Surrogacy and Egg Donation
by: Andrea Mechanick Braverman, Ph.D.
Pennsylvania Reproductive Associates
An increasingly popular option for building families is the choice of using a
gestational carrier/surrogate and an ovum donor. Often, couples will choose a
carrier/egg donor in place of a traditional surrogate due to a number of
different reasons: 1) the perception that donor/carrier is legally "safer" than
traditional surrogacy; 2) the availability of a friend or relative who is
willing to either donate or carry the pregnancy but not both; and 3) the ability
to select a donor who has more similar background or characteristics to the
intended mother. It is important to remember that most couples have undergone a
complex journey before ever considering egg donation or surrogacy.
It is the complex journey that couples have navigated that has demanded that
they address their feelings about genetic and biological "connectedness" to
their intended child. When choosing to work with a gestational carrier, couples
have confronted their own issues and reactions to working with a special woman
who will grow their baby and experience directly all the stages of pregnancy.
Feelings of envy and sadness as well as hope and joy must all be examined before
embarking on gestational carrier situations.
When choosing to work with an egg donor, the couple must mourn the loss of their
dream genetic child and the woman must mourn the loss of the genetic ties. The
assumption that families are tied through genetics must be examined and each
partner must explore the meaning of parenthood and family apart from these usual
assumptions. As many donors remark, "I understand I am the genetic mother, but
that doesn't make me a Mom. A Mom is the one who teaches you, comforts you and
worries about you." Obviously, genetics are not unimportant, but just like
gestation, is one part of the ingredients which makes up a family.
The Gestational Carrier/Surrogate
Every relationship between gestational carrier/surrogate and the intended
parents must be built upon the foundation of trust. Therefore, when utilizing an
egg donor, honesty is the only approach. A gestational carrier/surrogate must be
informed that an egg donor is involved; her feelings and reactions need to be
considered. For carriers whose fantasy is to provide a couple with their own
genetic child, an egg donor may diminish her emotional comfort level. For
others, the main motivation for the surrogate/carrier is to help the couple have
a baby, the issue of egg donation is unimportant as long as the couple is
Since the gestational carrier/surrogate is going to carry the pregnancy, the
couple should be comfortable sharing the type of screening the egg donor as well
as the intended father will need to undergo. Health concerns, like those
recognized and anticipated in the pregnancy, should also be recognized and
anticipated for the gestational carrier/surrogate with the egg donor.
Many gestational carriers/surrogates have concerns about the intended mother's
feelings about the pregnancy and the unique issues that arise because an egg
donor is involved such as:
¨ Will the intended mother have difficulties bonding with the pregnancy?
¨ Will the intended mother be jealous towards the gestational carrier/surrogate
because she is carrying the pregnancy?
¨ What will the delivery be like?
¨ What are the legal issues involved because there is an egg donor involved?
¨ Will the intended parents worry more that I will bond with the baby more
because there is an egg donor involved?
As in all aspects of the gestational carrier/surrogate relationship, honest
recognition of feelings and concerns is the best way to prevent problems.
Utilizing the mental health professional or professional support staff at the
beginning of the relationship all the way through delivery and postpartum allows
for insight and processing of the feelings. Articulating the question can often
dispel the fear. Gestational carrier/surrogates can reassure the intended
parents that an egg donor does not change her feelings towards the baby; most
volunteer carrier/surrogates are emphatic that if they wanted another baby, they
would get pregnant themselves.
In a situation where a gay male couple is working with a gestational
carrier/surrogate, the use of an egg donor is understood from the beginning. The
carrier should be informed about what type of donor is being utilized (friend,
family, recruited) and what role, if any, that donor will play during the
The Intended Parents
The intended parents should explore the issues and feelings raised in the
previous section for the gestational carrier/surrogate. Both intended mothers
and fathers have feelings about another woman carrying their pregnancy. The goal
of the relationship is not to spend tremendous amounts of energy trying to block
feelings that the intended parents would rather not feel, e.g. jealousy, but to
deal effectively with them when they should arise. For example, when one
intended mother felt jealous of her carrier being able to feel the baby move and
kick, she was able to voice her disappointment about not having that experience
to a dear friend and channeled some of her need to "feel" into reading books on
the baby's development and to fantasize about "feeling" the baby crawl and walk
for the first time. Unfortunately, our desire to only have positive feelings
often buckles under the pressure of the "real" feelings that arise. Feelings can
be worked through and channeled more productively better than they can be
Intended parents often need more support at the beginning of the decision to
involve an egg donor and gestational carrier/surrogate than after the baby is
born. Feelings do change over time. Consequently, it may be very helpful to the
intended parents to identify supportive friends and family. Sometimes intended
parents will find education for the support people also helpful. Many people
have no idea what information is shared about the egg donor with the intended
parents nor do they recognize what impact this may have on the carrier. Fears
can fuel limited support. Fears on the intended parents' part may damage a