The Surrogacy Alternative


surrogacy, baby, parenting

The options for women who may struggle with infertility or other challenges that keep them from bearing children themselves vary widely. One such option that is becoming increasingly more common is surrogacy. Funny enough, I first learned about surrogacy from an article about the comedian Jimmy Fallon. He and his wife struggled with fertility for about 5 years until they finally considered using a surrogate. Now they have two healthy children, both born via surrogate.

According to data from the American Society for Reproductive Medicine (ASRM), births via gestational surrogacy have been increasing steadily since year 2004. Their latest data indicate that in 2011 there were 1,593 babies born via gestational surrogacy compared to 738 babies seven years earlier in 2004. While very little data is currently being collected about it, by some estimates, up to 3,000 babies a year are born via surrogacy today.

So what is “surrogacy”, exactly?

Surrogacy is an agreement to carry a pregnancy for intended parents. Going back as far as ancient Mesopotamia (cca 1754 BC), the Babylonian law allowed infertile woman to have another woman bear a child for her and her husband to raise. This practice usually involved the husband as the genetic father and the surrogate as the genetic mother. This form of surrogacy is nowadays considered as ancient, and is no longer practiced. Unlike adoption, when the adopted child might be biologically unrelated to the adopting parents, surrogacy often involves one or both parent’s genetic material. There are cases, however, when the child is born solely of genetic material.

Nowadays, there are two main types of surrogacy: gestational and traditional.

Gestational surrogacy, also known as host or full surrogacy, means that the surrogate carries a child genetically unrelated to her. The pregnancy results from the transfer of an embryo created by in vitro fertilization (IVF). The embryo can be created in several ways:

  • using intended father’s sperm and intended mother’s eggs;
  • using one of the intended parent’s own egg/sperm and the other egg/sperm of a donor;
  • using both sperm and egg from a donor;
  • using a donor embryo.

Intended parents may seek a surrogacy arrangement with or without monetary compensation. If the surrogate receives money for the surrogacy arrangement, it is considered commercial surrogacy; if she receives no compensation beyond reimbursement of medical and other reasonable expenses, it is considered altruistic surrogacy.


In general, the cost for commercial gestational surrogacy ranges from around $80,000 to $200,000 or even beyond, depending on the selected program and state/country of the arrangement. Standard programs vary in the source of the egg donation, IVF insurance coverage, legal needs and other circumstances.

Traditional surrogacy involves naturally or artificially inseminating a surrogate with intended father’s sperm via IUI, IVF or home insemination. With this method, the resulting child is genetically related to the intended father as well as to the surrogate.

The surrogate can also be artificially inseminated with donor sperm using ICI, IUI or IVF, in which case the resulting child is genetically unrelated to the intended parents but is genetically related to the surrogate. However, in many jurisdictions, the intended parents will need to go through an adoption process to obtain legal rights over the resulting child.

Traditional surrogacy has become very rare these days. Most reputable clinics will work only with the parents’ genetic material and/or donor genetic material.

To my huge surprise, most European countries including France, Germany, Italy, Norway, Spain, banned any form of surrogacy arrangement. Only handful countries around the world allow both commercial and altruistic forms. In the United States, some states allow altruistic surrogacy only, some allow surrogacy for heterosexual married couples only, and others allow only non-commercial surrogacy arrangements. However, most states including Alaska, California, Connecticut, Colorado, Delaware, Florida, Hawaii, allow commercial surrogacy as well. On the contrary, states such as Michigan forbids surrogacy by law, and individuals who enter into surrogacy arrangements may be fined up to $50,000 and imprisoned for up to five years. Even liberal states such as New York are strictly against any form of surrogacy, and those who facilitate surrogacy arrangements, such as lawyers and agencies, can be fined in the first instance, and are considered guilty of a felony for the second offense.

When discussing the subject with a close friend, as a possible option if things didn’t go well naturally for my husband and me, she referred me to a mutual friend who was a surrogate for a couple in Colorado just a few years back. She carried and gave birth to twins for them, and remained in a close relationship with them since. I also remembered another friend in New York, who couldn’t carry on a pregnancy due to a genetic predisposition. She and her husband also used a surrogate, who successfully carried their twins.

I asked both of my friends to give me their side of the story to share with my audience, since each of them experienced surrogacy from a different side.

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Author:Katka Konecna-Rivera

Katka Konecna-Rivera, co-founder and host of Living Green with Baby, is an architect focused on sustainable design as well as a filmmaker, writer and personal wellness coach.

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