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Differences when it comes to traditional surrogacy vs gestational surrogacy

Surrogacy, the process by which a woman becomes pregnant and carries a child for others, is a growing field in the area of assisted reproduction. There are two types of surrogacy: traditional surrogacy and gestational surrogacy. There are significant differences when it comes to traditional surrogacy vs gestational surrogacy, the most noteworthy being the genetic relationship to the child(ren). Surrogacy may be done without compensation (also called “altruistic surrogacy”) or with the surrogate being financially rewarded for her time and the risk to her health that any pregnancy entails (also called “commercial surrogacy”). Most surrogates in the United States participate in commercial gestational surrogacy. If you’re an Intended Parent looking for either an altruistic or traditional carrier (or both), you will likely have a harder time finding a surrogate.

At present, the United States is unique in broadly allowing commercial surrogacy, mainly because no federal laws prohibit its practice and surrogacy is left up to the individual states to regulate. The countries that allow surrogacy include Ukraine, Georgia, Columbia, Israel and Mexico, though surrogacy in these countries may be restricted to married heterosexual couples with a proven history of infertility or to their own nationals. In terms of the best protections for all parties involved, United States is considered the top location for surrogacy globally.      

Traditional Surrogacy

Traditional surrogacy has been practiced for thousands of years, through the modern form of traditional surrogacy does not involve sexual intercourse or extra marital relations as it was practiced in early civilizations. In traditional surrogacy, the surrogate is the biological mother of the child(ren) she is carrying. She becomes pregnant via IUI (intrauterine insemination) using a donor or an Intended Father’s sperm.

Because traditional surrogates are the biological mother of the child(ren) they are carrying, there are legal considerations not found in journeys involving gestational surrogacy. Even in places where gestational surrogacy is practiced and well regulated, there are many states that ban traditional surrogacy outright because of the ethical considerations and potential for parentage disputes. Other states allow traditional surrogacy under certain restrictions such as compensation (many states allow it only when the surrogate isn’t financially compensated) and some limit Intended Parent eligibility. In states that allow traditional surrogacy, a surrogate is always free to assert her parental rights even if a surrogacy agreement is in place. This makes traditional surrogacy a risky proposition and is the reason the overwhelming majority of surrogacy is gestational. The famous “Baby M” case posed significant ethical and legal considerations to the New Jersey court system when the traditional surrogate decided to forgo her agreed-upon compensation and raise the child as her own.

Most traditional surrogacy is done on behalf of family members or close friends. A popular reason for pursuing traditional surrogacy is the overall lower costs and less hormones/medication needed throughout the process. Some Intended Parents that need egg donors also turn to traditional surrogacy to have more information about the genetics of their future child(ren). Some have other personal reasons why they are more comfortable with a traditional surrogacy journey vs. a gestational one. Whatever the reason, those pursuing traditional surrogacy need to do so only under the guidance of a qualified attorney.

surrogacy without the expensive surrogacy fees. Signup with Surrogacy Place today.Gestational Surrogacy

Gestational surrogacy has been practiced for almost 40 years. The first child created from gestational surrogacy was born in 1985. In contrast to traditional surrogacy, gestational surrogates do not use their own eggs. Rather, gestational carriers achieve pregnancy through in vitro fertilization (IVF). In IVF,  implanted embryo(s) are created from the egg of an Intended Mother or from a donor egg. At an IVF clinic, the egg is combined with sperm from an Intended Father or from donor sperm. Sometimes a donated embryo is used. Unlike traditional surrogates, gestational carriers do not share any genetic connections to the child(ren) they carry.

Because of the lack of a genetic relationship, there are significantly less legal hurdles and pitfalls under a gestational surrogacy journey. In gestational surrogacy, the Intended Parents are recognized as the legal parents of their own child(ren). This certainty with respect to whose child it is provides protections for both surrogate and Intended Parents.  Assisted Reproduction attorneys can discuss the advantages of gestational surrogacy over traditional surrogacy as the preferred means of family-building when parentage gray areas are removed.

Surrogates that choose to become gestational carriers will go through a hormonal regimen designed to decrease the likelihood of her own ovulation during the process and improve the chances of embryo implantation. These medications are identical to the ones given to women who are using IVF to conceive on their own. IVF has existed since the late 1970s and the safety of these medications is well established and closely monitored.  

The Gestational Surrogacy Process

Surrogates will meet Intended Parents through a process called “matching.” Surrogacy Place allows surrogates and Intended Parents the opportunity to self-match using our platform and database.

After matching, surrogates will be evaluated by the Intended Parent(s) fertility clinic and Reproductive Endocrinologist. The Reproductive Endocrinologist will review past medical records and do a full in-person examination where he/she will determine if a surrogate is likely to safely carry a pregnancy to term. Surrogates will also go through a psychological screening process where she will be asked about her reasons for wanting to be a surrogate among other considerations. Assuming she passes both her medical and psychological screenings, she will go through a legal phase where surrogacy contracts are drafted and finalized. This is an opportunity for the surrogate, with the help of her attorney (paid for by the Intended Parents), to advocate for all the things she is looking for in a surrogacy arrangement including: compensation level, lost wages, child care for her own child(ren), ideal birth plan, diet/lifestyle considerations, medical and life insurance requirements, and more.

Once agreements are fully executed by all parties, a surrogate will begin a medical protocol to prepare her body for embryo implantation and pregnancy. If all goes well, the embryo transfer will be successful and a pregnancy will result!

Surrogates always use their own OB-GYN for monitoring and pregnancy checkups including ultrasound appointments. If the pregnancy is carried to term, after the birthing process the child(ren) will be delivered and given to very grateful Intended Parent(s) who assume immediate custody and financial responsibility.

As surrogacy is a complex legal endeavor, all people seeking a surrogacy arrangement must work with a licensed and experienced attorney. If you need help finding one, Surrogacy Place has a directory of licensed attorneys organized by state.

Here’s a list of surrogate qualifications all prospective surrogates should meet.


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Bridget Myers

Bridget Myers grew up in small town in Maryland. She started her career as a substitute teacher before meeting the love of her life and moving to the suburbs of Chicago. She has a passion for dogs and painting. Bridget got involved in Surrogacy Place after researching surrogacy for her best friend. Since joining the team at Surrogacy Place, she has developed a passion for advocating on behalf of Intended Parents and surrogates and doing her part for meaningful reform in the industry.