Surrogacy Explained: Traditional vs Gestational
Learn the difference between traditional and gestational surrogacy, including genetics, IVF, legal considerations, donor eggs, and why gestational surrogacy is more common today.
“Surrogacy” can describe two biologically different arrangements.
In traditional surrogacy, the person carrying the pregnancy also provides the egg. That means the surrogate is genetically related to the child.
In gestational surrogacy, an embryo is created using eggs and sperm from intended parents, donors, or both, and then transferred to a gestational carrier. The carrier does not provide the egg and therefore has no genetic relationship to the child.
That distinction affects the medical process, legal complexity, and how the different people involved understand their roles.
Today, gestational surrogacy is far more common in clinical fertility practice, while traditional surrogacy is much less commonly offered and raises additional legal and ethical questions.
What is traditional surrogacy?
Traditional surrogacy—also called genetic, partial, or straight surrogacy—is an arrangement where the person carrying the pregnancy also provides the egg.
Her egg is fertilized using sperm from an intended parent or donor.
That means she is both:
- the person carrying the pregnancy;
- and the genetic contributor of the egg.
The HFEA describes traditional surrogacy as an arrangement where the surrogate's own egg is fertilized with sperm from the intended father.
Because the carrier is genetically related to the child, traditional surrogacy creates a different legal and emotional structure from gestational surrogacy.
Does traditional surrogacy require IVF?
Not necessarily.
Because the carrier's own egg is being used, traditional surrogacy can sometimes involve insemination rather than IVF.
ASRM notes that traditional or genetic surrogacy generally relies on the carrier's own egg and does not require IVF in the same way a gestational-carrier arrangement does.
The exact treatment method still depends on the medical plan and jurisdiction.
What is gestational surrogacy?
In gestational surrogacy, the carrier provides the pregnancy but not the egg.
An embryo is created through IVF before being transferred to her uterus.
The embryo may be created using:
- the intended mother's egg and intended father's sperm;
- donor eggs and an intended parent's sperm;
- an intended parent's egg and donor sperm;
- both donor eggs and donor sperm;
- or another permitted combination.
ASRM defines a gestational carrier as someone who carries a pregnancy created through IVF using an embryo to which she has no genetic relationship.
This separation between genetics and pregnancy is the defining feature of gestational surrogacy.
The simplest difference is genetic connection
The distinction can be summarized very simply:
Traditional surrogacy: the carrier provides the egg and is genetically related to the child.
Gestational surrogacy: the carrier does not provide the egg and is not genetically related to the child.
That one difference changes much of the rest of the process.
Gestational surrogacy requires IVF
Gestational surrogacy cannot happen through ordinary insemination because the carrier's egg is not being used.
An embryo first has to be created through IVF.
Eggs are retrieved from an intended parent or donor, fertilized with sperm in a laboratory, and the resulting embryo is transferred to the carrier.
ASRM describes IVF as an essential part of gestational-carrier treatment.
This makes gestational surrogacy medically more complex than some traditional-surrogacy arrangements.
Why is gestational surrogacy more common?
Modern fertility clinics overwhelmingly work with gestational carriers rather than traditional surrogates.
One reason is that the carrier and the genetic contributor are separate people.
That can make the intended family structure clearer and reduce some of the additional legal and ethical complexity created when the person giving birth is also genetically related to the child.
ASRM describes traditional surrogacy as uncommon in modern clinical practice and notes that most contemporary medical and statutory frameworks focus primarily on gestational-carrier arrangements.
Its Ethics Committee has also discouraged traditional surrogacy in some professional guidance because of the additional complexities involved.
Who might use gestational surrogacy?
Gestational surrogacy can be relevant in several circumstances.
A woman may be unable to safely carry a pregnancy because of a medical condition or absence of a functional uterus.
A gay male couple may use donor eggs and sperm from one of the intended fathers to create embryos.
A single man pursuing biological parenthood may similarly use donor eggs and a gestational carrier.
Other intended parents may use a carrier because repeated pregnancy or fertility-treatment problems make carrying a pregnancy inappropriate.
Both HFEA and ASRM recognize gestational surrogacy as a family-building option for people with medical indications, male same-sex couples, and single intended parents.
Who provides the egg in gestational surrogacy?
The egg may come from an intended parent or an egg donor.
For example, a heterosexual couple might create embryos using the intended mother's eggs and intended father's sperm.
A gay male couple generally needs an egg donor.
A single man also typically needs donor eggs.
The egg donor is separate from the gestational carrier.
This distinction is important because the two people have completely different roles.
The donor contributes genetics.
The carrier experiences pregnancy and birth.
Could the egg donor and gestational carrier be the same person?
If the carrier also provides the egg, the arrangement is no longer gestational surrogacy.
It becomes traditional surrogacy.
That is precisely why professional terminology separates the two.
The terms refer to the carrier's genetic relationship to the child, not simply whether someone is being called a “surrogate.”
Traditional surrogacy can create more complicated parentage questions
Parentage law varies widely, but the genetic connection in traditional surrogacy can make legal arrangements more complicated.
The carrier may simultaneously be the person giving birth and the genetic mother.
That is different from gestational surrogacy, where the carrier has no genetic connection.
ASRM specifically notes that traditional surrogacy presents distinct legal and ethical questions and is not the primary model addressed by modern gestational-carrier frameworks.
That does not mean gestational surrogacy is legally simple.
It is not.
But the legal questions are structured differently.
Gestational surrogacy law still varies enormously
There is no single international surrogacy law.
In the United States, gestational-carrier arrangements are governed mainly at state level. Some states have clear statutory frameworks, some have more limited law, and some restrict or prohibit certain arrangements. There is no overarching federal law governing gestational carriers nationwide.
Across the European Union, there is also no EU-wide surrogacy law. Each country sets its own rules, and approaches range from allowing certain altruistic arrangements to prohibiting surrogacy entirely.
Anyone considering surrogacy should therefore get advice specific to the jurisdiction where treatment, pregnancy, and birth will occur.
The UK uses a different legal structure again
The UK allows surrogacy, but the person who gives birth is initially treated as the legal mother regardless of genetic connection.
Intended parents generally need to obtain a parental order afterward to transfer legal parenthood under the UK's surrogacy framework.
UK surrogacy is also based on an expense-reimbursement rather than a straightforward commercial-compensation model.
This illustrates why terminology alone does not answer the legal question.
Two gestational-surrogacy arrangements in two different countries can have very different legal consequences.
The carrier still controls her own medical care
Gestational surrogacy separates genetics from pregnancy, but it does not remove the carrier's rights over her own body.
ASRM states that gestational carriers must retain authority over medical decisions involving embryo transfer, prenatal care, labor, delivery, and aftercare. It also recommends independent legal counsel and access to psychological support.
Intended parents can discuss expectations before pregnancy.
But a surrogacy agreement should not be understood as transferring medical control over the carrier to someone else.
Screening is important for gestational carriers
A gestational carrier is undergoing pregnancy, so medical suitability matters.
Professional programs generally assess health, pregnancy history, psychological readiness, and practical circumstances before proceeding.
A carrier who has previously experienced an uncomplicated pregnancy may often be preferred because there is already evidence of how her body handled pregnancy and childbirth.
The medical team also needs to assess whether embryo transfer and pregnancy are reasonably safe.
Traditional surrogacy combines donor and carrier considerations
Traditional surrogacy requires thinking about two sets of issues in one person.
The surrogate is both the egg provider and the person carrying the pregnancy.
That means questions relevant to egg donation—such as genetics and family medical history—combine with questions relevant to pregnancy and gestational-carrier care.
It also means the child has a direct genetic relationship with the surrogate and potentially with her wider family.
That can affect how the arrangement is understood by everyone involved.
How should intended parents think about future contact?
Contact with the carrier can continue after birth in either type of arrangement.
Some families remain very close.
Others exchange occasional updates.
Some relationships become more distant naturally.
In traditional surrogacy, the genetic relationship may add another dimension because the surrogate is also the child's biological relative.
In gestational surrogacy, there is no genetic connection, although the pregnancy relationship may still feel personally significant.
It is useful to discuss expectations before treatment without pretending that every future relationship can be predicted.
How should the arrangement be explained to the child?
Accurate language can make a complicated family story much simpler.
In gestational surrogacy, a child might eventually learn:
- an egg came from an intended parent or donor;
- sperm came from an intended parent or donor;
- a gestational carrier carried the pregnancy;
- and the intended parent or parents raised them.
In traditional surrogacy, the child should also understand that the person who carried the pregnancy provided the egg.
None of these stories needs to be presented as something shameful or secretive.
The roles simply need to be described accurately.
Traditional vs gestational does not mean altruistic vs commercial
These are separate distinctions.
Traditional vs gestational describes whether the carrier is genetically related to the child.
Altruistic vs compensated/commercial describes the financial arrangement.
A gestational carrier could participate in an altruistic arrangement or a compensated one where local law allows it.
Likewise, traditional surrogacy is defined by use of the carrier's egg, not by whether she receives compensation.
The European Parliament similarly distinguishes the genetic model of surrogacy from whether an arrangement is altruistic or commercial.
Which type is generally used today?
In modern fertility-clinic practice, gestational surrogacy is the dominant model.
ASRM states that traditional surrogacy is rare in contemporary clinical practice, while current medical and legal frameworks overwhelmingly focus on gestational-carrier arrangements.
HFEA also describes gestational, or “full,” surrogacy as the more common model in the UK.
That does not mean traditional surrogacy does not exist.
It means intended parents researching surrogacy today are much more likely to encounter gestational-surrogacy programs.
Where Banbino fits
Banbino's role is primarily around the people and family-building intentions that can come before treatment.
For example, gay couples or single men considering biological parenthood may use Banbino to explore identified egg donors.
Other people may be exploring different family-building structures before deciding which medical route makes sense.
But finding an egg donor is separate from arranging gestational surrogacy.
Once treatment becomes serious, IVF, carrier screening, pregnancy care, legal parentage, and surrogacy agreements require qualified medical and legal professionals.
The key difference is simple
If you remember only one thing, make it this:
Traditional surrogacy: the person carrying the pregnancy also provides the egg and is genetically related to the child.
Gestational surrogacy: the person carrying the pregnancy does not provide the egg and is not genetically related to the child.
The biology is easy to distinguish.
The harder part is everything surrounding it: medical screening, legal parenthood, consent, costs, relationships, and rules that vary significantly between jurisdictions.
That is why understanding which type of surrogacy you are considering should come before choosing a program, signing an agreement, or beginning treatment.