Surrogacy demystified: supporting employees on their journey to parenthood

By Carole Gilling-Smith, CEO and Medical Director of the Agora Clinic.

Surrogacy is becoming an increasingly common option for people wanting to start or grow their families. Whether it’s same-sex couples, heterosexual couples facing infertility, or single individuals, the surrogacy journey can be complex, emotional and filled with important decisions. For businesses, understanding this process and offering support and information to employees going through it is vital. In this article, I will start by delving a bit deeper into the surrogacy pathway and then share my top tips on how employers can provide practical and emotional support to their staff.

What exactly is surrogacy?

Surrogacy is when a woman, known as a surrogate, carries and gives birth to a child for someone else. This route is often chosen by:

• Individuals with medical conditions that prevent them from carrying a pregnancy safely.

• Same-sex male couples wishing to become parents.

• Heterosexual couples struggling with fertility issues or recurrent miscarriages.

• Single individuals who desire to have children.

The parent(s) who commission the surrogate are called the intended parents (IPs) as, under UK law, they will only become the legal parents of the child after it is born and a parental order has been granted.

There are two main types of surrogacy:

• gestational (or host) surrogacy, where the surrogate has no genetic connection to the baby (the embryo is created using the intended parent’s sperm and eggs or donor sperm and/or eggs),

• traditional surrogacy, where the surrogate’s own egg is used to create an embryo with one of the IPs sperm.

At the Agora Clinic, we support both types of surrogacy and have a specialised team dedicated to help couples navigate their way through this complex multi-step process. It’s a journey we find incredibly fulfilling to support and, as one of the most inclusive fertility clinics in the UK, we are proud to be recognised as national experts in this field.

How the surrogacy process works

The surrogacy journey is very structured but can feel overwhelming at first. We always start with an initial free Q & A session to help IPs understand the complexities of the journey, find their ideal pathway and signpost to additional educational resources such as the video on our website.  We then arrange an initial consultation, where IPs meet with me or one of our other medical consultants to explore their options and map out the best pathway for them to follow.

For those undergoing gestational surrogacy, the next step is usually to create embryos which are frozen and quarantined for a period of at least 3 months before they can be safely transferred into a surrogate. The quarantine period is legally necessary to ensure all the sexual health screening tests are done before the embryos are created and repeated after 3 months. The final stage takes place once the surrogate is ready, and we arrange the embryo to be transferred into her womb or in straight surrogacy for insemination of the male IP’s sperm into her uterus.

The IPs, surrogate and donors undergo medical assessment and psychological screening before starting to ensure they are physically and emotionally prepared for the process and then complete full sexual health screening.

What are the legal issues around surrogacy?

In the UK, surrogacy is an altruistic arrangement with no commercial gain allowed. That is why we only work with accredited not-for-profit surrogacy agencies such as Surrogacy UK alongside specialist family lawyers. We ask that IPs and surrogates take independent legal advice for two reasons:

1. The surrogate is considered the legal mother of the child until a Parental Order is granted after the birth when transfer of legal parenthood to the IPs can take place.

2. IPs and surrogates should draw up a Surrogacy Agreement which is not legally binding but sets out the road map between the parties and considers the unique issues that might occur during that journey and how each party agrees to handle it.

All IVF processes, including surrogacy and egg or sperm donation are also highly regulated in the UK by the Human Fertilisation and Embryology Authority (HFEA). At The Agora Clinic, we ensure all IPs, donors and surrogates undergo the rigorous medical and sexual health screening required to ensure the highest safety standards are met.

How can employers help?

For businesses, understanding the surrogacy journey and offering the right support can help create a more inclusive, family-friendly workplace. Here are a few tips:

• Parental leave policies: Ensure your parental leave policies are inclusive of surrogacy. This may include time off for both the intended parents and the surrogate, with clear guidance on maternity/paternity leave for those welcoming a child via surrogacy.

• Flexibility: Employees involved in surrogacy may need to attend medical appointments, meetings with legal professionals, or counselling sessions. Offering flexibility in working hours or remote working options can significantly reduce stress during this time.

• Mental health support: Surrogacy can be emotionally taxing. Providing access to counselling or mental health services can help employees manage the psychological and emotional demands of the process.

• Open communication: Encourage a culture of openness where employees feel comfortable discussing their surrogacy journey without fear of judgement. The Agora offers training such as webinars and educational resources about surrogacy to HR and management teams as well as employees.

What are some of the myths or misconceptions surrounding surrogacy?

Surrogacy is a poorly understood route to family creation and sadly a lot of myths and misconceptions persist: Here are just a few:

Myth 1: Surrogacy is only for same-sex couples. While surrogacy is a popular route for same-sex male couples, many heterosexual couples and single individuals also choose surrogacy due to fertility issues or other medical reasons.

Myth 2: Surrogates often change their minds and decide to keep the baby. In reality, this is rare. The legal framework in the UK, combined with thorough screening and support for surrogates, ensures that all parties enter into the agreement with clear expectations. Surrogates are often highly motivated by the desire to help others build their families.

Myth 3: Surrogacy is prohibitively expensive. We spend time with IPs to clearly outline costs and offer advice on where to get financing options, ensuring that surrogacy is accessible to as many people as possible

What sets the Agora Clinic apart when it comes to surrogacy?

At the Agora we offer a bespoke, patient-centred approach to all fertility journeys and offer IVF and all the other laboratory procedures required, including pre-genetic testing of embryos for aneuploidy (PGT-A), so that you can be assured that only chromosomally normal embryos are replaced in your surrogate. For further information, please visit the dedicated surrogacy page on our website: Surrogacy info.