.

The method of surrogacy that you choose to pursue will be dependent on factors such as your individual situation, whether you’re single or in a couple, your reasons for seeking surrogacy, and your specific relationship with the surrogate mother. At Qunomedical, we can support you in finding high-quality doctors abroad who specialise in gestational surrogacy.

How Does Surrogacy Work: Step-by-Step

Surrogacy journeys will vary depending on your individual situation, the method you choose, and where you decide to pursue the procedure. However, there are a few common steps involved in almost all surrogacy journeys and we’ve laid these out in more detail below.

1. Considering Surrogacy

Choosing to go down the path of surrogacy can be a long and emotional journey. Therefore, it’s really important to carefully consider whether or not it’s the right solution for you. Thinking about all the risks and benefits, as well as the significant financial investment that’s involved, will help you to decide whether or not this is a path that you want to go down. The consideration stage should also involve researching surrogacy laws, as the rules and restrictions around the procedure vary significantly from country to country. Surrogacy laws in the UK have gone through quite a few changes over the years, however, it still involves some restrictions that result in many IPs travelling to undergo surrogacy abroad.

2. Meeting With a Specialist

Once you feel that surrogacy is the right option for you, the next step is to arrange an initial consultation with a specialist. Your specialist will talk you through the whole process step-by-step, and answer any questions you may have. This is the time to discuss which type of surrogacy will work best and whether or not donor egg or sperm will be required. During this first consultation, it’s also likely that your specialist will carry out some diagnostic tests such as an ultrasound, blood test, or semen analysis.

3. Choosing a Surrogate

Initial meetings with your specialist are also the time to discuss options for a surrogate. Some IPs come into their initial consultations with a surrogate already in mind, such as a friend or family member. This can be a great solution if there’s already a good relationship and level of trust between the two parties. However, if you don’t already have a surrogate arranged, there’s no need to worry. Your specialist will be able to begin the process of finding a suitable match, as well as a sperm or egg donor if needed.

There are a number of ways in which to find a suitable surrogate. You can do this anonymously, through in-person events, via online forums, or by looking through surrogate profiles on trusted resources like Surrogacy UK. However you find your surrogate, it’s important that you consider some key questions around how things will work in the future. For example:

  • Do you want to be in contact with the surrogate before, during, and after the pregnancy?

  • How much involvement do you want the surrogate mother to have with your baby after birth?

  • When and how do you plan to talk to your child about their birth and do you want to include the surrogate mother in this conversation?

Of course, if you prefer for your surrogate to be anonymous this is also an option. What’s important is that a surrogate is able to have a stable, safe, and healthy pregnancy. There are strict selection criteria in place to ensure that this is the case, with all surrogate mothers being medically evaluated and psychologically screened.

4. Establishing a Legal Framework

Once you have found a suitable surrogate to move forward with, whether this be anonymously or otherwise, a legal contract will need to be drafted between the two parties. This sounds difficult, but your specialist and fertility clinic will assist you in drawing it up. Both you and the surrogate mother should have your own mediator, who will work closely with you both to discuss your legal rights, possible risks, and any agreed compensation.

Legal issues around surrogacy can be complicated and frustrating. In fact, a recent study found that 75% of surveyed respondents believed that UK surrogacy laws are out of date and should be reformed. This again highlights part of the reason as to why travelling abroad for the procedure is becoming increasingly popular.

However, for those who choose to undergo surrogacy in the UK, there are some important points to note:

  • Even if the sperm and egg came from the IPs, the surrogate is the legal mother of the newborn baby, regardless of her genetic relationship to the child. This is the case unless the IPs obtain a parental order from court.

  • Once a parental order form has been obtained, the rights and obligations of the surrogate mother towards the child will be removed.

  • Previously, the law stated that it was only possible for two people to apply for a parental order form, but this was recently changed to allow a single person to obtain one as long as that person is the biological parent of the child.

These laws can be complex and applying them to individuals cases can be tricky. Therefore, it’s important to talk to your fertility clinic during your very first consultations, in order to start planning the necessary framework early-on.

5. IVF and Embryo Transfer

Once all the legal contracts have been agreed and signed, the fertilisation process can get underway. To begin with, the intended mother and the surrogate’s cycles are synced. The process of embryo transfer is then carried out, typically using the reproductive medicine technique known as in-vitro fertilization (IVF). This involves the fertilisation of the egg, either using the sperm from the intended father or from a donor, outside of the uterus. The embryo is then safely incubated and transferred into the surrogate mother. Success rates for IVF are fairly high, however, they can be dependent on a number of factors, particularly the age of the IPs or surrogate mother. A pregnancy test is then taken around 10 days after the embryo transfer.

6. Pregnancy Confirmation

If all goes well, the next stage of your surrogacy journey should bring a confirmed pregnancy. The surrogate mother remains under close observation throughout the pregnancy to ensure that it runs as smoothly as possible. Depending on your arrangement with them, you can share the pregnancy experience, being alongside to provide emotional support. Alternatively, if your surrogate is anonymous, your fertility clinic and doctor will provide you with regular updates.

Following the first trimester of the pregnancy, your lawyer or mediator will work with you on the legal framework needed for establishing you as the legal parents. This can allow you to make medically-related decisions for the baby and have your names on the birth certificate. As mentioned earlier, in the UK this involves obtaining a parental order, however, specific processes vary greatly from country to country.

7. Welcoming Your New Arrival

After what may have been a long journey, the arrival of a healthy baby born through surrogacy is a life-changing event. In most cases, IPs join the surrogate mother at the hospital on the day of the birth.

After your baby is born and the surrogate is discharged from hospital, you’ll be able to return home. If you undergo surrogacy abroad, then the UK embassy will assist you in obtaining a passport and birth certificate for your baby. This is known as the “Exit Process” and is something that must be followed. Fertility clinics abroad help new parents to arrange all of this with their embassy.

Whether or not you choose to maintain a relationship with the surrogate mother following the birth of your baby is entirely up to you. Many parents and surrogates choose to keep in contact, with some even introducing the surrogate mother when the time comes to explain to the child the origins of their birth. However, only you — or you and your partner — can decide this. There’s no correct rule and it’s something that’s decided on a personal, case-by-case basis.

Taking the First Steps

Attitudes around surrogacy have changed, with new high-quality, affordable fertility clinics abroad giving more people their chance to start a family. Whatever your individual situation may be, it’s important that you have plenty of support around you before starting your surrogacy journey. At Qunomedical, we work hard to provide part of this support network. If you’d like to find out more about how surrogacy works, how much it costs, or find out about options for high-quality surrogacy abroad, contact us. One of our Patient Managers will be in touch to answer any questions you may have. We can provide you with information on a high-quality, reputable fertility clinic in Cyprus, home to renowned doctors specialising in gestational surrogacy. Your Qunomedical Patient Manager will always be available as a point of support throughout your entire surrogacy journey.

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