How Does Surrogacy Work? The Difference Between Traditional And Gestational Surrogacy

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With the news that Kim Kardashian and Kanye West reportedly hired a surrogate, according to People, you may be wondering — what is surrogacy? And how does surrogacy work? In short, it's when a woman carries a baby for a couple who intend to be the parents. Surrogacy is an option for couples who either have been unable to get pregnant through other means, are at risk for dangerous pregnancies, or don't have a uterus — either because of their gender or because one partner has had a hysterectomy. For some, this is the last option to have a child with their genetic material.

“Surrogacy is a process where a woman agrees to carry a pregnancy for another person or couple, who will become the newborn child's parents after birth,"  Dr. Pavna Brahma, M.D., and Reproductive Endocrinologist and Fertility Specialist at Prelude Fertility, tells Bustle. "Surrogacy involves the process of in vitro fertilization. During IVF, an egg and sperm are combined in the laboratory to create an embryo. The embryo is later implanted into the surrogate's uterus for her to carry the pregnancy. The surrogate takes medications to prepare her uterus to carry the pregnancy. There are also several steps of prescreening used during the process of selecting a surrogate.”

Firstly, it's important to note that surrogacy isn't without it's controversies  — there are many places where the practice isn't allowed. Now in the U.S., the legality of surrogacy varies from state to state. For example, in New York only volunteer surrogacy is legal — paid surrogacy is banned. But in states like California paid surrogacy is totally legal. The same is true from country to country. In some countries in Europe all surrogacy is banned, and in some only paid surrogacy is. So it's definitely a complicated area of law, but it's also a complicated process.

Here's what you need to know about how surrogacy works, because there are a lot of different ways that it can happen.  

There Are Different Options

When it comes to surrogacy, there are two different options. Traditional surrogacy is when a woman is artificially inseminated with the intended father's sperm — so the surrogate has a genetic tie to the baby.

With gestational surrogates, the surrogate does not have a genetic connection to the child. The Human Fertilisation and Embryology Authority points out that there are different ways surrogacy can take place. The options are:

So in these cases of gestational surrogacy, the baby could have one or both of the intended parent's genetic material — or it could have neither, if that's not an option. But the key is that the surrogate isn't genetically linked to the baby, which can make things easier in terms of legality of who has parental rights.

The Success Depends On A Lot Of Factors

With all the complications of just getting a surrogate and deciding what kind of surrogacy they'll be having, the question is — does it work? According to the Human Fertilisation and Embryology Authority, it depends on a lot of different factors. The age of the surrogate and their ability to get pregnant, the quality of the gamate given from the couple, and the age of the potential egg donor — or the intended mother giving the egg — can all affect how successful the procedure will be.

“In the setting of medical indications for surrogacy, surrogacy can sometimes save and preserve a mother's health," Dr. Brahma tells Bustle. "Of course maternal health during pregnancy does impact fetal outcomes. Therefore, in certain cases, surrogacy may help optimize the baby's health also. Prior to planning surrogacy, it's important to assess all of the potential psychological and legal implications. Taking the needed steps ahead of time can help prevent possible difficulties. Reproductive psychologists can help assure that both a surrogate and intended parent or parents are fully comfortable with their choices.”

It's definitely not a straightforward process. There's a lot of time, energy, and often money involved. But for couples who want to feel a genetic link to their children, it's often the last option.