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In a surrogacy arrangement, a woman agrees to become pregnant in order to carry and give birth to a child others will raise. Surrogacy is often the only option available to an infertile couple who wants to have a child that is genetically related to at least one of them, yet it is controversial and illegal in many parts of the United States.

The surrogate mother, or gestational carrier, may be artificially inseminated with the intended father's sperm and therefore be the child's genetic mother (a traditional surrogacy) or she may be implanted with an embryo created with the intended parents' sperm and egg (gestational surrogacy). In the case of gestational surrogacy, the intended parents typically undergo some form of ART (assisted reproductive technology), such as IVF, to create an embryo, although donated eggs, sperm, or embryos may also be used if necessary. In both forms of surrogacy, the carrier agrees to sign away her parental rights and turn the baby over to the intended parents after she delivers.

Couples who choose surrogacy often are infertile because the woman lacks ovaries and a uterus, or they function too poorly to sustain a pregnancy; or she has suffered recurrent pregnancy loss, repeated IVF implantation failures, or has a disease that precludes pregnancy but not motherhood. Single males and homosexual male couples also use surrogacy.

Gestational carrier arrangements are usually set up through agencies that specialize in surrogacy, or as independent adoptions (in states where they are legal) between the intended parents and carrier. Couples can locate potential carriers with the help of the surrogacy agencies or on their own through friends or family, surrogacy organizations, or on the Internet.

It is difficult to determine the success rate of surrogacy because so many couples make arrangements privately; however, the Organization of Parents Through Surrogacy estimates that approximately 10,000 babies have been born using surrogacy since 1976. The success rate also depends on the quality of the egg and sperm, or embryo used, as well as the fertility and health of the carrier.

There is no federal law regarding surrogacy, and most states in the United States do not have any laws regulating it. Only a handful of states officially recognize and regulate it, and it is illegal in several others, so if you are interested in surrogacy, check this map to be sure it is legal in your state.

For your own protection, it is a good idea to consult with an attorney familiar with your state's surrogacy laws before you enter into any arrangement.

There are potential obstacles and risks associated with surrogacy, including complications from ART procedures such as IVF and insemination, its high cost, legal complexities and possible snags, and the often intricate contracts and arrangements involved. Surrogacy can also be emotionally intense and risky for both parties, and there is always the chance that the carrier will change her mind and try to retain custody of the baby. The intended parents and the carrier may also have conflicting opinions on issues such as genetic testing, how the pregnancy should progress, and how the baby should be delivered.

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