Surrogacy, Gestational Carriers, and CF

Many people with CF choose surrogacy or gestational carriers as a family building option. By learning more about surrogacy and its potential challenges, you can ultimately assess whether it is right for you.

6 min read
In this article
  • Gestational surrogacy is when the eggs and sperm come from the intended parents to create an embryo through in-vitro fertilization.
  • The embryo is then placed in the uterus of the gestational carrier.
  • Most surrogacy in the United States involves the use of a gestational carrier.

What Is Surrogacy?

Traditional surrogacy refers to the process in which the surrogate provides her own eggs and undergoes in-vitro fertilization (IVF) or intrauterine insemination (IUI) with sperm from the intended male parent or a sperm donor. Therefore, the traditional surrogate is genetically related to the child she is carrying.

Gestational surrogacy, on the other hand, is when the eggs and sperm come from the intended parents to create an embryo through IVF, which is then placed in the uterus of the gestational carrier. Due to legal issues, the majority of surrogacy in the United States involves the use of a gestational carrier.

Finding a Gestational Surrogate

When it comes to finding a gestational surrogate, most people go through a full-service agency that matches the intended parents with potential carriers. It is important to choose an agency that offers adequate screening, clearly defined fees, and a reputable history. You can ask to speak to the agency’s former clients so you can get a better idea of how the process will work.

Due to the cost, some couples choose to sidestep the agency and search for a surrogate independently. In these cases, it is important that both you and your surrogate find legal counsel before making any arrangements, and develop a contract that clearly defines your expectations. In addition, it is important to get background information on your surrogate to ensure that she is the right person to carry your child.

In some cases, a family member or friend will offer to be a surrogate, which can help greatly reduce the cost of surrogacy by eliminating the need for an agency. However, most people will need to find a surrogate either through an agency or on their own.

“When I was first considering surrogacy, it seemed so inaccessible to me. But learning that the first step is to go and make an appointment at a fertility clinic helped me understand where to begin and just find information.” — Kristin Dunn, adult with CF

The Surrogacy Process

After you have completed initial fertility counseling and identified a surrogate, you, your surrogate, and your partner or spouse (if applicable) will undergo medical, financial, and psychological evaluations to ensure that surrogacy is right for you.

Infographic on Gestational Carrier Surrogacy
Infographic on Gestational Carrier Surrogacy (PDF) by RESOLVE: The National Infertility Association


Once you have been screened, you will then need to find legal representation for both yourself and your surrogate so that you can sign a legal agreement. It is important that you hire an attorney with experience in surrogacy who can help you create an in-depth document that addresses key concerns such as parental rights, custody, where the baby will be delivered, the behavior of the surrogate during pregnancy, medical decisions, and surrogate compensation.

Challenges and Considerations

In addition to the emotional and psychological aspects involved in surrogacy, there are many other factors that you need to consider before you decide if it is the right family building option for you.

Legal Issues

One of the greatest challenges involved in surrogacy is the issue of legality. The laws surrounding surrogacy and gestational carriers are either non-existent or differ by state, so it is important to find an attorney with experience in your state’s reproductive law.

For example, some states do not allow for a declaration of parentage prior to the birth of the child. This means that you and your partner may not be able to have your names listed on your child’s birth certificate and, therefore, may need to formally adopt the baby once it is born.

Learn more information about the legal aspects surrounding gestational surrogacy.

Costs and Financial Challenges

Although fees and expenses vary depending on factors such as if you use a donor or go through a private agency, using a surrogate is an extremely expensive process. The intended parents will be responsible for financially compensating the surrogate and covering any legal fees, travel expenses, screenings, psychological evaluations, medical expenses, maternity clothes, and any other baby-related costs that might arise. For this reason, it is important that you are financially prepared before pursuing surrogacy as a family building option.

Although some health insurance companies will cover surrogacy, most private insurance policies do not. You can always purchase a health insurance plan that does cover surrogacy, but it is important to understand that this will be an added expense. If your health insurance does happen to cover surrogacy, it is possible that you will pay little to no costs related to the maternity, labor, and delivery of the baby. For those who are not covered by insurance, you can always speak with your legal representative or ask your fertility center if they offer any in-house financing, payment plans, or cash discounts.

“I had to get a letter of medical necessity saying I shouldn’t carry a child and submit it to my insurance company. My fertility clinic told me that implantation was covered by my plan, so I assumed that all other costs would fall on my husband and me. It turns out that my insurance actually covered me all the way through the delivery. If I could do it again, I would have directly contacted my insurance company, worked with them to understand my coverage and approvals, and asked for advice on exactly how to best submit claims." — Kristin Dunn, adult with CF

Cystic Fibrosis Foundation Compass can also help by connecting you to resources for the cost of surrogacy and other financial barriers. Call 844-COMPASS (844-266-7277) Monday through Friday, 9 a.m. until 7 p.m. ET, or email

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