One may think that both methods can only be combined in the case of same-sex male couples. However, the truth is that it becomes useful also for a great number of straight couples in which the woman is unable to use her eggs, and to carry the pregnancy to term for medical reasons.
Parents via surrogacy
When a single man or same-sex male couple wish to have a baby using their own sperms, they have no alternative but to turn to donor eggs in order to bring the surrogacy process to an end.
In this case, it is not about a medical condition, but a biological inability. In other words, the reason why they cannot bear a pregnancy is solely the natural male anatomy, and not a health issue.
This is also the reason why many destination countries do not allow this group to undergo surrogacy, since the legal framework of some countries ask for a medical justification that proves you are actually unable to carry a pregnancy to term.
Incapacity to bear an effective pregnancy
The main reasons why a woman may need to use a gestational carrier because of her incapacity to bear a pregnancy to term are varied:
- Absent uterus, whether it is caused by a congenital or acquired dysfunction
- Uterine malformations
- Implantation failure
- Recurrent pregnancy loss (RPL)
- Certain diseases as to why pregnancy can put the health of the pregnant woman and/or the baby at risk
Some of the above-mentioned abnormalities are associated with the absence of viable eggs, thereby leaving the woman no choice but to use donor eggs. For instance, recurrent pregnancy losses and/or miscarriages may be caused by egg production problems, uterine alterations, or both. This is the reason why, in certain cases, egg donation can become the definitive solution; in other cases, however, a combination between egg donation and surrogacy may be necessary.
This also can be useful in cases where pregnancy can constitute a serious danger to the pregnant woman’s life because the intended mother suffers from a particular disease, as it may compromise egg quality and/or quantity.
Women with an absent uterus due to cancer, the oncological treatment administered could have compromised egg production. In these cases, a combination between surrogacy and egg donation may be necessary.
The regulations governing surrogacy vary to a great extent from country to country, and even in the countries where it is allowed, as each one may have established different requirements and peculiarities.
Certain policies force both intended parents to deliver their gametes for the creation of embryos in a surrogacy process, thereby ruling out the possibility of using donor eggs. Others, conversely, allow the use of donor gametes, whether it is only the egg, the sperm, or both, and regardless of whether the embryo transfer is done to the intended mother or the gestational carrier. Finally, certain places have an intermediate regulation, which is to say, it allows for the use of one donor gamete, but the other one must be delivered by one of the intended parents.
Egg donor identity is another crucial aspect. While some policies establish that donor and surrogate must be two different people, other countries allow traditional surrogacy as well, in which the surrogate herself delivers the eggs apart from being the gestational carrier.
Finally, we come back to the point related to a woman’s incapacity to bear an effective pregnancy. Certain destination countries allow patients to undergo surrogacy provided that they can justify their inability to carry a pregnancy to a live birth. Others, conversely, allow surrogacy to everyone wishing to have a baby through this technique, regardless of the reason that impelled them to pursue surrogacy.