Infertility affects millions of couples around the world and can make the dream of having a child feel out of reach. There are many reasons why a couple may not be able to conceive or carry a pregnancy, from medical conditions to anatomical issues or simply unexplained challenges.
In these cases, surrogacy can offer a clear and effective path to parenthood. It allows couples to grow their family with the help of a gestational carrier, while staying involved every step of the way.
In this article, we’ll explain how surrogacy works for infertile couples, what can cause infertility, and what to expect during the surrogacy process from start to finish.
What Causes Infertility in Couples?
Female-related infertility factors
Women may face several reproductive health challenges that impact their ability to conceive or carry a pregnancy:
- Ovulation disorders, such as polycystic ovary syndrome (PCOS) or hormonal imbalances, are among the most common causes of infertility in women. These conditions can prevent the ovaries from releasing eggs regularly, making conception difficult without medical assistance.
- Uterine abnormalities, including fibroids, polyps, or scar tissue (often from previous surgeries or infections), can interfere with embryo implantation or lead to early pregnancy loss. These structural issues are typically diagnosed through imaging and may require treatment before attempting pregnancy.
- Diminished ovarian reserve refers to a lower number or quality of eggs, which often occurs naturally with age. As women get older, especially after 35, fertility tends to decline significantly, making conception harder even with treatments like IVF.
- Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. It can cause inflammation, pain, and may also affect the ovaries or fallopian tubes, reducing the chances of a successful pregnancy.
Male-related infertility factors
While often less discussed, male infertility plays a role in up to 50% of infertility cases. Several factors can affect sperm production and function:
- Low sperm count or poor sperm motility make it harder for sperm to reach and fertilize an egg. These issues can result from hormonal problems, infections, or lifestyle factors.
- Abnormal sperm morphology, meaning the sperm’s shape is irregular, can interfere with its ability to penetrate the egg. Even when sperm count is normal, morphology issues can reduce fertility.
- Varicocele, a swelling of the veins in the scrotum, can raise the temperature in the testicles, negatively impacting sperm production and quality. It’s one of the most treatable causes of male infertility.
- The emotional impact and stigma surrounding male infertility often lead to silence, which can delay diagnosis and treatment. Support, education, and early medical evaluation are key for moving forward.
Why Couples Turn to Surrogacy
When traditional fertility treatments don’t work, or when pregnancy would pose a risk to the mother’s health, many couples turn to surrogacy as a safe and effective family-building option. Some of the most common reasons include:
- Medical conditions that make pregnancy dangerous:
Some women have serious health issues, such as heart conditions or autoimmune disorders, that make carrying a pregnancy life-threatening. In these cases, surrogacy provides a way to have a child without compromising maternal health.
- Repeated miscarriages despite treatment:
Couples who have experienced multiple pregnancy losses, even after IVF or fertility medications, may choose surrogacy to avoid the emotional and physical toll of another miscarriage. Surrogacy offers a controlled and medically monitored environment that may increase the chances of a successful pregnancy.
- Uterine issues or absence of a uterus:
Some women are born without a uterus (a condition known as Mayer-Rokitansky-Küster-Hauser syndrome), while others may have had a hysterectomy due to cancer or other medical complications. Others may have uterine scarring or malformations that prevent implantation or carrying a pregnancy. For these women, surrogacy is often the only path to parenthood using their own eggs and their partner’s sperm.
In each of these scenarios, surrogacy offers a clear, medically supported solution for growing a family even when pregnancy isn’t physically possible.
How Surrogacy Works for Infertile Couples
Surrogacy offers a way for couples to have a child when carrying a pregnancy isn’t possible or safe. It’s a medical process but also a legal and logistical one that involves collaboration between the intended parents, the surrogate, and medical and legal professionals. Here’s how it works:
What is gestational surrogacy?
Gestational surrogacy is the most common form used today. It involves creating an embryo in a lab through in vitro fertilization (IVF), then transferring it to a surrogate, a woman who carries the pregnancy but has no genetic link to the baby.
- The embryo can be created using the intended parents’ eggs and sperm, or using donor eggs, sperm, or both.
- Because the surrogate is not biologically related to the child, gestational surrogacy offers legal clarity in most U.S. states.
- Compared to traditional surrogacy (where the surrogate is also the egg donor), gestational surrogacy is now preferred due to its medical and emotional separation, making the process smoother for all involved.
Step-by-step overview of the surrogacy journey
The surrogacy journey is structured and supported by medical and legal professionals at every stage. Here’s a simplified breakdown:
- Initial consultation and fertility assessment
The intended parents meet with a fertility specialist to evaluate their reproductive options, including the possibility of using their own gametes (eggs and sperm) or donors.
- Matching with a surrogate
A surrogacy agency handles the matching process and helps the couple find a gestational carrier who has passed medical, psychological, and background screenings. Compatibility, values, and communication style are also taken into account.
- Legal contracts
Before any medical procedures begin, both parties sign detailed legal agreements. These contracts outline the rights, responsibilities, and expectations of each side, ensuring transparency and protection throughout the journey.
- Embryo creation and transfer
IVF is used to create embryos, which are then transferred into the surrogate’s uterus. The procedure is done in a fertility clinic and followed by close monitoring during the early stages of pregnancy.
- Pregnancy monitoring and parental involvement
The surrogate attends all prenatal appointments, and the intended parents are encouraged to be as involved as they wish, from hearing the baby’s heartbeat to joining ultrasound visits.
- Birth and legal parenthood
Once the baby is born, legal processes, already defined in the contract, confirm the intended parents’ legal rights. In many cases, they are recognized as the legal parents from birth, and they can be present for delivery.
Surrogacy for Couples with Male Infertility
When male infertility makes natural conception difficult or impossible, gestational surrogacy can be a great option. In this case, the embryo is created using the intended mother’s egg (or a donor egg) and either the intended father’s sperm or donor sperm. The embryo is then transferred to a surrogate, who carries the pregnancy but has no genetic link to the baby.
Using ICSI to Help Fertilization
One of the most common techniques used in cases of male infertility is ICSI (Intracytoplasmic Sperm Injection). This method helps fertilize the egg by injecting a single sperm directly into it. ICSI is often used when sperm count is low or sperm quality is poor. It increases the chances of successful fertilization, even if only a few healthy sperm are available.
What If the Sperm Can’t Be Used?
If the intended father doesn’t have usable sperm or if there’s a risk of passing on a genetic condition, sperm donation is another option. In this case, a carefully screened donor’s sperm is used to create the embryo. The process continues exactly the same; the embryo is transferred to the surrogate, who then carries the baby to term.
What to Expect
- The intended mother may go through an IVF cycle to provide eggs.
- The sperm (from the intended father or a donor) is used to fertilize the eggs.
- Once embryos are ready, the best one is transferred into the surrogate’s uterus.
- The surrogate carries the pregnancy, and the intended parents stay involved throughout.
Thanks to modern fertility techniques like IVF and ICSI, many couples facing male infertility can still have a baby who is genetically related to them. And with the help of a gestational surrogate, they can move forward confidently on their path to parenthood.
Surrogacy for Couples with Female Infertility
When female infertility prevents pregnancy, gestational surrogacy provides a safe and effective way for couples to build their family. This option is often chosen when the intended mother cannot carry a baby due to medical reasons or past unsuccessful fertility treatments.
Medical reasons that make pregnancy impossible or risky
Surrogacy is typically recommended in cases where the intended mother has no uterus, either due to a congenital condition or after a hysterectomy. It can also be the solution for women who have significant uterine abnormalities, such as scarring or malformations that prevent a pregnancy from developing. In addition, some women may have chronic health conditions, such as heart disease or autoimmune disorders, that make pregnancy too dangerous to attempt. Surrogacy offers a safe alternative without compromising the health of the mother or the baby.
When other fertility treatments haven’t worked
For couples who have gone through multiple rounds of IVF without success, surrogacy can offer a new path forward. Even if embryos are of good quality, some women face unexplained implantation failures. In these cases, transferring embryos into a surrogate with a healthy uterus may significantly increase the chances of success.
How surrogacy works in these cases
If the intended mother can still produce eggs, they are retrieved during an IVF cycle and fertilized in the lab using the intended father’s sperm (or donor sperm if needed). If egg quality is a concern, an egg donor can be used instead. Once embryos are created, one is transferred into the gestational carrier’s uterus. The surrogate then carries the pregnancy, while the intended parents remain involved and prepare for the baby’s arrival.
Key Benefits of Surrogacy for Infertile Couples
Maintaining a biological connection
One of the main reasons couples choose surrogacy is the ability to have a child who is biologically related to them. In most cases, the intended parents use their own eggs and sperm, or at least one of them contributes genetically. This allows them to maintain a family lineage and connection that feels deeply meaningful, especially after struggling with infertility.
Participating in the pregnancy experience
Even though the intended mother is not carrying the baby, surrogacy still allows the couple to be involved in the pregnancy. They can attend medical appointments, hear the baby’s heartbeat, see ultrasound images, and stay connected throughout the journey. This involvement helps create an emotional bond with the baby before birth.
Higher chances of success compared to repeated IVF
When previous IVF cycles haven’t worked, surrogacy may offer better results. Surrogates are selected for their good health and proven ability to carry pregnancies. This often leads to higher success rates, especially for couples who have faced repeated implantation failures or other medical challenges.
Legal security and emotional reassurance
Surrogacy agreements clearly define the roles and responsibilities of each party, including legal parenthood. This legal clarity helps reduce stress for intended parents, knowing that their parental rights are protected from the start. It allows them to focus on welcoming their child with peace of mind.
Choosing the Right Surrogacy Agency
Choosing the right surrogacy agency is one of the most important steps in the entire process. A good agency will not only guide you through the medical and legal aspects of surrogacy, but also support you emotionally and logistically throughout your journey. Here’s what to look for.
What To Look For in a Surrogacy Agency
A trustworthy agency should have a solid track record of successful matches and satisfied clients. Testimonials from other intended parents can give you a clear idea of what to expect. Make sure the agency has strict screening standards for surrogates, including medical evaluations, psychological assessments, and background checks. This ensures the surrogate is not only physically healthy but also emotionally ready to carry a child for someone else.
Transparency is also key. A good agency should clearly explain the costs involved, what’s included in their services, and how each phase of the process is managed. Ethical practices, open communication, and a respectful approach toward both intended parents and surrogates are signs of a professional and reliable agency.
Why Working With an Agency is Safer than Going Independent
While it may be tempting to explore independent surrogacy, working with a qualified agency offers much more protection and peace of mind. Agencies are experienced in handling the complex legal and medical aspects of surrogacy, which can vary from state to state. They also provide access to professionals who can draft and review contracts, coordinate medical appointments, and help manage communication between the intended parents and the surrogate.
In difficult or unexpected situations, such as a medical complication or a disagreement, an agency can also step in to mediate and offer solutions. Many agencies also offer counseling and support services for both parties, which can make the experience smoother and more emotionally balanced. Overall, choosing an agency means you’re not navigating this life-changing journey alone. You have a team behind you, helping at every stage.
Choose Surrogacy By Faith
At Surrogacy by Faith, respect for life is a core value. Except in cases of medical emergency or rare exceptional circumstances, pregnancy termination is not supported or permitted. This commitment, rooted in an ethic of care and responsibility, provides a reassuring framework for those seeking a surrogacy journey grounded in meaning, compassion, and integrity.
For intended parents considering surrogacy, the best way to start the journey is by exploring the intended parent application process. Women interested in becoming surrogates can learn more about the steps involved by reviewing the surrogate mother application process.