Born via surrogate meaning
What It Is and How Does Surrogacy Work
Written by Rebecca Buffum Taylor
Medically Reviewed by Jennifer Robinson, MD on November 04, 2021
In this Article
- What Is a Surrogate Mother?
- Who Uses Surrogates?
- Finding a Surrogate
- How to Choose a Surrogate
- Using a Surrogate
- Legal Issues With Surrogates
There's still some controversy about using a surrogate mother to have a baby. The legal process is also tricky because it varies from state to state. Even so, whether it's because of fertility problems or other reasons, surrogacy is an option for you and your partner. Find out how it works and see if it's right for you.
What Is a Surrogate Mother?
There are two kinds:
Traditional surrogate. It's a woman who gets artificially inseminated with the father's sperm. They then carry the baby and deliver it for you and your partner to raise.
A traditional surrogate is the baby's biological mother. That's because it was their egg that was fertilized by the father's sperm. Donor sperm can also be used.
Gestational surrogates. A technique called "in vitro fertilization" (IVF) now makes it possible to gather eggs from the mother (or an egg donor), fertilize them with sperm from the father (or a sperm donor), and place the embryo into the uterus of a gestational surrogate.
The surrogate then carries the baby until birth. They don't have any genetic ties to the child because it wasn't their egg that was used.
A gestational surrogate is called the "birth mother." The biological mother, though, is still the woman whose egg was fertilized.
In the U.S., gestational surrogacy is less complex legally. That's because both intended parents have genetic ties to the baby. As a result, gestational surrogacy has become more common than a traditional surrogate. About 750 babies are born each year using gestational surrogacy.
Who Uses Surrogates?
If you're a woman, you may consider a surrogate for several reasons:
- Medical problems with your uterus
- You had a hysterectomy that removed your uterus
- Conditions that make pregnancy impossible or risky for you, such as severe heart disease
You may want to think about surrogacy if you tried but couldn't get pregnant with a variety of assisted-reproduction techniques, such as IVF.
Surrogates have also made parenthood an option for people who might not be able to adopt a child, perhaps because of their age or marital status.
If gay men decide to use a traditional surrogate, one of them uses their sperm to fertilize the surrogate's egg through artificial insemination. The surrogate then carries the baby and gives birth.
A gay couple might also choose an egg donor, fertilize that donated egg, and then have the embryo implanted in a gestational surrogate to carry until birth.
Finding a Surrogate
There are several ways you can find a surrogate mother:
Friends or family. Sometimes you can ask a friend or relative to be a surrogate for you. It's somewhat controversial. But because of the high cost of surrogacy and the complex legal issues it raises about parental rights, a tried-and-tested family relationship can be simpler to manage.
The American Society for Reproductive Medicine accepts certain family ties as acceptable for surrogates.
It generally discourages surrogacy, though, if the child would carry the same genes as a child born of incest between close relatives.
A surrogacy agency. Most people use one to arrange a gestational surrogate. There are about 100 agencies now operating in the U.S. They act as go-betweens.
An agency helps you find a surrogate and make arrangements. It also collects any fees that get passed between you and the surrogate, such as paying for their medical expenses.
How to Choose a Surrogate
Right now there aren't any regulations about who can be a surrogate mother. But experts agree on a few points about how to select one.
You should choose surrogates who:
- Are at least 21 years old
- Have already given birth to at least one healthy baby so they understand firsthand the medical risks of pregnancy and childbirth and the emotional issues of bonding with a newborn
- Have passed a psychological screening by a mental health professional to uncover any issues with giving up the baby after birth
- Sign a contract about their role and responsibilities in the pregnancy, such as prenatal care and agreeing to give you the baby after birth
Using a Surrogate
The American Society for Reproductive Medicine says surrogates should get a medical exam to check that they are likely to have a healthy, full-term pregnancy.
The organization suggests they get tests that check for infectious diseases such as syphilis, gonorrhea, chlamydia, HIV, cytomegalovirus, and hepatitis B and C.
Surrogates should get tests to make sure they have immunity to measles, rubella (German measles), and chickenpox. Also, you may want to ask that they get a medical procedure to visually "map" the uterus, which can help the doctor check their potential to carry a pregnancy. Surrogate mothers should have their own doctor during pregnancy rather than use yours.
The cost of surrogacy can range from $80,000 to $120,000. A lot of different things go into the price, such as whether the surrogates have their own medical insurance or whether you need to buy a surrogacy-pregnancy policy for them.
Legal Issues With Surrogates
Parental rights aren't guaranteed after a surrogate pregnancy. The law continues to change as reproductive technology and the very definition of a "parent" changes.
There isn't a federal law on surrogacy and state laws vary.
After a surrogate pregnancy in some states, you may still have to pass adoption proceedings to gain legal custody of the child. In other states, a "declaration of parentage" before birth lets you avoid having to "adopt" the baby.
To protect your rights as parents-to-be -- and the rights of the child you're hoping to have -- hire an attorney who specializes in reproductive law in your state. They can write a surrogacy contract that clearly spells out what everyone needs to do.
A contract like that may help if legal issues come up after birth. It can also outline agreements about a variety of possible scenarios with the pregnancy, such as what happens if there are twins or triplets.
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What can a child inherit from a surrogate mother?
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/ What is transmitted to the child from a surrogate mother?
The first child born by a surrogate mother was born at 1985 year.
Over the past decades, thanks to the surrogate motherhood system, thousands of women and men have found parental happiness, and the procedure itself has become a medical routine. However, the method still sometimes causes concern among patients. At the heart of fears, as a rule, false information and myths.
Let's analyze one of these fears - what is transmitted to the child from the surrogate mother?
The essence of surrogate motherhood
Surrogate or substitute motherhood is a method of assisted reproduction. When using it, the baby is carried and given birth not by the mother, but by another woman who agrees to help people become parents. Surrogate mothers seek help for medical reasons - when a woman cannot bear the fetus herself (for example, after removal of the uterus) or she has contraindications for pregnancy and childbirth.
To understand whether a child will look like a surrogate mother or not, it is useful to understand how the whole process works.
In case of surrogate motherhood, the IVF method is mandatory.
- A woman who wants a baby but cannot bear it receives eggs. Or, if they cannot be obtained from the patient, the eggs are taken from a donor.
- Partner donates sperm. In the absence of a partner or absolute infertility of the spouse of the genetic mother, donor sperm can be used in the program.
- In vitro fertilization of eggs with spermatozoa is carried out in the laboratory.
- The resulting embryos develop for several days in special incubators to the desired stage.
- Doctors transfer one embryo (in rare cases, two) into the uterus of a woman who has agreed to become a surrogate mother for pregnancy.
- The surrogate mother bears the baby and passes it on to the parents after the birth.
In our country, surrogate motherhood is allowed and strictly regulated by law. According to the Order of the Ministry of Health of the Russian Federation dated July 31, 2020 No.
803N, a couple or a woman without a partner can apply for the method if there are medical indications. The law gives a clear answer to the question whose egg can be used in surrogate motherhood - the patient or the donor, but it is forbidden for a surrogate mother to be a donor.
Gestational and traditional surrogacy
There is a type of surrogate motherhood in which a new life is born from the egg of the surrogate mother herself. This is traditional surrogate motherhood (biological), which goes back centuries. He is mentioned (not under that name, of course) in the Old Testament - the story of Sarah, who hired a maid to bear a child to her and Abraham. Of course, in those days, conception occurred naturally.
Such surrogacy is also considered traditional, when a substitute mother is artificially injected with sperm into the uterine cavity (IUI) or an embryo obtained from her egg is transferred. However, this approach is prohibited almost everywhere in the world, including Russia.
The technology that is allowed and that excludes the use of a surrogate mother's egg is called gestational surrogacy (from the word "gestation" meaning "pregnancy"). Hence the term "gestational carrier" or "gestational courier", i.e., surrogate mother.
When you understand the essence of CM technology, the answers to many questions become obvious.
Are genes passed from a surrogate mother to a child?
In gestational surrogacy, the genetically surrogate mother is in no way related to the baby she carried and gave birth to. The DNA of the baby is formed from the DNA of the egg and the DNA of the sperm used in fertilization. The genetic material of the surrogate mother cannot be passed on to the unborn baby either at this moment or later.
In the wake of the news about the mitochondrial genome that has been appearing in recent years, reproductive specialists are sometimes asked if a surrogate mother passes on mitochondrial DNA to the child she is carrying.
No, it doesn't. Because a person receives mitochondrial DNA from the egg of a biological mother.
Have you heard somewhere that a woman who gave birth to a child gave him genes during pregnancy? This is impossible! After the embryo, obtained from the germ cells of genetic parents, is transferred to a surrogate mother, it continues to develop and grow in her uterus. Of course, a close relationship is established between the organisms of the baby and the woman carrying him. But the fetal genome is already formed, during pregnancy it will not change.
So, the genetic mother and genetic father of a child born as a result of the surrogacy procedure are a woman and a man, from whose germ cells the embryo was obtained. In most cases, these are the people who will be recorded by the parents during the state registration of the birth of the child. Less commonly, egg and/or sperm donors. In any case, the baby does not have common genes with the surrogate mother.
Will the child look like a surrogate mother?
Eye and hair color, nose shape, other features and features of appearance are encoded by genes. A child born to a surrogate mother does not inherit genes from her, but from her biological parents. Accordingly, like any other baby, outwardly it will look like a genetic mom and dad. Who bore the pregnancy does not matter.
Does the child resemble the surrogate mother in temperament, character traits, inclinations? Also not, because part of the character traits are inherited genetically, partly depend on the conditions in which a person grows up. On the other hand, a surrogate mother, whose genes are not passed on to the baby, determines a lot in his future life in terms of health. It is very important that the pregnancy develops normally, so that nothing threatens the fetus in the womb of the substitute mother. Therefore, a woman who bears a child must be healthy. In addition, it is important that the pregnancy proceeds in favorable conditions.
A surrogate mother needs to eat right, exclude harmful effects, be observed by a good obstetrician-gynecologist.
Is it necessary to do a genetic test for a child with surrogate motherhood?
Genetic tests are different. DNA tests to establish paternity or maternity for a child born to a surrogate mother may be appropriate in exceptionally rare cases. Why do a DNA paternity test if it is already known whose cells were used to obtain an embryo that was transferred to a substitute mother?
Theoretically, the establishment of kinship may be needed only for legal purposes if a force majeure situation arises - for example, a surrogate mother refuses to give up a child. Fortunately, such problems are extremely rare. The careful selection of a substitute mother and a competent contract with her, drawn up by a professional lawyer, protect against them.
There are other genetic tests - studies aimed at identifying chromosomal abnormalities and hereditary pathologies in an unborn child.
They can be performed during pregnancy (now there are non-invasive prenatal tests that are safe for the fetus) and even before pregnancy (preimplantation genetic testing of the embryo, PGT).
- Preimplantation genetic testing can be performed to detect chromosomal abnormalities (PGT-A) and hereditary diseases (PGT-M). The first type of diagnosis is indicated for the late reproductive age of a woman (35 years and older), with a history of several unsuccessful embryo transfers. PGT-M is recommended if one of the future parents is a carrier of monogenic diseases. For testing, several cells from the outer shell are biopsied from 5-6 day old embryos and examined in the laboratory (this is safe for the embryo!) Preimplantation genetic testing in surrogacy programs allows you to select an embryo for transfer to a surrogate mother without deviations and seriously increases the chances of birth healthy child.
- Non-Invasive Prenatal Tests (NIPT) can detect chromosomal disorders in the fetus in early pregnancy.
Venous blood is taken from a pregnant woman, fetal DNA is isolated from it and a genetic study is carried out. NIPTs are completely harmless to the unborn child - they are no more dangerous than a routine blood test for a woman. NIPT is indicated if abnormalities are suspected by the OB/GYN on routine screening. On the other hand, many future parents do such genetic tests just for peace of mind - to make sure that everything is in order with the baby.
Conclusions
All fears about the genetic connection between the child and the surrogate mother are groundless. This connection does not exist. The baby does not inherit the genes of the woman who carried him, but of his biological parents - those whose egg and sperm were used in the fertilization procedure. A child born in the surrogacy program is similar to its genetic father and mother. He is no different from children who were born in the usual way.
It is not necessary to do genetic tests to confirm paternity and motherhood, if the future parents carefully approached the choice of a surrogate mother and concluded an agreement with her drawn up by a professional lawyer.
But taking care of the health of the unborn baby is important and necessary! This care includes a full examination of the potential surrogate mother, the accurate performance of in vitro fertilization and embryo transfer procedures, and the qualitative monitoring of the replacement mother's pregnancy. All this is in the Life Line Reproduction Center. Our doctors at the highest level carry out the medical part of the program - examination of surrogate mothers, IVF program, embryo transfer, pregnancy management. Patients have access to modern methods and technologies that increase the likelihood of having a child, including preimplantation genetic diagnosis and non-invasive prenatal tests.
In preparation for the program and during its implementation, reproductive specialists answer any questions of future parents, help dispel fears. An experienced perinatal psychologist works with patients. All this helps to make the path to parenthood through the surrogacy system more calm and comfortable.
You can find out everything about surrogacy programs at the Liniya Zhizni clinic and make an appointment with a specialist by phone or in the online messenger on the website.
Reading time: 4 minutes
10.10.2022
Contents:
- The essence of surrogacy
- Gestational and traditional surrogacy
- Are genes transmitted from a surrogate mother to a child?
- Will the child look like a surrogate mother?
- Is it necessary to do a genetic test for a child with surrogate motherhood?
- Terminals
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Shepeleva: Many problems of surrogate motherhood are not settled
Fresh number
RG-News
Rodina
thematic applications
Union
Fresh number
10/26/2017 19:28
Category:
Society
Surrogate Maternal was in the legal labyrinth
Irina Krasnopol
How to give birth to a child if the diagnosis sounds like a harsh sentence: "Infertility"? Modern reproductive technologies and, in particular, surrogate motherhood successfully help such people. At the same time, the most difficult questions arise, the solution of which requires fundamentally new approaches. In some countries it is allowed, in others it is prohibited. Somewhere - just limited. The demand for surrogate mothers is huge. The Rossiyskaya Gazeta columnist talks about the problems of artificial human reproduction with an expert in the field of reproductive law, a member of the Russian Association for Human Reproduction, Daria Shepeleva.
According to your association, there has been an increase in the number of children born to surrogate mothers in Russia. But why do experts say that the proper legal framework in this area leaves much to be desired?
Daria Shepeleva: You are right. Most of the legal problems associated with the achievements of biomedicine in the field of infertility treatment have not been resolved, affecting only some aspects. Moreover, they are controversial, they contradict each other. But surrogate motherhood has already ceased to be a matter of national legislation only. For example, at the Hague Conference on Private International Law, issues of the nationality of born children, issues of their protection, issues of anonymity and non-anonymity of donor programs are discussed. It is important that everything related to such programs be decided in favor of a single document for all European countries.
Are there two types of surrogate motherhood?
Daria Shepeleva: Yes.
The so-called full surrogacy and partial surrogacy. With full - gestational surrogate motherhood, a woman is transferred a genetically alien embryo. That is, there is no genetic relationship between the unborn child and the surrogate mother. With partial (traditional) surrogate motherhood, the egg of a surrogate mother is used.
In surrogacy, the woman who gives birth is not the biological mother of the child. She does the "work"
Who and under what conditions can be admitted to surrogacy programs?
Daria Shepeleva: The federal law "On the basics of protecting the health of citizens in the Russian Federation" (part 9 of article 55) defines the concept of surrogate motherhood. This is "... the bearing and birth of a child (including premature birth) under an agreement concluded between a surrogate mother ... and potential parents whose germ cells were used for fertilization, or a single woman for whom the bearing and birth of a child is impossible due to medical testimony.
" Yes, there are contraindications. As there is a well-defined list of indications. All together they serve to protect the health of the unborn child and the surrogate mother, as well as to prevent precedents when parents abandon an unhealthy child.
For example?
Daria Shepeleva: The "Baby Doe case" in 1983 in the USA is quite well known. A Michigan housewife agreed to carry a child for Alexander M. and his wife. The child was born with hydrocephalus. The potential father filed a lawsuit to challenge paternity. The surrogate mother also did not want to keep the child. And as a result of the genetic test, it turned out that the genetic father of the born child is ... the husband of the surrogate mother.
Does the age of potential parents matter?
Daria Shepeleva: This issue is not regulated in any regulatory legal act. There are no age restrictions in the legislation. But how right is this? It is necessary not only to give birth to a child, but also to have time to educate him, give him the warmth and care of mother's hands, the opportunity to get an education, to keep him safe at least until the age of majority.
I think it would be right to introduce a legislative age limit for participation in such programs, to limit it in accordance with reasonable criteria and with an average life expectancy. And in the event of unforeseen circumstances that could theoretically happen to potential parents, introduce guardians and trustees into such obligations.
Can only married couples participate in the program?
Daria Shepeleva: Everything is not easy. Starting in 2016, registry offices began to refuse to register children born to couples who are not in an officially registered marriage. They also refuse single women. At the same time, they are guided by the norms of paragraph 5 of Art. 16 of the Federal Law "On acts of civil status". Now registration of birth for this circle of persons is possible only through the court. But this contradicts the current legislation, which does not provide for any prohibitions or restrictions on the basis of marital status in the implementation of surrogate motherhood programs.
All children born by surrogate mothers under pregnancy-bearing agreements with single women can only be registered by surrogate mothers. It also contradicts the fundamental principles and goals of surrogate motherhood technology, which implies the provision of medical assistance to persons for whom the bearing and birth of a child is impossible for medical reasons.
What about the participation of single men in surrogacy programs?
Daria Shepeleva: Russia has constitutional gender equality. However, a single man is not mentioned at all in the law as a person who can seek help in the treatment of infertility. In 2010, the Babushkinsky District Court of Moscow issued the first precedent decision on the obligation of the registry office to register a child born under the surrogacy program with donor oocytes for a single man. In the column "mother" was a dash. The court motivated this decision by the fact that Russian legislation "does not contain any prohibitions or restrictions regarding the possibility for a man or a woman .
.. to realize himself as a mother or father using artificial reproduction methods." Subsequently, Russian courts adopted several more virtually identical decisions in similar cases involving "single parents".
If the surrogate mother refuses to transfer the child, she can be sued for breach of contract
One of the most unpredictable processes in reproduction is childbirth: what to do if the surrogate mother cannot sign the consent to the transfer of the child due to objective reasons?
Daria Shepeleva: According to the law, we have a presumption of motherhood, that is, the mother who gave birth. In surrogate motherhood programs, the woman who gives birth is not the biological mother of the child. She performs "work" under the contract for carrying a pregnancy. Genetically, the child has nothing to do with her. The basis for the state registration of a child is, among other things, the consent of the surrogate mother to transfer the child to potential parents.
Without this consent, registration cannot be made. This can create a situation where the child cannot be transferred to the family, cannot be officially registered.
Which way out?
Daria Shepeleva: If the surrogate mother is in an officially registered marriage, then the spouse must give his consent to his wife's participation in such a program. Therefore, he has the right to legally decide the fate of the born.
What if the surrogate mother is not married?
Daria Shepeleva: Then it's harder. That is why we recommend prescribing in the pregnancy contract what will happen in the event of the death of potential parents and a surrogate mother, who will take the child, who and to whom will pay compensation. Unfortunately, from the point of view of the Law, it is impossible to resolve this issue at this stage.
Does it happen that after the birth of a child, a surrogate mother does not want to transfer the child to potential parents?
Daria Shepeleva: Sometimes.
And according to the law, a surrogate mother has such a right. There is a presumption of motherhood. Carrying a child in her womb for nine months, a woman can make such a decision. But, as a rule, this is already a kind of means of pressure on the part of the surrogate mother, who turned out to be dissatisfied with the compensation for the services she provided.
What can prospective parents do in this case?
Daria Shepeleva: This situation must be noted in the pregnancy contract, which is concluded between the surrogate mother and potential parents. Penalties should be introduced for refusing to sign consent for the transfer of a child. That is, a surrogate mother can be sued for breach of contract. In addition, the Family Code of the Russian Federation in Art. 68 provides for the protection of parental rights. This means that "parents have the right to demand the return of the child from any person who retains him not on the basis of the law or on the basis of a court decision.
In the event of a dispute, parents can apply to the court to protect their rights." The grounds for keeping a baby cannot be called illegal. But the court can consider the childbearing contract, take into account the very meaning of such programs, establish, if possible, the genetic relationship between the parents and the child, and make a positive decision regarding the transfer of the child to potential parents.
And if the parents do not want to take the child born in the surrogacy program. What to do?
Daria Shepeleva: Unfortunately, potential parents have this right. There is not a moral, but a legal possibility - to refuse to raise your child. In such a situation, either a surrogate mother will raise a child born under the surrogacy program. Or the child falls into the guardianship and guardianship authorities with the possibility of further adoption. Of course, the contract should fix the rule according to which the parents pay compensation to the surrogate mother, regardless of the decision made regarding the child, and bear parental rights and obligations in relation to such a child.
Returning to reproductive tourism, more and more genetic tourists are coming to places where commercial surrogacy and anonymous donation are allowed. How to register and take such a born child to a country whose citizens are potential parents?
Daria Shepeleva: As for similar programs in Russia, it is possible to register a child born on the territory of the Russian Federation, according to our law. But we cannot help foreign parents with obtaining documents for a child and granting citizenship. They need to resolve this issue on their own with the embassy of the country whose citizens they are.
Daria Aleksandrovna, what is reproductive tourism?
Daria Shepeleva: Commercial surrogacy is allowed in Russia, Ukraine, Belarus, Georgia, some US states. Non-commercial surrogacy is allowed (that is, free of charge) in the UK, Denmark, Israel, Australia. Surrogate motherhood in Spain is not regulated in any way at the legislative level.
