Gestational carrier and surrogate are terms frequently used interchangeably to describe a woman who chooses to carry a pregnancy for intended parents. However, these terms slightly different from each other.
First, we must distinguish the two types of surrogacy: traditional surrogacy and gestational surrogacy.
Traditional surrogacy
In traditional surrogacy, also known as genetic surrogacy or partial surrogacy, the surrogate has a genetic link to the baby she carries, as her eggs are used for conception. Hence, a traditional surrogate is the biological mother of the child.
In this modality, pregnancy can be achieved through artificial insemination (AI), and no donor eggs are needed. The reproductive doctors deliver the intended father’s sperm directly into the female reproductive tract (cervix, uterus or fallopian tubes) through artificial insemination. Ideally, the surrogate’s eggs will be fertilized and develop into an embryo which the surrogate will carry to term.
Before in vitro fertilization (IVF) became more common and successful, traditional surrogacy was the only type available. Now it is rarely used because IVF allows intended parents to use eggs from a woman other than the surrogate.
Gestational surrogacy
In gestational surrogacy (also called host surrogacy or full surrogacy), the laboratory creates embryos through IVF with gametes from the intended parents or using a donor egg/sperm. The doctor transfers one or more of those embryos into the surrogate’s uterus. The surrogate is not genetically linked to the baby: she is a gestational carrier (also referred to as gestational surrogate). This term describes a surrogate who has no biological connection to the baby.
Reasons to consider surrogacy
Women who are unable to carry pregnancies themselves due to a medical condition may seek a gestational carrier. Gestational surrogacy offers a solution to women who have uterine problems or have had a hysterectomy.
Women may also need surrogacy due to health conditions that can make carrying a pregnancy unsafe for them, or because they have a history of recurrent miscarriages. Gestational surrogacy can help them have a baby biologically related to them, which otherwise they could not achieve.
Although male couples or single men who want genetically-related offspring can use traditional surrogacy, most rely on gestational surrogacy to have children. In fact, the latter has grown to become the most common form of surrogacy.
Gestational surrogacy cycles tend to be more expensive than traditional surrogacy, primarily because IVF costs more. Despite this, traditional surrogacy can be more complex than gestational surrogacy from both a legal and emotional standpoint. Consequently, most prospective parents choose gestational surrogacy. Actually, some clinics no longer manage traditional surrogacy programs, and in many locations, this type of surrogacy is restricted or even outlawed.
Final thoughts
When considering surrogacy, intended parents should be aware of the different types of surrogacy options and their specific medical terminology. In brief, gestational carriers and surrogates are both women who decide to carry a pregnancy for people who cannot do it themselves. These different terms are a way to differentiate the two main existing forms of surrogacy. Gestational carriers achieve pregnancy through IVF using donor or the intended mother’s eggs, so they are not biologically related to the child or children they carry.
Though the term “surrogate” connotes a genetic relationship, it often is used to mean a gestational carrier. But legally and medically it is important to understand the differences.