For gay men and male couples, building a family through assisted reproduction often involves two important pieces: egg donation and gestational surrogacy.
The egg donor provides the eggs needed to create embryos, while a gestational surrogate carries the pregnancy. Although these are separate processes, they need to work together as part of one coordinated family-building journey.
Along the way, intended fathers will make decisions about choosing an egg donor, creating embryos, finding the right surrogate, completing medical and legal requirements, and preparing for pregnancy and delivery. Understanding how these pieces fit together can make the process feel much more manageable.
Why gay dads typically need both an egg donor and a surrogate
For male intended parents, an egg is needed to create an embryo and a uterus is needed to carry the pregnancy.
An egg donor provides the eggs that are fertilized with sperm from one or both intended fathers. The resulting embryo can then be transferred to a gestational surrogate.
The distinction between these two roles is important. The egg donor contributes genetic material to the embryo but does not carry the pregnancy. The gestational surrogate carries the pregnancy but does not provide the egg, so she does not have a genetic relationship to the baby.
This is known as gestational surrogacy, which is the type of surrogacy used by most fertility clinics and professional surrogacy programs today.
Choosing an egg donor
Choosing an egg donor can be one of the most personal parts of the journey.
Intended parents may find a donor through an egg donor agency, fertility clinic donor program, frozen egg bank, or someone they already know. Some gay couples also consider a known donor who is biologically related to the partner who will not be providing sperm.
When reviewing donor profiles, intended parents may consider physical characteristics, education, personality, interests, and personal background. Medical information is equally important.
At Simple Steps Fertility, egg donors complete a detailed personal and family medical history and an interview before they are added to our donor database. Once matched, additional screening is completed according to the fertility clinic’s requirements. This can include medical testing, genetic carrier screening, infectious disease testing, and psychological evaluation.
The fertility clinic ultimately determines whether a donor is medically cleared to proceed with a donation cycle.
Creating embryos through IVF
Once an egg donor is selected and the appropriate medical and legal steps are complete, the IVF process can begin.
During a fresh egg donation cycle, the donor takes fertility medications that encourage multiple eggs to develop. Her fertility clinic monitors her closely through bloodwork and ultrasounds. When the eggs are ready, they are collected during an outpatient egg retrieval procedure.
The eggs are then fertilized in the embryology laboratory using sperm from an intended father.
For couples, there are several ways to approach this decision. One father may provide sperm for all of the eggs, or the eggs may be divided so embryos can be created using sperm from each father. Some couples hope to have siblings in the future with each father having a biological connection to one child.
There is no single right approach. Your fertility specialist can help you understand your options based on the number of eggs available, sperm testing, your family-building goals, and other medical considerations.
Embryos typically develop in the laboratory for several days before suitable embryos are frozen.
Your fertility clinic may also discuss preimplantation genetic testing for aneuploidy, or PGT-A. PGT-A provides information about the number of chromosomes in an embryo, but it is not automatically recommended for every IVF patient. Whether testing makes sense for your journey is a decision to discuss with your reproductive endocrinologist.
Finding and matching with a gestational surrogate
Egg donation is only one part of the process. Intended fathers also need to find a gestational surrogate who is medically qualified and feels like the right match for their family.
Surrogate candidates go through a detailed screening process. This includes reviewing previous pregnancies and deliveries, medical records, health history, psychological readiness, background information, and the support available to them throughout the journey.
The intended parents’ fertility clinic also performs its own medical evaluation before approving a surrogate for embryo transfer.
A good match is about more than meeting medical requirements.
Before agreeing to work together, intended parents and surrogates should discuss communication preferences, expectations during pregnancy, prenatal testing, difficult pregnancy decisions, delivery, and the type of relationship everyone hopes to have.
Having these conversations before matching helps make sure everyone enters the journey with compatible expectations.
Medical and legal clearance before embryo transfer
Once intended parents and a surrogate have agreed to match, the medical and legal clearance process begins.
The fertility clinic completes a detailed evaluation of the surrogate. This may include bloodwork, infectious disease testing, a physical examination, and an evaluation of the uterine cavity.
The legal process is handled separately. Intended parents and the surrogate should each have their own attorney experienced in assisted reproduction law.
The Gestational Carrier Agreement outlines important parts of the journey, including surrogate compensation and expenses, insurance, medical expectations, communication, pregnancy-related decisions, and plans surrounding delivery.
Surrogacy laws and parentage procedures vary by state, so reproductive attorneys also determine what legal steps will be needed to establish the intended fathers’ parental rights.
Legal agreements and medical clearance are completed before the fertility clinic begins the embryo transfer cycle. Current ASRM guidance also recommends independent legal counsel for the parties and completion of legal agreements before treatment begins.
Embryo transfer, pregnancy, and delivery
After medical and legal clearance, the fertility clinic prepares the surrogate for embryo transfer.
She may take medications such as estrogen and progesterone while the clinic monitors the development of her uterine lining. When the timing is right, an embryo is transferred into the uterus using a thin catheter.
Pregnancy is not guaranteed after every embryo transfer. Some families may need more than one attempt.
When pregnancy occurs, the fertility clinic monitors the early stages before care eventually transitions to the surrogate’s obstetric provider.
From there, intended parents can begin experiencing many of the milestones they have been waiting for, including ultrasound appointments, pregnancy updates, and planning for delivery.
How involved intended parents are in appointments and day-to-day communication varies from one relationship to another. Those expectations are typically discussed during matching so both the fathers and surrogate feel comfortable.
As delivery approaches, the agency, attorneys, intended parents, surrogate, and hospital can work together to prepare for the birth and make sure important legal and logistical arrangements are in place.
Planning for egg donation and surrogacy costs
Because gay dads may need both egg donation and surrogacy, it is important to look at the cost of the entire journey rather than budgeting for either service alone.
Expenses can include egg donor compensation, donor screening and travel, IVF and embryo creation, surrogate compensation and benefits, fertility clinic care, agency services, legal representation, insurance, escrow, and travel.
Costs can also change during the journey. An additional embryo transfer, unexpected travel, insurance needs, or pregnancy complications can increase the total amount.
Understanding these expenses before you begin can help you create a more realistic family-building budget.
Why coordinating egg donation and surrogacy matters
Egg donation and surrogacy involve many different people and organizations. Your journey may include an egg donor, gestational surrogate, fertility clinic, embryology laboratory, attorneys, insurance professionals, escrow provider, and other specialists.
When these pieces are coordinated, it is easier to understand what needs to happen and when.
At Simple Steps Fertility, we support intended parents with both egg donation and gestational surrogacy. That allows our team to help connect the different stages of the journey, coordinate with the professionals involved, and provide one consistent source of support along the way.
Taking the first step toward fatherhood
You do not need to choose an egg donor, select a surrogate, or have every medical decision made before you begin exploring your options.
Your first step can simply be learning how the process works, what decisions you will need to make, and what your individual journey might look like.
Whether you need support with egg donation, gestational surrogacy, or both, Simple Steps Fertility can help you understand your options and guide you through each stage of building your family.
Contact Simple Steps Fertility to learn more about how egg donation and surrogacy can work together on your path to fatherhood.