Third Party Surrogacy: Borrowing a Uterus

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Individuals and couples challenged with the major life crisis of infertility often feel a range of strong and complicated emotions as they navigate the complicated medical procedures and terminology of making a family. 

In addition to feeling the stress and anxiety that are part and parcel of the process, many individuals report feeling shame, the deeply painful emotion that something about them is defective.  They can also find themselves experiencing envy toward others who are able to conceive on their own or who become pregnant.  When these feelings are felt toward a close friend or family member, the emotional pain can be exacerbated by feelings of guilt.  Moreover, feelings of grief or regret over past choices or events in their lives can also surface at this time. 

All of these emotions can be experienced while at the same time holding out hope for a healthy baby. Given the emotional minefield that infertility presents, psychological support, whether individual, as a couple, and/or with a group can make infertility treatments and the consequent decisions regarding family-making more manageable, help strengthen relationships, and increase success rates.  

If your journey with infertility has led you to the juncture where you are considering using a third party in order to have a child, it is important to know about the various options available and their possible dilemmas. Third party reproduction refers to those situations where an alternative pathway to pregnancy is utilized by the couple. 

Basically, these options encompass donor sperm, donor egg, and surrogacy.  For this article, we will focus on the option of surrogacy of which there are two types, gestational (IVF) surrogacy (not the surrogate’s egg) and true surrogacy, where the surrogate uses her eggs to conceive and carry your baby. Though ethical, moral, religious and legal concerns play a significant role in these treatments, they have allowed the miracle of childbirth to those who might otherwise be unable to achieve this goal.

When considering a surrogate, it is important to know the similarities and differences between a gestational carrier and a true surrogate.  Essentially, it comes down to what is needed to produce a child.  A gestational carrier is a good choice when a good egg has been produced either by the mother-to-be or an egg donor and is necessary because the woman desiring a child has health issues that would compromise either hers or her baby’s health.  For example, if the mother-to-be has had recurrent miscarriages or her anatomy prevents her from getting or staying pregnant.

Many women facing this choice tend to look to family members or close friends as first possible candidates. But if your sister, sister-in-law, best friend, or even your mother agrees to gestate your offspring there can be complicated and reverberating emotional ripples for years to come.  It is important to become educated about the possible complications down the road should you decide to go with this route.

Another, and more popular choice, is to find a surrogacy agency to help you find your gestational carrier. The agency will prescreen and psychologically evaluate the potential carrier. In most cases, these agencies have legal services available to prepare any necessary legal paperwork. It is paramount that you and the potential carrier are in agreement about genetic counseling, in case you want to terminate the pregnancy due to an abnormality in the fetus. Additionally, make sure your legal documents cover selective termination should more than one embryo implant in her uterus. The gestational carrier will go through IVF, using your egg and your partner’s sperm (or whatever arrangement you have made to create an embryo that is not using her eggs).

If you choose to use a true surrogate to carry your baby, you will be using the surrogate’s eggs, and therefore, it usually does not require IVF. However, a significant risk with this option, for which you need to be legally prepared, is the surrogate choosing to keep the baby after it is born, due to the fact it is her biological child.  Without legal backing, you could end up empty handed. Every state has different laws about the legality of surrogacy.  So, make sure to seek counsel from an attorney familiar with the law. Even when all goes as planned, you will more than likely have to go through formal adoption procedures after the baby is born, which may involve a home study by an adoption agency.

Many centers are available to help you navigate the psychological ramifications of choosing any of these paths to becoming a parent. Check in your area for local resources to help you and everyone else to get through this complicated, time consuming, and hopefully successful process.

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