On Wednesday, we learned that Kim Kardashian and Kanye West are expecting their third child, through a surrogate. The news wasn’t entirely surprising — she has been outspoken about her high-risk pregnancies and fertility issues in the past, as well as her desire to have another kid — and Kardashian had actually talked about the possibility of using a surrogate in an episode of Keeping Up With the Kardashians last fall. But while many of us are familiar with the concept of surrogacy, there are some surprising aspects of being and using a gestational carrier that you may not know. Here are a few.
The ideal surrogate has been pregnant before. It likely comes as no surprise that the ideal candidate to be a gestational carrier is young (under 40) and healthy — but you may not know that unlike egg donations, surrogacy agencies typically look for carriers who have already had a child. Dr. Brian Levine, founder and practice director of the fertility center CCRM New York, told the Cut that the process of finding a surrogate is overall quite similar to looking for egg donors — potential carriers need to undergo physical and mental exams, among other things — but agencies prefer to use gestational carriers who have already had a child so that they know whether the woman can carry a child to term and if there may be any medical risks associated with a surrogate pregnancy. “You don’t want to put the woman at risk,” Levine explained.
Surrogacy is only legal in certain states. Perhaps one of the most surprising aspects of surrogacy is that it isn’t actually legal in all states. In fact, according to Levine, surrogacy laws vary on a state-by-state basis. For instance, surrogacy agreements cannot be enforced under New York law, so someone in the state who would like to find a surrogate to carry an embryo to term will have to find a carrier in a surrogate-friendly state, like New Jersey or Connecticut. “This is a fascinating part of surrogacy that most people don’t realize,” Levine said. There are a number of attorneys who specialize in surrogacy law, so people wanting to use a surrogate will have to consider that legality and the legal cost as well, which brings us to …
It’s incredibly expensive. Surrogacy, unfortunately, is not an affordable option for everyone. According to Levine, the costs for the whole process — including IVF and compensating the surrogate — can range from $50,000 up to $200,000. But as Dr. Ryan Martin of Shady Grove Fertility explains, “The cost of transferring an embryo is not expensive; the cost is more so for paying the carrier to carry the pregnancy.”
Surrogates go through a trial run before the real deal. According to Martin, before a surrogate is implanted with an embryo, they basically go through a trial run — or mock pregnancy. The doctors give these carriers the medicines that they would need to take — two weeks of estrogen, as well as progesterone — during the process, to make sure that the lining of the uterus responds appropriately before the real transfer happens. “We try and thicken the lining of the uterus up like it would during a normal cycle,” Martin said. The goal of this mock trial is to see if the uterus responds appropriately and to make sure the surrogate doesn’t have any problems.
Carriers can be surrogates more than one time. Women who act as gestational carriers are able to serve as a surrogate more than once — depending on her health, age, and ability to successfully carry a pregnancy, of course. However, Martin notes that these women aren’t able to necessarily make a “career” out of surrogacy, although they do of course receive compensation. “Sometimes we have carriers that will do it multiple times for people, it’s a way for many women to give back to those that have been less fortunate reproductively,” he said.