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Evaluating Fertility Treatment Options

Learn about donor and gestational surrogacy and why you might consider these options.


Some people who have issues with their sperm or ovum (egg) or who have tried  In Vitro Fertilization (IVF) treatment without success may consider using a donor, gestational carrier or surrogate. Your doctor can provide information on these options to help determine what may be best for you.

Egg donation

This is an option for a person or family who needs healthy eggs to have a baby. Through IVF treatment, donor eggs

are joined with sperm in efforts to start a pregnancy. The egg donor may be someone the recipient knows or who

is anonymous through a donor agency or egg bank. Egg donations are highly regulated by the FDA and go through intense genetic and medical screenings. This treatment is usually more costly than other procedures but the national birth rate using egg donation through IVF was high — over 50 percent.

Sperm donation

For people who need healthy sperm, it’s most common to obtain it from a sperm bank. To ensure the health of the donor sperm, it is first evaluated with an intensive screening. This screening checks the donor’s medical and social history, as well as tests the sperm for infectious diseases and genetic defects. If it passes, the donor sperm is frozen for six months. Then it is screened again. Only sperm that has passed both screenings is released to a recipient. 

Embryo donation

If both partners have fertility issues, they may decide to use donor embryos that have been donated by a couple who went through fertility treatment. The same rigorous FDA standards are used to test these embryos before they can be used.


This is an option for a woman who may not have healthy eggs and cannot carry a child. A surrogate carries an embryo that is achieved through assisted reproductive technology (ART) or insemination. Using a surrogate may be a good option if

a woman does not produce eggs or has unhealthy eggs. The surrogate (the woman who carries the child) will be the child’s biological mother.

Gestational carrier

With this treatment, a woman’s egg is combined with her partner’s sperm through IVF. Once fertilized, the embryo is transferred to the gestational carrier’s uterus. This may be a good option for a woman who cannot carry a child for health reasons. The gestational carrier (the woman who carries the child) will not be the child’s biological mother.

Using a surrogate or gestational carrier may also be an option for singles or same sex couples.

Tips on choosing a surrogate carrier

A gestational surrogate or carrier can be someone the couple knows (like a friend or relative) or may be someone arranged through an agency. In most cases, the surrogate or carrier is at least 21 years old and has already delivered a live,  full-term baby.

Before the procedure, medical evaluations and screenings are done, as well as counseling to make sure the surrogate or carrier is aware of the issues related to pregnancy and to the arrangement.

Legal contracts

For any procedure, written consent is required. The couple and the surrogate or carrier usually sign a contract and also have legal counsel. The contract specifies the rights of the donor and any financial responsibilities.


Economic compensation for a surrogate or carrier must usually comply with state laws. Talk to your legal counsel for more information about these details.

By Kristin Nelson, Contributing Writer


Society for Assisted Reproductive Technology. Third party reproduction. Accessed November 2, 2020.
Resolve.org. What are my options. Accessed November 2, 2020.
U.S. Dept of Health and Human Services Office on Women’s Health. Infertility. Accessed November 2, 2020.
American Society for Reproductive Medicine. Assisted reproductive technologies. Accessed November 2, 2020.

Last Updated: November 11, 2020