Gestational vs. Traditional Surrogacy

by | May 16, 2022 | Fertility 101

What’s the difference between gestational and traditional surrogacy, and which is more common?

One often-misunderstood fertility topic is gestational vs. traditional surrogacy. Some patients are confused by what exactly “surrogacy” means when it comes to genetic, legal, and logistical details. In this article, we’ll go over the differences between gestational and traditional surrogacy, including which is more common and recommended by fertility experts.

What Is Gestational Surrogacy?

All pregnancies need three things: sperm, an egg, and a uterus. In gestational surrogacy, each of these three components comes from a different person. The sperm and egg come from the intended parent and/or a donor, while the uterus belongs to a third person, known as a gestational carrier (commonly called a surrogate). The gestational carrier receives the embryo through in vitro fertilization (IVF), carries the pregnancy to term, and delivers the baby. However, the gestational carrier has no genetic connection to the baby.

What Is Traditional Surrogacy?

In traditional surrogacy, also called “genetic surrogacy,” the surrogate provides both the egg and the uterus. Usually, traditional surrogacy uses intrauterine insemination (IUI) to impregnate the surrogate with sperm from the intended father or a sperm donor. In this case, the surrogate does have a genetic connection with the baby, providing half of the genetic material.

What Is the Difference Between Gestational vs. Traditional Surrogacy?

The main difference is the genetic connection. In traditional surrogacy, the surrogate provides the egg and shares a genetic connection with the baby. In gestational surrogacy, the surrogate does not provide the egg, and has no genetic connection. We use the term “gestational carrier” to emphasize that a gestational surrogate carries the baby to term without providing any genetic material.

This seemingly simple detail creates some major differences between gestational and traditional surrogacy.

Emotional Differences in Gestational vs. Traditional Surrogacy

Because of the biological relationship between a traditional surrogate and the baby, traditional surrogacy can be more emotionally complex than gestational surrogacy. A traditional surrogate may feel more attached to the baby or have complicated feelings about handing the baby over to the intended parents after birth. Similarly, intended parents may struggle with knowing their surrogate is biologically related to their baby. Gestational surrogacy removes the biological factor from the surrogate experience.

Legal Differences in Gestational vs. Traditional Surrogacy

Gestational carriers have no legal parental rights to the babies they carry. In most cases, the intended parents establish their full legal parenthood before their baby is born with a pre-birth order, which makes sure that their names are on their child’s birth certificate.

Traditional surrogacy has more legal risks. Many states don’t allow traditional surrogacy at all. Where it is allowed, the surrogate is legally considered the biological mother, and cannot formally give up parental rights until after the baby is born. If the surrogate decides she wants to keep the baby, the intended parents may have to go through a lengthy court process. Even if the surrogate gives the baby to the intended parents as agreed, the parent without a genetic connection to the baby (ex. the intended mother, or the parent in a gay couple who did not provide the sperm) may need to go through the legal process of adopting the baby to have parental rights.

Which Is More Common: Gestational or Traditional Surrogacy?

Gestational surrogacy is far more common nowadays. Since the development of IVF in 1978, gestational surrogacy quickly replaced traditional surrogacy as the preferred method. In fact, most fertility clinics (including PNWF), surrogacy agencies, and fertility lawyers only work with gestational surrogacy agreements. Similarly, the American Society for Reproductive Medicine (ASRM) only provides guidelines for gestational surrogacy, as “traditional surrogacy is rarely offered by most programs, and is more ethically and legally complex.”

Interested In Gestational Surrogacy?

At PNWF, we have a dedicated team to coordinate and assist with gestational surrogacy. While the process is complex, we have decades of experience helping intended parents navigate their surrogacy journey. If you’re interested in gestational surrogacy, reach out to us today.