Using a surrogate

What is surrogacy?

Surrogacy offers an alternative way to start or grow a family for people who are unable to carry a pregnancy themselves. This may include single people, heterosexual couples, and LGBTQIA+ couples.

In the UK, surrogacy is a regulated treatment pathway that involves specific medical, legal and consent requirements. Fertility treatment using a surrogate usually involves IVF or frozen embryo transfer, depending on individual circumstances.

At the Assisted Conception Unit at Guy’s Hospital, we provide fertility consultations, investigations and treatment for patients using a surrogate. We do not match surrogates with intended parent(s) – our role is to deliver the clinical aspects of treatment once a surrogate has been independently identified.

Why opt for surrogacy?

Surrogacy is when a woman carries a pregnancy and gives birth to a baby for a couple or an individual who is unable to get pregnant.

It can be an option for women with medical conditions that prevent them from getting pregnant or giving birth. These conditions can include:

• recurrent miscarriages
• absence of the uterus (womb)
• uterine malformation
• repeated implantation failures with IVF treatment

Types of surrogacy

There are two types of surrogacy: gestational and partial.

Gestational surrogacy

In gestational surrogacy – also known as full surrogacy or host surrogacy – there is no genetic link between the surrogate and the baby.

This type of surrogacy uses the eggs of the intended mother or from a donor. The eggs are fertilised using the IVF technique, following a period of ovarian stimulation, during which the intended mother or donor takes medication to stimulate her ovaries to produce eggs.

After the eggs are retrieved and fertilised with sperm from the intended father, or a donor, they are placed into the uterus of the gestational surrogate. The surrogate then carries the pregnancy and gives birth to the baby.

Many people opt for gestational surrogacy because it maintains a genetic link between the intended mother, father and their child.

Partial surrogacy

Partial surrogacy – also known as traditional surrogacy or straight surrogacy – involves the fertilisation of the surrogate’s egg with the intended father’s sperm or sperm from a donor.

Done using intrauterine insemination (IUI) where your consultant will place the sperm in the uterus. IUI uses sperm that has been processed and concentrated. It is timed to when the surrogate’s ovary releases eggs increasing the chances of pregnancy. In partial surrogacy, the surrogate is the biological mother of the baby.

To discuss the different types of surrogacy in more detail and consider which option might be right for you, book an appointment with one of our specialist consultants.

How to start the surrogacy process

Although we do not match surrogates with families, we understand the important considerations involved in surrogacy. If you are looking for a surrogate, considering becoming a surrogate or wondering how to start the process a number of specialist surrogacy organisations in the UK can provide guidance and support.

These organisations can help you explore your preferences, understand different types of surrogacy arrangements, and support you through the early stages of your journey. The main surrogacy organisations in the UK include:

• Childlessness Overcome Through Surrogacy (COTS)
• Surrogacy UK
• My Surrogacy Journey
• Brilliant Beginnings

Once you have identified a surrogate, our fertility specialists can support you with consultations, investigations and treatment.

Speak to a member of our fertility team by completing our online enquiry form, who can discuss your situation and arrange the next appropriate appointment.

Benefits of surrogacy

Surrogacy can offer a viable route to parenthood for individuals and couples who are unable to carry a pregnancy themselves. Depending on the type of surrogacy, there may be different medical, emotional and practical considerations.

Benefits of gestational surrogacy

In gestational surrogacy, the surrogate is not genetically related to the baby.

• intended parent(s) may use their own eggs and/or sperm, where clinically appropriate
• a genetic link between the intended parent(s) and child may be maintained
• roles and expectations are often clearer, as the surrogate is not the biological mother
• widely used in the UK and internationally within regulated fertility treatment

Benefits of partial surrogacy

In partial surrogacy, the surrogate uses their own egg.

• treatment may be less medically complex, as IVF is not always required
• typically involves fewer clinical procedures for the surrogate
• may be associated with lower treatment costs compared with gestational surrogacy

Risks of surrogacy

As with any pregnancy, surrogacy carries potential medical, emotional and legal risks. These should always be considered carefully on an individual basis.

General pregnancy‑related risks

Common side effects can include nausea, fatigue, soreness and discomfort. More serious but less common risks may include high blood pressure, gestational diabetes and other pregnancy‑related complications.

Risks and considerations of gestational surrogacy

• the IVF process can be physically and emotionally demanding for the surrogate
• intended parent(s) do not have full control over day‑to‑day pregnancy decisions

Risks and considerations of partial surrogacy

• may be emotionally more complex, as the surrogate is the biological mother
• surrogacy agreements are not legally enforceable in the UK
• in the event of a dispute, legal parenthood is determined through the courts

The potential risks and benefits of surrogacy should always be discussed with an experienced fertility specialist as part of a personalised consultation. Complete our online enquiry form to speak with our expert team.