Surrogacy and Pregnancy

Abstract

Importance Surrogacy allows for parenthood when it is otherwise impossible or exceedingly difficult; however, the risks of surrogate pregnancy for the gestational surrogate and the fetus are not well defined. Objective The aim of this study was to review the literature to examine the prevalence and requirements of surrogate pregnancy and maternal and perinatal outcomes. Evidence Acquisition A CINAHL and 2 PubMed searches were undertaken using the terms “surrogate mothers” OR “(surrogate or surrogacy)” AND “(mothers OR pregnancy OR pregnant).” The second search used these terms and pregnancy outcomes. The search was limited to the English language, but the years searched were unlimited. Results The search identified 153 articles, 36 of which are the basis for this review. The number of surrogate pregnancies is increasing in the United States. Fetal risks associated with surrogacy include low birth weight, increased risk of multiple gestation, and preterm birth. Maternal complications associated with surrogate pregnancy include hypertensive disorders of pregnancy, postpartum hemorrhage, and gestational diabetes. Conclusions and Relevance Surrogacy is a route to parenting that is not without risk to the surrogate or the fetus, and surrogate pregnancy is increasing in frequency in the United States. Target Audience Obstetricians and gynecologists, family physician. Learning Objectives After completing this activity, the learner should be better able to identify candidates for surrogacy; describe the effects of obesity on surrogacy; and explain the maternal and perinatal complications associated with surrogate pregnancy.

Donor sperm recipients: fertility treatments, trends, and pregnancy outcomes

“…Scant literature has examined outcomes specifically in co-IVF cycles, which may differ from gestational carrier (GC) cycles given the intimate relationship between the partner carrying the pregnancy and the oocyte source. Literature specifically in GC cycles has demonstrated higher rates of adverse perinatal outcomes, such as hypertensive disorders, gestational diabetes, placental disorders, preterm delivery, low birth weight, and postpartum hemorrhage [ 36 , 37 ]. More studies with larger sample sizes are needed to further study the perinatal outcomes of co-IVF in order to provide comprehensive patient counseling.…”

Commercial Surrogacy: An Overview

“… 99 100 101 102 103 Nevertheless, no gestation is exempt from risk. 104 105 Also, double embryo transfers are quite common in surrogate processes, because it is usually cheaper than having two separate pregnancies, resulting in more multiple pregnancies. 106 107 108 109 In addition, it is believed that cesarean section rates are high among surrogates, not only because IPs may ask for it, but also because low-income surrogates receive medical care in private clinics while in other situation they would be treated in public health systems.…”

Surrogacy and the law in the UK

“…Gestational surrogacy (also known as host or full surrogacy): The intending parent(s)’ gametes or donor gametes are used and implanted into the surrogate using in vitro fertilisation (IVF). In gestational surrogacy, the surrogate has no genetic relation to the embryo 6…”

“…Surrogacy is used as a method of assisted reproduction in women who have uterine abnormalities, do not have a uterus or suffer from medical conditions which contraindicate pregnancy 6. It is also used in women who have suffered from repeated miscarriages or unsuccessful fertility treatments.…”