For many people, surrogacy is the path that finally makes parenthood possible after years of difficulty. It is also a process that raises a lot of questions, because it brings together medicine, law and deeply personal decisions. This guide explains the meaning of surrogacy, the types that exist, how the process works step by step, who can pursue it and what alternatives are worth considering. If you are exploring your options, our fertility program in Medellín can walk you through what surrogacy and assisted reproduction look like in practice.
What does surrogacy mean?
Surrogacy is an arrangement in which a woman, the surrogate or gestational carrier, carries and gives birth to a baby for another person or couple, the intended parents, who will raise the child. The definition matters because it separates two ideas that are often confused: who is pregnant, and who the genetic and legal parents are. In modern surrogacy these roles are usually held by different people, which is exactly what assisted reproductive technology made possible.
A short history of surrogacy
Surrogacy has roots that reach back to ancient times, and even biblical texts describe women carrying children for others. Modern gestational surrogacy, however, only became possible with the rise of assisted reproductive techniques in the late twentieth century. The first legally recognised case of traditional surrogacy took place in the United States in 1985, when a woman was inseminated to carry a baby for the intended parents. The more influential milestone came in 1986, when in vitro fertilisation made it possible to biologically separate the surrogate from the baby she carried, which is the model most programs follow today.
When was gestational surrogacy legalised?
Legalisation varies enormously from one country to another. In the United States and Canada gestational surrogacy has been legal since the 1980s, governed by specific state or provincial rules. In much of Europe and Latin America the picture is more restrictive and has evolved slowly. Colombia, for example, recognises the right to gestational surrogacy in exceptional cases, although the legal framework remains ambiguous and benefits from careful professional guidance.
Types of surrogacy
There are two main types of surrogacy, and the difference between them comes down to whether the surrogate has a genetic link to the baby.
Traditional surrogacy
In traditional surrogacy the surrogate uses her own egg, which makes her the biological mother of the baby. Conception happens through artificial insemination with the sperm of the intended father or a donor. This method has become far less common because of the emotional and legal complications that a genetic connection between the surrogate and the child can create.
Gestational or full surrogacy
Gestational surrogacy is by far the most widely used option today. Here the surrogate has no genetic relationship with the baby, because the embryo is created from the eggs and sperm of the intended parents or donors and then transferred to her uterus. This approach depends on in vitro fertilisation, which allows the medical team to control how the embryo is formed and to keep parentage clear from the very start.
When is surrogacy necessary?
Surrogacy becomes a realistic option in several situations where carrying a pregnancy is not possible or safe. It is often considered by women who were born without a uterus or with uterine malformations, and by women whose serious health conditions would make pregnancy dangerous. It is also chosen by same-sex couples who want a biological child, by single men who wish to start a family, and by people who have been through repeated failed cycles of assisted reproduction. A thorough gynecological evaluation usually helps clarify whether surrogacy is the right route, and chromosomal factors such as those covered in our article on aneuploidy are sometimes part of that conversation too.
What are the steps in the surrogacy process?
The surrogacy process can be detailed, and it usually unfolds across several connected phases. It begins with a medical and psychological evaluation, since both the intended parents and the surrogate need to be physically and emotionally prepared for the journey ahead. Next come the legal agreements, where all parties sign a contract that sets out rights, responsibilities and expectations and protects everyone involved. The embryo is then created, through in vitro fertilisation in gestational surrogacy or artificial insemination in traditional surrogacy. After that the embryo is transferred to the surrogate's uterus, and she carries the pregnancy to term. Throughout those months the gestational carrier receives ongoing prenatal medical care so that both she and the baby stay healthy. Understanding fertility timing, including how to calculate fertile and infertile days, can be useful background for anyone learning how conception and transfer are scheduled.
Alternatives to surrogacy
Surrogacy is not the only path for people facing fertility challenges. Adoption and foster care offer routes to parenthood that do not involve assisted reproduction at all, while other medical options can resolve the underlying difficulty without a gestational carrier. Choosing between them is a personal decision that benefits from honest medical and emotional counselling.
Egg and sperm donation
Egg or sperm donation is used when one partner cannot provide their own gametes because of infertility or a genetic health concern. Egg donation applies when a woman cannot produce viable eggs or wants to avoid passing on a genetic disease; the donor eggs are fertilised in the laboratory through IVF and transferred to the recipient's uterus. Sperm donation is used when the man has severe infertility, or when a single woman or a same-sex couple wishes to build a family. When male factors are involved, a focused male fertility assessment helps the team decide whether donation is the best step. Medication protocols such as the one explained in our overview of clomiphene may also form part of a wider treatment plan.
In which countries is surrogacy legal?
Surrogacy laws differ widely around the world. In some places the practice is fully legal, while in others it is illegal or tightly restricted. The United States, in certain states, and Canada allow surrogacy under their own regulations. In Colombia the process is legal but still lacks a robust legal framework, which can create complications that good legal advice helps anticipate. By contrast, countries such as Spain, France and Germany prohibit it, and in places like Mexico the rules vary by state and have changed over time. Because of this patchwork, intended parents who travel for treatment should confirm the legal situation carefully before they begin.
Requirements to become a surrogate mother
Becoming a surrogate involves meeting clear medical, emotional and legal criteria. Most programs ask the candidate to be of legal age, generally between 21 and 40, and to have already had at least one biological child after a healthy pregnancy without complications. She should be in good physical and emotional health, pass thorough medical and psychological evaluations, and be free of financial pressures that could distort her decision to carry a pregnancy for someone else. She must also live in a country or region where surrogacy is legal and regulated. These safeguards exist to protect both the surrogate and the intended parents throughout the process.
Need medical guidance?
Surrogacy and the alternatives around it are easier to navigate with an experienced team at your side. Our fertility and reproductive specialists in Medellín review your situation, explain the medical and practical steps in plain language and coordinate care for patients who travel from abroad. Reach out through our fertility specialists in Medellín to discuss whether surrogacy fits your story, and learn more about coming to the city through our overview of specialised medical care in Medellín.
