When a true medical condition precludes you from carrying a pregnancy or pregnancy would pose significant risk of death or harm to you or your baby, we may recommend the use of a gestational carrier. These conditions include:

  • Absence of a uterus
  • Significant uterine abnormality that cannot be surgically repaired
  • Absolute medical contraindication (eg. pulmonary hypertension, organ transplant)
  • Serious medical condition that would be worsened by pregnancy or cause significant risk to your baby
  • Biological inability to conceive: single male or homosexual couple
  • Repeated implantation failure with IVF

To be a gestational carrier, a woman must meet some basic requirements.

  • 21 to 45 years of age
  • Have had at least one full-term, uncomplicated pregnancy
  • Cannot have had more than five total pregnancies and no more than three cesarean sections
  • Have a stable family environment with adequate support
  • No significant medical conditions or a body mass index (BMI) greater than 40
  • No significant mental health issues
  • Nonsmoker, nonalcoholic with no other harmful habits
  • No criminal record
  • Citizen of the United States

Testing

As the intended parents, you will need to undergo the following tests.

  • Psychological evaluation
  • FDA screening/testing as a “donor” (required to prevent the transfer of communicable diseases to the gestational carrier and/or your baby)
  • Hormonal screening
  • Semen analysis

The gestational carrier will also need to undergo some specific testing, including:

  • Psychological evaluation
  • Uterine cavity evaluation
  • Hormonal and immunity screening
  • FDA donor screening/testing (required to prevent the transfer of communicable diseases to the fetus)
  • Additional testing may be required based on the health or age of the gestational carrier

Legal Counseling, Contract and Compensation

All parties will need legal counseling from a qualified legal practitioner who is familiar with this type of assisted reproduction to help prepare a Parenting Contract. The attorney should be from the state where the gestational carrier will be delivering, so the attorney is familiar with that state’s laws. We recommend that the intended parents initiate the parenting contract. The gestational carrier should have her own attorney to review the contract to make sure her rights and interests are protected.

A parenting contract is required as some states do not have any laws governing surrogacy (use of a gestational carrier). Some states do have legislation regarding surrogacy (gestational carrier), but the laws differ from state to state. A parenting contract helps to determine parentage, regardless of who gave birth to the baby. A parenting contract also addresses issues such as: the gestational carrier has no biological connection to the child, the gestational carrier has no intent to parent the child, nor has any legal obligation to parent the child.

The parenting contract addresses many other legal issues and interests, including the number of embryos to be transferred to the gestational carrier’s uterus and compensation. The Froedtert & the Medical College of Wisconsin Reproductive Medicine Center recommends a single embryo be transferred at a time, to decrease pregnancy risks to the gestational carrier. Some compensation to the gestational carrier from the intended parents is strongly recommended, even if the gestational carrier is a family member or friend.

Gestational Carrier Process

The Froedtert & MCW Reproductive Medicine Center has a three-phase process when using a gestational carrier. The process typically takes about 12 months due to the complexity of testing and cycle coordination.

Phase 1

  • New patient consult or follow up consultation
  • Psychological consultation for intended parent(s)
  • Pay administration fee per financial guide
  • Testing and screening per requirements for the intended parent(s)
  • Partner to schedule a physical exam, FDA labs, and freezing sperm sample(s), if applicable
  • In vitro fertilization (IVF) process including injection teaching class
  • Freeze all embryos

Phase 2

  • Schedule a new patient consultation for the gestational carrier
  • Psychological consultation for gestational carrier and partner, if applicable
  • Pay administration fee per financial guide
  • Testing and screening per requirements for the gestational carrier
  • Parenting agreement, provide a copy to RMC on attorney letterhead

Phase 3

  • Eligibility determination to be completed and signed by the physician
  • Order medications to prepare the gestational carrier for the frozen embryo transfer
  • Schedule injection teaching for the gestational carrier, if giving injectable medication
  • Cycle coordination and embryo transfer

Surrogacy

Traditional surrogacy is when a woman has the intended father’s sperm placed in her uterus to create an embryo with her own egg, and then also carries the pregnancy. We do not work with couples wanting to do traditional surrogacy due to the high risk of potential legal issues for the intended parents.

Resources: Froedtert Reproductive Medicine Center Policies and Procedures
American Society of Reproductive Medicine, Vol 103, #1 January, 2015

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