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Guest Blogger, Christina Barnes, MSN, CPNP, explains surrogacy with donor sperm.

What is the difference between a surrogate and a gestational carrier?

The terms “surrogate” and “gestational carrier” are often used interchangeably in everyday conversation, but there is a difference between the two. According to the American Society for Reproductive Medicine, a surrogate is a woman who donates her own egg and carries a pregnancy for another person or couple. A gestational carrier is a woman who carries a pregnancy for another person or couple without using her own egg. 

In other words, a surrogate is biologically related to the baby, while the gestational carrier is not. In both situations, the baby’s legal parent(s) are someone other than the surrogate or gestational carrier. 

Who uses a surrogate or gestational carrier?

Individuals and couples of all ages and genders use surrogates or gestational carriers. Some common situations in which families choose a surrogate or gestational carrier include:

• Opposite-sex couples or single women with female infertility 

• Same-sex male couples or single men who require a donor egg and carrier to have a baby

• Same-sex female couples who choose to have one partner carry the other partner’s egg. This is often called reciprocal IVF, and the partner who carries the pregnancy is technically a gestational carrier. 

• Individuals with eggs and a uterus who are physically able to conceive and carry a child, but choose to use a surrogate or gestational carrier for personal or professional reasons. 

• Women unable to carry a pregnancy because of health conditions or medications that would be unsafe for the mother or baby

• Women with previous traumatic pregnancy or birth experiences

This is not a complete list of every possible scenario where someone would want to use a surrogate or gestational carrier, so – 

Who uses donor sperm with a surrogate or gestational carrier?

Any of the people or couples described above can use donor sperm with a surrogate or gestational carrier. Donor sperm can be used for issues with infertility, personal preference, or for females without a male partner. 

Families who choose donor sperm with surrogacy often pick this route for reasons similar to families who do not use surrogacy. Families who choose to use donor sperm with a surrogate may include:

• Same-sex female couples or single females who need both donor sperm and a surrogate or gestational carrier in order to have a baby

• Opposite-sex couples with both female and male infertility 

• Same-sex male couples or single men with infertility   

• Anyone who would choose donor sperm for any other reason, such as reducing the risk for certain genetic diseases 

What is the process for using donor sperm with a surrogate or gestational carrier?

When a surrogate uses her own egg, donor sperm can be used to fertilize the egg through intravaginal insemination (IVI), intrauterine insemination (IUI), or in vitro fertilization (IVF). The type of fertilization will depend on many factors, such as cost, convenience, and medical recommendations. It’s similar to the process of a woman using donor sperm when she intends to keep the child – she must fertilize her own egg with donor sperm, and there are different ways she can do that. 

With a gestational carrier, the only way to fertilize an embryo is to do so through IVF. This is the rule regardless of sperm source – a gestational carrier does not use her own eggs, and therefore needs an outside egg to be fertilized and then implanted into her uterus. The egg can come from the biological mother, or it can come from an egg donor. That egg is then fertilized outside of the body with donor sperm, and then implanted into the uterus of the gestational carrier. 

Where is the best place to get donor sperm to use with a surrogate or gestational carrier?

Donor sperm generally comes from one of two categories: known donors and unknown donors. Known donors can be friends or acquaintances, and unknown donors usually come from professional sperm banks. 

Known donors can be a less expensive route than traditional sperm banks, but they do carry some additional risks. Known donors have probably not completed the extensive genetic and medical testing required by sperm banks, including a comprehensive family history and testing for sexually transmitted infections. 

There are also important legal considerations when it comes to your donor. With a professional sperm bank, all donors have legally given up parental rights to biological offspring. If using a known donor, consider what parental rights (if any) you and your family want the donor to keep, and make sure all legal documents are signed before you use the sperm. 

Using a surrogate or gestational carrier adds an additional level of legal complexity. Each state has different rules, and when using donor sperm or eggs it’s important to clearly establish who the intended parents are. It’s best to consult with a lawyer specialized in fertility law at the start of the surrogacy process. If you choose to use a surrogacy agency to build your family, they will work with you to make sure all legal issues are addressed.