Gestational carriers and surrogacy

Abstract

Surrogacy is likely the earliest treatment for impaired fertility dating back to the beginning of reported history. The term is derived from the Latin word surrogatus, meaning substitute or appointed to act in place of. Historically, from Babylon to the Bible, there have been laws and customs allowing a substitute woman, or surrogate, to act in the place of a barren wife, thus avoiding the inevitability of divorce in a childless marriage. Today, traditional surrogacy occurs when a woman carrying a pregnancy is genetically related to the baby by providing her own eggs. In this instance, the pregnancy can be established medically by intrauterine inseminations or through in vitro fertilization (IVF). However, the most common form of surrogacy, accounting for approximately 95 % of all surrogate pregnancies in the USA, is gestational surrogacy or gestational carrier. In this arrangement, the woman carrying the pregnancy is not genetically related to the baby, and the egg(s) is from the intended biological mother, who generally for medical reasons cannot carry a pregnancy herself, or is from an egg donor. Women acting as surrogates may be commercially recruited and paid for their service (the most common) or may be altruistic as when a family member or friend volunteers pro bono.