Doctor giving baby to couple surrogacy

Gestational Surrogacy: Is it Right for You? Understanding the Realities and Results

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"Exploring a Decade of Surrogacy in the Netherlands: Outcomes, Obstetric Risks, and What Intended Parents Need to Know"

Surrogacy, particularly when combined with In Vitro Fertilization (IVF), has become an increasingly viable option for couples unable to carry a pregnancy themselves. This method, which involves retrieving oocytes from the intended mother, fertilizing them with the intended father's sperm, and transferring the resulting embryo into a gestational carrier, offers a pathway to biological parenthood where it might otherwise be impossible.

While gestational surrogacy has been surrounded by legal and ethical debates, with varying acceptance across different countries, it has been legally practiced in the Netherlands since 1997. The Dutch approach emphasizes non-commercial surrogacy, focusing on the well-being of all parties involved and ensuring a supportive environment throughout the process. The VU University Medical Centre in Amsterdam has been the sole provider of IVF treatment within gestational surrogacy in the Netherlands since 2006, accumulating valuable experience and data over the years.

In a comprehensive study conducted at VU University Medical Centre, researchers analyzed a decade's worth of data from gestational surrogacy treatments, shedding light on pregnancy outcomes and maternal complications. This article delves into the findings of this study, providing an in-depth look at the effectiveness, challenges, and important considerations for those contemplating gestational surrogacy as a path to parenthood.

What Factors Determine Success?

The retrospective cohort study meticulously gathered data from 60 intended parents and 63 gestational carriers treated at VU University Medical Centre between October 2006 and March 2017. Researchers examined various aspects, including IVF treatment details, pregnancy progression, and any complications encountered. They obtained information from the medical records of both intended parents and gestational carriers, ensuring a holistic view of each case.

All intended mothers involved in the study had a medical indication for gestational surrogacy and used their own oocytes, fertilized with the intended father's sperm. A total of 93 IVF cycles were initiated, leading to 184 single embryo transfers in the gestational carriers. Here are some inclusion criteria for accepting gestational surrogacy treatment:

Intended mothers must be 40 years old or younger.
Intended parents must have an expected supply of oocytes and semen.
Intended parents should have good biopsychosocial health.
Gestational carriers should have one or more uncomplicated term pregnancies and vaginal deliveries.
Gestational carriers should also have good biopsychosocial health and be between the ages of 25 and 45.

This meticulous approach resulted in 35 ongoing singleton pregnancies, with a live birth achieved for 55.0% of intended couples. However, the study also revealed potential challenges, including hypertensive disorders during pregnancy (20.6% of cases) and postpartum hemorrhage (23.5%). Notably, there were no instances of preterm birth among the pregnancies.

What Does This Mean for You?

The findings of this study emphasize the importance of a multidisciplinary approach to gestational surrogacy, involving careful screening, psychological counseling, and close monitoring throughout the pregnancy. While gestational surrogacy offers a promising path to parenthood, intended parents should be aware of the potential obstetric risks for surrogate mothers, including hypertensive disorders and postpartum hemorrhage. By understanding these realities, intended parents can make informed decisions and work closely with healthcare professionals to ensure the safest and most successful outcome possible.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.rbmo.2018.09.017, Alternate LINK

Title: Gestational Surrogacy: Results Of 10 Years Of Experience In The Netherlands

Subject: Developmental Biology

Journal: Reproductive BioMedicine Online

Publisher: Elsevier BV

Authors: Henrike E. Peters, Roel Schats, Marieke O. Verhoeven, Velja Mijatovic, Christianne J.M. De Groot, Joanna L. Sandberg, Immelie. P. Peeters, Cornelis B. Lambalk

Published: 2018-12-01

Everything You Need To Know

What is gestational surrogacy, and how does In Vitro Fertilization (IVF) play a role in it?

Gestational surrogacy is a method where a woman carries a pregnancy for individuals or couples who are unable to do so themselves. IVF is integral to this process. The intended mother's oocytes are retrieved and fertilized with the intended father's sperm. The resulting embryo is then transferred into the gestational carrier's uterus. This allows intended parents to have a biological child when pregnancy isn't possible for them. The VU University Medical Centre in Amsterdam is the only provider of IVF treatment within gestational surrogacy in the Netherlands since 2006.

What are the main inclusion criteria for intended parents and gestational carriers to be accepted for gestational surrogacy treatment, according to the VU University Medical Centre study?

The VU University Medical Centre study outlines specific inclusion criteria for both intended parents and gestational carriers. For intended mothers, they should be 40 years old or younger, and both parents should have an expected supply of oocytes and semen and demonstrate good biopsychosocial health. Gestational carriers should have a history of one or more uncomplicated term pregnancies with vaginal deliveries, be between 25 and 45 years old, and also have good biopsychosocial health. Meeting these criteria is essential for consideration in the gestational surrogacy program.

What does the decade-long study at VU University Medical Centre in Amsterdam reveal about the success rates and potential complications associated with gestational surrogacy?

The decade-long study at VU University Medical Centre indicates that gestational surrogacy can be a viable option, with a live birth achieved for 55.0% of intended couples. However, it also highlights potential obstetric risks for the gestational carriers, including hypertensive disorders during pregnancy (20.6% of cases) and postpartum hemorrhage (23.5%). Interestingly, the study reported no instances of preterm birth among the pregnancies. These findings underscore the need for careful screening, psychological counseling, and close medical monitoring throughout the gestational surrogacy process.

Considering the legal and ethical debates surrounding gestational surrogacy, what is the approach taken in the Netherlands, and how does it differ from other countries?

In the Netherlands, gestational surrogacy has been legally practiced since 1997, with a strong emphasis on non-commercial surrogacy. The Dutch approach prioritizes the well-being of all parties involved, focusing on creating a supportive environment throughout the process. Unlike some countries where commercial surrogacy is permitted, the Netherlands aims to ensure that surrogacy is driven by altruistic motives rather than financial gain. The VU University Medical Centre in Amsterdam is the sole provider of IVF treatment within gestational surrogacy in the Netherlands since 2006.

How does a multidisciplinary approach contribute to the success and safety of gestational surrogacy, and what specific aspects does it involve?

A multidisciplinary approach is critical for the success and safety of gestational surrogacy. This involves several key components, including careful screening of both intended parents and gestational carriers to ensure their suitability for the process. Psychological counseling is essential to address the emotional and psychological aspects of surrogacy for all parties involved. Close monitoring throughout the pregnancy is necessary to detect and manage any potential obstetric complications, such as hypertensive disorders or postpartum hemorrhage. By integrating these elements, healthcare professionals can optimize the chances of a safe and successful outcome for everyone involved.