Surrogacy

Surrogacy has been practiced as a means of helping women who are unable to bear children for centuries. The earliest mention is in the Old Testament of the Bible. Before the advent of modern assisted conception techniques, "natural surrogacy" was the only means of helping certain barren women to have babies. Before the introduction of artificial insemination, babies were conceived the "natural way," as practiced by Abraham. Later, as artificial insemination techniques were introduced, it became more socially acceptable to use these than "natural means". Later still, when assisted conception techniques, such as in vitro fertilization (IVF), were introduced, embryos created entirely from the gametes of the "genetic" or "commissioning couple" could be transferred to the "surrogate host", who therefore provided no genetic contribution to any child that resulted from the arrangement. She bore the child and handed it over to the full "genetic parents". The "genetic couple" in an IVF surrogacy arrangement therefore became the full genetic parents of the resulting child.

"Gestational surrogacy", otherwise known as "IVF surrogacy" or "full surrogacy," is now generally accepted in many countries as a treatment option for infertile women with certain clearly defined medical problems. The first report of a baby being born by gestational surrogacy was from the United States in 1985.

The principal indications for treatment by gestational surrogacy are as follows:

After hysterectomy for cancer Congenital absence of the uterus Hysterectomy for post-partum hemorrhage Repeated failure of IVF treatment Recurrent abortion Hysterectomy for menorrhagia Severe medical conditions incompatible with pregnancy

(Source: Textbook of Assisted Reproductive Techniques. Edited by Gardner, Howles, Weissman, and Shoham. Martin Dunitz, 2001)