28/03/2014 06:50 GMT | Updated 27/05/2014 06:59 BST

Surrogacy Defined

Let's talk surrogacy. With a hat tip to advances in reproductive technology, couples who struggle to conceive have more options now to build their families. Surrogacy has recently started gaining momentum with celebrities deciding to come out of the infertility closet such as Jimmy Fallon and Giuliana and Bill Rancic. Partly due to the rising popularity of Indian Surrogacy (outsourcing) which is becoming less expensive than the costs incurred with some adoption placements which is why this option is now more attractive to infertile couples.

Whether you deem it as a social family building trend or simply the scientific ability to navigate around Mother Nature, "traditional" surrogacy is not a new concept. As a matter of fact, it is the only form of assisted reproduction that dates back to biblical times. The story of Abraham and Sarah in Genesis chapter 16, is the most notable example. They could not conceive so Sarah asked Hagar her servant, to be their surrogate. Abraham would go on to sleep with Hagar and have a son. Lucky Abraham right? A free pass to cheat, but in this time period IUI's (Intra Uterine Insemination) and IVF (In Vitro Fertilization) were not on the list of options available. In this era, a woman who could not bear children lived a life of shame and would be out casted by her friends and family. Minus the out casting of friends and family, infertility is an isolating and empty feeling.

How do you know when to pursue Surrogacy or a Gestational Carrier?

1. Missing or Abnormal Uterus

2. Multiple Pregnancy Loss

3. Several Failed IVF Transfers

4. Potential Life-Threatening Health Risks from Pregnancy

5. Unexplained Infertility

We fall into 2 of 5 of those categories.

Let's talk terminology. First of all my husband Chris, and I would be called "Intended Parents". We are the recipients of the baby to be. We are the ones pestering the surrogate to go to ultrasound appointments and doting over the surrogate's every need while she carries our child.

Next point of clarification is the term "Surrogacy." Basically, it is when a woman carries and delivers a baby for a person or couple. Duh, I know most of you know this but just starting out with the basics. The first recognized surrogate mother arrangement was made in 1976. Since the late 1980's surrogacy has been more common and thousands of infertile couples are able to become parents as a result. Many countries deem surrogacy illegal or have restrictions on terms. For example, the UK does not enforce surrogacy contracts, it is illegal to pay a surrogate in the UK and all parental rights are in favor of the surrogate even if the surrogate mother has no biological tie. For most couples in surrogacy-unfriendly countries it is an insurmountable climb to have surrogacy as an option. For the UK, the couple will have to seek out a best bud or family member willing to carry for them at no charge. On top of that challenge, they have to be certain that the trusted oven will not run off with your bun. Quite risky, if you ask me. I cannot imagine the emotional turmoil of knowing that there is biological child that you have prayed for until your knees were bruised and battered only to not be able to claim parental rights due to a change of heart and a harsh government mandated law.

Back to the basics. There are many different types of surrogacy, mostly dealing with the different ways the surrogate becomes pregnant and whose biological bits and pieces are used. Basically, it can be quickly separated into 2 different categories though. There is Traditional (Genetic) Surrogacy where the intended father's sperm is transferred to the surrogate through an IUI. Or think back to Abraham, Sarah and Hagar. From this, the resultant child would have genetic contributions from the intended father and surrogate. When surrogacy first started (and we are talking biblical times... seriously, although it may not have involved an IUI back then), this was the most popular method of surrogacy.

If the surrogacy is arrived at in any other manner, then it is considered to be a Gestational Surrogacy. For example, the most common type, currently, is the transfer of a fertilized embryo or blastocyst that was generated from the intended mother's egg and the intended father's sperm. Upon a successful pregnancy and delivery of the infant, the genetic make-up of the child will reflect that of both the intended parents. Thus, if the child has terrible gas, horrible allergies, or loses all their hair at 17, it can clearly be blamed on either of the intended parents. Beyond this, there are several different alternative approaches to gestational surrogacy involving donor sperm, donor eggs, donor sperm and eggs (donor embryo). Our friend Wikipedia has broken down all of the particulars for the different types of surrogacy if you want all of the details.

Finally, there are two types of legal surrogacy agreements: Commercial Surrogacy and Altruistic Surrogacy.

Altruistic Surrogacy is where a woman (typically a sister, relative, or close bestie) offers to unselfishly abandon her wine habits for 9 months and volunteers to carry a baby for an infertile couple with no monetary gain. Commercial Surrogacy is where there is a business relationship established and the surrogate and the intended parents enter into a contract where there is monetary exchange. Both are very different but similar in the fact that the surrogate is selflessly (paid or not) helping create families for childless couples.

It is all about knowing your options and understanding the local government laws surrounding surrogacy. I think surrogacy is a misunderstood form of family building in the eyes of legislative bodies and even religious factors. But knowing that childless couples have options such as assisted reproduction, adoption and surrogacy they can open the door to rallying for change and reform and can begin filling their homes with the scent of dirty diapers and the sound of the pitter patter of little feet.

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