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Surrogacy – is an arrangement whereby a
woman agrees to become pregnant for the purpose of gestating and giving
birth to a child for others to raise.
She may be the child's genetic mother (the more
traditional form of surrogacy), or she may be implanted with someone
else's fertilized egg (gestational surrogacy), as this trend started
since the first artificial surrogate mothers in Europe or the U.S. back
in the 1960s.
Surrogacy is a method of assisted reproduction.
In some cases it is the only available option for a couple who wish to
have a child that is biologically related to them. Changing attitudes
towards illegitimacy have led to fewer women having to go through the
difficulties of international adoption. The choices for childless
couples were made easier by two men who joined forces in the early
1980's. An attorney named Noel Keane is generally recognized as the
mastermind behind surrogate motherhood. However, it was not until he
developed an association with a physician named Warren J. Ringold, MD
in the city of Dearborn, Michigan that the program was suddenly
perceived with much more legitimacy. Prior to the association of these
two men, couples were doing their own artificial insemination
procedures with items such as turkey basters.
Dr. Ringold agreed to perform all of the artificial inseminations, and
the clinic grew rapidly thus catching the eye of Morley Safer and
"Sixty Minutes" in the early part of 1981. Even though Keane and
Ringold took a great deal of criticism from the more conservative
elements of the press and politicians, they eventually prevailed and
were instrumental in the passage of laws that protected the entire
concept of surrogate mothers. They went state by state seeking
political acceptance. Now less then 25 years later, the idea of a
surrogate mother is totally acceptable for most people. More
importantly laws protecting the contractual relationships exist in
almost every state. Although Mr. Keane died a few years ago, he and
Ringold remained close friends and associates until the end and Dr.
Ringold remains very proud of his role in advancing this very important
area of reproductive science.
Research carried out by the Family and Child
Psychology Research Centre at City University, London, UK in 2002
showed surrogate mothers rarely had difficulty relinquishing rights to
a surrogate child and that the commissioning mothers showed greater
warmth to the child than mothers conceiving naturally
(From Wikipedia)
Gestational Surrogacy is an Assisted
Reproduction method when the embryo created using the sperm and ovum of
a couple (or donor's ovum) is implanted in the uterus of the surrogate
mother ( gestational carrier), who carries the child and relingish it to the biological perents upon birth.
A gestational
carrier is a woman who carries a pregnancy for another woman. She does
not provide a genetic contribution (ovum) to the pregnancy but provides
strictly a pregnancy carrier service ("a rented womb") and hands the
baby over to the genetical mother at the conclusion of the pregnancy.
Thus, gestational carrying is a form of assisted reproductive
technology
Gestational carrier services may be needed in women who have normal
ovarian function but have no uterus, be it the result of a congenital
defect (i.e. Mullerian agenesis) or a hysterectomy at young age. Also,
in some women, the uterus may be damaged from scarring (Asherman's
Syndrome) or leiomyoma.
In many cases, donated eggs are used because of growing number of single and married women of older age (over 38), and single males looking to
achieve parenthood via Gestational Surrogacy.
Gestational Surrogacy always inolves using IVF
(in-vitro fertilization). In the USA, high costs of IVF and lack of
medical coverage for Assisted Reproduction prevent many families to
seek surrogacy as family building options.
In the same time, the USA remains the country where gestational surrogacy arrangements are not illegal in mosts of its states.
Traditional Surrogacy is an Assisted Reproduction method when the Surrogate Mother agrees to donate her eggs. The child that is concieved
using IVF (in-vitro fertilization) or IUI (intra-uterus insemination) is biologically related to the Surrogate Mother.
There is a common mistakes that the majority of
couples make while pursuing Traditional Surrogacy. The try to use IUI
rather than IVF. IUI method is
very unefective with pregnancy chance of only 8-10% per attempt. In the
same time, IVF gives 40% success rate per attempt for women under 35.
Traditional Surrogacy involves obious legal
risk: the "traditional surrogate" carries her own biological child and
may experience emotional attachement
to the child.
The infamous "Baby M" case involved traditional surrogacy. The Surrogate mother carried a biological child and later refused to relinquish her
parental rights to the biological father. She fleed from New York to Florida trying to escaple the Judge's Order.
Baby M. case attracted a lot of publicity and caused the changes of New York and New Jersey laws on surrogacy.
New York still prohibits and criminalizes
commercial surrogacy that represents complete ignorance of individual
reproductive rights in this state.
Most attorneys do not recommend using Traditional Surrogacy for the couples and individuals seeking assisted reproduction because of obsious
legal risk invovled.
In the same time, there were hundreds, if not thousands, of successful Traditional Surrogacy cases that caused no complications.
Surrogacy with donor's egg involves hiring an
Egg Donor, if the couple cannot produce viable eggs. Since the majority
of couples who
cannot concieve a child are in their late 30s or older, using Donor's
Egg will increase their chances of having a baby from "none" to "100%".
It is very simple to predict if you need to use Donor's egg. Please
review Will I succeed with IVF? and
IVF Success Rate to be able to predict the outcomes.
The general rule is: if the couple (women) is
younger than 35, her eggs are viable enough and surrogacy success rate
is 40-45% per IVF attempts.
If the couple (women) older than 35, the success rate for surrogacy
goes down very dramatically, from 40-45% at the age of 35, to 8-10% at
the age of 42.
Male's fertility is not very important factor, since ICSI procedure
almost eliminates "male factor".
Unfortunately, hiring a Gestational Carrier who is under 35 does not increase a chance for healthy pregnancy. Egg quality that is translated into
the "age factor" is the dominating factor for an IVF success.
If you are female over 40 years trying to pursue
surrogacy arrangement, consider your chances for success prior to
spending thousands of dollars on
IVF treatment. It is not you, it is Mother Nature that limited human
reproduction to very young age!
In
some cases a women has trouble to concieve via IVF due to unknown
implantation problems. Embryo mplantation still remains misterious
process with a a lot of questions remained open.
In other cases, a women has trouble to carry
pregnancy. In all cases, a women may use Assisted Reproduction
techniques(ART) with a gestational carrier (surrogate).
Gestational carriers were used i 0.8% of ART cycles using fresh
nondonor embryos in 2004 (710 cycles)
In general, the success rate for gestational carriers is slightly
higher, than for the ART patients.
Women age <35: With Gestational Carrier - Live birth rate 46.7%
Women age <35: Without Gestational Carrier - Live birth rate 42.7%
Women age 35-37: With Gestational Carrier - Live birth rate 40.4%
Women age 35-37: Without Gestational Carrier - Live birth rate 35.5%
Women age 38-40: With Gestational Carrier- Live birth rate 31.5%
Women age 38-40: Without Gestational Carrier - Live birth rate 25.2%
Women age over 40: With Gestational Carrier - Live birth rate 18.6%
Women age over 40: Without Gestational Carrier - Live birth rate 11.9%
(Source: USA Department of Health Publications, Assisted Reproduction Technology Success Rate, 2004
The most facinating results come from using
Donor's Egg and the Gestational Carrier. Since it eliminates both
factors, women's age and implantation failure, the success rate may
reach 60-65% per IVF transfer!
Countries where Surrogacy and Egg Donation is legal
Russia - legal. Russia recognized its population problems and widely supports using of ART. Please, contact East Coast Assisted Parenting, LLP,well known US agency practicing ART in Russia and Ukraine for years.
Ukraine - legal. Ukraine recognized its population problems and widely supports using of ART.
Nitherlands - legal. Must be citizen of Nitherlands.
Finland - legal. Citizenship is not important.
Canada - Ontario recently clanged its law. Noncompensated Surrogacy and Egg Donation is legal.
France, Italy, Germany, Norway, and Sweeden still
maintain disgracefull laws that prohibit and criminalize Surrogacy and
Egg Donation.
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