One of the areas of focus in my practice as a therapist is helping couples struggling with infertility. Many couples choose to go through medical procedures to help their own natural fertility kick in so that they can bear their own child naturally. While these procedures often work, sometimes they do not.
When a couple comes to the realization that they may not be able to conceive, I help them walk through their feelings and their next steps forward: to embrace life without children or to pursue other options for fulfilling their dream of parenthood. Surrogacy, while not commonly chosen, is one of those options.
Types of Surrogacy
Most surrogate mothers are compensated for their services. Surrogacy agencies secure the services of women; bearing the child is in essence a form of employment. In some instances, a woman will be a surrogate for a couple out of altruism, but this usually occurs when the surrogate knows the couple personally.
There are three ways a child can be conceived through a surrogate arrangement:
- Partial or genetic surrogacy: The prospective father provides his sperm to fertilize the egg of the surrogate mother. Thus, the child has the father’s DNA.
- Gestational surrogacy: The prospective parents contribute their own sperm and egg to conceive in vitro. The embryo or embryos are then implanted into the womb of the surrogate mother.
- Total surrogacy: The prospective parents do not contribute their DNA. Both the sperm and egg are chosen from a donor bank, thus the adoptive parents and the surrogate mother are unrelated to the child.
Apparent Benefits and Drawbacks of Surrogacy
Several reasons why couples choose surrogacy include:
- The chance to have a child genetically related to one or both parents
- The expectation that it will be quicker than adoption
- The option to be involved in the pregnancy along the way and get to know the surrogate mother
Surrogacy is not without significant risks, however. They include:
- Availability – Surrogacy is not available in all states
- Significant expense – compensation for the surrogate, program fees of the agency, medical expenses for the surrogate mother, possibly also in vitro costs could reach $80,000 or more
- Delays and timeframe – surrogacy takes longer than expected, usually 18 months or more
- Difficulty in finding a reputable surrogacy agency – Some agencies exploit poor women, promoting the financial benefits of surrogacy without fully informing them of the possible risks
- Physical and mental health effects on the surrogate mother – Pregnancy affects the physical and mental health of any mother, but surrogacy adds additional risks. Months of fertility medications to prepare her body for pregnancy can have negative effects. Multiple births (as is often the case with IVF) increase maternal risks in gestation and delivery. And although the surrogate mother knows the child is not her own, many surrogates experience long-term emotional distress from the process.
Alternative to Surrogacy
A similar option to surrogacy is infant adoption from a pregnant birth mother. Agencies that offer this form of adoption create a family profile for prospective parents, provide screening and counseling to the pregnant mother, and present to the mother various family profiles. Once chosen, the adoptive parents cover the expenses for the mother and are able to have interaction with her during the pregnancy, based on mutual agreement, possibly even attending the birth. Most adoptions of this kind are open adoptions, meaning your family and the birth mother can remain in contact so the mother knows her child is in good hands.
This method for the most part is significantly less expensive than surrogacy, is fairly readily available, can be a quicker process, and is a healthier option for mothers and babies. It does, however, have a few of its own drawbacks. First, the adoptive parents will not be genetically related to the child. Second, while agencies screen prospective mothers for their commitment to adoption, occasionally a mother changes her mind and decides to keep her child. Usually, however, the agency is able to match the couple with another mother.
Ultimately, the decision to adopt, choose surrogacy, or decide to remain childless must be made between the two of you. If you need help working through the issues surrounding this major life decision and you reside in or around the New York City area, reach out to me to see how I can help.