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How to Choose a Surrogate

Surrogacy involves the use of another woman to carry a child through to birth. The surrogate then hands the child over to the intended parents after the birth. Surrogacy is not legal in all countries so always check the law relating to the country you are in. Most countries which allow IVF will often also allow surrogates to be used during the IVF process. However private arrangements are banned in some countries. The UK allows both clinics and private individuals to use surrogacy. However in the UK any private arrangements are not legally recognised and therefore are not enforceable. Surrogates can only be paid reasonable expenses and it is illegal to advertise for a surrogate.

You should also check whether the surrogacy laws only apply to married couples. In the UK at present only married couples can take part in a surrogacy and this therefore excludes homosexual couples and single people. However the surrogacy law in the UK is currently under review.

Surrogacy is often chosen where it is impossible or dangerous for the intended mother to carry the baby herself. Adoption or fostering may be another choice open to the couple.

There are two main types of surrogacy:

Traditional Surrogacy (also known as ‘partial’ or ‘straight’ surrogacy) – this is where the surrogate mother provides her eggs and uses the sperm of the intended father to conceive. This can be done by self-insemination using artificial insemination in the home (involves a syringe) or using the services of a licensed private clinic. This method means that the baby is biologically related to the intended father and surrogate mother but not the intended mother.

Host Surrogacy (also known as ‘gestational’ or IVF surrogacy) – this is where the egg of the intended mother is combined with the egg of the intended father and then implanted in the surrogate mother. This is the method which is more commonly used in conjunction with IVF. This means that the baby will be biologically related to both the intended father and the intended mother and the surrogate mother will have no biological ties. This is not something which can be done at home and must always involve a clinic.

When choosing a surrogate it is therefore important to decide which method you would prefer. You must be comfortable with the process. Whilst gestational surrogacy means both the intended father and mother will be related to the child the conception success rates are much lower than with traditional surrogacy. It is possible to buy insemination kits if your choice is to try artificial insemination at home using the traditional surrogacy process. If you do not use a surrogate from a clinic you should be aware that the surrogate may not have been screened for inherited diseases and sexually transmitted diseases. After the age of 35 the chances of conceiving a child with Downs Syndrome are greater. You may therefore want to consider choosing a surrogate under the age of 35.

Not all women would be suitable as surrogates. Some women are not able to carry a child to full term. Clinics are less likely to choose women over 45 and would also take into account health, weight, history of miscarriages, high blood pressure etc. A surrogate should ideally have already had children of her own.

You also need to consider the issue of the surrogate’s expenses. If these have to be paid they could cover everything from maternity clothing to lost earnings in taking time off work as well as hospital bills particularly if you choose a surrogate from overseas. If you choose host surrogacy then you will also have to pay for the costs of IVF any medical visits as well as all tests and drugs used.

Joint decisions will also have to be made about how the pregnancy should proceed e.g. ultrasound, blood tests, amniocentesis, Chorine Villus sampling (CVS) to detect chromosome abnormalities, the preferred method of delivery, who will be present at the birth etc. You will need to discuss what will happen if the child is severely disabled and the surrogate mother is opposed to termination or if the surrogate mother has a change of mind and wants to keep the baby. Agreement needs to be reached as to what stage sole decision making powers are passed to the intended father and mother and at what stage contact with the surrogate mother will stop. A surrogacy arrangement will require all parties to open with each other and counselling is recommended as this is an emotional process

Finally it is important to remember that the surrogate’s legal status in some countries will be that of the mother until such time as you have obtained a court order making you and your partner the legal parents.If the surrogate is overseas you could also encounter problems bringing the child into the country. Even after that you will face the big question of whether and how you will tell the child about his or her origins.