Gestational carriers, briefly
Outcomes are slightly better than other IVF pregnancies and worse than ordinary ones.
Use of gestational carriers has grown steadily. Embryo transfer cycles using a carrier rose from 3,202 in 2012 to 8,862 in 2021, from 2.4% to 4.4% of all assisted reproduction cycles, and 90% of reporting clinics offer the service. Use rises with the intended parent's age, from 2.9% of transfers under 35 to 9.0% over 40.
The outcome data, pooled across 6 studies covering 28,300 gestational carrier pregnancies against 1,270,662 others:
| Comparison | Outcome | Adjusted odds ratio (95% CI) |
|---|---|---|
| Carrier vs other IVF pregnancies | Hypertensive disorders | 0.86 (0.45 to 1.64), no difference |
| Carrier vs other IVF pregnancies | Preterm birth | 0.82 (0.68 to 1.00), no difference |
| Carrier vs other IVF pregnancies | Cesarean delivery | 0.42 (0.27 to 0.65), lower |
| Carrier vs general pregnancies | Hypertensive disorders | 1.44 (1.13 to 1.84), higher |
Carriers were more likely to have a multiple pregnancy than other IVF patients (odds ratio 1.18), which is the finding most within anyone's control. Almost all of them had given birth before: only 6 of 361 in one dataset were nulliparous, meaning they had never given birth.
have a right to be fully informed of the risks as well as the contractual and legal aspects; they
have autonomy in making their own decisions regarding medical care and should be free from undue influences by the stakeholders involved; they should have access to psychological evaluation and counselling
before, during, and after; and
GCs require separate independent legal counsel regarding the contract and arrangement.
Separate. Not the intended parents' lawyer, and not the agency's.
This guide deliberately does not list which states permit what. State law here changes frequently, any list dates immediately, and a stale list would function as legal advice. Both the intended parents and the carrier need separate lawyers licensed in the relevant state. That, rather than any list, is the reliable instruction.