Surrogacy

The term surrogacy is used when a woman carries a pregnancy and gives birth to a baby for another woman. Opinion on the morality of surrogacy is divided. Surrogacy is legally accepted in some countries such as UK as a treatment option for selected groups of patients. However, surrogacy is still not allowed in many countries. Legislation governing surrogacy varies between countries and even in same country such as the USA, where policies vary between states.Religious attitudes to surrogacy varies. Roman catholic and Anglian Christian do not accept surrogacy because it contrary to the unity of marriage. Islam forbids surrogacy (pregnancy should be the fruit of a legitmate marriage). Surrogacy is not forbidden in both Jewish and Buddhist .Surrogates can be divided into natural surrogates and IVF surrogates.
 

IVF surrogacy (gestational carrier) - full surrogate
This is where a woman carries a pregnancy created by the egg and sperm of genetic couple. The carrier is not genetically related to the child


Natural surrogacy (traditional/straight surrogate)
Here, the surrogate is inseminated with sperm from the male partner’s of an infertile couple. The child that results is genetically related to the surrogate and to the male partner but not to the commissioning female partner.


To whom surrogacy is advised?
There are several groups of patients that natural and IVF surrogacy may be advised to.IVF surrogacy

Women whose ovaries are producing eggs but they do not have uterus this could be because they have had a hysterectomy (removal of uterus) performed due to cancer, severe hemorrhage or ruptured womb, or they were born without a uterus. This is by far the most common indication for IVF surrogacy.

 A woman whose uterus is malformed or damaged and is incapable of carrying a pregnancy to term, may be recommended IVF surrogacy.

 Women who suffer from medical problems such as diabetes, heart and kidney diseases and in whom a pregnancy would be life threatening. However, their long term prospect for health is good.

 Repeated miscarriages where the causes of miscarriage have been fully investigated, may also suggest IVF surrogacy treatment.
 
 
Traditional surrogacy

 Women who have no functioning ovaries due to premature menopause ( some may argue that the best option for these patients is egg donation).

 A woman who is at risk of passing on a genetic disease to her offspring, may opt for traditional surrogacy.
 
As with IVF surrogacy, women who suffer from medical problems such as diabetes, heart and kidney diseases and in whom a pregnancy would be life threatening may select traditional surrogacy if their long term prospect for health is good.
 
Surrogacy for social reasons such as the inconvenience of carrying a child, fear of pregnancy or interrupting a career is not accepted.Women who agree to become a surrogate may do so for compassionate reasons to help a sister, daughter or friend. Some women may agree to become surrogates for financial remuneration. However, commercial surrogacy is not allowed in the United Kingdom.
 
Between 30-40 IVF surrogacy procedures are carried out annually in the United Kingdom.
 
  
Protocols and guidelines for managing surrogacy
Most infertility clinics have protocols and guidelines for managing surrogacy. Such clinics only accept couples for treatment if both the genetic and host couples fulfill their criteria.
 
Consultation
Consultation with a medical doctor to assess whether the couple are medically suitable for treatment.
 
Assessment of genetic couples
For IVF surrogacy in the UK, the ages of commissioning genetic couple should be under 35 years for women and under 55 year for men. In natural surrogacy, no restrictions are placed on the mans age. An in depth review of the medical history from both partners and a physical examination is normally performed. The male partner will usually have a semen analysis.
 
Assessment of the host - the carrier
The ideal surrogate should be married or in a stable relationship and relatively young, less than 38 years old to minimize the obstetric risk to the host and her family. It is also preferable if the surrogate has at least one previous live birth without complications. In addition, it is important that potential surrogates do not have habits of smoking, alcohol, illicit drug use, or a history of medical disorders such as diabetes or Rhesus (Rh) antibodies that could jeopardize the health of the fetus. In order to ensure the above criteria are met, the patients medical history is reviewed, physical and internal examinations are performed, and the surrogates uterus is evaluated by ultrasound scan or hysteroscopy. Furthermore, a psychological evaluation is usually carried out.
 

Male Infertility

 

Female Infertility

 

Diagnosis Male

 

Diagnosis Female