Parents' relationship with their surrogate in cross-border and domestic surrogacy arrangements: comparisons by sexual orientation and location

Location of surrogacy was associated with parent’s level of involvement in the pregnancy and their subsequent relationship with the surrogate. Few differences were found between heterosexual and gay couples.

Volume 111, Issue 3, Pages 562–570


Vasanti Jadva, Ph.D., Natalie Gamble, P.G.D.L., Helen Prosser, B.Comm., Susan Imrie, Ph.D.



To study heterosexual and gay couples' relationship with their surrogate and their disclosure decisions when the surrogacy arrangement was completed domestically compared with internationally.


Cross-sectional study.


Not applicable.


Participants were 40 gay couples and 76 heterosexual couples who had domestic surrogacy in the United Kingdom (UK) (n = 38) or international surrogacy in the United States (n = 58) or Asia (20). Most (75%) of the children were aged <4 years.


Online surveys containing open-ended and multiple-choice questions.

Main Outcome Measure(s)

Experiences of finding a surrogate, relationship with the surrogate, and disclosure to the child were examined among UK parents who had undergone surrogacy in the UK, United States, or India/Thailand.


Parents who had surrogacy in the UK and United States felt very involved in the pregnancy compared with those who had surrogacy in Asia. Couples whose surrogacy was completed in Asia were less likely to want contact with their surrogate after the birth and were also less likely to have any current contact with the surrogate. Parents who had surrogacy in the UK and United States described positive relationships with their surrogate. Gay couples intended to tell their child about surrogacy more than heterosexual couples.


The specific country where couples conducted their surrogacy arrangement (i.e. United States, UK, or Thailand/India) was associated with how involved they were in the pregnancy and their contact with the surrogate over time. Limitations of the study include use of survey methodology and that the representativeness of the sample is not known.

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Go to the profile of Mary Samplaski
almost 4 years ago

Were the authors able to gain any insight as to why these differences were seen? Were Asian donors less contacted because of government restrictions on outside communication? Lack of access to telephones or long distance calling capabilities? Or was it that these women were less "emotionally attached" to the donor process? Did they see themselves as simply egg donors and desire no connection with their offspring? This is compelling data. 

Go to the profile of Marine Poulain
almost 4 years ago

How do couples choose the country for the procedure? They may have not really the choice to be less involved in the pregnancy because of local organization but are forced to choose a country for economic reasons.