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Surrogacy refers to an arrangement where a woman carries a pregnancy for another woman/couple intended to parent the resulting child.
Types of surrogacy:
Gestational surrogacy (GS)
The surrogate is implanted with an embryo created by IVF using the egg and sperm of the intended parents. The resulting child is genetically related to the intended parents, and genetically unrelated to the surrogate. Gestational surrogates are also referred to as gestational carriers.
Gestational surrogacy and egg donation (GS/ED)
The surrogate is implanted with an embryo created by IVF using the intended father’s sperm and donor eggs. The resulting child is genetically related to the intended father and genetically unrelated to the surrogate.
Gestational surrogacy and donor sperm (GS/DS)
The surrogate is implanted with an embryo created by IVF using the intended mother’s eggs and donor sperm. The resulting child is genetically related to the intended mother and genetically unrelated to the surrogate.
Gestational surrogacy and donor embryo (GS/DE)
A donor embryo is implanted in a surrogate. Such embryos are usually donated by other couples who have gone through IVF themselves and have surplus embryos left over. The resulting child is genetically unrelated to the intended parent(s) and genetically unrelated to the surrogate.
Aurora only offers gestational surrogacy, as it is more commonly sought after and less legally complex than traditional surrogacy.
Traditional surrogacy (TS)
This involves naturally or artificially inseminating a surrogate with the intended father’s sperm via IUI, IVF or home insemination. With this method, the resulting child is genetically related to the intended father and genetically related to the surrogate. This service is not available at Aurora.
Traditional surrogacy and donor sperm (TS/DS)
The surrogate is artificially inseminated with donor sperm via IUI, IVF or home insemination. The resulting child is genetically unrelated to the intended parent(s) and genetically related to the surrogate. This service is not available at Aurora.
Who might require Surrogacy?
Intended parents may seek a surrogacy arrangement when medical issues make pregnancy impossible or when it is considered too risky for the mother’s health. Examples include:
- Absent uterus (womb)
- Abnormal uterus (womb) unable to support pregnancy
- Severe maternal illness contraindicating pregnancy
The legal aspects of surrogacy tend to hinge on a few central questions:
- Are surrogacy agreements enforceable, void or prohibited?
- Does it make a difference whether the surrogate mother is paid (commercial) or simply reimbursed for expenses (altruistic)?
- What, if any, difference does it make whether the surrogacy is traditional or gestational?
- Is there an alternative to post-birth adoption for the recognition of the intended parents as the legal parents, either before or after the birth?
UK law stipulates that the woman giving birth to a child is that child’s legal mother, and the only way for another woman to be recognised as the mother is through adoption (usually requiring the birth mother’s formal abandonment of parental rights).
If a surrogate changes her mind and decides to keep the child, the intended mother has no claim to the child even if it is her genetic offspring, and the couple cannot get back any money they may have paid or reimbursed to the surrogate.
If the intended parents change their mind and do not want the child after all, the surrogate cannot get any reimbursement for expenses, or any promised payment, and she will be left with legal custody of the child.
Ethical issues that have been raised include:
- Concerns about exploitation, commodification, and/or coercion when women are paid to be pregnant and deliver babies, especially in cases where there are large wealth and power differentials between intended parents and surrogates.
- Is it right for society to permit women to make contracts about the use of their bodies?
- What does motherhood mean?
- Should a child born via surrogacy have the right to know the identity of any/all of the people involved in that child’s conception and delivery?
Different religions take different approaches, often related to their stances on assisted reproductive technology in general.
Paragraph 2376 of the Catechism of the Catholic Church states that: “Techniques that entail the dissociation of husband and wife, by the intrusion of a person other than the couple (donation of sperm or ovum, surrogate uterus), are gravely immoral.”
Jewish law states that the parents of the child are the man who gives sperm and the woman who gives the egg cell. More recently, Jewish religious establishments have accepted full gestational surrogacy with both intended parents’ gametes included and fertilization done via IVF.
A study by the Family and Child Psychology Research Centre at City University London in 2002 concluded that surrogate mothers rarely had difficulty relinquishing rights to a child and that the intended mothers showed greater warmth to the child than mothers conceiving naturally.
- Surrogates are generally encouraged by the agency they go through to become emotionally detached from the foetus prior to giving birth. Instead of the popular expectation that surrogates feel traumatised after relinquishment, an overwhelming majority describe feeling empowered.
- There are cases in which they are not. Unmet expectations are associated with dissatisfaction. Some women did not feel a certain level of closeness with the couple and others did not feel respected by the couple.
- Some women may experience emotional distress as a surrogate mother. This could be due to a lack of therapy and emotional support through the process.
- Some women may have psychological reactions. These include depression when surrendering the child, grief, and even refusal to release the child.
- A 2011 study from the Centre for Family Research at the University of Cambridge found that surrogacy does not have a negative impact on the surrogate’s own children.
- A recent study (involving 32 surrogacy, 32 egg donation, and 54 natural conception families) examined the impact of surrogacy on mother-child relationships and children’s psychological adjustment at age seven. Researchers found no differences in negativity, maternal positivity, or child adjustment.
As with other kinds of fertility treatment, surrogacy is a complex and emotional issue. It can be a stressful process, and it is essential that all parties involved maintain a healthy psychological attitude. Aurora provides robust counselling and psychological support all throughout the process for the surrogate and intending parents.
To find out more about Surrogacy please ring our enquiries line on 01625 617 316.