Tag: genetics

Understanding Modern Surrogacy: A Path to Parenthood

Three people sitting together on a couch, smiling and holding hands in a supportive gesture
How reproduction science is helping people build families that biology alone could not

There is a particular kind of grief that does not announce itself loudly. It arrives quietly — in hospital waiting rooms, after failed procedures, or in the simple biological reality that your body cannot carry a pregnancy. For millions of people, the desire to become a parent exists, but the conventional path does not. It is in that space, between longing and impossibility, that surrogacy steps in.

Surrogacy is one of the oldest concepts in human history, but its modern form is something entirely different: a medically supervised, legally structured arrangement in which one person carries a pregnancy for another.

Two Types, One Purpose

In traditional surrogacy, the surrogate provides her own egg, making her the biological mother of the child she carries. After birth, she must legally surrender her parental rights, a complexity that has made this form rare and illegal or restricted in many jurisdictions.

Gestational surrogacy is different entirely. An embryo is created through IVF using eggs and sperm from the intended parents or donors, then transferred to the surrogate’s uterus. She carries the pregnancy but has no genetic connection to the child. Today, gestational surrogacy accounts for roughly 99% of all arrangements. The surrogate’s role is to nurture a life she did not create, her body sustains the pregnancy, but the genetic blueprint belongs entirely to the embryo.

How the Process Actually Works

The journey begins long before any embryo is transferred. Intended parents work with a surrogacy agency, which coordinates matching, medical, legal, and emotional aspects of the process. Surrogates undergo psychological evaluations, medical examinations, and background checks. Most agencies require that she has already carried at least one healthy pregnancy.

Once matched, both parties sign detailed legal contracts covering parental rights, compensation, and possible scenarios. In many jurisdictions, intended parents can obtain a pre-birth order, placing their names on the birth certificate from the start. Embryos are then created in a laboratory, often screened via pre-implantation genetic testing (PGT), which can push live birth rates to 70–80% per transfer. Once pregnancy is confirmed, the surrogate receives ongoing medical care and support through to delivery.

Who Surrogacy Helps — and Why It Is Growing

The reality of who needs surrogacy is far broader than the traditional image of an infertile couple. In September 2025, Australia formally expanded its national definition of infertility to include personal circumstances, recognising that a gay male couple or single person faces the same fundamental need as anyone with a medical condition.

For women without a uterus, those who have had hysterectomies, or those with conditions that make pregnancy dangerous, surrogacy is the only path to a genetically related child. The same is true for gay male couples and transgender individuals. The global surrogacy industry reached an estimated $28.91 billion in 2026, with over 210,000 cycles completed in 2025. In the US, embryo transfers to gestational carriers more than tripled between 2010 and 2019. The LGBTQ+ community now represents one of the fastest-growing segments of intended parents, with 85% of gay male couples pursuing biological parenthood choosing gestational surrogacy. Clinics describing themselves as LGBTQ+-affirming have increased by 78% since 2020.

Technology is also transforming access, online platforms now coordinate matching, scheduling, legal paperwork, and communication in ways impossible a decade ago. Some employers have begun including surrogacy in workplace fertility programmes, lowering the financial barrier for many.

The Ethical Landscape

Surrogacy raises genuine ethical questions. It is expensive,  total costs in the United States typically range from $120,000 to $220,000, placing it beyond reach for most without financial assistance. The legal landscape is uneven: countries like the US and Canada have well-developed frameworks, while others have banned the practice entirely. Italy in 2024 criminalised its own citizens for pursuing surrogacy abroad.

Critics argue that paying someone to carry a child risks exploiting economically vulnerable women. Advocates counter that transparency, legal protection, psychological screening, and fair compensation together respect the surrogate’s autonomy. What is not in dispute is the outcome: children born via surrogacy develop healthily, bonding with intended parents is not diminished, and surrogates themselves often describe the experience as profoundly meaningful.

A Different Kind of Gift

What a surrogate offers cannot be easily quantified,  nine months of her body, her health, and her attention to a life that will belong entirely to someone else. The word surrogate comes from the Latin subrogare, meaning to substitute or appoint in place of another. In modern medicine, that substitution makes parenthood possible for those to whom it would otherwise be denied.

The science has advanced. Legal frameworks are maturing. Social acceptance, while still uneven, is growing. Surrogacy,  at its best, is a remarkable alignment of medical technology, legal structure, and human generosity. A person who wanted a child but could not carry one. Another willing to carry that child. A baby who arrives into a family that fought hard to have them.

That is not a medical transaction. It is a story about what people will do for one another when the system works as it should.

Bibliography

Cleveland Clinic. “Gestational Surrogacy: What Is It, Process, Risks & Benefits.” Cleveland Clinic, 30 Jan. 2026,

my.clevelandclinic.org/health/articles/23186-gestational-surrogacy.

Wikipedia Contributors. “Surrogacy.” Wikipedia, The Free Encyclopedia, Wikimedia Foundation, updated June 2026,

en.wikipedia.org/wiki/Surrogacy.

Dastidar, S. Gon, and H. Ghosh. “Insight into Different Aspects of Surrogacy Practices.” Journal of Human Reproductive

Sciences / PMC, U.S. National Library of Medicine, pmc.ncbi.nlm.nih.gov/articles/PMC6262674/.

WebMD Editorial Contributors. “Surrogate Mothers: What It Is and How Does Surrogacy Work.” WebMD, reviewed by

Traci C. Johnson, 2 Jan. 2026, webmd.com/infertility-and-reproduction/using-surrogate-mother.

Circle Surrogacy. “What Is Surrogacy: Traditional vs Gestational Surrogacy.” Circle Surrogacy, updated 7 May 2025,

circlesurrogacy.com/post/what-is-surrogacy-traditional-vs-gestational-surrogacy.

UPMC Editorial Staff. “Surrogacy Options | Comprehensive Guide and Resources.” UPMC, reviewed 5 Sept. 2024,

upmc.com/services/womens-health/services/obgyn/obstetrics/fertility/surrogacy.

OVU Editorial Team. “Complete Surrogacy Guide 2025: Process, Costs & Success Rates.” OVU, 12 Sept. 2025,

ovu.com/fertility-insights/complete-surrogacy-guide-2025-process-costs-success-rates.

ACRC Global. “Surrogacy Statistics 2026: Success Rates, Costs & Key Data.” ACRC Global, 14 Apr. 2026,

acrcglobal.com/post/surrogacy-statistics-2026-success-rates-costs-key-data.

Infertility Cure Hub. “Surrogacy Market Expands Amid Rising Infertility and Legal Complexities Worldwide.”

infertilitycurehub.com, 9 Apr. 2026, infertilitycurehub.com/archives/24062.Egg Donor & Surrogacy Institute (EDSI). “The U.S. Surrogacy Industry Outlook: Trends, Statistics, Costs, and Laws.”

EDSI, 1 Feb. 2026, eggdonorandsurrogacy.com/surrogacy-trends-2025/.

Men Having Babies. “Fertility Equality: Removing Discriminatory Financial Barriers for Gay and Surrogacy Parenting.”

Men Having Babies, menhavingbabies.org/advocacy/fertility-equality/.

GWK Academy. “Pathways to Parenthood: Surrogacy and IVF — 2025.” GWK Academy, 21 July 2025,

gwkacademy.org/lgbtq-surrogacy-and-ivf/.

OVU Editorial Team. “LGBTQ Family Building 2026: Complete Fertility Options Guide.” OVU, June 2026,

ovu.com/fertility-insights/lgbtq-family-building-2026-complete-fertility-options-guide.

Hatch Editorial Team. “Traditional vs. Gestational Surrogacy: What Is the Difference?” Hatch, 30 Dec. 2025,

hatch.us/en/blog/the-two-types-of-surrogacy.

First Fertility. “Choosing Between Traditional and Gestational Surrogacy.” First Fertility, 14 Apr. 2025,

firstfertilityivf.com/2025/04/14/choosing-between-traditional-and-gestational-surrogacy/.

The 23rd Pair: That Decides Who We Are

There is something remarkable happening inside every single cell of your body, right now, as you read this. Inside each cell sits a complete set of instructions so precise that no two people on earth share an identical copy. These instructions are stored in structures called chromosomes. Most people have heard the word. Very few have stopped to understand what chromosomes actually do, how they pass from parent to child, or why the long-held belief that a mother decides the sex of her baby is not just wrong, it is scientifically backwards.

What a Chromosome Actually Is

Think of your DNA as a massive instruction manual, one that tells your body how to build organs, fight infection, and decide whether your eyes are brown or green. The problem is that DNA, if stretched out fully from a single cell, would run about six feet long. 

Chromosomes are the solution. They are DNA coiled tightly around spool-like proteins called histones, compressing the whole thing into a structure small enough to fit inside a nucleus. Humans have 46 chromosomes arranged in 23 pairs. Twenty-two pairs handle the general business of building and running the body. The 23rd pair is the one that determines biological sex, made up of what are called the X and Y chromosomes. That last pair is where most of the interesting questions about inheritance,syndromes and gender get answered.

The Moment Two Cells Become One

Every human being starts as a single cell formed when a sperm and an egg meet. But before that meeting, both cells go through a process called Meiosis, a special kind of cell division that halves their chromosome count. Normal body cells carry 46 chromosomes. Sperm and egg cells carry only 23 each, so that when they fuse, the resulting embryo gets the full complement of 46.

The journey to that fusion is not easy. At ejaculation, up to a billion sperm are released at once. Most do not make it far. Of that billion, only a few hundred ever reach the egg. Only one gets in. The moment it does, a chemical change seals the surface of the egg, locking everything else out. The 23 chromosomes from the sperm and the 23 from the egg come together, and a new human life,in its earliest, single-cell form, begins. Every instruction for that person’s development, from the structure of their heart to the texture of their hair, is now written in that one cell.

The Myth of the Mother: Who Actually Decides the Baby’s Sex

For generations, and in many places still today, families have placed the responsibility for a baby’s sex entirely on the mother. Women who gave birth to only daughters were sometimes blamed or shamed as though they had failed at something. This belief is not just culturally harmful. It is biologically wrong.

Here is what actually happens. Eggs carry sex chromosomes, but an egg can only ever carry an X. This is because women are genetically XX, and when meiosis divides those chromosomes into gametes, the only option available is X. Sperm on the other hand are different. Men are genetically XY, so meiosis produces two types of sperm in roughly equal numbers: half carry an X chromosome, and half carry a Y. The egg has no say in which type arrives.

If the sperm that fertilises the egg carries an X, the embryo is XX, female. If it carries a Y, the embryo is XY, male. The mother contributes an X either way. She cannot change it. The sex of the baby is decided entirely by which type of sperm reaches the egg first, and that is a matter of the father’s biology and chance.

The Y chromosome is considerably smaller than the X. While the X carries around 900 genes, the Y carries roughly 100, and its main job is triggering male development through a gene called SRY, the sex-determining region Y. Without that gene, the embryo develops along a female pathway by default. Biology, in a sense, starts from female and requires an active signal to become male.

This is not a new or contested finding. It is foundational biology, documented across decades of research. The idea that a mother is responsible for the sex of her child has no biological basis. The sex chromosome that decides the outcome comes from the father, carried by whichever sperm cell wins the race.

Citations

AlphaBiolabs USA. “Which Parent Determines the Sex of a Baby?” AlphaBiolabs USA, 10 Apr. 2026, alphabiolabsusa.com/learning-center/which-parent-determines-the-sex-of-a-baby/.

Cleveland Clinic. “Chromosomes.” Cleveland Clinic, 26 Aug. 2025, my.clevelandclinic.org/health/body/chromosomes.

Live Science. “Chromosomes: Facts about our genetic storerooms.” Live Science, 25 Feb. 2022, livescience.com/27248-chromosomes.html.

National Human Genome Research Institute. “Chromosomes Fact Sheet.” Genome.gov, 9 Mar. 2019, genome.gov/about-genomics/fact-sheets/Chromosomes-Fact-Sheet.

NCBI. “Chromosomal Sex Determination in Mammals.” Developmental Biology, ncbi.nlm.nih.gov/books/NBK9967/.

Pampers. “What Determines the Sex of a Baby.” Pampers, 18 Feb. 2026, pampers.com/en-us/pregnancy/pregnancy-announcement/article/what-determines-the-sex-of-a-baby.

WebMD. “What Are Sex Chromosomes?” WebMD, webmd.com/sex/xx-and-xy-chromosomes.

IVF : science of second chances 

Today, For millions of people, In Vitro Fertilization is not the last resort, but rather it’s the most beautiful thing that science has to offer, to transform a couple to a family, to give hope to the opens who have already lost it, Science stands in the way to support them and make it happen. 

There is a particular kind of silence that settles over a couple who have been trying to have a baby for a long time. A silence that lives in the space between hope and grief, in the months that pass without the news they were waiting for. People of Reproductive age will know that silence. For many of them, in vitro fertilisation — IVF — is the thing that breaks it. Not always. Not easily. But often enough that it has become one of the most important medical developments of the last fifty years. Yet most people, even those who have been through it, would struggle to explain in plain terms what IVF actually does.

What does IVF give you

The basic problem IVF solves is this: for some people, the steps of natural conception, egg meets sperm, fertilisation happens, embryo implants in the womb, are blocked somewhere along the way. Blocked fallopian tubes. Very low sperm counts. Diminished ovarian reserve. In many couples, both partners contribute something to the difficulty. These are biological realities, not personal failures, and for a long time medicine had almost nothing useful to offer in response to them. IVF changed that by moving the process out of the body and into a controlled laboratory environment, where each step can be supported, monitored, and when necessary, corrected. Here is what happens. A woman is given hormone injections — gonadotropins — over roughly ten days, which stimulate the ovaries to develop several follicles at once instead of the usual one. When those follicles are mature, the eggs inside them are collected through a minor procedure guided by ultrasound. In the lab, those eggs are fertilised either by placing them in a dish with prepared sperm, or by injecting a single sperm directly into each

egg using a technique called intracytoplasmic sperm injection. The fertilised eggs are then cultured for three to five days while embryologists watch them divide and develop, assessing their quality at each stage. The best-looking embryo is transferred into the uterus. Any others, if viable, are frozen.


The Many Lives Changed by IVF

IVF has also turned out to be far more than a treatment for infertility in the conventional sense. It has become an entire infrastructure. A young woman diagnosed with cancer who freezes her eggs before chemotherapy begins,  that is IVF technology. A same-sex male couple working with a donor egg and a surrogate, that is IVF. A single person in their late thirties who wants to preserve their options,  that, too, is IVF. The field of oncofertility, which exists specifically to protect the reproductive futures of cancer patients, depends entirely on techniques developed through IVF research. None of these possibilities existed a generation ago. 

“The science of IVF has also taught us things about early human development that we could not have learned any other way.”

Before IVF, the first five days of human development after fertilisation were essentially invisible to science. The laboratory stepped in and changed that. Embryos donated for research with the full consent of patients have allowed scientists to map the molecular events of early development in extraordinary detail,  how the embryo transitions from a clump of identical cells to a blastocyst with distinct layers, which genes switch on and off, what signals the embryo sends and receives. This knowledge has fed back into better culture conditions, better selection criteria, and a much deeper understanding of why some

pregnancies fail that would otherwise remain completely unexplained.

But, is it safe?

Safety, understandably, is one of the first concerns people raise when talking about IVF. Historically, the biggest medical risk was ovarian hyperstimulation syndrome, or OHSS, where the ovaries react too strongly to fertility drugs and become swollen, sometimes causing serious complications. Years ago, severe cases were a genuine concern. Today they are far less common because fertility clinics use gentler stimulation protocols and safer trigger medications for patients who are considered high-risk. In most modern clinics, severe OHSS is now rare.

There are also understandable questions about the long-term health of children born through IVF. After decades of research and millions of births worldwide, the overall evidence has been reassuring. Large studies following IVF-conceived children into later childhood and adolescence have found no meaningful differences in cognitive ability, neurological health, or educational outcomes once broader family and health factors are considered.

That does not mean IVF is easy. It can be physically exhausting, emotionally draining, and financially overwhelming. It also does not guarantee success, which is something any honest discussion of IVF has to acknowledge. Access remains deeply unequal, with treatment costs placing it out of reach for many people, especially in countries where public healthcare support is limited. Those criticisms are real and important. But so is the scale of what IVF has made possible. The evidence supporting its safety and effectiveness now stretches across decades and millions of cases. For the millions of people born because of it,  and the families that exist because of those births,  IVF stopped being an experimental idea a very long time ago.

Should We Edit Babies Before They Are Born?

What Is Fetal Gene Editing?

Scientists can now go inside a mother’s womb and change the DNA of a growing baby. This is called fetal gene editing. The goal sounds good, fix a dangerous disease before the baby is even born. But here is the problem, the baby has no say in it. No one asks the baby. No one can. And the change made to its DNA is permanent,  it cannot be undone. This raises a question the medical world has not fully answered yet,is this right?

The Baby Cannot Say Yes or No

When a doctor edits a baby’s DNA in the womb, the baby carries that change for its entire life. If something goes wrong — if the edit accidentally turns on a harmful gene or causes a health problem, the baby has no way to reject the treatment or report the harm. The parents give permission on the baby’s behalf, but the baby is the one living with the result. We would never do this to an adult without their full agreement. So why is it different for a baby who cannot speak? 

It Could Affect Children Not Yet Born

Here is where it gets even more serious. Some gene edits do not just affect the baby, they can affect that baby’s future children too. This is called germline editing. It means the change gets passed down like any other trait, from generation to generation. People who have not been born yet, who have no voice at all, could carry a change made today in a hospital room. In 2018, a scientist in China did exactly this and the world was outraged. Yet the science is moving forward again, without a clear global rulebook to stop it from happening.

The Baby Is Being Used as a Test Subject

Fetal gene editing is still experimental. That means doctors are still learning what works and what does not. The baby in the womb is, in plain terms, part of that experiment. The parents agree to it — often because they desperately want to protect their child from a terrible disease, which is completely understandable. But the baby’s own interests are not independently represented. No one in the room is specifically there to speak for the baby alone. And all the risk, the possibility of a wrong edit, an unexpected side effect, a lifelong consequence is carried entirely by the baby.

We Need Better Rules Before We Go Further

This is not an argument against helping sick babies. That goal is good and worth pursuing. But right now, the science of editing a baby’s DNA is moving faster than the rules meant to keep it safe and fair. The baby being edited is a human being — small, voiceless, and entirely dependent on the decisions of adults. It deserves more than just good intentions. It deserves a proper ethical framework: independent oversight, honest risk disclosure, and a serious conversation about how far we should go. That conversation is overdue.