The risks and rewards of surrogacy

Currently, 1 in 6 people experience infertility in their lifetime. In recent years, advancements in assisted reproductive technologies and medical practices have made surrogacy a potential option for those seeking to expand their families despite infertility or other challenges.

Surrogacy involves a woman — the surrogate — carrying and giving birth to a child on behalf of another person or couple — the intended parent or parents. There are two main types of surrogacy:

• Traditional Surrogacy: This is an uncommon form of surrogacy in California, when the surrogate's own egg is fertilized with sperm, either from the intended father or a sperm donor. The surrogate is genetically related to the child in traditional surrogacy.
  

• Gestational Surrogacy: In this more common type of surrogacy, during which the surrogate carries a child conceived using an egg and sperm from the intended parents or gamete donors — people who provide reproductive cells, including the female egg cells and male sperm — through in vitro fertilization (IVF). The surrogate is not genetically related to the child in gestational surrogacy.

“Surrogacy can be an incredibly meaningful and profound experience for intended parents who wish to expand their family and are unable to do so in a more traditional way,” says Dr. Arlene Morales, a reproductive endocrinologist affiliated with Sharp Mary Birch Hospital for Women & Newborns.

A partnership between surrogates, parents and specialists

The decision to grow a family through surrogacy begins with a partnership between the surrogate and the intended parents. However, it also involves the extensive coordination between reproductive endocrinologists, obstetricians, perinatologists, psychologists, attorneys and surrogate agencies. These dedicated individuals collaborate tirelessly to ensure the well-being of everyone involved.

“While the overall process may share similarities, surrogacy involves the participation of multiple individuals, making it a distinct and complex journey of its own,” Dr. Morales says.

Mitigating potential surrogacy complications

According to Dr. Morales, it’s important to understand the risks associated with surrogacy are comparable to that of all IVF pregnancies. IVF pregnancies are considered higher risk due to advanced maternal age, recurrent pregnancy losses and other reasons.

Thus, these types of pregnancies are more likely to experience complications, such as premature birth, high blood pressure, placenta abnormalities and other issues. “Nonetheless, it is essential to acknowledge that every pregnancy inherently carries some degree of risk,” she says.

As in most IVF cases, and in an effort to mitigate potential complications, the primary objective is to transfer a single embryo, thereby minimizing the risks associated with multiple pregnancies. “The ultimate goal is the birth of a healthy child, while fostering a relationship built on mutual respect and understanding between the gestational carrier and the intended parents,” says Dr. Morales.

Specialized teams help manage surrogacy pregnancies

While surrogacy pregnancies can carry certain risks, Dr. Morales says Sharp Mary Birch Hospital for Women & Newborns has specialized teams of healthcare professionals, including obstetricians, maternal-fetal medicine specialists, neonatologists and support staff who are experienced in managing high-risk pregnancies. These teams, she says, can provide comprehensive care, monitoring and interventions as needed to ensure the best possible outcome for both the surrogate and the baby.

“It is important to approach this topic with compassion, empathy and a deep understanding of the emotional and physical journey experienced by all parties involved,” says Dr. Morales. “Surrogacy may provide a remarkable path for individuals or couples to realize their dreams of parenthood.”

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