Becoming a surrogate mother is a courageous decision that supports families who cannot carry a pregnancy themselves; this decision involves not only generosity but real health responsibilities and awareness of what are the medical risks of surrogacy, particularly in gestational surrogacy. At Made in USA Surrogacy we believe it is our duty to provide full transparency about the health risks, pregnancy complications, medical procedures, and emotional challenges so that every gestational carrier can make an informed choice. This guide explains current evidence about health risks of becoming a surrogate mother, how the surrogacy process works especially with in vitro fertilization and embryo transfer, how we help mitigate risks, and how surrogates can be supported throughout their journey.
What Gestational Surrogacy Means
Gestational surrogacy is a form of assisted reproductive technologies where a gestational carrier carries a pregnancy using embryos created with donor eggs or an egg and sperm donor or donor sperm. A gestational surrogacy process uses in vitro fertilization for embryo creation, embryo transfer into the surrogate’s uterus, monitoring through pregnancy complications, delivery, and postpartum care. The gestational carrier has no genetic link to the child.
Understanding the gestational surrogacy process helps in grasping what health issues may arise, what medical evaluation is necessary, and what medical risks and medical screening are involved. Surrogacy arrangements like altruistic surrogacy or commercial surrogacy vary in their motivations and legal frameworks, and all are subject to specific surrogacy laws that govern the rights and responsibilities of all parties involved.
Health Risks and Medical Complications in Surrogate Pregnancy
Gestational surrogacy offers the chance for a healthy pregnancy with assisted reproductive technologies but there are health risks and pregnancy complications to consider. Studies from 2024 and 2025 confirm that gestational carriers face higher risk of certain medical complications compared with women who conceive naturally or via IVF without surrogacy.
Severe Maternal Morbidity Rates
Severe maternal morbidity refers to serious health problems during pregnancy or early postpartum that can threaten the surrogate’s health. A large population based study compared three groups: unassisted conception, IVF pregnancies, and surrogate pregnancy in gestational carriers. The study found rates of severe maternal morbidity about 2% in unassisted conception, 4.3% in IVF pregnancies, and 7.8% in surrogate pregnancies. This means gestational carriers have about triple the risk compared to women who conceive naturally, and a significantly higher risk even compared with IVF alone.
Hypertensive Disorders, High Blood Pressure, Gestational Diabetes
Gestational carriers are more likely to develop hypertensive disorders such as preeclampsia or gestational hypertension, especially when other risk factors are present like obesity, prior history of hypertension, or multiple pregnancies. The study found gestational carriers were about 75% more likely to have hypertensive disorders compared with those who conceive naturally. Gestational diabetes is another pregnancy complication that is more likely when hormone treatments are used to prepare the uterus and embryo transfer is done, especially in older women or those with other risk factors. Good prenatal medical practices including regular monitoring, blood tests, glucose screening, and lifestyle interventions can reduce risks.
Postpartum Hemorrhage and Cesarean Delivery Risks
Surrogate pregnancies are associated with higher chances of postpartum hemorrhage. The gestational carrier group showed a significantly higher risk of postpartum hemorrhage compared with unassisted pregnancies. Cesarean delivery, whether elective or emergency, carries risks like surgical complications, longer healing time, infection, and anesthesia risks. Surrogate pregnancies may have higher occurrence of cesarean section because of pregnancy complications or multiple gestation.
Preterm Birth, Low Birth Weight, Placental Issues
Surrogate pregnancies carry higher risk of premature birth, that is birth before 37 weeks gestational age. Women acting as gestational carriers were about 79% more likely to have premature birth at less than 37 weeks compared with women with unassisted conception. Low birth weight in babies born via surrogacy is also more common when multiple births occur or when medical complications happen during pregnancy. Placental issues such as placenta previa or placental abruption are possible contributing factors to complications. Although many babies born via gestational surrogacy are healthy, the risk of neonatal complications increases with premature birth and multiple gestation.
Other Risks Associated with Medical Procedures and Assisted Reproductive Technologies
The medical process of becoming a gestational carrier includes fertility clinic treatments like hormone therapy, embryo transfer, possibly ovarian stimulation for donor egg cycles if donor eggs are required to produce multiple eggs, and frequent medical evaluation, ultrasounds and blood tests. Those medical procedures can lead to side effects such as mood swings, swelling, headaches, nausea, discomfort, sometimes even more serious reactions if protocols are not well managed. Assisted reproductive technologies bring risk of multiple embryos being transferred, which can lead to multiple pregnancies, higher risk of pregnancy complications and premature birth. Genetic screening may reduce some risks of congenital anomalies but does not eliminate risk of complications arising in the pregnancy itself. IVF babies born via these procedures may face some of these risks as well.
Emotional Risks Health Issues and Psychological Well Being
Being a gestational carrier involves not just physical health risks but emotional risks. Studies show gestational carriers are more likely to develop new onset mental health conditions during and after surrogate pregnancy compared with women who carry their own children. For example a 2025 study found a 43% higher incidence of new mental illness among surrogate women compared to women with unassisted conception, and 29% higher compared to women who had IVF pregnancies. Emotional challenges include stress from medical appointments, physical discomfort, grief or emotional attachment to the baby after birth, anxiety about potential complications, and balancing personal and medical responsibilities.
Risk Factors That Increase Likelihood of Problems
Every surrogate pregnancy has its own risk profile, many gestational carriers with no risk factors have healthy pregnancy outcomes but some factors increase risk:
- Age and Body Mass Index (BMI) Older maternal age and higher BMI correlate with increased risk of pregnancy complications, gestational diabetes, high blood pressure and hypertensive disorders.
- Previous Obstetric History Surrogates who have had multiple births, prior cesarean sections, or pregnancy complications are more likely to face obstetric complications in future gestational surrogacy process.
- Chronic Hypertension or Other Preexisting Conditions Women with heart disease, kidney disease, diabetes or chronic hypertension are at higher risk and often require more careful medical evaluation and monitoring.
- Multiple Pregnancies and Multiple Gestation When more than one embryo is transferred or when unintended multiple births happen there is a much higher risk of premature birth, low birth weight health problems, and complications in pregnancy.
- Support, Access to Quality Medical Care, Fertility Clinic Standards The medical risks are lower when surrogacy agency works with high quality fertility clinics, when surrogates have strong support for rest, emotional counseling, transportation to appointments, when medical practices are excellent, when medical screening is strict and ongoing.
How Made in USA Surrogacy Helps Reduce Medical Risks
At Made in USA Surrogacy we recognize the responsibilities involved in the surrogacy process and we design our programs to protect gestational carriers emotionally, physically, and medically. Here are ways we act to reduce health risks:
- Thorough Medical Screening Every prospective gestational carrier undergoes a detailed medical evaluation including review of prior pregnancies, health issues, chronic conditions, BMI, obstetric complications and other health risk factors. We work with medical professionals in fertility medicine and reproductive medicine to make sure you are physically fit and emotionally ready.
- Strict Fertility Clinic Partnerships We partner only with IVF clinics with high standards of care protocols for in vitro fertilization, embryo transfer, ovarian stimulation when needed, and follow up medical monitoring. Clinics we select have proven track records of safety in medical practices and success.
- Single Embryo Transfer Preference and Avoiding Multiples We strongly encourage elective single embryo transfer to minimize risk of multiple births or multiple gestation. When multiple embryos are transferred the risks of premature birth, low birth weight, pregnancy complications increase significantly.
- Ongoing Prenatal and Postpartum Care We ensure every surrogate mother gets quality prenatal care with frequent check ups, blood tests, ultrasounds, gestational diabetes screening, high blood pressure monitoring, and continual support after delivery to reduce complications arising postpartum hemorrhage or other medical complications.
- Emotional Support and Counseling We believe emotional risks are as crucial as physical risks. We ensure psychological assessments before and after the surrogate pregnancy along with ongoing emotional check ins to help navigate stress, attachment, grief or mental health needs.
- Transparent Surrogacy Contracts and Coverage of Medical Expenses and Legal Fees Our surrogate agreements include coverage of medical expenses related to pregnancy complications, fertility clinic procedures, in vitro fertilization, embryo transfer, any hospital stays, legal fees, and other miscellaneous expenses so that gestational carriers are not facing unexpected financial burden.
Comparing Surrogacy Pregnancies to IVF Pregnancies and Regular Pregnancy
It is helpful to compare what risks gestational surrogates face relative to pregnancies in IVF treatment or pregnancies achieved through natural conception:
- Studies show IVF pregnancies have higher risk of pregnancy complications compared with pregnancies conceived naturally but often lower than surrogate pregnancies for some complications like severe maternal morbidity. The study found IVF pregnancy group had severe maternal morbidity about 4.3% while gestational surrogates had 7.8% and unassisted pregnancies had about 2.3%.
- Outcomes such as low birth weight and premature birth, although increased in surrogate pregnancies, are often similar to those in IVF pregnancies when adjusted for multiple gestation and other risk factors.
Frequently Asked Medical Risks in Surrogacy Questions
Are the medical risks higher for gestational surrogacy compared with regular pregnancy
Yes there is higher risk for certain health risks and pregnancy complications in surrogate pregnancy compared with pregnancies conceived naturally however many risks are manageable with high quality medical screening and care.
Can I become a gestational carrier if I have had a previous C-section
Often yes as long as healing was good, there are guidelines agencies use and fertility clinic medical evaluation will review obstetric history, prior surgeries and current health status to decide suitability.
How does in vitro fertilization raise risks
In vitro fertilization involves medications to stimulate eggs or prepare the uterus, embryo transfer procedures, sometimes donor eggs or sperm donor involvement, and those medical procedures can increase risk of gestational diabetes, high blood pressure, pregnancy complications, multiple pregnancies if more than one embryo transferred.
What is elective single embryo transfer
This means transferring only one embryo into the uterus in embryo transfer to reduce chances of multiple pregnancies which are associated with much higher risk of premature birth, low birth weight, and other complications.
What medical screening is required
Medical evaluation will include obstetric history review, chronic health conditions check, blood tests, ultrasonography, monitoring for high blood pressure, gestational diabetes screening and lifestyle assessments to make sure health problems are minimized.
Do I have coverage for medical expenses and legal fees if complications happen
Yes our surrogacy agreements ensure coverage of medical expenses related to medical complications from pregnancy, fertility clinic costs, in vitro fertilization and embryo transfer procedures, hospital stays and legal fees so the gestational carrier is not left with unexpected costs.
Final Thoughts Choosing Surrogacy with Confidence
The risks of surrogacy are real but for many women the choice to become a gestational carrier leads to deeply rewarding experiences helping families build their future. By understanding what are the medical risks of surrogacy, engaging in thorough medical screening, working with a high quality IVF clinic, choosing elective single embryo transfer when possible, having strong support systems and ensuring medical expenses are covered, most gestational surrogates have successful outcome and healthy pregnancy.
If you are considering becoming a surrogate mother reach out to our team to learn more about our standards, our surrogacy process, the comprehensive medical evaluation and support we provide. You deserve to feel confident, supported and safe throughout every step of the gestational surrogacy process.
