surrogasurrogacycy

surrogasurrogacycy

VAHID F MDVAHID F MD

2006-13852006-1385VAHID F MDVAHID F MD

2006-13852006-1385

DefinitionsDefinitions

Natural surrogacy or partial surrogacy

Gestational surrogacy , full surrogacy, or IVF surrogacy

Genetic couples , commissioning couple or intended parents.

Surrogacy host

Natural surrogacy or partial surrogacy

Gestational surrogacy , full surrogacy, or IVF surrogacy

Genetic couples , commissioning couple or intended parents.

Surrogacy host

IndicationIndicationIndicationIndication

After hysterectomy for cancer

For post partum Hemorrhage

for menorrahgia Congenital absence of the uterus Repeated failure of IVF Recurrent abortion Severe medical conditions

incompatible with pregnancy

After hysterectomy for cancer

For post partum Hemorrhage

for menorrahgia Congenital absence of the uterus Repeated failure of IVF Recurrent abortion Severe medical conditions

incompatible with pregnancy

CounseliCounselingng

CounseliCounselingng

for the Genetic couplesfor the Genetic couplesfor the Genetic couplesfor the Genetic couples

a review of all alternative treatment a review of all alternative treatment optionsoptions

the need for counselingthe need for counseling the need to find their own host(UK)the need to find their own host(UK) the practical difficulty and cost of the practical difficulty and cost of

treatment by gestational surrogacytreatment by gestational surrogacy the medical and psychological the medical and psychological

risks of surrogacyrisks of surrogacy

a review of all alternative treatment a review of all alternative treatment optionsoptions

the need for counselingthe need for counseling the need to find their own host(UK)the need to find their own host(UK) the practical difficulty and cost of the practical difficulty and cost of

treatment by gestational surrogacytreatment by gestational surrogacy the medical and psychological the medical and psychological

risks of surrogacyrisks of surrogacy

potential psychological risk to the childpotential psychological risk to the child the chances of having a multiple the chances of having a multiple

pregnancypregnancy the degree of control that the host the degree of control that the host

should have over the child of the genetic should have over the child of the genetic couple both during the pregnancy and couple both during the pregnancy and after after

the possibility that a child may be born the possibility that a child may be born with a handicapwith a handicap

the risks to the baby of the host smoking the risks to the baby of the host smoking and drinking during a pregnancyand drinking during a pregnancy

the possibility that the host may wish to the possibility that the host may wish to retain the child after birth retain the child after birth

the importance of obtaining legal advicethe importance of obtaining legal advice

potential psychological risk to the childpotential psychological risk to the child the chances of having a multiple the chances of having a multiple

pregnancypregnancy the degree of control that the host the degree of control that the host

should have over the child of the genetic should have over the child of the genetic couple both during the pregnancy and couple both during the pregnancy and after after

the possibility that a child may be born the possibility that a child may be born with a handicapwith a handicap

the risks to the baby of the host smoking the risks to the baby of the host smoking and drinking during a pregnancyand drinking during a pregnancy

the possibility that the host may wish to the possibility that the host may wish to retain the child after birth retain the child after birth

the importance of obtaining legal advicethe importance of obtaining legal advice

FOR THE HOSTFOR THE HOSTFOR THE HOSTFOR THE HOST

The full implications of undergoing treatment The full implications of undergoing treatment by IVF surrogacyby IVF surrogacy

The possibility of multiple pregnancyThe possibility of multiple pregnancy The possibility of family and friends being The possibility of family and friends being

against such treatmentagainst such treatment The need to abstain from unprotected sexual The need to abstain from unprotected sexual

intercourse during and just befor the intercourse during and just befor the treatmenttreatment

The normal medical risks associated with The normal medical risks associated with pregnancy and the possibility of caesarian pregnancy and the possibility of caesarian sectionsection

The full implications of undergoing treatment The full implications of undergoing treatment by IVF surrogacyby IVF surrogacy

The possibility of multiple pregnancyThe possibility of multiple pregnancy The possibility of family and friends being The possibility of family and friends being

against such treatmentagainst such treatment The need to abstain from unprotected sexual The need to abstain from unprotected sexual

intercourse during and just befor the intercourse during and just befor the treatmenttreatment

The normal medical risks associated with The normal medical risks associated with pregnancy and the possibility of caesarian pregnancy and the possibility of caesarian sectionsection

Implications and feelings of guilt on Implications and feelings of guilt on both sides if the host should both sides if the host should spontaneously abort a pregnancyspontaneously abort a pregnancy

The possibility that the host will feel a The possibility that the host will feel a sense of bereavement when she gives sense of bereavement when she gives the baby to the genetic couplethe baby to the genetic couple

The possibility that the child may be The possibility that the child may be born with a handicapborn with a handicap

Implications and feelings of guilt on Implications and feelings of guilt on both sides if the host should both sides if the host should spontaneously abort a pregnancyspontaneously abort a pregnancy

The possibility that the host will feel a The possibility that the host will feel a sense of bereavement when she gives sense of bereavement when she gives the baby to the genetic couplethe baby to the genetic couple

The possibility that the child may be The possibility that the child may be born with a handicapborn with a handicap

How and when to tell the How and when to tell the childchild

Breast feeding Breast feeding

How and when to tell the How and when to tell the childchild

Breast feeding Breast feeding

Relationship of genetic Relationship of genetic mothers to surrogate hosts.mothers to surrogate hosts.

Relationship of genetic Relationship of genetic mothers to surrogate hosts.mothers to surrogate hosts.

Relations Relations Sister to sisterSister to sister 35%35% Sister to sister in lawSister to sister in law 20%20% Stepdaughter to stepmother Stepdaughter to stepmother 5%5%

Friends to friendsFriends to friends 15%15% Through an organizationThrough an organization 25%25%

Relations Relations Sister to sisterSister to sister 35%35% Sister to sister in lawSister to sister in law 20%20% Stepdaughter to stepmother Stepdaughter to stepmother 5%5%

Friends to friendsFriends to friends 15%15% Through an organizationThrough an organization 25%25%

ResultsResultsResultsResults

Live birth rate = 37 – 43% per Live birth rate = 37 – 43% per genetic couple genetic couple

prematurity prematurity low Birth weight low Birth weight Lower rate of PIH and third Lower rate of PIH and third

trimester bleeding trimester bleeding Spontaneous abortion 40%.Spontaneous abortion 40%.

Live birth rate = 37 – 43% per Live birth rate = 37 – 43% per genetic couple genetic couple

prematurity prematurity low Birth weight low Birth weight Lower rate of PIH and third Lower rate of PIH and third

trimester bleeding trimester bleeding Spontaneous abortion 40%.Spontaneous abortion 40%.

ComplicationsComplicationsComplicationsComplications

The host may wish to keep the child .The host may wish to keep the child . An abnormal child may be rejected An abnormal child may be rejected

by both genetic and host parents.by both genetic and host parents. The question of whether it is ethical The question of whether it is ethical

to pay hosts(and if so how much).to pay hosts(and if so how much). The long term effects on the children The long term effects on the children

born as a result of gestational born as a result of gestational surrogacy are not known.surrogacy are not known.

The host may wish to keep the child .The host may wish to keep the child . An abnormal child may be rejected An abnormal child may be rejected

by both genetic and host parents.by both genetic and host parents. The question of whether it is ethical The question of whether it is ethical

to pay hosts(and if so how much).to pay hosts(and if so how much). The long term effects on the children The long term effects on the children

born as a result of gestational born as a result of gestational surrogacy are not known.surrogacy are not known.

The long term psychological effect The long term psychological effect on both the “genetic couple” and on both the “genetic couple” and “host surrogates” is not known.“host surrogates” is not known.

A few of “genetic women” have A few of “genetic women” have responded poorly to follicular responded poorly to follicular stimulation.stimulation.

The follicular responses of women The follicular responses of women with the Rokitansky-Kuster-Hauser with the Rokitansky-Kuster-Hauser syndrome were good.syndrome were good.

The long term psychological effect The long term psychological effect on both the “genetic couple” and on both the “genetic couple” and “host surrogates” is not known.“host surrogates” is not known.

A few of “genetic women” have A few of “genetic women” have responded poorly to follicular responded poorly to follicular stimulation.stimulation.

The follicular responses of women The follicular responses of women with the Rokitansky-Kuster-Hauser with the Rokitansky-Kuster-Hauser syndrome were good.syndrome were good.