People in different situations enter into surrogacy arrangements for a number of reasons, including:

• A woman is unable to become pregnant or carry a baby for medical reasons
• A woman at risk of harming herself or the child if she becomes pregnant
• Same-sex couples (male or female) or individuals may want to have a child, conceived using their own sperm or eggs and donor sperm or eggs
• Couples for whom repeated IVF attempts have failed
• Couples who are involved in an IVF treatment program may have embryos in storage and, if the woman dies, the male partner may wish to commission a surrogate to carry and give birth to a child.

The chance of having a baby with surrogacy depends on a range of factors, including:

• the age of the person providing the egg or sperm
• the age of the surrogate
• the lifestyle of the surrogate and egg, sperm or embryo providers
• the stage of development when the embryo is transferred to the surrogate (2-3 day or 5-day embryo).

Once you have decided, in consultation with your fertility specialist, that surrogacy is the right option for you, it’s up to you to find a person willing to act as a surrogate. This is not an easy task. Some options include:

• letting family/friends know that surrogacy is your only option
• asking family or friends for help
• seeking a surrogate online (surrogacy support groups or online forums)

It’s important to:

• Understand that decisions may affect your relationship with them in the future if they are not comfortable with the idea.
• Reassure those involved that you’ll understand if they don’t feel able or comfortable to do this for you. It is better that they are honest rather than going ahead if they have doubts.

It is illegal to publish an advertisement or notice or attempt to publicly seek a surrogate. Fertility clinics cannot advertise on your behalf. You are not allowed to pay a surrogate other than prescribed costs.

As with those who are seeking a surrogate as intended parents, laws in Victoria, Tasmania, South Australia, and Queensland make it illegal for people to advertise or publish that they are willing to act as a surrogate. This includes both altruistic and commercial surrogacy arrangements. The most common scenario is that someone known personally to the intended parent(s) acts as the surrogate.

In Australian Capital Territory, intended parents (IP) may advertise for a surrogate as long as it is altruistic.
In New South Wales, advertising may be permitted with limitations, such as, ensuring there are no fees paid for the advertisement or other materials.
In Western Australia and the Northern Territory, advertising may be allowed with some limitations.

The cost of surrogacy varies significantly based on location, number of cycles required and individual circumstances. Surrogacy Australia estimates an average cost of around $55,000 – $75,000 over a two-year period. This includes costs such as legal fees, non-rebatable IVF, mandatory counselling, allowable surrogate compensation, insurance and travel, and transfer of parentage.

In 2017-18, 35 women received fertility treatment as surrogates in Victorian clinics, and 13 babies were born as part of surrogacy arrangements.

Children, and especially teenagers, often question:

• Who am I?
• Where did I come from?
• Do I have anything in common with my donor or surrogate?
• For those who do not already know their donor or surrogate: would I like them?
• Why did they (the donor/surrogate) want to help make me?

If children have not already met their donor/surrogate, they may wonder what they are like. This is normal and healthy and does not undermine your role as their parents in any way. You may be curious too. Answer questions as honestly as you can. While it is important to talk about your donor or surrogate with high regard, do not overdo it either – your child may then have unrealistic expectations of their donor or surrogate. Share with your child the information you have available.

Surrogacy arrangements in which a surrogate uses her own eggs is known as traditional surrogacy.
In Victoria, fertility clinics are only permitted to practise gestational surrogacy. This means that the surrogate is implanted with an embryo created using an egg from another woman (either the intended parent or donated from another woman).
However, without the involvement of a fertility clinic, traditional surrogacy is permitted. If you are considering traditional surrogacy, ARTFam recommends that you obtain legal advice, especially with respect to obtaining legal parentage of any child born.

The possible health effects of surrogacy are similar to IVF. These can include:

• The egg provider may experience hot flushes, feelings of depression or irritation, headaches and restlessness as a result of the fertility drugs. There is also a small risk of ovarian hyper-stimulation syndrome (OHSS), which can cause stomach pains, nausea, vomiting, shortness of breath and faintness.
• The surrogate carries the same risks associated with any pregnancy and birth, and similarly, these risks increase with the age of the surrogate.
• There is also the rare risk of transfer of HIV and/or hepatitis. To eliminate this risk, mandatory screening of everyone involved in surrogacy is required. To enhance safety, embryos are also ‘quarantined’ for six months (although this time period may vary from clinic to clinic), at the end of which, before proceeding with the embryo transfer, any infections or diseases are screened for a second time. For more detail about the risks involved in surrogacy, please consult your fertility specialist.