What is surrogacy, exactly?

A plain-language explanation of gestational surrogacy — how it works, why it is different from traditional surrogacy, and what your role would actually be.

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The short answer

Surrogacy is when a woman — the surrogate — carries and delivers a baby for someone else, known as the intended parent or parents. Most modern U.S. agency-supported surrogacy journeys are gestational surrogacy, meaning the surrogate has no genetic connection to the baby.

"In gestational surrogacy, you're not giving up a baby. You're carrying a pregnancy for intended parents using an embryo that is not genetically yours."

Gestational vs. traditional surrogacy

Gestational surrogacy

An embryo is created in a lab using IVF — with eggs and sperm from the intended parents, donors, or both. That embryo is transferred into the surrogate's uterus. She carries the pregnancy, but she is not genetically related to the baby.

Traditional surrogacy

The surrogate's own egg is used, making her the genetic mother of the child. This type is far less common in modern U.S. agency programs because it carries more legal and emotional complexity.

Who needs a surrogate?

Same-sex male couples

Building a family with a surrogate and an egg donor.

Women with medical conditions

Uterine issues, prior hysterectomy, or health risks that make pregnancy unsafe.

Single parents by choice

Individuals building a family on their own terms.

Couples after infertility struggles

Often after repeated unsuccessful IVF or pregnancy loss.

What you would actually do

As a surrogate, your role centers on the pregnancy itself — attending medical appointments, following your clinic's guidance, and carrying the baby. Parenting decisions rest with the intended parents, with communication and relationship expectations discussed before matching.

Common questions

Is it legal?

Gestational surrogacy is available in many U.S. states, but the legal process varies by state, county, court practice, and family structure. A reproductive attorney should explain exactly how your delivery state handles parentage and legal protections.

Will I have a relationship with the baby afterward?

That's up to you and the intended parents. Many surrogates build lasting friendships with the families they help; others prefer a more private arrangement. You discuss this before matching.

What if something goes wrong medically?

Your pregnancy-related medical expenses should be covered through an insurance and reimbursement plan reviewed before contracts are signed. This may involve your existing policy, a new policy, supplemental coverage, or another arrangement depending on your situation.

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