Modern Routes to a Family: Surrogacy, Adoption, and Being a Donor

Published: 13/10/2022

Sometimes it can be impossible to become pregnant through natural means, however there are many alternative routes to parenthood.

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Whether you're same-sex, single, or a heterosexual couple, with modern family structures and advanced fertility technology, everyone can become a parent and start a family. In this article, we give you the lowdown on all routes to starting a family, whatever your family looks like.

All about surrogacy

Surrogacy allows people who cannot have children naturally to become parents. In England and Wales, the route to becoming surrogate parents has almost quadrupled in the last ten years.

There are several reasons why hopeful parents use surrogates:

  • Women who have medical issues, e.g., cardiac problems, hysterectomy

  • Infertility – Congenital uterine abnormality

  • Same sex couples

  • Physical and emotional trauma with a past pregnancy or birth. Severe postpartum depression can have a negative impact on pursuing another pregnancy

  • Single men might use a surrogate mother

  • Age – The chances of having a congenitally normal baby and carrying to term drops drastically after the age of 40 years, therefore surrogacy might be the best route to take

It needs to be stated – surrogacy can be a difficult process. 

Make sure you are prepared to completely commit to the surrogacy process before you begin by educating yourself on the advantages and risks of surrogacy.

Traditional surrogacy and gestational surrogacy

There are two types of surrogacies: traditional surrogacy and gestational surrogacy 

Traditional surrogacy

In traditional surrogacy, the surrogate is, in fact, the baby's biological birth mother who carries the child for the intended parents. She is genetically connected to the child since she provides the egg fertilised by the sperm of either the intended father or a donor. 

This route is extremely unusual these days due to the legal and emotional issues involved, and because of this, this type of surrogacy is treated legally like adoption.

Gestational surrogacy

A gestational carrier (also known as a surrogate mother) is used by intended parents (IPs) whereby an embryo (created from either the intended mother's egg or a donor's egg) is implanted in the uterus of the prospective birth mother who carries the baby to term. 

The gestational carrier/host carrier is the preferred method of surrogacy since the surrogate is not biologically related to the child. 

In the UK, the law states that the surrogate mother is the baby's legal mother until the intended parents apply for a parental order to transfer parenthood to them. This could take anywhere from 3–12 months. 

The process for gestational surrogacy

The biological mother will go through stimulation of her ovaries and have an oocyte (immature egg) retrieval. 

The partner will give his sperm or the use of donor sperm, and via IVF, the embryo will be created and transferred to the gestational mother. 

This process can be a fresh embryo transfer or done as a frozen cycle. 

Generally, the best option is a frozen cycle since there is no pressure on creating embryos and preparing the gestational carrier's endometrium simultaneously in fresh embryo transfer. 

The use of donor eggs and donor sperm (also known as ‘third-party reproduction') is a complex issue where intended parents purchase donated gametes to be transferred to the gestational carrier.

Choosing your surrogacy route

Every intended parent should take their time choosing which route and surrogacy arrangements best suit them. 

Both types of surrogacies can be time-consuming. You should anticipate spending around half a year on an egg donor waiting list before undergoing laboratory testing and mandatory counselling before attempting to conceive.

The processes for traditional and gestational surrogacy take place in very different environments. 

Some intended parents may prefer the more natural home insemination process, whereas others may prefer the expertise provided by a clinic.

You should bear in mind if you use traditional surrogacy, your surrogate will have a biological connection to the baby.

You must cover significant clinic fees if you choose gestational – in addition to the surrogate's expenses.

Surrogacy professionals

If you're unsure, it's always best to seek expert advice. There are two types of surrogacy professionals who can help you navigate the surrogacy journey:

  1. Surrogacy Agency – This option may provide various surrogacy services, such as case management, assistance, counselling, matching, screening, legal implications, and long-term assistance.

  2. Surrogacy Lawyer – It is necessary for every surrogacy arrangement to ensure it's done legally. So while a surrogacy attorney can ensure all surrogacy arrangements happen legally, the lawyer will not provide any other services.

About UK adoptions

Adoption provides a new family for children where it isn't possible to be raised by their biological parents. Anyone over 21 can adopt as long prospective adopters fulfil the criteria with social services, local police services, the social worker, and the registered adoption agency. 

The process takes about 6–12 months, and once the adoption order has been granted, the adoption cannot be revoked. Adopted children typically change their last name to that of their adoptive parents and sever all legal links with their biological mother and father.

You can contact adoption agencies online, and all information will be sent. The agency will arrange to meet you as prospective parents who want to adopt. The application process begins if you are happy to move forward with the adoption. 

Donor (Egg/Sperm) Recipient

Egg Recipient

Egg recipient treatment is a fertility treatment for women under 50 who can't use their eggs to have a child. 

This could be because of age-related infertility, premature menopause, ovarian failure, genetic history, or chemotherapy, which leads to infertility. 

Same-sex couples can also use donor eggs to have a child using a gestational surrogate. Before receiving donor eggs, implications counselling is mandatory to begin this process. 

Many egg donor agencies have frozen eggs – and they'll match your characteristics to the donor's. 

Strict screening guidelines for egg donors will be adhered to as per the HFEA policy. 

The process involves in vitro fertilisation (IVF), whereby the donor egg is fertilised with the partner's sperm or donor sperm before it's implanted into the intended mother. 

Pregnancy outcomes are high using donor eggs since the donors are young (18–35 years) non-smokers with a good ovarian reserve.

Sperm Recipient

Single women, lesbian couples, men with inherited genetic disorders, or men who do not have sperm in their ejaculate most commonly require donated sperm. 

All sperm donors are screened per HFEA policy and can be known or anonymous donors. Many clinics have their own donor banks, or you can use an agency in the UK or abroad as long as the screening is complete and the donors are fit and healthy. 

Implications counselling is mandatory before using donor sperm. Using donor sperm can be bought in a clinic and inseminated at home or in the clinic by intrauterine insemination (IUI) or IVF. 

As per HFEA, treatment at a licensed clinic ensures that the donor is not recognised as your child's legal parent and that your partner (if you have one) is the child's second legal parent.

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