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How Does Surrogacy Work?

Olga Pysana
October 05 2024

Intended parents often ask questions about what the surrogacy process entails and how it works. Let’s look at the steps you should anticipate when embarking on the surrogacy journey.

  1. You may choose to walk this path alone. But suppose you decide to request assistance from the surrogacy agency. In that case, you will have an initial consultation where you will be asked questions about your goals and unique situation, and also develop your surrogacy plan.

  2. After the initial consultation, you will undergo the surrogate selection and matching. Reputable agencies have an extensive surrogate database and can provide intended parents with several options to meet their requirements. This means shorter wait times than when looking for a surrogate on your own.

  3. After the intended parents are matched with a surrogate, both they and the surrogate will undergo medical and psychological screenings to ensure the absence of infectious diseases and mental and genetic disorders.

  4. The next stage is for the intended parents and a surrogate to sign a legal agreement outlining their rights, responsibilities, and compensation for the surrogate.

  5. After the above steps are completed, a clinic performs in-vitro fertilization (IVF) and transfers the embryo into the surrogate’s uterus.

  6. After birth, the intended parents can take their baby home. 

How Does Surrogacy Work with Insurance?

It’s important to know that insurance companies usually do not cover surrogacy-related medical fees, as surrogacy is considered a choice rather than a necessity. Sometimes, the intended parents and a surrogate’s health insurance will cover some expenses but not the entire process.

Let’s look at what procedures insurance does cover:

  • Depending on your medical plan, insurance covers one in-vitro fertilization necessary to create embryos.

  • Insurance may cover lab testing associated with fertility treatment.

  • In the case of traditional surrogacy, when a surrogate’s own eggs are used, insurance covers the cost of artificial insemination.

  • Some private health plans may offer a benefit to retrieve and freeze eggs.

  • Some health insurance companies offer an option to cover a surrogate’s fertility treatments, labor, and recovery period for an additional cost.

Insurance companies do not cover the following:

  • Fertility treatments and embryo transfer to a surrogate.

  • The cost of donated eggs.

  • Surrogate’s compensation.

  • In many cases, a surrogate’s insurance will not include pregnancy. With the rising popularity of surrogacy, many health insurance companies have changed their policies to avoid paying for surrogacy pregnancies.

It will be helpful for intended parents to make sure they know what their insurance covers and what expenses to expect so that they can use the insurance coverage to the max and plan their expenses accordingly.

How Does Surrogacy Work for Gay Parents?

Same-sex couples face unique challenges when pursuing surrogacy. Unlike many heterosexual and female gay intended parents, male gay couples need both an egg donor and a surrogate, while female couples may only need a sperm donor. Some female couples choose one partner to donate eggs and another one to carry a pregnancy. 

For gay couples, two main surrogacy options are available. Traditional surrogacy is when the egg donor also carries the child. The surrogate is inseminated with the intended father’s sperm through medically assisted artificial insemination and is biologically related to the child.

Another option is gestational surrogacy, which involves eggs and sperm from the intended parents or a donor. In this case, the surrogate and the baby are not genetically related. Sperm from one or both fathers fertilizes donor eggs in a lab, and the resulting embryos are transferred to a surrogate's uterus.

There is also an excellent option for male-gay couples to have siblings born around the same time. How does it work?

Embryos are created from the intended parents’ or their donor’s genetic material and transferred into two different surrogates. Two children will be born at approximately the same time. This option makes it possible to have two children of the same age genetically related to both intended parents. The donor’s egg is split between the two fathers, with half the egg fertilized by each. The two embryos from two fathers are then transferred to two different surrogates.

You can find more about surrogacy for LGBTQ+ here.

How Does Gestational Surrogacy Work?

Gestational surrogacy involves using IVF to create an embryo from the intended parents' egg and sperm or donors. The surrogate who carries the baby has no genetic link to the child. This is often preferred as it avoids legal and emotional complications associated with traditional surrogacy, where the surrogate's egg is used.

Gestational surrogacy is usually more expensive than traditional surrogacy because it requires additional procedures, such as egg retrieval and embryo transfer, and using an egg donor.

More about gestational surrogacy here.

How Does IVF Surrogacy Work?

During in-vitro fertilization, eggs are removed from the ovaries and combined with sperm in a laboratory. The fertilized egg, or embryo, is then placed in the uterus of a surrogate. The process can take from a couple of weeks to a few months to complete. IVF can be performed using intended parents’ own eggs and sperm or eggs and sperm from donors. The procedure may need to be repeated multiple times to increase the chances of pregnancy.

Sometimes, IVF works on the first try, but many people need more than one round of IVF to get pregnant. Everyone’s body is different, and your surrogate might need more than one procedure.

Usually, the intended parents and their surrogate take medications to synchronize their cycles and stimulate egg growth. The eggs are retrieved from the intended mother or egg donor. They are then fertilized with sperm from the intended father or sperm donor. Then, the embryos are transferred to the surrogate's uterus. 

Final Thoughts

The answer to how surrogacy works and how much it will cost varies on your specific situation. Same-sex couples face unique aspects when pursuing surrogacy. Luckily, they have several options for the surrogacy process. Gestational surrogacy is a predominant solution as the surrogate who carries the baby has no genetic link to the child. The surrogacy process usually involves in-vitro fertilization when eggs are removed from the ovaries and combined with sperm in a laboratory. The embryo is then placed in the uterus of a surrogate.

Surrogacy is expensive, so use all the insurance provisions available. However, health insurance usually covers some expenses but not the entire process. Make sure you use your insurance to the max.

If you have questions concerning surrogacy in your unique situation, contact us for guidance, and we will explain all the steps.

 

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