The short answer
In gestational surrogacy, an embryo is created through IVF using intended-parent or donor gametes and transferred to the gestational carrier's uterus. Because the carrier does not provide the egg, she is not genetically related to the embryo through her own egg.
Gestational versus traditional surrogacy
Gestational surrogacy
The carrier does not provide the egg. The embryo may be created using eggs and sperm from intended parents, donors, or a combination.
Traditional surrogacy
The person carrying the pregnancy also provides the egg, creating a genetic relationship to the child. Traditional surrogacy can involve different legal and practical issues and is treated differently in some jurisdictions.
Why intended parents may use a gestational carrier
Reasons vary widely. They may include medical conditions that make pregnancy impossible or inadvisable, absence of a uterus, repeated pregnancy complications, family-building by male couples or single intended fathers, or other individualized medical and family circumstances.
What the gestational carrier's role involves
The carrier participates in medical screening, embryo-transfer treatment, pregnancy and delivery if the transfer results in a pregnancy. She remains the patient for her medical care and retains authority over her own medical decisions. Communication, travel, appointment involvement and relationship expectations should be discussed before the parties commit to a match.
How legal parentage works
The intended parent or parents generally plan to become the child's legal parents, but the mechanism for establishing parentage varies by jurisdiction and by the facts of the arrangement. Some states provide detailed statutory procedures; others rely more heavily on existing parentage law or court procedure. A state-specific attorney should explain the actual process.
Insurance and medical expenses
Do not assume that a carrier's existing health plan automatically covers a surrogate pregnancy. The actual policy, exclusions, network and cost-sharing terms need to be reviewed. The written agreement should also address who is financially responsible for premiums, deductibles and uncovered pregnancy-related expenses.
What happens after birth?
Hospital procedures, newborn logistics and legal documentation depend on the delivery location, the parentage plan and the parties' agreement. Emotional and ongoing relationship expectations can also vary. They should not be treated as automatic or identical from one journey to another.
Related guides
Requirements · Medical guide · Legal considerations · Laws by state