Surrogacy 101

How Does a Surrogate Become Pregnant?

Written by Caroline Shannon

April 11, 2023

Learn more about IVF for surrogacy and the embryo transfer process, plus what leads people to surrogacy in the first place.

Blame it on Baby Mama or a simple lack of understanding—there are a lot of misconceptions about how a surrogate becomes pregnant. 

In addition to finding the right match, a successful surrogacy pregnancy culminates a few efforts, including IVF and embryo transfer (more on both later). Keep reading to learn more about what leads people to surrogacy and the reproductive technology that enables a surrogate to carry a pregnancy for someone else in the first place. 

What is surrogacy? 

Surrogacy is a form of third-party reproduction in which a person consents, often by a legal agreement, to carry a pregnancy for the intended parent(s) with the understanding that custody of the child belongs to the intended parent(s)

Put simply: Surrogacy is when you carry a baby for someone else, and parental rights are assigned to the intended parent(s) upon birth.

Related: My Surrogacy Journey as a Surrogate

Who might benefit from surrogacy?

While everyone’s reason for choosing a surrogacy journey differs, a few common situations may lead a person down this path, including:

- Heterosexual couples who are unable to become pregnant (as a result of, for instance, infertility, a biological inability to conceive, or pre-existing health conditions that could be exacerbated by pregnancy)

- Single fathers by choice

- Same-sex male couples

- Women who opt not to carry a pregnancy

While these are common scenarios that may lead to a surrogacy journey, each experience is unique. 

What are the requirements to become a surrogate? 

Before we dig into how surrogates become pregnant, let’s review what is required to qualify as a surrogate.

To become a surrogate, you must meet the following criteria: 

- You are 21 to 43 years old.

- You have a Body Mass Index (BMI) of less than 32.

- You live in a surrogacy-friendly state.

- You’ve experienced at least one successful pregnancy with no complications.

- You’re currently parenting at least one of those children.

- You do not smoke or use drugs.

- You have a reliable personal support system.

- You do not financially rely on government assistance (e.g., cash assistance, welfare, or public housing).

- You can travel to appointments independently.

The above set of qualifications—created by the American Society for Reproductive Medicine (ASRM)—is in place for a reason. Age, for instance, is in place to protect a surrogate and the baby she is carrying. Research has shown that women over 35 are considered “advanced maternal age,” which can lead to an increased risk of preterm birth, stillbirth, miscarriage, and low birth weight, among other serious issues. 

Related: What Disqualifies You From Being A Surrogate?

How do surrogates become pregnant? 

A surrogate becomes pregnant through a medical procedure called in vitro fertilization (IVF), a fertility procedure that involves combining an egg and sperm in a laboratory to create an embryo. IVF requires (1) egg donation from the intended mother or an egg donor and (2) sperm donation from the intended father or a sperm donor. The resulting embryo is transferred into the surrogate’s uterus during a procedure called embryo transfer.

Before embryo transfer, a surrogate will administer fertility medications to prepare their body for transfer, including birth control pills, estrogen, and progesterone injections.

A successful IVF cycle leads to a surrogacy pregnancy.

The bottom line. 

Surrogates become pregnant during a process known as an embryo transfer, which involves an embryo that has been created during an IVF cycle. 

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