Choosing a family member as a surrogate

By (project manager) and (babygest staff).
Last Update: 10/10/2019

To carry out a surrogacy process, the most common is that the surrogate is a person who has no family connection with the intended parents.

However, there are those who prefer their surrogate to be a a familiy member. Therefore, there have been cases where the grandmother has given birth to her own grandson or a sister has become pregnant with her nephew.

Why chosing a family member as surrogate?

Although for many it is preferable, using a woman as surrogate who is part of the family raises a new situation. However, there are many who choose to interact with someone close to them, as they consider that this will make surrogacy a more bearable process.

The most common reasons why a person or couple prefers the surrogate to be a relative rather than an unknown woman have to do, among others, with the following aspects:

  • Genetic inheritance
  • Blood relation
  • Risk of transmitting STD
  • Hereditary genetic diseases
  • Acceleration of the process
  • Cost reduction

The last two points should be highlighted, since the use of assisted reproduction places an economic burden on patients, mainly because access to these treatments is not usually covered by health insurance. It's also a way to avoid the long waiting lists for some treatments.

Who can be a surrogate for a family member?

According to the Ethics Committee of the American Society for Reproductive Medicine (ASRM), the surrogate may be a relative at two different levels:

Intergenerational level
when it is the mother who gestate her daughter's baby, and vice versa (first degree of consanguinity).
Intragenerational level
when the surrogate is the sister, niece or aunt of the intended mother (second degree of consanguinity).

First degree of consanguinity

Within the first degree of kinship we find the parents and, therefore, the children. If two people who are in the first degree of kinship agree to start a surrogacy, the possible combinations are:

  • Grandma giving birth to her own grandson
  • The daughter giving birth to her own brother

Today, there have already been cases in which a grandmother has been the surrogate of her own daughter. In 2016, Julie Bradford, of British origin, gave birth to her daughter's baby after her daughter became infertile at the age of 21 after receiving chemotherapy for the treatment of cervical cancer.

It should be remembered that having a baby through a surrogate pregnancy is allowed in this country. If you want to know more about the legislation and the conditions to carry it out there, click here: Surrogacy in the UK.

Second degree of consanguinity

In the second degree of consanguinity/affinity we find grandparents, grandchildren, siblings and brothers-in-law. In most cases, intended parents search for a person of this grade, given the possibility of having a young woman and therefore a higher chance to get pregnant.

Let's see how the possible assisted reproduction treatments would be carried out:

Artificial insemination
would imply that it was a partial surrogacy. For example, if surrogacy happens between sisters, the surrogate would simply be inseminated with her brother-in-law's semen. Thus, the surrogate (sister) would be the biological mother of the child.
In vitro fertilization
it would be a complete surrogacy. Following the example of the sisters, the eggs and spermatozoa of the intended parents are fertilized in the laboratory and then the resulting embryos are transferred to the sister.

In the case of IVF, donor eggs could also be used, in which case the procedure would be exactly the same. For more information, we recommend visiting the following article: Is it possible to use egg donation in surrogacy?

Combinations according to type of surrogacy

When resorting to a woman who is part of the family to carry the pregnancy to term and give birth to your child, various combinations can be given depending on whether it is a process of partial surrogacy or complete surrogacy. Both possibilities are discussed below:

Partial surrogacy

In a process of partial surrogacy, traditional surrogacy or artificial insemination (AI) surrogacy, the surrogate provides her genetic load, i.e. her eggs. This form of surrogacy is currently being avoided in order to minimize the maternal-fetal bond.

If the surrogate is a relative and the intended parents choose this type of surrogacy, the combinations shown in the following table may occur:

When the surrogate is the sister of the mother of intention (case 1), the ASRM indicates that the type of relationship of the surrogate with her sister's husband should be examined. He also considers that the surrogate should not be allowed to be the sister of the intending father (case 2) because in many social contexts this could be seen as an incestuous relationship.

Complete surrogacy

The procedure of complete surrogacy or gestation differs from the previous point by the origin of the female gamete. In this case, the The surrogate is not the woman who provides the egg, but either the eggs of the mother of intention or those of a donor are used.

This is the type of surrogacy most used today precisely to prevent the development of a genetic link between the surrogate and the future baby. When choosing this option, there can be up to five combinations if the surrogate is part of the family:

In cases 1 and 2, it might appear that incest has been committed when it is daughter to father or sister to brother, but there really is no consanguinity relationship. If the surrogate is the grandmother of the future baby (case 3), she will have to undergo more exhaustive tests to analyse her state of health.

Risks and possible complications

Although, in principle, using a woman who is part of the family as a surrogate does not entail any risk, the truth is that in many cases ends up in conflict for reasons related to the social impact and genetic burden of the future baby, among others that are detailed below:

Relationship Surrogate- Intended Parents

It may happen that the family tends to pressure or condition the will of the Surrogate mother or that a woman in the family is forced or committed to being the Surrogate mother by the simple fact that another family member is asking for it.

The degree of influence that the family can exert on the decision of the the surrogate will depend on the following factors:

  • Affective attachment
  • Similar physical characteristics
  • Economic dependence

In this sense, it is advisable that there be a certain level of emotional distance and a low degree of affectivity between the surrogate and the IPs so that the surrogate can make a decision voluntarily and with full knowledge of the cause.

On the other hand, it should be kept in mind that, our society has always considered as a taboo subject the idea of having sexual relations, marrying and/or having children with members of the same family, fundamentally due to the risk of the baby developing some congenital defect or genetic disease.

Another extremely important aspect to bear in mind when the surrogate is a relative is her ability to emotionally separate herself from the future baby.

It is essential to take into account the social and psychological impact that this may have on the future baby, since, depending on the community where you live, you may have problems when establishing interpersonal relationships with people around you.

Finally, the fact that the surrogate is a relative could alter the way in which the child understands the concept of family, mainly because this type of surrogacy can give rise to relations between relatives that are unusual and difficult to understand in today's world.

For this reason, when choosing this type of surrogacy, the consequences for the child's cognitive development must be taken into account.

FAQs from users

Can my sister be my surrogate and my brother the sperm donor?

By Natalia Álvarez (project manager).

This combination would be possible as long as it was a complete surrogacy in which eggs from a donor outside the family were also used. In such a case, there would be no risk of congenital disease, since the genetic load of the sister would not be present at any time.

I have ovarian cancer. Can my sister be my surrogate?

By Natalia Álvarez (project manager).

Yes, in countries where surrogacy is permitted, it is possible to use a sister or any other woman in the family to act as a surrogate. Many countries require a medical cause to impede pregnancy in order to have access to this treatment: in this case, this requirement is met, so this combination would be perfectly valid.

Suggested for you

Surrogacy poses a new scenario unknown to many in which degrees of kinship can be intermingled to give rise to a new member of the family- but what possible consequences can it have on the pregnant woman? We'll explain them here: Consequences of surrogate motherhood on the surrogate.

If the characteristics of surrogacy between relatives are not adapted to your needs, it is possible to select a surrogate from outside the family. For more information, don't forget to click on one of the following links:

Finally, it should be taken into account that the conditions in all countries are not the same, so there may be more or less limitations when it comes to using a sister, mother or aunt to conceive your future baby. We recommend that you find out more about the possible destinations here: Where is surrogacy legal?

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References

Authors and contributors

 Natalia Álvarez
Natalia Álvarez
Project Manager
Graduated in Business Administration from the University of Alicante. She has more than 9 years of experience in the field of assisted reproduction and was the creator and director of the first assisted reproduction fair in Spain. She is the director of Wearesurrogacy and is an expert in the sector of surrogacy because during all these years has had the opportunity to know hundreds of real cases of couples who have carried out treatments for surrogacy and the best professionals, international clinics. More information about Natalia Álvarez
Adapted into english by:
 Romina Packan
Romina Packan
Babygest Staff
Editor and translator for the Babygest magazine in English and German. More information about Romina Packan

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