Gestational carrier (otherwise known as gestational surrogacy or host uterus), like many other aspects of assisted reproductive technologies, began with utilizing family volunteers and then moved on to involve recruited volunteers. Currently, it appears that more recruited volunteer carriers are involved than family members.

There is not as much known about how families fair when choosing to go through a gestational carrier situation. Nonetheless, the early experiences with gestational carrier often involve family members. Therefore, there is clinical experience to learn from for those individuals who are exploring the possibility of using a family member as a gestational carriers.

Unlike recruited volunteer gestational carriers, family members are drawn to being a gestational carrier after having direct experience of watching a loved one go through infertility or being asked directly. Often, it is a dramatic medical situation which propels a person into needing a gestational carrier such as a racial hysterectomy, life long illness such as diabetes or a congenital absence of the uterus. Family members are aware of the medical situation, and respond to the need at hand.

Consequently, it is hard for the prospective genetic mother and father to ascertain whether the family member is volunteering because they want to or because they feel that they have a duty or obligation to volunteer. This situation is probably the most difficult one to evaluate for both the woman who is volunteering to be a carrier as well as for her family member.

Just like other forms of gestational carrier, a good assessment prior to beginning any cycle is absolutely necessary. Certainly there are advantages to using a family member as a gestational carrier. Specifically, the genetic mother and father know the history and daily routine of the carrier. There is a great deal of comfort that can be gained from having easy and ready access to their gestational carrier during both the attempts and the pregnancy. In addition, they do not have to negotiate any type of relationship for after the baby is delivered, because there is already an established relationship.

Yet, it is the very fact that there is a relationship that exists, that the carrier and her partner as well as the genetic mother and father need to explore how this collaborative reproductive effort is going to affect their future relationship. It is ridiculous to assume that going through a gestational carrier experience together would not alter a relationship. This does not mean to say that it would alter the relationship for better or for worse, but rather any significant life relationship changes a relationship. For example, when a sister marries, it inevitable alters her relationship with other siblings. There is no relationship that we have as adults, that is not subject to change over time and life experience.

Consequently, it behooves any group going through this experience to look long and hard at how this will change their relationship. Clearly, there will be the issue of how, what and when to tell any child born through the gestational carrier experience about his or her special origins. In addition, the carrier and her partner have children that they need to incorporate into the carrier experience. If the children are very small, different accommodations need to be made then if the children are older. Regardless of their age, children that are already involved in the carrier process, need to be brought into the experience and their feelings and reactions need to be anticipated.

THE GESTATIONAL CARRIER

The family member who chooses to serve as a gestational carrier has the same personal evaluation process to go through to determine whether or not gestational carrier would be a positive experience in her life. The carrier and her partner need to look at both their feelings about this situation. It is imperative that both partners feel equally committed to going through the carrier experience. The carrier's partner will have his life impacted upon as much as the gestational carrier. Should the carrier need to be at doctor's visits or on bed-rest, the partner will find that his duties within the household will change. In addition, the gestational carrier experience will affect everything from their sex life to their travel plans. Both the potential carrier and her partner both need to feel comfortable that this will not affect their children adversely. Often, both partners are not in the same place either emotionally or in their concerns about participating in the gestational carrier program. This issue can emerge very strongly with regard to the potential effects on the children.

Listed below are some questions that may be helpful to explore with a friend or family member when considering embarking on a gestational carrier program:

• Why do you want to be a gestational carrier?
• What are your expectations about your relationship with the child?
• What do you imagine how you will feel if the procedure is not successful?
• Do you expect any legal relationship with the baby?
• What are your expectations, if any, around receiving a fee for your participation?
• Are you willing to participate in a counseling session with us to discuss relevant concerns? Are you willing to continue counseling indefinitely if the need arises?
• Have you had the opportunity to thoroughly discuss the medical risks associated with the procedure, medication and pregnancy?
• If you have a husband/partner, how does he feel about you being a gestational carrier?
• What is your understanding of the medical procedure that will be involved?
• Who will be your support person during the attempts? Who will give you your injections?
• Are you aware that we may have multiple pregnancies? How do you feel about this possibility? How do you all feel about selective reduction?
• Are there people that you have shared your interest to be a gestational carrier? If there were any, what were their reactions?
• Why do you think you would be a good gestational carrier?
• What do you believe your strengths and weaknesses are?
• Do you have any ethical or religious viewpoints which might affect your decision to be a gestational carrier?
• What are your feelings about the unlikely prospect that we might choose or need to abort a fetus? (First explore your own feelings before raising this issue with your prospective carrier)
• Are you aware that the legal issues surrounding gestational carrier and parental rights differ from state to state?
• Do you want publicity about your decision to be a gestational carrier if the possibility arises?
• Is there anything significant about your relationship with me/us that contributed to your decision to be a gestational carrier?
• How do you imagine your relationship will change?
• How do you imagine your relationship will change?
• How does your family feel about your decision to be a gestational carrier?
• Who will know about this decision and who will not?
• If you have a husband or partner, how does he feel about the possibility of a baby born of this procedure? Will he participate in counseling if requested?
• Have you discussed with your partner the risks associated with this procedure and with the medication you must take?
• What do you think the impact will be on the extended family?
• How do you think being a carrier will effect your children?
• What do you think the community reaction will be? Your children's teachers or friend's parents?
• Do you feel that it would be helpful to discuss this with your minister, priest, rabbi, etc.?

  
  
  

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