Surrogacy: Challenges and Ambiguities

Abstract

Surrogacy, an increasingly frequent form of family building, allows individuals to become parents despite an infertility diagnosis or a biological impossibility. Regardless of the inherent medical, psychological, ethical and legal complexities, altruistic gestational surrogacy became legal in Portugal in 2016. This paper's main goal is to analyse the existing scientific knowledge on the subject and try to understand it in light of the current Portuguese Law. To achieve this goal, PubMed, Scopus, and Web of Science databases were used to search original studies published in English, that included the keywords 'assisted reproduction, commissioning couples, cross-border surrogacy, ethics, gay father, gestational carriers, gestational surrogacy, surrogacy, surrogacy families, surrogate mothers', from 2011 to 2017. Positive outcomes for both the surrogacy child and the surrogate mother have been reported, including in cases of same-sex male couples and single persons, who still have their access to surrogacy restricted in Portugal. Even though payment is forbidden in Portugal, an ongoing debate still exists because remuneration does not necessary involve undue inducement of the surrogate or transformation of the child into a commodity. The growing crossborder surrogacy business raises discussion on the women exploitation's risks and the lack of security for all parties involved. Additionally, the alarming hazard of surrogacy children becoming stateless creates an urgent need for international regulations. The right to regret and the doctors' autonomy before the committee are two issues neglected by the Portuguese Law that should be investigated. Nevertheless, literature on surrogacy is scarce, and most of the existing studies have important methodological limitations, so further investigation is much needed.

Children of Single Fathers Created by Surrogacy: Psychosocial Adjustment Considerations and Implications for Research and Practice

“…Much of the investigation studying single-father families’ interactions and the psychosocial adjustment of children born via surrogacy, have demonstrated that these families are well adjusted and function well [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Far fewer studies have been implemented with children born via surrogacy than on families with children formed through other more recurrent procedures of reproduction [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

“…Additionally, surrogacy itself may pose specific challenges, because a single’s man choice of becoming a father through surrogacy (whether altruistic or commercial, traditional, or gestational) is often seen as an eccentricity and an exploration of the female body [ 11 ]. However, to break this level of complexities and moral judgement, many men choose to pursue gestational surrogacy, because the embryo is produced via the in vitro fertilization of gametes from an egg donor and the father, then being shifted to the surrogate’s uterus, creating no genetic relation between the baby and the surrogate [ 12 ].…”

Caring for Delivery: Healthcare Professionals’ Ethical Conflicts in Surrogate Pregnancy

“…There is a case mentioning some healthcare professionals’ claim for a clause of conscience to not support surrogacy itself (Armuand et al 2018). In other work, conscientious objection is addressed in the framework of potential restrictions on single persons or same-sex couples by healthcare professionals, a possibility that the authors consider an act of “discrimination and prejudice” (Igreja and Ricou 2019, 69).…”

Promoting Social Visibility for Single-Father Families Created by Surrogacy

“…On the contrary, surrogacy has the potential to expand social norms, allowing the creation of families where it was previously impossible. This is especially the case with gestational surrogacy, where the embryo results from in vitro fertilization (IVF) of gametes from the egg donor and the intended father and is subsequently transferred to the surrogate’s uterus, because under these circumstances, there is no genetic connection between the surrogate and the child (Igreja & Ricou, 2019).…”