If you are beginning to research surrogacy, one of the first distinctions you are likely to encounter is gestational surrogacy versus traditional surrogacy.
The most important difference is straightforward:
In gestational surrogacy, the surrogate does not provide the egg used to create the embryo and is not genetically related to the child. In traditional surrogacy, the surrogate’s own egg is used, so she has a genetic relationship to the child she carries.
That distinction affects almost every other part of the journey—from how pregnancy is achieved to the medical process, legal considerations, screening, and the roles of everyone involved.
Today, gestational surrogacy is the model overwhelmingly used in modern fertility treatment. Traditional surrogacy still exists, but it is much less common and can create additional legal and ethical considerations.
At Simple Surrogacy, we have helped families navigate third-party reproduction since 2002. Understanding the difference between these two forms of surrogacy is an important first step toward understanding which path may apply to your family.
Gestational surrogacy is an arrangement in which a woman carries a pregnancy created from an embryo but does not provide the egg used to create that embryo.
The embryo is created through in vitro fertilization, or IVF, using:
The embryo is then transferred into the gestational surrogate’s uterus.
Because the surrogate does not contribute the egg, she is not a genetic parent of the baby.
The American Society for Reproductive Medicine, or ASRM, uses the term gestational carrier for someone who carries a pregnancy but does not provide the gametes used to create it.
Gestational surrogacy is the form of surrogacy most people are referring to today when they talk about working with a surrogate.
If you are considering this path, our Surrogacy Process Overview for Intended Parents explains how matching, screening, contracts, embryo transfer, pregnancy, and delivery fit together.
Traditional surrogacy—also sometimes called genetic surrogacy—is different because the surrogate provides her own egg.
That means the woman carrying the pregnancy also has a genetic relationship to the child.
Pregnancy may be achieved through insemination using sperm from an intended father or sperm donor rather than by transferring an embryo created from someone else’s egg.
This was historically the primary form of surrogacy before IVF made gestational surrogacy possible.
Today, traditional surrogacy is far less common.
ASRM describes traditional or genetic surrogacy as rare in modern clinical practice and notes that it presents different legal and ethical issues from gestational-carrier arrangements.
Because laws differ significantly by state, anyone considering traditional surrogacy should obtain specific advice from an attorney experienced in assisted reproductive technology before proceeding.
| Gestational Surrogacy | Traditional Surrogacy | |
|---|---|---|
| Whose egg is used? | Intended parent or egg donor | Surrogate’s own egg |
| Is the surrogate genetically related to the baby? | No | Yes |
| Is IVF required? | Yes | Not necessarily |
| Is an embryo transferred to the surrogate? | Yes | Usually no |
| Common in modern U.S. surrogacy? | Yes | Much less common |
| Legal considerations | State-specific | State-specific and often more complex |
| Donor eggs can be used | Yes | Not for the surrogate’s genetic contribution |
| Fertility clinic involvement | Extensive | Depends on method and circumstances |
The genetic connection is the central difference. But from there, the medical and legal processes can diverge significantly.
A gestational surrogate does not contribute the egg or sperm used to create the embryo, so she is not a genetic parent of the child.
The child’s inherited genetic material comes from the egg and sperm used to create the embryo.
For example:
If an intended mother and intended father create an embryo using their own eggs and sperm, the child may be genetically related to both intended parents.
If an intended father uses his sperm with an egg donor, the child may be genetically related to him and the egg donor.
If donor eggs and donor sperm are used, the child may not be genetically related to either intended parent.
In each of those examples, however, the gestational surrogate does not contribute the egg and therefore is not the child’s genetic parent.
Pregnancy itself is biologically complex, and the environment of any pregnancy can influence fetal development. That is different from contributing the inherited genetic material used to create the embryo.
For a deeper answer to one of the questions we hear frequently, see Will the Baby Look Like the Surrogate Mother?.
Gestational surrogacy combines assisted reproductive medicine with surrogate matching, screening, legal preparation, and pregnancy coordination.
Although every journey differs, the process generally includes several major stages.
The intended parents work with a fertility clinic to create embryos through IVF or prepare embryos they already have in storage.
If donor eggs are necessary, an egg donor may become part of the process.
Simple Surrogacy also works with intended parents who need help identifying a donor. You can learn more about choosing an egg donor.
The intended parents and surrogate need to be compatible not just medically but also in their expectations for communication, pregnancy decisions, boundaries, and the relationship.
At Simple Surrogacy, the surrogate reviews appropriate intended-parent profiles first. When she is interested in a family, her profile is then presented to those intended parents.
If everyone is interested, the parties have an opportunity to talk before deciding whether they want to proceed together.
Learn more about how intended parents and surrogates are matched.
After matching, the intended parents’ fertility clinic evaluates the surrogate before approving her for an embryo transfer cycle.
This is separate from the agency’s pre-screening process.
The fertility clinic has the responsibility of determining whether she is medically appropriate to carry the pregnancy under its protocols.
Our Surrogacy 101: Medical Screening guide explains this stage in greater detail.
The intended parents and surrogate should have separate legal representation.
Their attorneys negotiate and review the gestational carrier agreement, which addresses issues such as responsibilities, compensation and expenses, insurance, medical expectations, communication, confidentiality, embryo transfer, pregnancy, delivery, and other important terms.
Only after the appropriate legal clearance has been issued does the fertility clinic proceed toward embryo transfer.
Read more about the surrogacy legal process.
The gestational surrogate follows the fertility clinic’s medication protocol to prepare her uterus.
An embryo is then transferred into her uterus.
If implantation occurs and pregnancy is confirmed, the fertility clinic continues monitoring the pregnancy during its early stages before eventually releasing the surrogate to her obstetric provider.
From this point, the surrogate receives normal prenatal care along with any additional care her physicians consider necessary.
The intended parents and surrogate continue the relationship they discussed during matching and formalized during the legal process.
The agency continues coordinating the many logistical pieces of the journey through pregnancy and delivery.
There are several reasons.
The development of IVF made it possible to separate who provides the egg from who carries the pregnancy.
That changed surrogacy significantly.
In a gestational-carrier arrangement, the surrogate can help another family have a child without also being the child’s genetic parent.
This creates a clearer distinction among the roles involved:
Modern fertility programs, professional guidance, and many state surrogacy statutes therefore focus primarily on gestational-carrier arrangements.
ASRM notes that traditional surrogacy is rarely offered by most programs because of its additional ethical and legal complexity.
There is no single nationwide U.S. surrogacy law.
Surrogacy is primarily governed at the state level, through statutes, court decisions, and other state-specific legal rules.
Some states have detailed laws expressly governing gestational-carrier arrangements. Other states have different statutory or case-law frameworks. The requirements for establishing parentage can also differ according to the state and the circumstances of the intended parents and surrogate.
This is why the location of the surrogate can matter so much.
It is also why intended parents should work with attorneys experienced specifically in assisted reproductive law rather than relying on assumptions about what happens in another state.
Our Surrogacy 101 Legal Process guide provides a broader overview of what happens during the contract and parentage stages.
There is no universal answer to this question either.
Traditional surrogacy can be treated differently from gestational surrogacy because the woman carrying the pregnancy is also genetically related to the child.
Some jurisdictions may treat these arrangements under different statutes or legal doctrines, and some surrogacy agreements may face enforceability issues depending on the state.
Anyone considering traditional surrogacy should therefore speak with an assisted-reproduction attorney before agreeing to an arrangement or beginning treatment.
The fact that two people trust one another does not eliminate the need for legal advice.
There is no single type of intended parent.
Gestational surrogacy can help people become parents when carrying a pregnancy themselves is impossible, medically inadvisable, or biologically unavailable.
That can include people facing infertility, uterine-factor infertility, serious medical conditions that make pregnancy unsafe, repeated pregnancy complications, or other medical circumstances.
Gestational surrogacy is also an important family-building path for gay men, LGBTQ+ families, and single intended parents.
You can learn more about surrogacy for gay couples and LGBTQ+ parents.
At Simple Surrogacy, we believe people pursuing parenthood deserve to be evaluated according to their ability to responsibly participate in a surrogacy journey—not according to their sexual orientation or marital status.
Yes.
This is another important advantage of IVF-based gestational surrogacy: the egg and sperm used to create the embryo can come from different sources depending on the intended parents’ circumstances.
An intended parent may use:
For gay male couples, for example, an egg donor is typically part of the family-building process.
For an intended mother who cannot safely carry a pregnancy but can produce viable eggs, her own eggs may be used while a gestational surrogate carries the pregnancy.
For another family, medical circumstances may mean both an egg donor and surrogate are needed.
This flexibility is one reason gestational surrogacy can serve many different types of families.
This question needs a more careful answer than simply saying “no.”
A gestational surrogate’s lack of genetic relationship to the child is an important distinction, but legal parentage is still determined according to the law applicable to the particular journey.
Depending on the state, attorneys may use pre-birth orders, post-birth proceedings, validation procedures, acknowledgments, or other legal mechanisms to establish the intended parents’ legal status.
The appropriate process should be determined by experienced attorneys before embryo transfer and completed according to the jurisdiction involved.
This is another reason proper legal planning is essential even in a gestational-surrogacy arrangement.
In everyday conversation, yes.
Both terms are commonly used for a person who carries a pregnancy created from an embryo with which she has no genetic relationship.
Medical and professional organizations often use gestational carrier, while agencies and families frequently use gestational surrogate.
At Simple Surrogacy, you will see both terms.
What matters is the underlying distinction: the person carrying the pregnancy did not provide the egg used to create the embryo.
The cost structures are different.
Gestational surrogacy requires IVF and embryo transfer, which introduces fertility-clinic costs that may not be part of a traditional-surrogacy arrangement using insemination.
But total surrogacy costs involve far more than the method used to achieve pregnancy.
Expenses may include surrogate compensation and benefits, agency services, screening, attorneys, insurance, escrow, travel, fertility treatment, donor services when needed, medications, monitoring, and pregnancy-related expenses.
Our Surrogacy Fees and Costs page provides a detailed breakdown of the current expense categories involved in a Simple Surrogacy journey.
One caution: do not choose a surrogacy structure based solely on which method initially appears less expensive.
Medical appropriateness, legal protection, professional screening, and the long-term interests of everyone involved should come first.
Gestational surrogacy is the standard model for modern surrogacy journeys and represents the primary form of surrogacy most intended parents encounter today.
Simple Surrogacy’s published programs and process are built extensively around gestational carriers, IVF, embryo transfer, fertility-clinic screening, matching, contracts, escrow, pregnancy coordination, and parentage.
Our current fee information also separately addresses coordination involving traditional surrogacy. Because traditional arrangements raise different legal questions, intended parents considering that option should discuss their circumstances with us and with an experienced reproductive attorney before proceeding.
For most people beginning their research, gestational surrogacy is the model they should expect to encounter.
No. She does not provide the egg or sperm used to create the embryo, so she is not a genetic parent.
Yes. A traditional surrogate provides her own egg, so she has a genetic relationship to the child.
Yes. An embryo must first be created through IVF before it can be transferred to the gestational surrogate.
Not necessarily. Traditional surrogacy has historically involved insemination using the surrogate’s own egg.
No. If the woman carrying the pregnancy also provides the egg, the arrangement is traditional or genetic surrogacy rather than gestational surrogacy.
Yes. Egg donation and gestational surrogacy are frequently used together when the intended parents need both an egg donor and someone to carry the pregnancy.
Yes. Gay male intended parents commonly pursue gestational surrogacy using donor eggs and sperm from one or both intended fathers.
Surrogacy law is state-specific. The legal framework and parentage process depend on the jurisdictions and individual circumstances involved, so experienced reproductive legal counsel is essential.
Traditional surrogacy involves a genetic relationship between the surrogate and child and can raise additional legal and ethical issues. Modern fertility practice and many legal frameworks therefore focus predominantly on gestational-carrier arrangements.
When people first encounter surrogacy, the terminology can make the process sound more complicated than it needs to be.
The basic distinction is simple:
A gestational surrogate carries an embryo created from someone else’s egg. A traditional surrogate provides the egg herself.
From that one difference follow many of the medical, genetic, legal, and practical differences between the two arrangements.
For most intended parents pursuing surrogacy in the United States today, gestational surrogacy is the pathway they will encounter.
If you are considering becoming an intended parent and want to understand what your individual journey might involve, review our complete Surrogacy Process for Intended Parents or contact Simple Surrogacy to schedule a consultation.
You do not need to understand every detail before you call. Helping you understand which pieces apply to your family is part of what the first conversation is for.
Go backSurrogacy 101: Becoming an Intended Parent Through Surrogacy Becoming an intended parent through surrogacy can feel exciting, hopeful—and, at first, a little overwhelming. Most people begin the process with far more questions than answers. Do you need embryos before contacting…
Lern more →Why Surrogates Should Think Twice Before Choosing an Agency That Also Represents the Intended Parents Choosing a surrogacy agency is one of the most important decisions a gestational carrier will make during her journey. Your agency is often the central…
Lern more →Surrogacy Pregnancy and Delivery: What Intended Parents and Surrogates Should Expect Quick Summary Once an embryo transfer results in an established pregnancy, a surrogacy journey enters a very different stage. The fertility clinic eventually releases the gestational surrogate to her…
Lern more →
