When people hear the word surrogacy, they often assume it’s a one-size-fits-all process. But there are actually two different types of surrogacy: gestational and traditional. Each comes with its own legal, medical, and emotional complexities.
Gestational Surrogacy (What We Did)
Gestational surrogacy is the most common form of surrogacy today. According to Google’s definition:
“Gestational surrogacy is when a woman carries and delivers a baby for another person or couple using an embryo that is not genetically related to her.”
This means that the surrogate has no biological connection to the baby. The embryo is created through in vitro fertilization (IVF) using either the intended parents’ sperm and egg, donor sperm and egg, or a combination of both. The embryo is then transferred into the surrogate’s uterus to carry the pregnancy to term.
This is the path we chose for all of our surrogacy journeys.
Traditional Surrogacy (Much Less Common)
Traditional surrogacy is an older method that is far less common today. Google defines it as:
“Traditional surrogacy is when a woman acts as both the egg donor and the surrogate, meaning she is genetically related to the child she carries.”
In this case, the surrogate’s own egg is fertilized, either through artificial insemination or IVF. This means she is the biological mother of the child. Due to the complex legal and emotional ties that come with traditional surrogacy, it’s rarely practiced—especially through agencies.
For us, this was never even a consideration. From my research, it seems that traditional surrogacy is legally riskier and emotionally complicated, which is why most agencies (and intended parents) opt for gestational surrogacy instead.
The IVF Process: What It’s Really Like
Regardless of whether you’re doing gestational or traditional surrogacy, if IVF is involved, it’s an intense process. There are multiple steps, medications, and screenings to ensure the surrogate’s body is ready to carry the embryo.
1. Prepping the Body
Before the embryo transfer, surrogates follow a strict medication protocol to prepare their body for pregnancy. This includes:
• Hormone medications to regulate and sync the surrogate’s cycle with the embryo transfer date.
• Estrogen and progesterone to create the ideal uterine environment for implantation.
• Medications that trick the body into thinking it’s pregnant, so it accepts the embryo as if it were naturally conceived.
2. The Embryo Transfer
Once the uterus is ready, the embryo transfer takes place. This is a quick and painless procedure done at the fertility clinic—often compared to a Pap smear. The surrogate then goes on bed rest for a day or two to give the embryo the best chance to implant.
3. Progesterone Support (Not Fun, but Necessary)
After the transfer, most surrogates need progesterone injections to support early pregnancy. These are usually intermuscular shots in the hip, which can be painful and cause bruising.
We were lucky in that we were able to use a mix of intermuscular injections every few days combined with a vaginal suppository instead. This was way less painful and worked just as effectively. If you’re considering surrogacy, I always recommend discussing medication options with your doctor to find what works best for you.
The Reality: It’s Invasive and Intense
Let’s be honest—surrogacy (especially the IVF process) is not for the modest. You’ll get very comfortable, very fast with a medical team being all up in your business. From screenings to ultrasounds to check your uterine lining, the process is invasive, detailed, and physically demanding.
But despite all of that, I can say without hesitation—it was worth it.
Final Thoughts
If you’re considering surrogacy, understanding the difference between gestational and traditional surrogacy is crucial. For most, gestational surrogacy is the safest, most legally protected, and emotionally straightforward option. But no matter which route you take, IVF is a long, involved process that requires patience, preparation, and a willingness to be poked and prodded more times than you can count.
For those who’ve been through it—what was your IVF experience like? Would love to hear your thoughts!
The Anker Homestead 