• starting treatment
• drug therapy
• surgery
• assisted reproduction
  • ART overview
  • IUI
  • IVF
  • ICSI
  • using donors
  • surrogacy
  • health care employees
  • genetic testing

surrogacy

The term surrogacy is used for the situation in which a woman (the surrogate) becomes pregnant and has a child on behalf of another woman (the intended mother) who is physically incapable of doing so. The intention is that the surrogate agrees, from the very beginning, to hand the child over directly to the intended parents.

Surrogacy offers some couples, struggling with infertility, the opportunity of still being the parents of their or at least the male partner’s biological child. The surrogate agrees to carry a child for a childless couple and then give birth to it. After the child is born, the surrogate waives all parental rights.

A distinction is made between ideal surrogacy, in which a close relative or girlfriend volunteers to be the surrogate, and commercial surrogacy, in which the surrogate only comes forward through the intermediary of an agency or person for financial reward. Commercial surrogacy is prohibited in UK.
 
Although surrogacy is an option, which may be worth considering, there are a number of things associated with it which couples have to think seriously about. Surrogacy is time-consuming, emotionally stressful and is accompanied by a whole series of legal obstacles.

types of surrogacy

Surrogacy takes two forms.

In what is called ‘straight’ surrogacy, the surrogate mother supplies her own egg. The surrogate is inseminated with the intended father’s semen and therefore makes both her own womb and her egg available. The surrogate mother is in fact also the genetic mother of the child.

In ‘host mothering’ surrogacy, an IVF procedure is carried out using the intended father’s semen and eggs from the intended mother, but the resultant embryo is transferred into the womb of the surrogate. As a result, the surrogate gives birth to the (biological) child of the intended parents. For women who do not have a functioning womb, this is the only possibility of having their own genetic child. Further information on surrogacy can be obtained from Infertility Network UK .

Due to the fact that a third person is involved in a couple’s reproduction, surrogacy is a complex matter. Ethical, moral, legal and psychological questions all play a role.

psychological problems

Surrogacy goes hand in hand with many psychological considerations, both for the intended parents and the surrogate mother. There is always the risk, for example, that the surrogate mother becomes so attached to the child she is carrying that she does not want to give it up, even if the child is not hers genetically. In an attempt to prevent this, women are subjected to a battery of psychological tests before they become surrogates. The surrogate mother must be ready to act as a surrogate completely of her own free will and without any moral pressure. Besides this, the pregnancy and delivery can carry direct health risks and consequences on the surrogate mother’s own fertility and health. It is therefore usual for the surrogate mother to have one or more children herself.

extra tensions

Because a third party is involved in the pregnancy and birth of the child, the couple are faced with a unique challenge – there are no longer two people involved in the decision, but three. Although clear agreements have to be reached beforehand, there are still matters over which the couple do not have full control and which have to be discussed with the surrogate if they come up. For example, the couple and the surrogate mother may have opposing opinions on the course of the pregnancy and the birth. The surrogate mother and the couple may have different convictions concerning genetic tests.
 
In choosing a surrogate mother, the concerns often increase as well. Not only are the couple concerned about having a healthy baby, they also experience the extra pressure of the worries about the legal problems or that the surrogate mother will change her mind.