Surrogacy has evolved dramatically in the past few decades, and today, there’s one method that stands out as the clear frontrunner: gestational surrogacy. While both gestational surrogacy and traditional surrogacy involve someone carrying a child for intended parents, the differences between them—legally, emotionally, and medically—have led to gestational surrogacy becoming the preferred choice for nearly all modern surrogacy arrangements.
But why is that the case? Why has traditional surrogacy faded into the background, and what makes gestational surrogacy so appealing to intended parents, surrogates, and professionals alike?
Let’s break it all down, covering everything from biology to law, risk to reputation, and exactly why most surrogacy agencies today work almost exclusively with gestational surrogates.
1. What Is Gestational Surrogacy?
Gestational surrogacy is a form of surrogacy where the surrogate (often called a gestational carrier) is not genetically related to the child she carries. The embryo is created using in vitro fertilization (IVF), combining the egg and sperm from the intended parents or donors. That embryo is then implanted into the surrogate’s uterus. This is different from traditional surrogacy, where the surrogate uses her own egg, making her the biological mother of the baby. The difference may seem technical, but it carries massive implications—legally, emotionally, and socially.
2. Why Is Gestational Surrogacy the Preferred Choice Today?
There are several factors behind the shift. Let’s explore each one in detail.
2.1 Clearer Legal Standing and Parental Rights
This is, without a doubt, the number one reason gestational surrogacy is now dominant.
In traditional surrogacy, the surrogate is also the biological mother of the child, which raises complex legal questions:
Can she change her mind and keep the baby?
Do the intended parents have full parental rights at birth?
How are custody and consent handled in court?
Because of these complications, traditional surrogacy often requires court intervention, and outcomes can vary by state. In contrast:
With gestational surrogacy, the surrogate has no biological ties to the child.
Intended parents can obtain pre-birth orders, establishing their legal parentage before the child is born.
Courts and attorneys strongly prefer gestational arrangements due to the legal clarity they offer.
For anyone trying to start or grow a family through surrogacy, that peace of mind is invaluable.
2.2 Reduced Emotional Complexity
When you become a surrogate, emotional boundaries are a key concern. Carrying a child for someone else is already a profound experience—layering in biological connection (as in traditional surrogacy) only amplifies the emotional stakes.
In gestational surrogacy:
Surrogates often view themselves as “babysitters for nine months” rather than biological mothers.
There’s less chance of emotional conflict or attachment to the baby.
Intended parents feel more confident that their parental bond won’t be challenged or complicated by biology.
It’s not about minimizing the role of the surrogate—it’s about recognizing the emotional clarity gestational arrangements create for everyone involved.
2.3 Broader Acceptance by Surrogacy Agencies and Clinics
Today, nearly every surrogacy agency in the United States works exclusively or almost exclusively with gestational surrogates. Why?
Insurance companies are more willing to cover gestational surrogacy cases.
Fertility clinics are structured around IVF, not intrauterine insemination (used in traditional surrogacy).
Agencies want to protect their clients from unnecessary legal or emotional risks.
This institutional support has created a streamlined, safer process—making gestational surrogacy the go-to path for most intended parents.
2.4 More Flexible Use of Donors and Technology
Gestational surrogacy allows for greater flexibility in how embryos are created:
Egg donor + sperm from intended father
Sperm donor + egg from intended mother
Embryos from both intended parents
Donor embryo from a fertility clinic
In other words, gestational surrogacy can accommodate many types of families, including:
LGBTQ+ couples
Single parents by choice
Individuals with fertility challenges or medical conditions
Traditional surrogacy doesn’t offer this level of customization, since the surrogate is genetically involved. Gestational surrogacy fits better with today’s diverse family structures.
2.5 More Medical Control Through IVF
Because gestational surrogacy relies on IVF, every step is planned, screened, and controlled:
The embryos can be genetically tested (e.g., PGT-A for chromosomal normality).
Single embryo transfer reduces the risk of twins or multiples.
Medication protocols are designed to support a healthy uterine lining and successful implantation.
In traditional surrogacy, the process often involves artificial insemination, which is less predictable and harder to control.
Medical precision translates to higher success rates, fewer risks, and more confidence for intended parents.
2.6 Strong Ethical Frameworks
Gestational surrogacy is often seen as more ethically sound—particularly when all parties are well-informed and protected by clear contracts.
Why?
The surrogate enters the arrangement knowing she has no genetic tie to the child.
There’s a stronger culture of counseling and informed consent in gestational arrangements.
Most agencies and clinics ensure both surrogate and intended parents receive psychological evaluations and legal counsel.
This helps to eliminate power imbalances, unrealistic expectations, or emotional confusion that can happen with traditional surrogacy.
2.7 Wider Global Acceptance and Legal Alignment
In many countries, including several U.S. states, traditional surrogacy is legally restricted or outright banned. On the other hand, gestational surrogacy is legally recognized in more regions and is better supported by existing family and reproductive law.
Internationally, gestational surrogacy is often the only form allowed in countries like:
Canada
United States (certain states)
Ukraine (prior to the war)
Greece
Colombia
Georgia
For intended parents pursuing cross-border surrogacy, gestational arrangements are often the only viable legal option.
3. Is Traditional Surrogacy Still Used?
Technically, yes—but it’s extremely rare and usually limited to:
Private, independent arrangements between people who already know each other
Situations where IVF is not an option (for cost or accessibility reasons)
Jurisdictions with outdated or unclear surrogacy laws
In most cases, surrogacy agencies will not support or facilitate traditional surrogacy due to the legal and emotional risk involved.
4. What If I Want to Become a Surrogate?
If you’re looking to become a surrogate, almost all pathways today will lead you to gestational surrogacy. Here’s what you can expect:
You’ll undergo a medical screening, including bloodwork, ultrasound, and health history reviews.
You’ll complete a psychological evaluation to assess emotional readiness.
You’ll work with a surrogacy agency to match with intended parents.
A legal contract will outline expectations, responsibilities, and parental rights.
The embryo transfer will be done through IVF using embryos provided by the intended parents or donors.
While the process is structured, it’s also deeply rewarding—many surrogates report that helping someone build a family is one of the most fulfilling experiences of their lives.
5. Why Gestational Surrogacy Leads the Way
From medical safety to legal clarity, emotional ease to broad applicability, gestational surrogacy has become the gold standard in the modern surrogacy landscape. It’s not just about avoiding complications—it’s about building families in a way that’s safe, ethical, inclusive, and empowering for everyone involved. Whether you’re an intended parent hoping to welcome a child or someone considering whether to become a surrogate, understanding the benefits of gestational surrogacy helps ensure that your path forward is well-informed and protected.
