- Infertility or uterine problems: Missing uterus, previous hysterectomy, or conditions that prevent a healthy pregnancy.
- High-risk pregnancy: Serious health conditions or previous complications that make pregnancy unsafe.
- Repeated pregnancy loss or failed IVF: Surrogacy may help in selected cases involving uterine or implantation problems.
- Alternative paths to parenthood: Single fathers and male same-sex couples may use surrogacy where legally permitted.
- How surrogacy works: Gestational surrogacy uses IVF. The carrier has no genetic connection to the baby.
- Important considerations: Medical screening, pregnancy risks, costs, legal parenthood, and eligibility rules vary by country.
What Is Surrogacy, and Why Is It Used?
Surrogacy is an arrangement in which a woman, called a surrogate or gestational carrier, carries a pregnancy for another person or couple. The people planning to raise the child are known as the intended parents.
People choose surrogacy when they cannot carry a pregnancy, when pregnancy poses serious medical risks, or when their family-building circumstances require a gestational carrier.
There are two main types of surrogacy:
- Gestational surrogacy: An embryo is created through in vitro fertilization (IVF) using eggs and sperm from the intended parents, donors, or both. The embryo is transferred to a gestational carrier who has no genetic relationship to the baby.
- Traditional surrogacy: The surrogate’s own egg is used. She is genetically related to the child. This arrangement is less common and can involve additional legal complexities.
Gestational surrogacy is commonly used in modern fertility treatment because it separates carrying the pregnancy from providing the egg.
Read more: Independent Surrogacy
7 Common Reasons People Choose Surrogacy
People pursue surrogacy for medical, biological, and personal reasons. The following seven situations explain why intended parents may consider using a surrogate.
1. Absence of a Uterus or Previous Hysterectomy
One of the clearest medical reasons for surrogacy is the absence of a functional uterus.
Some women are born without a uterus. Others undergo a hysterectomy, which is surgery to remove the uterus.
Common reasons for a hysterectomy include:
- Certain gynecological cancers.
- Severe or uncontrollable uterine bleeding.
- Some serious uterine disorders.
- Complications that require removal of the uterus.
Without a uterus, a woman cannot carry a pregnancy herself.
However, gestational surrogacy may allow her to have a genetically related child if suitable eggs or previously created embryos are available.
Donor eggs or embryos may also be considered when necessary.
2. Uterine Conditions That Prevent a Healthy Pregnancy
Some women have a uterus but cannot safely or successfully carry a pregnancy because of structural abnormalities or severe uterine damage.
Examples include:
- Severe Asherman syndrome: Extensive scarring inside the uterus.
- Congenital uterine abnormalities: Certain structural conditions present from birth.
- Severe uterine damage: Conditions that cannot be adequately treated.
- Persistent uterine problems: Selected cases in which the uterus cannot support a healthy pregnancy.
Not every uterine abnormality requires surrogacy. Some conditions can be treated with surgery or other fertility procedures.
When treatment is unsuccessful or the uterus cannot safely support pregnancy, a fertility specialist may recommend evaluating gestational surrogacy.
3. Medical Conditions That Make Pregnancy Dangerous
Some intended mothers choose surrogacy because carrying a pregnancy could seriously threaten their health.
Pregnancy places additional demands on the heart, kidneys, lungs, and circulatory system.
Examples of conditions that may make pregnancy unsafe include:
- Severe pulmonary hypertension.
- Certain serious cardiovascular diseases.
- Selected advanced kidney diseases.
- Other serious medical conditions in which specialists advise against pregnancy.
The risks depend on the specific diagnosis and its severity.
Why choose surrogacy in these situations? A gestational carrier may allow intended parents to pursue parenthood without exposing the intended mother to the medical dangers of pregnancy.
Medical evaluation is essential before deciding whether surrogacy is necessary.
Read more: risks of surrogacy
4. Previous Serious Pregnancy Complications
Some women consider surrogacy after experiencing life-threatening complications during an earlier pregnancy.
Examples may include:
- Severe pregnancy-related cardiovascular complications.
- Serious maternal complications requiring intensive treatment.
- Previous conditions that create substantial risks in another pregnancy.
- Medical advice to avoid future pregnancy because of a specific diagnosis.
These experiences can make another pregnancy medically unsafe.
However, a difficult previous pregnancy does not automatically mean a woman needs a surrogate.
A maternal-fetal medicine specialist should assess the risks of another pregnancy and discuss available options.
5. Recurrent Pregnancy Loss
Recurrent pregnancy loss is another reason some intended parents explore gestational surrogacy.
Repeated miscarriages may have several causes, including:
- Uterine abnormalities.
- Chromosomal problems affecting embryos.
- Certain medical or hormonal conditions.
- Other factors requiring specialist investigation.
When repeated pregnancy losses are linked to severe, untreatable uterine problems, surrogacy may be considered.
However, surrogacy is not a guaranteed solution for recurrent miscarriage.
For example, if pregnancy losses are caused by embryo-related genetic abnormalities, transferring embryos to a surrogate may not resolve the underlying problem.
Important: A thorough fertility evaluation should identify possible causes before surrogacy is recommended.
6. Repeated IVF Failure in Selected Cases
Some couples consider surrogacy after multiple unsuccessful IVF attempts.
During IVF, eggs are fertilized in a laboratory. The resulting embryo is then transferred into a uterus.
IVF may fail for several reasons:
- Embryo-related genetic or developmental problems.
- Age-related changes in egg quality.
- Uterine abnormalities.
- Implantation-related problems.
- Other unidentified fertility factors.
When repeated unsuccessful transfers involve good-quality embryos and a suspected uterine problem, a gestational carrier may be considered.
The American Society for Reproductive Medicine recognizes selected cases of repeated unexplained unsuccessful IVF attempts as a possible indication for using a gestational carrier.
However, repeated IVF failure alone does not prove that surrogacy will improve the chance of a live birth.
A fertility specialist should review embryo quality, the uterine environment, and previous treatment results before recommending surrogacy.
7. Family Building for Single Fathers and Male Same-Sex Couples
Surrogacy is also a family-building option for people who cannot carry a pregnancy for biological reasons.
Examples include:
- Single men who wish to become fathers.
- Male same-sex couples planning to have children.
- Intended parents who need both an egg donor and a gestational carrier.
Gestational surrogacy may allow a child to be genetically related to one intended father when his sperm is used with a donor egg.
However, the legal availability of these arrangements varies significantly between countries.
Some jurisdictions permit surrogacy for single individuals and same-sex couples, while others restrict eligibility.
Important: These family-building arrangements are not available through every surrogacy program, including programs operating under restrictive eligibility requirements in Iran.
Why Do Women Become Surrogates?
Intended parents choose surrogacy to build their families. But why would a woman choose to carry a child for someone else?
Surrogates may have different motivations, including:
- Helping people experiencing infertility: Supporting intended parents who cannot carry a pregnancy.
- Helping friends or relatives: Carrying a pregnancy for someone they know.
- Positive pregnancy experiences: Wanting to help others after having uncomplicated pregnancies of their own.
- Personal fulfillment: Finding meaning in helping another family.
- Financial compensation: Receiving compensation where permitted by applicable laws.
Motivations vary from person to person. Compensation should not replace voluntary participation, informed consent, or appropriate safeguards.
Medical screening, psychological assessment, and independent legal advice are important for protecting the surrogate and intended parents.
Is Surrogacy Better Than IVF?
Surrogacy and IVF are not necessarily alternative treatments.
Gestational surrogacy generally requires IVF. The difference is that the embryo is transferred to a gestational carrier rather than the intended mother.
The appropriate approach depends on whether the intended mother can safely carry a pregnancy.
| Medical Situation | Possible Fertility Approach |
|---|---|
| Infertility with a uterus capable of supporting pregnancy | IVF or another fertility treatment |
| Missing uterus or severe untreatable uterine problems | Gestational surrogacy |
| Pregnancy presents serious medical risks | Gestational surrogacy may be considered |
| Age-related decline in egg quality | Fertility assessment and possible donor-egg treatment |
| Repeated unexplained IVF failure | Further investigation before considering surrogacy |
Surrogacy does not reverse age-related egg-quality problems or guarantee pregnancy success.
The best option depends on the medical diagnosis, available embryos, fertility history, and specialist recommendations.
What Should Intended Parents Consider Before Choosing Surrogacy?
Before beginning surrogacy, intended parents should understand the medical, legal, financial, and emotional responsibilities involved.
- Medical eligibility: Confirm whether surrogacy is appropriate for the intended parents’ circumstances.
- Fertility treatment: Determine whether embryos, donor eggs, or donor sperm are needed.
- Surrogate screening: Review the carrier’s medical history, pregnancy history, and psychological assessment.
- Pregnancy risks: Understand possible complications, miscarriage, and unsuccessful embryo transfer.
- Legal parenthood: Confirm how parental rights and birth documentation will be established.
- Financial planning: Review medical costs, compensation arrangements, insurance, and unexpected expenses.
- Emotional support: Consider counseling and communication arrangements for everyone involved.
Successful surrogacy planning requires cooperation between fertility specialists, the surrogate, intended parents, and qualified legal professionals.
No surrogacy arrangement can guarantee pregnancy or a healthy birth.
Read more: Types of surrogacy
At IranHealthAgency, If you want to start a family through surrogacy, we know that it’s a big and exciting step. We’ll be with you every step of the way, giving you trust, care, and information to make your trip go well.
Why Do Some Intended Parents Consider Surrogacy in Iran?
Some international intended parents consider surrogacy in Iran because of the availability of assisted reproductive services and potentially lower treatment costs compared with certain other countries.
However, Iran is not a suitable destination for every intended parent.
Potential Reasons for Considering Surrogacy in Iran
- Fertility services: Access to assisted reproductive technologies, including IVF.
- Potentially lower costs: Treatment expenses may be lower than in some international destinations.
- Coordinated medical care: Some agencies assist international patients with fertility appointments and treatment arrangements.
- Specialized fertility centers: Access to reproductive medicine professionals and relevant medical facilities.
Who Is Eligible for Surrogacy in Iran?
Surrogacy programs in Iran generally focus on married heterosexual couples with documented medical indications for using a gestational carrier.
Eligibility can depend on medical findings, legal requirements, and individual program policies.
Single individuals and same-sex couples should not assume that surrogacy services available in other countries are accessible in Iran.
Iran does not have a dedicated, comprehensive surrogacy statute governing every aspect of the process.
International intended parents should obtain independent legal advice about:
- Eligibility for a surrogacy arrangement.
- Surrogacy contracts and informed consent.
- Legal recognition of intended parents.
- Birth registration and required documentation.
- The child’s nationality and passport.
- Recognition of parenthood in the home country.
- Travel requirements after the child’s birth.
Medical and legal eligibility should be confirmed before making treatment payments or travel arrangements.
To learn more about available fertility services, read Iran Health Agency’s Surrogacy in Iran guide.
Frequently Asked Questions About Surrogacy
Why Would a Woman Use a Surrogate Instead of Getting Pregnant Herself?
A woman may use a surrogate because of infertility, an absent or damaged uterus, serious medical conditions, or pregnancy-related health risks. A fertility specialist should determine whether surrogacy is medically appropriate.
Can Someone Use a Surrogate Even if They Are Fertile?
Yes, in some jurisdictions. Medical fertility is not the only factor determining surrogacy eligibility. Personal circumstances, pregnancy risks, local laws, and program requirements also matter.
Why Do Celebrities Use Surrogacy?
Celebrities may use surrogacy for medical, reproductive, or family-building reasons. Their motivations should not be assumed unless they have publicly explained them.
Does Using a Surrogate Mean the Baby Is Genetically Related to the Intended Parents?
Not always. In gestational surrogacy, the carrier has no genetic connection to the baby. The child may be genetically related to both intended parents, one intended parent, or neither, depending on the eggs and sperm used.
Can Surrogacy Work After Several Failed IVF Attempts?
Surrogacy may help in selected cases where uterine factors are suspected. However, unsuccessful IVF can have many causes. A medical evaluation is necessary, and success is not guaranteed.
Is Surrogacy Safe for the Surrogate Mother?
Surrogacy involves the usual risks of pregnancy and childbirth, including potentially serious complications. Medical screening, prenatal care, informed consent, and psychological support are important, but cannot eliminate every risk.
What Is the Main Reason People Choose Surrogacy?
One of the main reasons is the inability to carry a pregnancy safely or successfully. This may result from uterine infertility, serious medical conditions, or certain reproductive complications. Other people pursue surrogacy for family-building reasons.
Is Surrogacy an Option After a Hysterectomy?
Yes. Gestational surrogacy may be an option after a hysterectomy because the intended mother no longer has a uterus. Her own eggs or previously created embryos may be used when medically suitable.
Is Surrogacy Legal in Every Country?
No. Surrogacy laws vary widely. Some countries permit compensated arrangements, others allow only altruistic arrangements, and some prohibit or severely restrict surrogacy. Legal advice is essential, especially for international treatment.
Final Thoughts: Why Do People Choose Surrogacy?
People choose surrogacy when carrying a pregnancy is impossible, medically unsafe, or not feasible for their family-building circumstances.
The most common reasons include:
- Absence of a uterus or previous hysterectomy.
- Severe uterine abnormalities.
- Medical conditions that make pregnancy dangerous.
- Previous serious pregnancy complications.
- Selected cases of recurrent pregnancy loss.
- Repeated IVF failure involving suspected uterine factors.
- Family building for individuals and couples who cannot carry a pregnancy.
Every surrogacy journey is different. A thorough fertility evaluation, appropriate medical screening, and reliable legal guidance are essential before proceeding.
Surrogacy can offer a path to parenthood, but it involves medical risks, emotional responsibilities, financial costs, and legal considerations.
Considering Surrogacy in Iran?
Iran Health Agency provides information about fertility treatment and surrogacy services in Iran.
If you are exploring your options, the first step is to confirm your medical suitability and eligibility under the applicable program and legal requirements.
Contact Iran Health Agency to learn about available fertility services, initial consultations, and the surrogacy process in Iran.
Surrogacy service information: https://iranhealthagency.com/services/surrogacy-in-iran/
Medical References and Further Reading
- American Society for Reproductive Medicine (ASRM): Recommendations for Practices Using Gestational Carriers, 2022.
- Cleveland Clinic: Gestational Surrogacy.
- American College of Obstetricians and Gynecologists (ACOG): Family Building Through Gestational Surrogacy.
Medical Disclaimer: This article provides general educational information and does not replace individualized advice from qualified fertility specialists or legal professionals. Treatment suitability and surrogacy eligibility depend on medical circumstances and applicable laws.
Medical References and Sources
- American Society for Reproductive Medicine (ASRM) – Recommendations for Practices Using Gestational Carriers (2022):
https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-for-practices-using-gestational-carriers-a-committee-opinion-2022/ - Cleveland Clinic – Gestational Surrogacy: Process, Risks and Benefits:
https://my.clevelandclinic.org/health/articles/23186-gestational-surrogacy - American College of Obstetricians and Gynecologists (ACOG) – Family Building Through Gestational Surrogacy:
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/03/family-building-through-gestational-surrogacy - Human Fertilisation and Embryology Authority (HFEA) – Surrogacy:
https://www.hfea.gov.uk/treatments/explore-all-treatments/surrogacy/ - American Society for Reproductive Medicine (ASRM) – Consideration of the Gestational Carrier (2023):
https://www.asrm.org/practice-guidance/ethics-opinions/consideration-of-the-gestational-carrier-an-ethics-committee-opinion-2023/ - American Society for Reproductive Medicine (ASRM) – Recurrent Pregnancy Loss (2026):
https://www.asrm.org/practice-guidance/practice-committee-documents/recurrent-pregnancy-loss-a-committee-opinion-2026 - ReproductiveFacts.org – Gestational Carrier (Surrogate):
https://integration.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/gestational-carrier-surrogate/
