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What is Surrogacy? The 2 Types of Surrogacy and How They Work

what is surrogacy cover

As surrogacy gains more popularity, it’s not always clear what exactly it is and how the process works. It’s essential to get started with a clear idea of what surrogacy is and how the process differs between the two types, traditional and gestational. We will start with the basics of the two types of surrogacy and then look at what it means for both intended parents and surrogates.

We’ll look at the various surrogacy types and how the surrogacy process works. This guide will also provide key factors to consider before you begin your journey and resources to help. 

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What is Surrogacy?

Simply put, surrogacy is an arrangement where a woman (the surrogate) agrees to give birth to a child for another person (or persons) who will become the parent(s) of that child.

Even if not referenced with the exact term, it has been around since ancient times. In the last three decades, as in vitro fertilization became a more viable conception method, surrogacy has become more widely used and accepted.

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What Surrogacy Means To Intended Parents

For intended parents, surrogacy may be their only option to experience the joy of becoming a parent.

Here are some of the top things you hear about what it means to them or what the best part of the process was for them:

  • Surrogacy is highly controllable and likely to be successful. Many intended parents go through years of infertility treatments and heartache before turning to surrogacy. At this point, it’s reassuring to know that surrogacy has a track record of being successful. Many fertility clinics have high success rates for IVF pregnancy with surrogates.

“Becoming a parent by international surrogacy is a complex procedure which should never be taken lightly. IARC supported us through every stage of the process, from finding us the ideal surrogate carrier to finding a fertility clinic.” –H&D, IARC Parents | November 2013

  • Surrogacy gives parents a chance to have a genetically-related child even though they are unable to carry the pregnancy; the primary reason intended parents seek out surrogacy to have a child.
  • Lifelong friendships can form with the person who carries their baby and her family.

“From the beginning, our goal was to expand our family by one. But in the end, we not only have our wonderful son, but our amazing surrogate will forever be part of our family as well.” –J&J IARC Parents, Czech Republic | July 2020

  •  There is a stronger sense of calm and security in the process if you’re working with a reputable surrogacy agency and legal team.

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What Surrogacy Means To Surrogates

Contrary to what many believe, surrogacy has many benefits to the surrogate and her family aside from compensation. Surrogacy means many things to the women who carry a child for another family.

Here are some benefits and what many surrogates say means the most to them:

  • They experience the pure joy of giving such an invaluable and selfless gift.

“It is truly a magical experience handing someone the baby they have dreamed of.”–Lisa Surrogate, October 2020

  • Friendships that form with the parents they carry for and getting periodic updates throughout the child’s life.
  • They gain a strong connection with other surrogates. This is especially true when working with an agency, like IARC, that fosters a welcoming, positive surrogacy community for women to connect throughout their journeys (both through online and in-person group events.)

“I loved attending surrogate socials and was strengthened by other supportive surrogates. There was a constant network of support, and the amazing team at IARC made my time as a surrogate a beautiful one.” –Elena, IARC Surrogate | June 2019

Learn more about the pros and cons of being a surrogate and our surrogacy process.

Types of Surrogacy

the two types of surrogacy

There are two different types of surrogacy. The main difference between them is whether or not the carrier has a genetic link to the child. These two types of surrogacy are:

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Traditional Surrogacy

Traditional surrogacy is where the surrogate not only carries the baby but is also the egg donor. This type of surrogacy was popular before in vitro fertilization became an option. These days, traditional surrogacy is very rare.

How Does Traditional Surrogacy Work?

Since traditional surrogacy requires the surrogates’ egg to fertilize, a couple of medical procedures are used to accomplish this.

Intrauterine Insemination (IUI)

In an IUI, the sperm is placed directly into the uterus to help facilitate fertilization. Intrauterine insemination is a relatively simple procedure, but it can take longer to find success. It may take several insemination cycles before a pregnancy is achieved (just like achieving pregnancy naturally).

In Vitro Fertilization (IVF)

The surrogate would undergo egg retrieval with IVF, which is the same procedure an egg donor in gestational surrogacy would do. IVF is also what intended mothers do when using their own eggs to create embryos.

Those eggs are then fertilized in the lab with the genetic father’s sperm (or donor sperm, when applicable). The resulting embryo is then transferred back into the uterus of the surrogate.

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Gestational Surrogacy 

With gestational surrogacy, the surrogate carries an embryo not genetically related to her. The embryo is created with the intended parents’ genetics and/or genetics from a donor.

How Does a Gestational Surrogate Work?

IARC works with gestational surrogacy, so the surrogates are not related to the baby. It is not her own egg and DNA involved in the process.

Many parents begin their journey with embryos already made. If that’s the case, they likely also have a fertility clinic selected already. All they need is to find a surrogate (and agency) to begin the surrogacy process.

If parents begin with IARC and don’t have embryos or a clinic selected, we will help them find one based on their specific needs. If they need an egg donor, many clinics have an internal list of medically screened donors to make it easy to select one and have embryos created.

After the embryos are created, the surrogate’s medical steps are pretty uniform across each journey. There will be a screening process, both with the agency for pre-screening and then with the clinic for final medical screening.

Typically, a surrogate will go to the fertility clinic at least twice, once for final medical screening and once for the embryo transfer. Once they are fully medically screened and the gestational surrogacy contract between the surrogate and intended parents is finalized, she will begin medications to prepare her body for the embryo transfer.

How Does Surrogacy Work?

how does surrogacy work

Surrogacy is when a woman offers to carry a baby for intended parents so they can have a child. With the help of fertility clinics and IVF, parents create embryos that can later be placed in their surrogate’s uterus. This leads to a pregnancy where the surrogate can then deliver the intended parents’ baby for them.

The surrogacy process takes time, and specific steps must be followed to protect all of the parties involved. After the intended parents find a surrogate match, it is critically important to follow certain medical, psychological, and legal steps. This will include meeting with a psychologist, hiring an attorney to draft a contract, the surrogate reviewing the contract with her attorney, and then being medically screened by the fertility clinic.

Intended parents who live outside the U.S. have the added step of ensuring they consult an attorney in their own country for the legal process after returning home with the baby to ensure their parentage is recognized in their home country.

Careful financial planning and budgeting for your process before you begin is also important. While surrogates are altruistic in their desire to help intended parents, most are compensated for their time and physical commitment in the process. There are other unavoidable costs related to her expenses, including medical care and the other required medical and legal steps throughout the journey. Here are three things to consider:

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Domestic vs. International 

When you hear the terms “domestic” or “international” surrogacy, it can relate to various aspects of the process, including…

  • Where are the intended parents located?
  • Where is the surrogate located?
  • Where is the agency and fertility clinic located?

At IARC, all of our surrogates are in the U.S. We help intended parents from all around the world. The intended parents select their fertility clinic, and most times, the clinic is in the U.S. Many countries worldwide have laws that don’t allow for surrogacy in their home country. This is why many international intended parents must pursue surrogacy in the U.S.

It’s crucial to find an agency with an exceptional reputation and a legal team to help navigate the laws both where the surrogate lives and in the intended parents’ home country. This will ensure a safe and smooth journey here in the U.S. and when the parents return home with their baby.


 Agency vs. Independent 

Doing an independent surrogacy means both the intended parents and surrogate coordinate all aspects of the journey independently without the support of an agency.

For intended parents, this includes finding a surrogate, coordinating her medical screening and fertility treatments with the fertility clinic, locating a psychologist, finding an attorney, and coordinating all legal, medical, insurance, and financial aspects of the process.

For surrogates, this means scheduling all of her own appointments, navigating all fee and reimbursement payments directly with the intended parents, and coordinating all other steps without agency support.

This can get complicated and stressful quickly. There are many things to consider and many steps to go wrong without professional experience and guidance. For this reason, most intended parents will choose to work with an agency if possible.

  • Finding a Surrogate: Reputable agencies pre-screen surrogates so that intended parents do not spend unnecessary time and money on someone who may ultimately be disqualified. This also avoids possible heartache and emotional turmoil.

IARC fully pre-screens surrogates medically and psychologically. Intended parents are presented with potential matches only after that pre-screening is completed.

  •  Navigating the Legalities: This includes a comprehensive surrogacy contract that reflects the specifics of the match, facilitating a smooth experience at the hospital for the birth and establishment of the parents’ parentage, medical insurance reviews for pregnancy and newborn coverage, and estate planning to prevent undesirable outcomes in the event something happens to either the surrogate or intended parents throughout the process.

With a well-known, longstanding agency that partners with an expert legal team, you will have all the various arms of your process connected and monitored to be sure things are as seamless and smooth as possible.

  • Coordination of All Steps: There are hundreds of small steps involved throughout a surrogacy journey. An agency like IARC knows all of those steps and how to coordinate each as successfully as possible.

IARC takes away much of the administrative and logistical burden from the parents and surrogate so they can focus on enjoying the journey and pregnancy together.

The journey can be successful without an agency, but only if done correctly with experienced professional support from a psychologist, attorney, and fertility clinic – and if the parties are comfortable with the added work involved (legal and emotional).

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Compensated vs. Altruistic 

When researching surrogacy, you may hear the terms “compensated” and “altruistic” surrogacy. While many surrogates who are compensated are also altruistic in their motivation, the term “altruistic surrogacy” refers to is one where the surrogate is not requesting any compensation – only reimbursement of actual expenses.

Altruistic surrogacies are generally those in which the surrogate is a friend or family member. When there is no pre-existing relationship between the surrogate and intended parents, it is generally accepted that the immense time and physical commitment the surrogate and her family put into this process is compensated.

We see first hand that compensated surrogacy still involves a significant component of altruism. Our surrogacy community is defined by amazing women who genuinely want to help another family overcome their infertility struggles. Despite the financial compensation they rightfully receive, becoming a surrogate reflects their altruistic and caring nature.

Learn More About Becoming a Surrogate

There is so much to learn about a surrogate pregnancy beyond just the meaning of a surrogate and the types of surrogacy that exist. You’ll want to know the requirements for being a surrogate or find answers to other frequently asked questions about surrogacy in our FAQ.

Eager to find out if you qualify? Fill out a questionnaire to get started today.

IARC prides itself on providing education and information to surrogates and parents alike to ensure you make the best decision for you and your family. Please let us know if you have any questions or how we can help. We hope to have the chance to speak with you soon!

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