Surrogacy

Women who are unable to carry a pregnancy might consider the use of a gestational carrier (surrogate). Surrogacy requires a complex legal and financial arrangement, as well as carefully coordinated and synchronized medical oversight. Many states and countries do not recognize surrogacy. Couples in these places may choose to travel to a state that recognizes surrogacy in order to pursue this option.

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Clinics that work with surrogacy usually do gestational surrogacy, in which the baby is not genetically related to the surrogate mother. In gestational surrogacy, both the sperm and egg come from the intended parents or from donors. Traditional surrogacy, in which the surrogate is inseminated with the intended father's sperm but uses her own egg, is rarely done at fertility clinics now because it is legally complex.

A woman without a uterus or with a uterine abnormality might also choose to use a surrogate and, rarely, so might a woman who has had many miscarriages. Still, most of the patients who use a surrogate do not have infertility, but instead have a medical condition that makes it difficult for them to have a healthy pregnancy. For example, some women have such bad morning sickness that they have to be hospitalized for months, and might choose not to go through a second pregnancy. Or a woman who has had an organ transplant and is not healthy enough to be pregnant might use a surrogate.