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Surrogates

Omega Family Global is possibly the most experienced firm in managing the legal aspects of surrogate use.  In 2013 alone, Omega Family Global worked with more than 200 Intended Parents and their surrogates.  California is the globally perferred location for using a surrogate for family completion due to its laws.  Why not have Omega Family Global find and manage a surrogate for you?  Please contact us for more information about using a surrogate.  As a courtesy, we provide information on surrogate use in this section of our site.

If you want to help Intended Parents and be a surrogate, please read this section and contact us.

Surrogate Use: Rationale, Type, and Success Rates

Surrogacy is defined as an arrangement where a woman agrees to carry (gestate) a baby for a couple (intended parents) or individual.

Monetary compensation may or may not be involved in surrogacy arrangements. If the surrogate receives compensation beyond the reimbursement of medical and other reasonable expenses, the arrangement is called commercial surrogacy; otherwise, it is often referred to as altruistic surrogacy.

The legality and costs of surrogacy vary widely between states and countries. However, because California has clear laws in this area, it is the world’s most popular place for surrogacy.

Rationale

In many cases of infertility in male/female couples, the use of a surrogate is the last step on the road to a family after simpler options have been tried. Often the woman has uterine or ovarian health issues, or is past the age of fertility. Intended Parents (male/female couple in this case) usually have been through of number of fertility treatments and tests, and have learned, in the end, the woman is not able to gestate a child.

In the case of gay couples starting a family, a surrogate is obviously needed. In the case of lesbian couples, one can carry a child after artificial insemination, but she is technically not a surrogate because she is one of the Intended Parents. However, lesbian couples might choose to use a surrogate if needed or desired.

There are two types of surrogates. Each of these will be described along with the rationale for their use.

Gestational or Host Surrogate

The most common type of surrogate normally involves egg donation, in vitro fertilization (combining egg and sperm outside the body), and placement of the fertilized egg into the surrogate mother. This medical practice falls under the category of assisted reproductive technology (ART) because both sperm and eggs are handled outside the body (in vitro). The other type of surrogacy is not technically under the umbrella of procedures termed ART and is addressed later in this section.

A gestational surrogate carries the baby of another couple. Her eggs (genetic material) are not used and she is not related to the newborn.

In these cases of gestational surrogacy, the surrogate is implanted with an embryo (fertilized egg which can come about through a number of techniques described in other sections). She carries the baby to term and gives birth. When the egg and sperm are not from this gestational surrogate, the baby’s birth certificate will bear the name of the Intended Parents and not the surrogate. The laws in California are clear on the matter of the name on the birth certificate. This is just one aspect Omega Family Global will manage for the Intended Parents. The details are described in the legal section under Surrogates.

Any Intended Parent couple can use this surrogate option (gestational). In fact, it is by far the most common type of surrogacy. For many reasons, including legal issues, Omega Family Global encourages this type of surrogacy. Nonetheless, there are cases where the second type of surrogacy might be a good option (described below).

Description and Procurement of Gestational Surrogates

A typical woman serving as a surrogate is between the ages of 21 and 37, has two children, and more than a high school degree. The majority (over 70%) of these women are married, and many are employed full time. Agencies that typically screen and catalog surrogates do not allow women to serve as surrogates for strictly financial gain.

Many of the prime motivators for being a surrogate are listed below:
a) enjoys being pregnant but does not want a child of her own presently
b) has a history of easy, uncomplicated pregnancies
c) has empathy for childless couples and wants to help others
d) feels having children, theirs or those of others, is important in life
f) desires an opportunity to make a unique contribution
g) seeks financial gain for her family
h) wants an opportunity to make up for a pregnancy previously terminated.

Most gestational surrogates are women who have had their own families and want to help others have children for primarily for altruistic reasons and less so for monetary reasons. These women are medically and psychologically screened for their ability to successfully carry a child. They are not people who are economically desperate and have no other means to make money. In fact, women of this profile would not be used.

Omega Family Global provides surrogates, and partners with agencies that are experienced with this process. Because the legal climate is favorable for contracted surrogacy, there are many agencies in California providing pre-screened women willing to be surrogates. However, Intended Parents need to be aware that all FDA and ASRM screening procedures are followed.

Omega Family Global has a very through screening process for our surrogate mothers. We follow all ASRM and FDA guidelines in our screening process and conduct personal interviews. We assist our clients’ will all aspects of selecting an OFG surrogate and our Surrogate Liaison has managed over 2000 surrogates and has been a four-time surrogate herself.  If you want to be a surrogate and/or have questions about OFG´s surrogate screening process, contact Dr. Kramer directly (drkramer@omegafamilyglobal.com)

Advantages and Disadvantages of Gestational Surrogacy

The primary advantage of gestational surrogacy is that it poses fewer ethical issues and legal problems than a standard surrogate who may have donated the egg and does not want to give the child up at birth, because she is genetically related. The primary disadvantage of gestational surrogacy is strictly price due to necessary additional fertility procedures.

Success Rate of Gestational Surrogacy

The success rate for gestational surrogacy as a stand-alone medical practice is difficult to measure as it always involves ART techniques. In general, success rates have been climbing over the past few decades. Nonetheless, some factors known to contribute to the success are listed below:

  • the surrogate’s ability to get pregnant, which is why surrogacy agencies prefer women who have had children
  • the age of the egg donor (if involved); younger women are preferred
  • the success of medical procedures such as IVF, which varies clinic by clinic
  • the quality of gamete (fertilized egg or embryo) provided by the Intended Parents (if used).

The most recent data available, published in Fertility and Sterility (Fertil Steril. 2007 Jun; 87(6):1253-66.) suggest that following ART, gestational surrogacy is about 38.7% successful on a single cycle. Data from 385 clinics were collected electronically using the Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System software and were submitted to the American Society for Reproductive Medicine/SART Registry. Data reported were all from procedures preformed in 2001. Comparing later reports to earlier ones show increasing frequency of use of both ART and surrogacy, and increased success rates over the years.

Monitoring of ART and Surrogacy Success Rates

All ART cycles performed in United States fertility clinics are reported to Centers for Disease Control (CDC: www.cdc.gov). Partners of the CDC include the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART), who are involved in framing the surveillance and research questions and in collecting and reporting data from member clinics. Other important partners who represent consumers of ART and infertility services include RESOLVE, the American Fertility Association, and most recently, Fertile Hope. These organizations provide ongoing advice about ART reporting and its use for public health communications and education.

The CDC posts on their website ART success rates per year for all reporting clinics combined. Simply click on the tab on the upper left to access year. The information can be found here:

http://nccd.cdc.gov/DRH_ART/Apps/NationalSummaryReport.aspx

Data on 443 individual fertility clinics in the United States that report treatment results can be accessed here:

(Inset Excel file Individual_Clinics_Data_2010-xls)

Traditional Surrogacy

In traditional surrogacy, the woman who carries the baby has donated her egg and is biologically related to the child. In these cases sperm can be from a number of sources, which could include one of the intended parents or a donor. In most cases sperm is anonymously donated, from the male of a male/female couple, or from a member of a gay couple. In the case of a lesbian couple a banked sperm might be used, or that of a relative or chosen friend.

A traditional surrogate relinquishes the baby at birth, giving up her parental rights in favor of the Intended Parents. Because she is genetically related to the child, mothers who are traditional surrogates are often friends or relatives of the parents. This is not a common practice. In fact, under most circumstances, it is discouraged due to legal complications.

Advantages and Disadvantages of Traditional Surrogacy

Traditional surrogacy has an advantage of lower costs because egg donation is not involved. Technically speaking, traditional surrogacy is not ART because eggs are not handled. Artificial insemination is commonly the only fertility procedure used in this process.

The disadvantage is that the surrogate has donated her egg and may have stronger emotional connections to the newborn because she is genetically related. Legal implications in this type of surrogacy are more complex and a very small percentage (< 1%) of women in this example do not want to give up the baby at birth. However, over 99% follow the contractual obligations. The resultant baby will not bear the name of the Intended Parents and an adoption will be needed to transfer custody of the newborn to the Intended Parents.