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Human Reproduction Update 2016Surrogacy is a highly debated method mainly used for treating women with infertility caused by uterine factors. This systematic review summarizes current levels of... (Review)
Review
BACKGROUND
Surrogacy is a highly debated method mainly used for treating women with infertility caused by uterine factors. This systematic review summarizes current levels of knowledge of the obstetric, medical and psychological outcomes for the surrogate mothers, the intended parents and children born as a result of surrogacy.
METHODS
PubMed, Cochrane and Embase databases up to February 2015 were searched. Cohort studies and case series were included. Original studies published in English and the Scandinavian languages were included. In case of double publications, the latest study was included. Abstracts only and case reports were excluded. Studies with a control group and case series (more than three cases) were included. Cohort studies, but not case series, were assessed for methodological quality, in terms of risk of bias. We examined a variety of main outcomes for the surrogate mothers, children and intended mothers, including obstetric outcome, relationship between surrogate mother and intended couple, surrogate's experiences after relinquishing the child, preterm birth, low birthweight, birth defects, perinatal mortality, child psychological development, parent-child relationship, and disclosure to the child.
RESULTS
The search returned 1795 articles of which 55 met the inclusion criteria. The medical outcome for the children was satisfactory and comparable to previous results for children conceived after fresh IVF and oocyte donation. The rate of multiple pregnancies was 2.6-75.0%. Preterm birth rate in singletons varied between 0 and 11.5% and low birthweight occurred in between 0 and 11.1% of cases. At the age of 10 years there were no major psychological differences between children born after surrogacy and children born after other types of assisted reproductive technology (ART) or after natural conception. The obstetric outcomes for the surrogate mothers were mainly reported from case series. Hypertensive disorders in pregnancy were reported in between 3.2 and 10% of cases and placenta praevia/placental abruption in 4.9%. Cases with hysterectomies have also been reported. Most surrogate mothers scored within the normal range on personality tests. Most psychosocial variables were satisfactory, although difficulties related to handing over the child did occur. The psychological well-being of children whose mother had been a surrogate mother between 5 and 15 years earlier was found to be good. No major differences in psychological state were found between intended mothers, mothers who conceived after other types of ART and mothers whose pregnancies were the result of natural conception.
CONCLUSIONS
Most studies reporting on surrogacy have serious methodological limitations. According to these studies, most surrogacy arrangements are successfully implemented and most surrogate mothers are well-motivated and have little difficulty separating from the children born as a result of the arrangement. The perinatal outcome of the children is comparable to standard IVF and oocyte donation and there is no evidence of harm to the children born as a result of surrogacy. However, these conclusions should be interpreted with caution. To date, there are no studies on children born after cross-border surrogacy or growing up with gay fathers.
Topics: Child; Cohort Studies; Family; Female; Humans; Infant, Newborn; Infertility; Oocyte Donation; Parent-Child Relations; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 26454266
DOI: 10.1093/humupd/dmv046 -
Ceska Gynekologie 2019Provide background to the debate on the criteria for selecting a surrogate mother, if the procedure should be regulated in the Czech Republic.
OBJECTIVE
Provide background to the debate on the criteria for selecting a surrogate mother, if the procedure should be regulated in the Czech Republic.
DESIGN
Qualitative content analysis of documents.
SETTING
Faculty of Health and Social Studies, University of South Bohemia, České Budějovice; AK Prudil et al., Brno.
METHODS
Several sources of data have been used: 1. Legal documents of several European countries where surrogate motherhood is regulated by law: UK, NL, Greece, Portugal. 2. The websites of agencies that mediate surrogate motherhood; analysed number: 23.
RESULTS
The most frequently mentioned criterion for selection a surrogate mother was her parental status and gynecological history. Further, the requirements related to age, state of health (exclusion of psychiatric diagnosis), lifestyle. Less often, BMI requirements, citizenship, relationship with the applicant, marital status, impeccability, financial stability, number of procedures underwent. In addition, difficult-to-assess features, such as willingness to process or family support, are required.
CONCLUSION
The criteria formulated by the SAR ČGPS ČLS are highly qualified, taking into account the complexity of the procedure. We recommend to reconsider the upper age limit and the number of procedures that an adept can pass (we recommend one). The psychologist should be qualified in psychodiagnostics. We recommend starting negotiations with professional psychological societies about his required qualifications. We also recommend accepting this procedure only for couples residing in the Czech Republic.
Topics: Czech Republic; Europe; Female; Humans; Pregnancy; Qualitative Research; Surrogate Mothers
PubMed: 31213055
DOI: No ID Found -
Taiwan Yi Xue Ren Wen Xue Kan Mar 2004A "surrogate mother" is a woman who, for financial or other reasons, agrees to bear a child for another woman who is incapable to conceive herself. In other words, she...
A "surrogate mother" is a woman who, for financial or other reasons, agrees to bear a child for another woman who is incapable to conceive herself. In other words, she is a "substitute mother" that conceives, gestates and delivers a baby on behalf of another woman who is subsequently to be seen as the "real" (social and legal) mother of the child. Though the practice of surrogacy has already become a big market in western countries, it has also generated countless challenges for the law because it adds a third dimension to the meaning of motherhood. Like adoption, surrogacy separates the role of rearing mother from what the law has called the natural mother, but gestational surrogacy breaks the latter down into the roles of genetic mother and birth mother, leaving two women with biological connections to the child. Because surrogacy tends to commodify and dehumanize people, and because of all its legal, social, and psychological complications, it is obviously not wise to accept surrogacy as an alternative way of procreation.
Topics: Commodification; Contracts; Female; Humans; Parent-Child Relations; Pregnancy; Surrogate Mothers
PubMed: 15460596
DOI: No ID Found -
Ceska Gynekologie 2018The aim of this article is to give a critical overview of the main concepts used in surrogate motherhood, taking into account the influence of some terms, such as the... (Review)
Review
OBJECTIVE
The aim of this article is to give a critical overview of the main concepts used in surrogate motherhood, taking into account the influence of some terms, such as the commissioning parents, commercial surrogacy or the phrase „gift of life“, on a specific framework of interpretation of this reproductive model. Partial interest is to compare the findings with the results of foreign studies and propose alternative concepts suitable for scientific and political discourse in the Czech Republic.
DESIGN
Review.
SETTING
Department od Medical Ethics, Faculty of Medicine, Masaryk University, Brno.
METHODS
Summary of texts on surrogacy motherhood, published in the years 1986-2017 in the Czech Republic, taking into account the terminology used by the surrogacy. Comparison with foreign studies.
CONCLUSION
Terminology of surrogacy has its ethical and psychosocial consequences. In some cases, the terms implicitly include the attitudes of the authors. It is preferable to use preferential terms of surrogacy, surrogate mother. The use of the notion of commissioning parents becomes unacceptable. The use of the terms of intended parents is more correct, respecting the autonomy of the persons involved. The terms „commercial surrogate motherhood“ and „gift of life“ should be further discussed. Keywords surrogacy, surrogate mother, intended parents.
Topics: Czech Republic; Ethics, Medical; Female; Humans; Pregnancy; Surrogate Mothers
PubMed: 30848153
DOI: No ID Found -
Clinics in Perinatology Jun 1987Numerous legal and ethical issues are raised by the use of surrogate arrangements as a reproductive alternative. The purpose of this article is to provide physicians and... (Review)
Review
Numerous legal and ethical issues are raised by the use of surrogate arrangements as a reproductive alternative. The purpose of this article is to provide physicians and other health care professionals with a basic overview of the legal issues and to outline some of the ethical considerations so that they might make more well-informed decisions about their personal involvement in surrogate arrangements and to better counsel their patients who might be considering such arrangements.
Topics: Contract Services; Contracts; Ethics, Medical; Female; Humans; Jurisprudence; Maternal-Fetal Relations; Mothers; Pregnancy; Surrogate Mothers; United States
PubMed: 3297465
DOI: No ID Found -
Fertility and Sterility May 2020Gestational surrogacy can provide an effective family-building method for women whose uterus is absent or dysfunctional and with contraindications to pregnancy, single...
Gestational surrogacy can provide an effective family-building method for women whose uterus is absent or dysfunctional and with contraindications to pregnancy, single men, and same-sex male couples. Over the past 30 years, gestational surrogacy cases have represented a growing percentage of third-party reproduction cases, both in the United States and internationally. The following series of articles provides a summary of current topics in optimizing GS arrangements. They focus on medical and psychological screening; psychosocial adjustment of carriers, children, and their families; legal considerations with precedent-setting cases that every clinician should know; and an international overview of cross-border surrogacy.
Topics: Female; Humans; Policy Making; Pregnancy; Reproductive Medicine; Reproductive Techniques, Assisted; Surrogate Mothers
PubMed: 32312561
DOI: 10.1016/j.fertnstert.2020.03.016 -
Medicina (Kaunas, Lithuania) Jan 2021: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of... (Review)
Review
: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of children and parents. Surrogacy is a form of medically-assisted procreation (MAP) in which a woman "lends" her uterus to carry out a pregnancy on behalf of a third party. There are pathological conditions, such as uterine agenesis or hysterectomy outcomes, that may prevent prospective mothers from becoming pregnant or carry a pregnancy to term; such patients may consider finding a surrogate mother. Many issues relating to surrogacy remain unresolved, with significant disagreements and controversy within the scientific community and public opinion. There are several factors called into play and multiple parties and stakeholders whose objectives and interests need to somehow be reconciled. First and foremost, the authors contend, it is essential to prioritize and uphold the rights of children born through surrogacy and heterologous MAP. : To draw a parallel between Italy and the rest of the world, the legislation in force in twelve European countries was analyzed, eleven of which are part of the European Union (France, Germany, Italy, Spain, Greece, Netherlands, Belgium, Denmark, Lithuania, Czech Republic and Portugal) and three non-members of the same (United Kingdom, Ukraine and Russia), as well as that of twelve non-European countries considered exemplary (United States, Canada, Australia, India, China, Thailand, Israel, Nigeria and South Africa); in particular, legislative sources and legal databases were drawn upon, in order to draw a comparison with the Italian legislation currently in force and map out the evolution of the Italian case law on the basis of the judgments issued by Italian courts, including the Constitutional and Supreme Courts and the European Court of Human Rights (ECHR); search engines such as PubMed and Google Scholar were also used, by entering the keywords "surrogacy" and "surrogate motherhood", to find scientific articles concerning assisted reproduction techniques with a close focus on surrogacy. : SM is a prohibited and sanctioned practice in Italy; on the other hand, it is allowed in other countries of the world, which leads Italian couples, or couples from other countries where it is banned, to often contact foreign centers in order to undertake a MAP pathway which includes surrogacy; in addition, challenges may arise from the legal status of children born through surrogacy abroad: to date, in most countries, there is no specific legislation aimed at regulating their legal registration and parental status. : With reference to the Italian context, despite the scientific and legal evolution on the subject, a legislative intervention aimed at filling the regulatory gaps in terms of heterologous MAP and surrogacy has not yet come to fruition. Considering the possibility of "fertility tourism", i.e., traveling to countries where the practice is legal, as indeed already happens in a relatively significant number of cases, the current legislation, although integrated by the legal interpretation, does not appear to be effective in avoiding the phenomenon of procreative tourism. Moreover, to overcome some contradictions currently present between law 40 and law 194, it would be appropriate to outline an organic and exhaustive framework of rules, which should take into account the multiplicity of interests at stake, in keeping with a fair and sustainable balance when regulating such practices.
Topics: Altruism; Australia; Child; Child Welfare; Commerce; Europe; Female; Humans; Israel; Italy; Japan; Medical Tourism; Pregnancy; Public Policy; Reproductive Techniques, Assisted; Russia; Social Problems; Surrogate Mothers; Thailand; Ukraine; United States
PubMed: 33429930
DOI: 10.3390/medicina57010047 -
Proceedings of the National Academy of... Sep 2022Previous studies showed that baby monkeys separated from their mothers develop strong and lasting attachments to inanimate surrogate mothers, but only if the surrogate...
Previous studies showed that baby monkeys separated from their mothers develop strong and lasting attachments to inanimate surrogate mothers, but only if the surrogate has a soft texture; soft texture is more important for the infant's attachment than is the provision of milk. Here I report that postpartum female monkeys also form strong and persistent attachments to inanimate surrogate infants, that the template for triggering maternal attachment is also tactile, and that even a brief period of attachment formation can dominate visual and auditory cues indicating a more appropriate target.
Topics: Animals; Female; Haplorhini; Humans; Love; Mothers; Object Attachment; Pregnancy; Surrogate Mothers
PubMed: 36122229
DOI: 10.1073/pnas.2212224119 -
European Journal of Health Law Oct 2023In the sphere of new modalities of creating offspring, one of the most controversial issues is related to surrogacy because it opens the space to unforeseeable ethical,...
In the sphere of new modalities of creating offspring, one of the most controversial issues is related to surrogacy because it opens the space to unforeseeable ethical, legal, sociological and psychological world of dilemmas. Surrogacy is the process whereby a woman carries and gives birth to a baby for a couple who cannot conceive naturally and it has become increasingly popular worldwide. This reproductive method relativized the biological fact of birth and denied the central moment in identifying motherhood, expressed in the ancient Roman proverb that the mother of a child is the woman who gave birth to it. Surrogate motherhood changes the notion of motherhood as it separates the natural functions of a woman as a mother, or it separates the genetic from the gestational motherhood. In such a situation, the biological riddle is: Who is the real mother of the child: the one who gives the genetic material or the one who gives birth to it? The answer to this question opens many moral and ethical dilemmas in complex relationships: the surrogate mother, the couple-clients and the child. As the successful medical practice of giving birth to another undeniably exists in different countries of the world, the further fate of this method of reproduction will significantly depend on ethical justifications.
Topics: Child; Female; Humans; Pregnancy; Surrogate Mothers; Morals
PubMed: 38382555
DOI: 10.1163/15718093-bja10115 -
Harefuah Nov 1992