Surrogacy is an arrangement whereby a woman gets pregnant and gives birth on behalf of another person or couple who will become the child's legal parents after birth. People pursue surrogacy for a variety of reasons such as infertility, dangers or undesirable factors of pregnancy, or when pregnancy is a medical impossibility. A surrogacy relationship or legal agreement contains the person who carries the pregnancy and gives birth and the person or persons who take custody of the child after birth. The person giving birth is the gestational carrier, sometimes referred to as the birth mother, surrogate mother or surrogate. Those taking custody are called the commissioning or intended parents. The biological mother may be the surrogate, the intended parent, or neither. Gestational carriers are usually introduced to intended parents through third-party agencies, or other matching channels. They are usually required to participate in processes of insemination (no matter traditional or IVF), pregnancy, and delivery. In surrogacy arrangements, monetary compensation may or may not be involved. Receiving money for the arrangement is known as commercial surrogacy, a practice legally regulated or banned in many countries. The legality and cost of surrogacy varies widely between jurisdictions, contributing to fertility tourism, and sometimes resulting in problematic international or interstate surrogacy arrangements. For example, those living in a country where surrogacy is banned travel to a jurisdiction that permits it. In some countries, surrogacy is legal if there is no financial gain. Where commercial surrogacy is legal, third-party agencies may assist by finding a surrogate and arranging a surrogacy contract with her. These agencies often obtain medical tests to ensure healthy gestation and delivery. They also usually facilitate legal matters concerning the intended parents and the gestational carrier.
Methods Surrogacy refers to an arrangement where a woman carries a child for intended parents. In some cases, it is specified as traditional surrogacy, where the gestational carrier's own egg is used. More commonly, surrogacy is when the egg comes from someone other than the gestational carrier, making the legal and emotional boundaries clearer.
Surrogacy Surrogacy (also known as host or full surrogacy) was first achieved in April 1986. It takes place when an embryo created by in vitro fertilization (IVF) technology is transferred to a gestational carrier. Surrogacy has several forms, and in each form, the resulting child is genetically unrelated to the surrogate:
The embryo is created using the intended father's sperm and the intended mother's eggs; The embryo is created using the intended father's sperm and a donor egg; The embryo is created using the intended mother's egg and donor sperm; A donor embryo is transferred to a gestational carrier. Such an embryo may be available when others undergoing IVF have embryos left over, which they donate to others. The resulting child is genetically unrelated to the gestational carrier and the intended parents.
Traditional surrogacy A traditional surrogacy (also known as partial, natural, or straight surrogacy) is one where the gestational carrier's egg is fertilised by the intended father's or a donor's sperm. Insemination of the gestational carrier can be either through sex (natural insemination) or artificial insemination. Using the sperm of a donor results in a child who is not genetically related to the intended parents. If the intended father's sperm is used in the insemination, the resulting child is genetically related to both him and the gestational carrier.
Risks
Embryo The embryo transferred to the gestational carrier faces the same risks as any embryo transferred through IVF. Pre-transfer risks of the embryo include unintentional epigenetic effects, influence of media which the embryo is cultured on, and undesirable consequences of invasive manipulation of the embryo. Often, multiple embryos are transferred to increase the chance of success, and if multiple gestations occur, both the gestational carrier and the embryos face higher risks of complications. Children born through singleton IVF surrogacy have been shown to have no physical or mental abnormalities compared to those children born through natural conception. However, children born through multiple gestation by gestational carriers often result in preterm labor and delivery, resulting in prematurity and physical or mental anomalies.
Gestational carriers Overall, the medical risks for the gestational carrier, such as pre-eclampsia, are higher than if she were carrying her own genetically related baby. Research showing that gestational carriers have a smaller chance of medical complications such as hypertensive disorder during pregnancy compared to mothers pregnant by oocyte donation are usually comparing younger, healthier, fertile gestational carriers against older, less healthy, infertile women using assisted reproductive technology. About 5% of surrogate pregnancies develop placenta previa or placental abruptions, which can cause dangerous complications for both the gestational carrier and the baby. In some countries, such as China, there exists a gap in the legal framework between the legislation and regulation for surrogacy. There can be an increase in the safety risks of artificial surgeries such as egg retrieval and insemination. Moreover, any underground contracts can inflict serious psychological harm on gestational carriers. Surrogacy agencies have ignored gestational carriers health risks which has led to death and have enforced foetal sex selection through abortions. Multiple embryo transfers and foetal reduction procedures may also be repeated on the same gestational carrier, causing health hazards such as miscarriage, infertility, and even death.
… excerpt ends here. Continue reading the full article.
