Surrogacy Awareness Month
As a Reproductive Endocrinologist, a gay man, husband and father to two children born through surrogacy, I am honored to celebrate Surrogacy Awareness Month. Globally, surrogates help both women and the LGBTQIA+ community have families. For the LGBTQIA+ community, surrogacy is necessary in order to have a child. And, surrogates help women, individuals and couples who can not have a child of their own fulfill their dreams of having a family. As part of recognizing Surrogacy Awareness Month, I felt it important to demystify what surrogacy is in order to better understand the many reasons people seek surrogacy.
Surrogacy Facts
By definition, a gestational surrogate or gestational carrier is a woman who is not genetically related to the intended parents and who agrees to engage in an arrangement where she has an embryo transferred into her uterus. The hope is that the surrogate eventually conceives and gives birth to a child for the intended parents. Prior to the procedure, legal agreements are established and the baby that is born is legally connected to the intended parents.
Women, Individuals, Couples Who Need Surrogates
Imagine a woman in her childbearing years who dreams of having a child. Further imagine that at some point in her family planning journey she has been told she can not carry a child herself. There is a moment when women, individuals and couples make the emotional decision to choose the path of surrogacy in order to achieve their dream of becoming a parent. The shift of seeking a gestational surrogate to help build a family offers women, individuals and couples hope and for these intended parents, I think there needs to be more awareness and respect for this choice. A gestational surrogate can be critical to help these people begin building their family.
Some of the life altering reasons women, individuals and couples seek a surrogate because they can’t have a child themselves include:
A woman/person was born without a uterus.
A woman/person who has experienced an unexplained death of a baby in utero and she fears losing another baby.
A woman/person who has had a previous delivery where a life threatening event occurred including the removal of her uterus.
A woman/person who has had a medical disorder such as anorexia, cancer and autoimmune or cardiovascular disease.
A woman/person who has experienced recurrent pregnancy loss.
A woman/person or couple who have had many infertility attempts.
IVF Facts
In order to fully understand the role of a gestational surrogate in relation to how she assists these families, there needs to be an understanding of how in vitro fertilization (IVF) leads to an ongoing pregnancy; and hopefully to the birth of a child for another person or couple.
In simple terms, IVF is a medical and technological process whereby a woman injects herself with medicine to stimulate her ovaries to develop many eggs at the same time over a 2 week period. Next, eggs are retrieved during a surgical procedure. In a laboratory, these eggs are fertilized with sperm and placed in an incubator designed to mimic the human fallopian tube. After 5-7 days, the embryo (s) that demonstrates the most potential for pregnancy success is eligible to be transferred into a prepared uterus or womb. This embryo (s) is warmed and placed into the uterus of the patient or the gestational surrogate in hopes that the embryo (s) will continue to grow and develop into an ongoing pregnancy. All other extrauterine embryos which show reproductive potential are cryopreserved by the embryologist.
IVF, as it relates to gestational surrogacy, is a well established medical treatment option for individuals or couples worldwide. In gestational surrogacy two possible IVF circumstances may occur. The first is the intended parents may have used IVF themselves to create their own embryos with their own sperm and egg. One of these embryos will be transferred into the surrogate's uterus. The second circumstance might include IVF with donated eggs, donated sperm or both to create the embryo to be transferred into the surrogate’s uterus. Both of these require a care team including doctors, nurses, lawyers, and mental health professionals.
LGBTQIA+ & Surrogacy
I believe the desire to have a child is a natural drive to experience the joy and love of children and also serves to maintain the human species. It is independent of sexual orientation or gender identity. For single men and cis-gender male couples, their family building path is very complex and requires an egg donor, IVF, and a gestational carrier to help them become parents. Surrogacy Awareness Month offers an opportunity to shed light on these complexities and the opportunities surrogacy offers the queer community.
Final Thoughts
There are many emotional, physical and financial hardships along the journey to parenthood via IVF and surrogacy. In today’s climate, federal legislation must be passed to make access to IVF universal across the United States. No single state’s legislation should add to the burden of interfering with a woman’s access to IVF and surrogacy. I have always believed that building a family is a fundamental right of all people. Join me throughout the month of March in being mindful and aware that IVF, with surrogacy, may be the only way for someone to become a parent and raise a child.