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Surrogacy is often portrayed as the “last resort” — a Plan Z for those who’ve run out of options. But that’s not the full picture. For many families, surrogacy is a brave, intentional, and deeply hopeful choice. And sometimes, the people who guide others through the journey — like reproductive endocrinologists — find themselves walking it, too.
This is the story of Dr. Roberts, a fertility specialist who became the patient. It’s also the story of what surrogacy is really like: the beauty, the grief, the logistics, and the fierce love that brings it all together.
What is surrogacy — and who is it for?
Surrogacy is a path to parenthood where someone else carries a pregnancy for the intended parent or parents. There are two main types:
- Gestational surrogacy (most common in the US): An embryo created via IVF is transferred into the uterus of a gestational carrier who has no genetic connection to the baby.
- Traditional surrogacy (rare in the US): The carrier's own egg is used, meaning she is biologically related to the child.
In gestational surrogacy, the embryo may be created using the eggs and sperm of the intended parents, donors, or a combination of both. Surrogacy may be considered for many reasons — a history of miscarriage, failed IVF transfers, medical conditions that make pregnancy unsafe, same-sex couples, single parents, or unexplained infertility.
A physician becomes the patient: Dr. Roberts’ story
Dr. Roberts had spent her career guiding others through fertility treatment, but her world shifted when pregnancy complications made it unsafe for her to carry again. “Hearing those words was heartbreaking,” she said. “As an REI fellow, I had worked with incredible gestational carriers and the families they helped grow — but I never imagined I’d one day need to take that path myself.”
“Still, when it became clear that carrying again wasn’t an option, turning to a gestational carrier felt like a natural and deeply hopeful next step. In fact, we started discussing it even before I delivered my son. We knew our hearts were open to a bigger family, and we wanted to make space for that dream, even if it would look different than we first imagined.
Having walked with so many patients through this process, I thought I understood it — but going through it personally brought a new depth to my perspective. It taught me that even as a doctor, you're never fully prepared for the emotions that come with handing over something as intimate as pregnancy to someone else. But it also showed me the beauty of trust, the generosity of others, and the many forms that love and family can take.
It wasn’t the journey we expected, but it was one filled with grace, resilience, and so much gratitude.”
The emotional side of surrogacy
Even with her years of clinical experience, the emotional side of surrogacy took her by surprise.
“Navigating my own fertility challenges as a reproductive endocrinologist was both humbling and profoundly transformative. I’ve spent my career supporting others through the heartbreak, hope, and resilience that come with fertility treatments, but nothing truly prepares you for living it yourself,” Dr. Roberts explained.
“Being on the other side of the table gave me a deeper empathy that no amount of medical training could have taught. I understood the science, the statistics, the protocols, but I came to truly feel the emotional weight that patients carry: the anxiety between appointments, the constant mental juggling of hope and fear.
It was a deeply personal and humanizing journey. It reminded me why I chose this path in the first place — to walk alongside people during one of the most intimate and challenging chapters of their lives. My experience reshaped how I practice as I now meet my patients not just with knowledge, but with a shared understanding of what it means to hope fiercely and to keep going.
In many ways, my own fertility journey deepened my connection to this work — and to the incredible strength of the people I have the privilege to care for.”
Common misconceptions about surrogacy
Even fertility experts aren’t immune to assumptions. Dr. Roberts admitted that, at first, she believed the hardest part would be the medical side — the hormone injections, early morning monitoring, and physical side effects.
“But once I became the patient,” she said, “I realized those were the easy parts to manage — because they were tangible. You could check them off a list. What I wasn’t prepared for was the emotional weight: the uncertainty that lingers between appointments, the invisible grief of a negative result, the mental exhaustion of trying to stay hopeful while protecting your heart.”
This emotional complexity is common, and it’s something many intended parents aren’t warned about. The sense of loss, even when surrogacy is the right choice, is real and valid. So is the awkwardness of letting go of control, trusting someone else to carry your baby, and navigating how involved to be in a process that’s no longer happening inside your own body.
The logistics: more complicated than most expect
Surrogacy isn’t as simple as a match and a baby. The process typically includes:
- Finding a gestational carrier through an agency or personal network
- Psychological screenings for all parties
- Legal contracts defining roles, responsibilities, and rights
- IVF to create and transfer the embryo
- Regular monitoring and support throughout the pregnancy
“What I didn’t fully appreciate until I was living it was how much coordination, trust, and emotional bandwidth it really takes. There are a lot of starts and stops to the process, with twists and unexpected turns,” explains Dr. Roberts.
“One of the most surprising emotional aspects was how vulnerable it felt to place something so deeply personal — in someone else’s hands. Even when you completely trust your gestational carrier, there’s a sense of distance and lack of control that can be unexpectedly hard to sit with.”
It’s not always a smooth journey. There are moments of deep vulnerability. And while the goal is joyful, the path can feel like a long emotional balancing act.
What makes a good surrogacy experience?
According to Dr. Roberts, the key is communication and mutual respect. Her relationship with her gestational carrier was built on openness and boundaries. “You want to be involved and connected, but you also want to respect her space and autonomy,” she explained. “That balance was something we worked through with a lot of open communication and mutual respect, and I’m so grateful for the partnership we built.”
Some intended parents want to attend every scan. Others prefer updates from afar. There’s no right or wrong approach — only what works best for everyone involved. A good agency and legal team can help define those expectations early on.
“[My] experience completely shifted how I approach my patients. I now understand that the hardest parts often have nothing to do with the medications or procedures. It’s the quiet moments — the waiting, the wondering, the inner dialogue — where so much of the emotional toll lives. And those are the places where I try to meet my patients now, with more softness, presence, and understanding than ever before.”
Support is also essential. That means mental health support for both the intended parents and the gestational carrier. As Dr. Roberts put it, “There’s joy and anticipation, yes, but also grief, worry, and a sense of loss that comes with not being the one pregnant. What helped us most was having a strong support system — personally and professionally — and staying grounded in the “why” behind our journey. Surrogacy is beautiful, but it’s also complex.”
A deeper kind of empathy
Living through fertility treatment — and ultimately surrogacy — shifted how Dr. Roberts shows up for her patients.
“Now, I don’t just understand the emotional toll — I’ve felt it,” she said. “I give more space for patients to express what they’re feeling, even if it’s messy or contradictory.”
“I’m also more mindful of language — how certain phrases, even when well-intentioned, can feel dismissive or minimizing. I try to be more gentle, more present, more attuned to the nuance in each person’s story.” Even the most well-meaning phrases can hit differently when someone is grieving, anxious, or holding complicated emotions. The words “just relax” or “it’ll happen when it’s meant to” can feel hollow or even dismissive.
Her experience changed her practice in quiet but powerful ways. “What people need most isn’t a plan or a protocol right away — it’s permission to feel what they’re feeling without judgment.”
The importance of choice, inclusivity, and support
Every surrogacy journey is different. Some involve known carriers, like a sister or friend. Others are built through surrogacy agencies. Some intended parents are straight couples, others are LGBTQ+ couples, or single parents. The common thread? The desire to grow a family with love and intention.
What matters most is that intended parents and gestational carriers are treated with dignity, agency, and care. That includes:
- Clear legal protections
- Accessible mental health resources
- Inclusive, trauma-informed medical care
- Transparency around costs and expectations
And yes — financial accessibility matters, too. In the US, surrogacy can cost anywhere from $80,000 to $200,000, depending on location, agency fees, legal support, and medical expenses. It’s worth advocating for better financial support and policy reform to make surrogacy an option for more families who need it.
There's more than one path to parenthood
Dr. Roberts’ story is a powerful reminder that there’s no one “right” way to become a parent. What matters is the love, the intention, and the community built along the way.
Surrogacy isn’t a backup plan — it’s a valid, empowering, and deeply human way to build a family. And when doctors like Dr. Roberts share their own stories, they help break down stigma and remind others that asking for help doesn’t make you less of a parent. It makes you strong, open-hearted, and deeply connected to the journey.
As Dr. Roberts explained, “I now lead with the understanding that fertility care isn’t just about helping people get pregnant — it’s about walking with them through one of the most emotionally complex chapters of their lives. My journey didn’t just make me a more empathetic physician — it made me a more human one.”
Tassia O'Callaghan is an experienced content writer and strategist, having written about a vast range of topics from chemical regulations to parenting, for brands like Peanut App Ltd, Scary Mommy, Tally Workspace, and Fertility Mapper. She's an advocate for realistic sustainable living, supporting small businesses (author of A-Z of Marketing for Small Businesses), and equity across all walks of life. Follow her on LinkedIn or TikTok, or see more of her work on Authory or her website.