Donation & Surrogacy

Donation & surrogacy at a glance

  • If a couple is struggling with infertility due to poor egg or sperm quality, or lack of eggs or sperm, they can consider egg or sperm donation.
  • Women who can carry a pregnancy but do not have healthy eggs may consider egg donation.
  • Men who have extremely low sperm counts and men who do not have viable sperm (sperm that can fertilize the woman’s egg), can use donor sperm.
  • Single women and lesbian couples may also consider sperm donation to produce a pregnancy.
  • A surrogate (gestational carrier) may be used by a woman who cannot carry a pregnancy. Gay male couples may also use a surrogate to have a child.

When to consider donation

Egg donation

Egg donation is an option for women who are able to carry a pregnancy (have a healthy uterus), but cannot produce healthy eggs for fertilization, either due to premature menopause or diminished ovarian reserve, or who have been found to have very poor egg quality through prior in vitro fertilization (IVF). Additionally, donor eggs can be used if the woman carries a genetic disorder that she does not want to pass on to the child.

Donor eggs collected from a known or, typically, an anonymous donor are fertilized with the male partner’s sperm to create embryos, then one or more embryos is transferred into the woman’s uterus to create a pregnancy through IVF.

Sperm donation

If the couple is diagnosed with male factor infertility due to a problem with the man’s sperm, sperm donation may be considered as an alternative to IVF. Problems with sperm movement (motility), shape (morphology), or ability to penetrate the egg (velocity) can cause infertility that makes pregnancy using the male partner’s sperm unlikely or impossible. Donor sperm may also be used if the male partner does not want to pass on a genetic disorder to the child.

Donor sperm is collected from a known or, typically, an anonymous donor and frozen. The sperm can be placed into the woman’s uterus (intrauterine insemination, also known as IUI) around the time of her ovulation. Or the woman can use these sperm in the IVF process, and the resulting embryo(s) can be implanted into her uterus.

Single women or lesbian couples wishing to have children may also consider sperm donation in order to produce a pregnancy without a male partner.

Embryo donation

During the IVF process, embryos are created and one or more is implanted in a woman’s uterus to begin a pregnancy. The remaining embryos are then cryopreserved (frozen), or discarded. Some couples choose to donate their unused cryopreserved embryos. An infertile couple (either from female or male infertility, or both) may consider using donated embryos (sometimes called adopting embryos) as a way for the woman to carry a pregnancy. Although the couple will not be related to the child genetically, they will get to have the experience of pregnancy and birth.

When to consider a gestational carrier or surrogate

If a woman has healthy eggs but is not able to carry a pregnancy, either due to problems with her uterus or other health factors, she may consider using a gestational carrier. A gestational carrier is a woman who carries a couple’s or another woman’s pregnancy, but is genetically unrelated to the baby.

Typically, the female partner’s eggs and the male partner’s sperm (or donor sperm) are collected, the eggs are fertilized to create embryos, and the resulting embryo(s) are implanted in the gestational carrier, who will carry the pregnancy. After delivery, the baby is given to the couple.

Gay male couples may also consider surrogacy, using donor eggs combined with one of the partners’ sperm, creating one or more embryos to implant into the gestational carrier’s uterus.

Surrogacy is when a woman uses her own eggs to help a couple or individual achieve a pregnancy. In this case, the male partner’s sperm is used to get the surrogate pregnant. The surrogate carries the pregnancy and after delivery, relinquishes the child to the intended parent(s).

Due to legal and/or emotional concerns, gestational carriers are generally the preferred method.

Laws governing gestational carriers and surrogacy vary by state, and couples considering this should seek consultation with their physician and with an attorney familiar with the laws of the states where the treatment and/or birth will occur. Tennessee laws specifically allow both gestational carriers and surrogates, with specific protection for married couples who are the intended parents. Tennessee laws do not mention protection for unmarried or gay couples. Georgia and Alabama have no statutes regarding surrogacy or gestational carriers.