Breaking Down Third-Party Reproduction
Before we dive head first into this breakdown, let’s start with the obvious question here: what is third-party reproduction? The phrase is commonly used to describe when Assisted Reproductive Technology (ART) involves someone other than the person or couple that plans to raise the child, also known as the intended parent(s). Some forms of third-party reproduction include egg donation, embryo donation, sperm donation, and surrogacy.
Navigating third-party reproduction — whether you are an intended parent, a donor, or a gestational surrogate — can be overwhelming. Having a strong support system of professionals and people who have been through the process themselves can help make it easier.
Circle Surrogacy is an incredible resource that boasts an experienced team made up of former surrogates, egg donors, and parents. Their program educates, leads, and guides individuals and couples through their journey. Whether it is your dream to start a family of your own or help someone build theirs, Circle Surrogacy is there every step of the way.
Now let’s go through the different ways third-party reproduction can happen, who may need it, and what the gist of each path to parenthood entails.
Types of Third-Party Reproduction
Egg donation can either come from someone the intended parent(s) knows or an egg donor. Egg donations require in vitro fertilization (IVF) because the eggs are removed from the donor’s ovaries, fertilized in a lab, and then the fertilized egg, or the embryo, is either frozen or transferred to the receiving woman’s uterus.
Here is a general overview of the process:
- The intended parent(s) find an egg donor — someone known or found through egg donation programs or agencies.
- The donor takes hormonal medications to stimulate their ovaries to produce multiple eggs for retrieval. Then, the ovulation process is triggered with an injection of medication, allowing the eggs to mature in time for retrieval.
- Sperm from the male partner, or a sperm donor, is collected and used to fertilize the harvested eggs in a lab.
- An embryo(s) — either fresh or frozen — is chosen and transferred to the intended mother’s or surrogate’s uterus.
Intended parents may choose egg donation for a variety of reasons, including the absence of working ovaries or low ovarian reserve due to age or other factors. Donor eggs may also be necessary for former cancer patients that have had toxic exposure to chemotherapy and radiation. Poor egg quality and multiple failed IVF cycles are other common reasons that may push individuals and couples toward egg donation.
Whether the donor is known or anonymous, they must be between 21 and 29 years of age, complete an extensive medical questionnaire and undergo medical screenings as well as screening by a mental health professional (MPH).
When the male partner has abnormalities in his semen or reproductive system, such as an absence of or an obstruction of sperm, decreased sperm count, ejaculatory dysfunction, possible hereditary defects, or azoospermia, sperm donation may be considered. Single women looking to become independent parents, lesbian couples, or trans men looking to become parents may also consider donor insemination (DI).
In order to test the quality of the donated sperm and to allow it to be quarantined for at least 6 months per the FDA and ASRM guidelines, only frozen sperm is used with donor inseminations. And much like an egg donor, sperm donors must undergo extensive medical testing and screening, including psychological evaluations. Donors also need to be of legal age and ideally less than 40 years old.
Donor sperm can either be used during the IVF process or with donor insemination – either at home or through intrauterine insemination (IUI). The procedure can be timed with the woman’s natural cycle or with a medically-induced ovulation cycle. In the clinician’s office, the woman will be positioned much like a pelvic exam, a speculum will be placed in the vagina, and the semen will be drawn up into a catheter attached to a syringe. During intrauterine insemination (IUI), the washed semen will be placed into the uterine cavity, or with intracervical insemination (ICI), the unwashed semen will be placed in the cervix.
Embryo donation differs from egg and sperm donation in a few ways: it is the process that allows embryos created during someone’s fertility treatment to be donated to other patients struggling to get pregnant. In other words, patients can donate their unused or leftover embryos to their fertility clinic for future patients to use.
An individual or couple may choose embryo donation if both partners have untreatable infertility, or in the case of a single woman with infertility. Recurrent pregnancy loss, poor embryo quality, or shared genetic disorders are other common reasons intended parents decide to adopt embryos to grow their families.
Following suit with the other types of gamete donation, embryo donation requires that the receiving woman undergo both medical and psychological screenings. The donation must also meet FDA guidelines, and it’s recommended that the embryo undergoes the screening and testing required of all egg and sperm donors.
Surrogacy and Gestational Carriers
While “surrogacy” is often used as a blanket term to refer to one woman carrying another woman’s baby, there are two types of surrogacy: traditional and gestational.
Traditional surrogacy is an arrangement in which a woman is inseminated with sperm to become pregnant for someone else. The surrogate not only carries the pregnancy but provides the egg as well. Gestational surrogacy is when a woman carries a pregnancy from an embryo created from the sperm and egg of the intended parents (or donors). A gestational carrier has no genetic connection to the fetus, and the process requires IVF.
Gestational surrogacy is much more common in the United States than traditional surrogacy, which may be illegal in some states where gestational surrogacy is legally accepted. In fact, Circle Surrogacy only practices gestational surrogacy.
The gestational carrier can be someone the intended parents personally know or someone they find and meet through an agency. Carriers must be at least 21 years old and have delivered a liveborn child to term.
Counseling is also really important for all parties, including the gestational carrier, who needs to clearly understand the psychological impact and potential issues related to surrogate pregnancy. A mental health professional can help the carrier manage their relationship with the intended parents, and vice versa, making sure their desires and values are aligned throughout the process.
An individual or couple may seek the help of a gestational carrier if the intended mother does not have a uterus — either born without one or has had a hysterectomy — has uterine abnormalities, or has suffered from recurrent pregnancy loss. Some women have medical conditions that make it unsafe for them to be pregnant, which is another reason why they may work with a gestational carrier. Gestational surrogacy is also a wonderful way for the LGBTQIA+ community to grow their family and have a genetic connection to their child(ren).
Whether you are seeking help to start your family via gamete donation — egg, sperm, or embryo — or you decide to work with a gestational surrogate, always remember that you are not alone in the process. Your team of fertility specialists is more than willing to provide you with any and all information you may need in order to make the best decision for you and your future family. A company like Circle Surrogacy exists to make parenthood possible and has got you covered every step of the way.
Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.