Gestational carrier & surrogacy

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Michael J. Levy, M.D.

Metro Weekly’s recent article, “Other People’s Children: Surrogacy and its misconceptions,” covers the legal complications surrounding surrogacy in the state of Maryland. In this piece, Michael J. Levy, M.D., a founding partner and Director of IVF at Shady Grove Fertility, provides context for this assisted reproductive technology.

How the Gestational Carrier Process Works

A gestational carrier—a woman who carries a pregnancy but is in no way biologically or genetically related to the child she is carrying—is needed for any couple in which the female partner cannot carry the pregnancy. An inability to carry a pregnancy may result from the following conditions in which the female partner has had her uterus surgically removed:

In other cases, the woman may have an intact uterus but the uterus still may not be able to carry a pregnancy to term. Same sex male couples will also work with a gestational carrier to have a child.

While Shady Grove Fertility does not recruit gestational carriers, the patients’ medical team will refer them to reputable agencies and attorneys who specialize in identifying gestational carriers. After the couple has met with the agency/attorney, the prospective carrier (who, by law, has had successful pregnancies/live births previously) and the intended parents will meet in order to determine compatibility. If they decide to work together, an attorney will draw up a legally-binding contract at that time. The gestational carrier will also have to undergo medical and psychological screening.

In the case of a same sex male couple, the couple will select an egg donor after the screening and legal contracts are in place. Once that process has been completed, a physician will retrieve the eggs from the donor and one or both male partners will provide previously frozen sperm samples that an embryologist will use to inseminate the donated eggs. After the embryos have developed in the lab for 5 to 6 days, the physician will transfer the embryo(s) to the gestational carrier.

The Need for Legislation

While legally-binding agreements must be in place for a couple to work with a gestational carrier, these agreements are not currently recognized in the state of Maryland. Thus, without any laws governing gestational carriers, the gestational carrier is initially assumed to be legally responsible for the child. Additionally, there are no guarantees that Maryland courts will enforce the legally-binding agreement if something went wrong. Legislators have been trying to clarify the law with respect to the rights and responsibilities of intended parents and carriers who enter into gestational carrier agreements, but this bill has so far failed to move forward in the General Assembly.

Dr. Levy said that some of the opposition that the gestational surrogacy bill ran into was ideological, based on opposition to any form of conception that occurs outside of the body. He continues, “If you’re personally unaffected, you have an abstract view that is different.” Dr. Levy notes that other opposition comes from issues related to abortion rights and embryo rights and opposition to “destroying embryos,” as many embryos are utilized in the process of in vitro fertilization (IVF).

While opponents may feel this way, gestational carriers and intended parents share a very positive experience with one another. Sarah Cowen, a gestational carrier who worked with Shady Grove Fertility, said, “I picked this couple just as much as they picked me. Just like a pregnancy, it’s up to an individual woman what she should do with her own fertility. I chose it. I loved it…I got to experience helping create an entire family. It’s my greatest accomplishment, and I can’t imagine not having this as a part of my life story.”

Del. Kathleen Dumais (D-Montgomery Co.), the House sponsor of the gestational carrier bill, plans to bring the bill forward again in an upcoming term.

To schedule a new patient appointment at Shady Grove Fertility or to learn more about using a gestation carrier to build your family, please call our New Patient Center at 877-971-7755.

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Gestational carriers are women who choose to carry another person’s child. What makes someone decide to move forward on this path? In U.S. News & World Report’s recent article, “What’s It Like to Be a Surrogate Mom,” the author interviews two women who became intertwined through the gestational carrier process. Jodie Hayes had two teenage daughters when she made the decision to help another woman fulfill her dreams of parenthood. She became the gestational carrier for Dr. Angeline Beltsos (the intended parent), medical director of Fertility Centers of Illinois-Highland Park IVF.

Dr. Beltsos’ first three children were born via caesarean section, but her fourth was born prematurely and did not survive. Due to the prior C-sections and the complications from the last delivery, Dr. Beltsos knew that working with a gestational carrier was the best option for her to grow her family. Thanks to Hayes, Dr. Beltsos and her husband now have a healthy 3 month old daughter.

Also in this article, Shady Grove Fertility’s very own Michele Purcell, BSN, RN, MHA, Donor Egg and Gestational Carrier Program Director, speaks about the gestational carrier process.

What is a gestational carrier?

A gestational carrier is a woman who carries a pregnancy for a couple but is in no way biologically or genetically related to the child she is carrying. She is merely providing a nurturing environment in the form of a uterus for the child to grow for the gestational period of 40 weeks. The term “surrogate” refers to a woman who donated her egg and then carried the child.

Who uses a gestational carrier?

For any couple in which the female partner cannot carry the pregnancy, a gestational carrier is required. This may result from conditions in which the female partner has had her uterus surgically removed—such as in the case of cervical or uterine cancer, fibroids, severe endometriosis, or conditions requiring a hysterectomy. In other cases, the woman may have an intact uterus but the uterus still may not be able to carry a pregnancy to term. A physician will obtain the eggs from the intended parent or from an egg donor.

Same-sex male couples will work with a gestational carrier, egg donor, and with one/both of the partner’s sperm to conceive.

How does a couple select a gestational carrier?

SGF will refer patients needing a gestational carrier to experienced and reputable agencies and attorneys who recruit carriers. Prospective carriers (all of whom have had successful pregnancies/live births previously like Hayes) and intended parents will meet in order to determine compatibility. If they decide to work together, an attorney will draw up a legally-binding contract at that time. The gestational carrier will also have to undergo medical and psychological screening. The average wait to be matched with a gestational carrier can run from approximately 2 to 6 months.

How do you get started with the gestational carrier process?

Step One: Schedule a new patient appointment with a reproductive endocrinologist at SGF to review your medical history and determine a treatment plan.

Step Two: If the plan is to proceed with a known gestational carrier, the couple will schedule a consult at SGF. If the couple has not yet selected a gestational carrier, SGF will direct them to an attorney or agency to start the recruiting process.

Step Three: SGF will outline the medical screening process for all parties.
Step Four: SGF must receive confirmation of legal counsel and contracts prior to the start of the fresh cycle.

What success rates can a recipient expect using a gestational carrier?

The success rates for a gestational carrier cycle are largely determined by the quality of eggs available and the health of the gestational carrier’s uterus. Traditionally, outcomes in this program are among the highest at our practice.

Where can I find additional information about SGF’s Gestational Carrier Program?

While SGF does not recruit gestational carriers, the following partners meet our standards for quality:

  • ART Parenting: 301-217-0074
  • Center for Surrogate Parenting: 410-990-9860
  • Create Family Connections: 866-407-4224
  • Family Forward Surrogacy: 301-320-3086
  • Melissa B. Brisman, Esq.: 201-505-0099
  • Surrogacy America: 888-587-8939
  • The Surrogacy Group: 410-990-0018

For more information about SGF’s Gestational Carrier Program or to schedule a new patient consultation, please call our New Patient Center at 1-888-809-5577.

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Sharing their story with the Today Show: Andrea is carrying twins for Sandi and Philip.

On Shady Grove Fertility’s Facebook page 12,000 participants gather to share their experiences and offer advice. Well, one couple, Marc and Andrea had a very long and difficult journey that happily ended almost two years ago with the birth of their twins. Andrea was active on the page from the start and was able to relate with so many other patients and patients to-be with similar questions and concerns. One of the women Andrea met on the page was Sandi. After realizing they lived close to each other the ladies decided to meet for lunch and found that besides the topic of fertility, they had so much in common. Soon Andrea’s husband Marc and Sandi’s husband Phil were included for a double date.

Almost three years ago Andrea and Marc received the best news: Andrea’s latest round of IVF was successful and she was pregnant with twins. Andrea and Marc wanted deeply to share this joy with their close friends Sandi and Phil.

Only three months pregnant, Andrea and Marc decided that they would help Sandi and Phil any way they could. When Sandi and Phil shared that they would require a gestational carrier, Marc and Andrea already had a solution: Andrea would be Sandi’s surrogate.

Now, with their own beautiful babies turning two this February, Marc and Andrea are getting ready to give Sandi and Phil the best gift ever: twin babies of their own.

The Shady Grove Fertility Family is so excited to welcome Sandi and Phil’s babies in 2014!

Watch their story on the Today Show

If you have questions about fertility or are ready to schedule an appointment at Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

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SGF Nurse
Guiliana & Bill Rancic have announced they will be using a gestational carrier.

The term “gestational carrier” has been in the headlines lately, thanks to reality stars Giulana and Bill Rancic. After miscarriage, hurdles and a scare with breast cancer, the couple is using a gestational carrier, a woman who carries another couple’s fertilized embryo to term, to have their baby.

Contrary to what some might think, gestational carriers and surrogates are not the same, as a surrogate is someone who donates her egg and then subsequently carries the child; she is genetically linked to that baby. In the case of a gestational carrier, the woman carrying the pregnancy is in no way biologically related to the child she is carrying; the eggs and sperm are derived from the “intended parents” (or possibly an egg donor, or sperm donor), through the process of In Vitro Fertilization (IVF). The egg is fertilized in the lab, and then the embryo (or embryos) is placed into the uterus of the gestational carrier. Finding and using a gestational carrier can be complicated in some states.

“Fortunately, Maryland is one of the states which recognizes there are medical reasons why a gestational carrier may be the only way a couple can have a baby and allow gestational surrogacy. Consequently, many couples come to Shady Grove Fertility for care,” says Gilbert L. Mottla, MD, a Reproductive Endocrinologist in Shady Grove Fertility’s Annapolis office.

According to the American Society for Reproductive Medicine, 859 surrogacy and gestational carrier cycles were performed in the United States in 2010. Notably, there has been a 28% increase in gestational carrier cycles since 2007. Shady Grove Fertility has extensive experience with the gestational carrier process, excellent success rates, and offers unique financial programs. If a couple does not bring home a baby through the gestational carrier, 100% of their money is refunded (some exclusions apply).

Though Shady Grove Fertility treats couples for a variety of fertility issues, there are many medical reasons that preclude a couple from conceiving and carrying a baby to term themselves.

“Any female who has had her uterus surgically removed from cervical or uterine cancer, fibroids, severe endometriosis, or a hysterectomy or where her uterus is simply not functional may be a candidate for a gestational carrier.” said Michele Purcell, RN Shady Grove Fertility’s Donor & Gestational Carrier Program Manager. Women who suffer from heart or other health problems that may make pregnancy dangerous for the mother and baby may need gestational carriers as well.

SGF Nurse
Since 2007, the number of gestational carriers used have increased by 28%.

The good news is that as long as the ovaries are intact and functional, there is a strong possibility that the eggs may be retrieved and fertilized with the male partner’s sperm, or donor sperm, to create embryos that can then be placed into the uterus of the gestational carrier. “With In Vitro Fertilization (IVF) and a gestational carrier, a woman can still be a genetic mother while not putting herself or her baby at any dangerous health risk,” said Purcell.

“Shady Grove Fertility relies on experienced and reputable reproductive attorneys and agencies to recruit our gestational carriers,” said Purcell. “Though some couples come to us with a gestational carrier in mind, like a sister who is willing to carrier their embryo, about 75% of couples in this situation rely others to help find them a gestational carrier.”

In the case of same sex couples, intended fathers can use a gestational carrier along with a donor’s egg to complete their family. “In some recent cases here at Shady Grove Fertility, the sister of one partner donated the egg and the other partner’s sperm, linking the child genetically to both partners,” said Dr. Mottla. “The bottom line is that there are now many ways for couples to build a family.”

For more information on Shady Grove Fertility’s Gestational Carrier Program, or to schedule an appointment with one of the center’s physicians, please contact a New Patient Liaison by calling 877-971-7755.

2026 Shady Grove Fertility

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