Surrogacy has become more mainstream, thanks to celebrities like Kim Kardashian West, who used a surrogate to carry baby Chicago (opens in new tab). In fact, in an original survey (opens in new tab) conducted by Marie Claire in partnership with SurveyMonkey (opens in new tab), 23 percent of Millennial women said they would consider surrogacy if they couldn't conceive naturally. Just 9 percent of Gen-X women said the same.
Still, the process remains mysterious.
A surrogate (opens in new tab), also known as a gestational carrier, is a woman who carries and delivers a child for another couple or person who are that child’s intended parents; a gestational carrier can carry an embryo that is created from the intended parents’ own sperm and egg, or donated sperm and/or egg, depending on the family and the fertility issues needing to be addressed. (“Surrogate” is an older term for the same arrangement; the preferred term is gestational carrier, though, as the word surrogate traditionally implies that the woman carrying the fetus has a genetic connection to it.)
Interested couples will be referred by their fertility clinic to agencies that manage gestational carriers, says Aaron K. Styer, M.D., reproductive endocrinologist and co-medical director of CCRM Boston. “Reputable agencies, like Circle Surrogacy, Conceivabilities, and The Center for Surrogacy and Egg Donation (CSED), will have completed comprehensive medical and psychological evaluations and background checks of gestational carrier candidates,” Dr. Styer explains, adding that once the intended parents match with a gestational carrier, their infertility doctor will also evaluate her in person to ensure she is medically and psychologically ready to carry a pregnancy.
If surrogacy is legal in the state where the surrogate lives (four states expressly ban surrogacy (opens in new tab): New York, New Jersey, Indiana, and Michigan), the intended parents and gestational carrier will likely complete a binding contract that governs the terms of the medical care during the pregnancy and explicitly states that the gestational carrier has no legal claim to the child. After that paperwork is completed, the process of trying to conceive begins.
The gestational carrier is placed on a hormonal treatment regimen to build up her uterine lining in preparation for the transfer of the embryo. An embryo created from the egg and sperm of the intended parents (or via donated eggs or sperm, when applicable) is then transferred into the uterus of the gestational carrier. In other words, in most instances, the intended female parent will go through the first half of an IVF cycle (opens in new tab) to have her eggs retrieved, while the second half of the cycle is completed by the gestational carrier to prepare her uterus for embryo transfer.
According to at least one agency, the total cost (opens in new tab)of a gestational carrier cycle can reach as high as $240,000, though other sources (opens in new tab) put the price tag at about one-fourth of that. These costs include fees to the agency that identified the gestational carrier (approximately $20,000), payment to the gestational carrier herself for her time and effort (approximately $20,000–$25,000, which covers both healthcare-related expenses and, typically, an additional fee unrelated to medical costs), screening of the gestational carrier (approximately $5,000) and roughly $20,000 for the medications and procedures associated with egg retrieval, fertilization, and embryo transfer. Future parents pursuing a family via gestational carrier can purchase separate gestational carrier insurance, with premiums of approximately $10,000 and deductibles starting anywhere from $15,000 to $30,000, depending on the number of embryos being carried.
Still have questions about getting pregnant? Check out our fertility FAQ here (opens in new tab).
Editors’ note: We use the terms “woman” and “female” in this article to refer to people with internal reproductive organs; however we understand that not everyone with internal reproductive organs identifies as a woman or a female. We use the terms “man” and “male” to refer to people with external reproductive organs; however we understand that not everyone with external reproductive organs identifies as a man or a male.
Jennifer Gerson is a Maggie Award-winning journalist whose reporting on reproductive rights, women's health, and sexual violence regularly appears in Cosmopolitan, as well as The Guardian, Yahoo, Allure, Teen Vogue, Mic and other national publications.
Sex Toys For Partner Play
If you thought toys were just for me-time, think again.
By Gabrielle Ulubay
The Cast of 'Money Heist: Korea - Joint Economic Area': Your Guide
Meet Netflix's new cast of thieves.
By Quinci LeGardye
Lawmakers, Activists, and Allies Are Reacting With Fury to 'Roe' Being Overturned
Thousands are taking to Twitter to express their grief and anger.
By Tanya Benedicto Klich
Senator Klobuchar: "Early Detection Saves Lives. It Saved Mine"
Senator and breast cancer survivor Amy Klobuchar is encouraging women not to put off preventative care any longer.
By Senator Amy Klobuchar
How Being a Plus-Size Nude Model Made Me Finally Love My Body
I'm plus size, but after I decided to pose nude for photos, I suddenly felt more body positive.
By Kelly Burch
I'm an Egg Donor. Why Was It So Difficult for Me to Tell People That?
Much like abortion, surrogacy, and IVF, becoming an egg donor was a reproductive choice that felt unfit for society’s standards of womanhood.
By Lauryn Chamberlain
The 20 Best Probiotics to Keep Your Gut in Check
Gut health = wealth.
By Julia Marzovilla
Simone Biles Is Out of the Team Final at the Tokyo Olympics
She withdrew from the event due to a medical issue, according to USA Gymnastics.
By Rachel Epstein
The Truth About Thigh Gaps
We're going to need you to stop right there.
By Kenny Thapoung
3 Women On What It’s Like Living With An “Invisible” Condition
Despite having no outward signs, they can be brutal on the body and the mind. Here’s how each woman deals with having illnesses others often don’t understand.
By Emily Shiffer
The High Price of Living With Chronic Pain
Three women open up about how their conditions impact their bodies—and their wallets.
By Alice Oglethorpe