IVF & Surrogacy

Surrogacy pregnancies have an increased risk for adverse obstetric outcomes. In a study done among American woman, compared to non-surrogate pregnancies, surrogate mothers reported more complications during their surrogacy pregnancies such as hypertension, preeclampsia/eclampsia, and haemorrhaging. After the pregnancy they reported complications such as a degenerated disc, embolism, and postpartum depression. The chance of having a caesarean-section was 300% higher with a surrogate pregnancy. The percentage of caesarean-sections in non-surrogate mothers was 12.2%, compared to 35.5% in surrogate pregnancies. Most surrogate mothers felt they bonded with the babies they carried and many women stay in contact with the baby and their intended parents.

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IVF & Surrogacy

USA – Children born through IVF can now be US citizens

U.S. Citizenship and Immigration Services has announced that a non-genetic, non-gestational legal parent of a child born through assisted reproductive technology (ART) outside of the United States may transmit U.S. citizenship to the child under certain circumstances. This is the latest in a line of complex policy changes that have started to recognize the realities of modern families and citizenship may now be transmitted it: the parent is married to the child’s genetic or gestational parent at the time of the child’s birth; and if the relevant jurisdiction recognizes both parents as the child’s legal parents. More

IVF & Surrogacy

South Africa – Men choosing to become single fathers

A fertility lawyer, who heads his own firm in Cape Town, has registered a number of babies for single fathers through surrogacy over the past decade. The process is rather laborious since choosing a donor means looking into health records, family history, smoking habits, are they on medication, do they drink, how much do they exercise, eye & hair colour, what is their height, academic & sporting ability, are they introvert or not etc. The process is not cheap either. Other challenges single men face when having children is that they will be doing this on their own and the child won’t have a mom. Would be interesting to find out why single men choose this route instead of the natural way. More

IVF & Surrogacy

Australia – Specialist question the need for expensive add-ons of IVF

Two Australian IVF (in-vitro fertilisation) Specialists are questioning the need for expensive IVF add-ons that get offered to so many IVF clients. If standard IVF works, why all the expensive add-ons? They claim that many expensive IVF add-ons rest on very shaky evidence.

Take, for example, ICSI, intracytoplasmic sperm injection. First developed in 1992 (without clinical trials) as a way of treating male infertility, it has become the most popular method of IVF – even though the rate of birth defects appears to be a bit higher. The authors recently published an article in The Lancet based on data from Vietnam which claims that, ICSI – which is much more expensive — does not improve the chance of a baby when compared with standard IVF if men have a normal sperm count. “So why do clinics routinely offer it?”

Their hunch is that “doctors may recommend it for fear of patients’ reactions if the eggs don’t fertilise, even if ICSI doesn’t improve the ultimate chance of a baby for those with a normal sperm count.”

They conclude: “Couples with infertility belong to a very vulnerable group who will do almost anything to achieve a pregnancy. They deserve our dedicated care and evidence-based treatment.” More

IVF & Surrogacy

USA –  Fertility clinics are being taken over by profit-driven companies selling false hope

Rachel Strodel, a first year med student describes how the fertility industry is dangerously glossing over what science tells us these treatments can and can’t offer. “Assisted reproductive technology is a potent tool for empowerment for some, and can bring a peace of mind that we should not take lightly. Yet the industry is increasingly exploiting anxieties about reproduction without addressing the urgent inequities, unfounded promises and disregard for medical best practices in the field.” Rachel feels that it’s time to establish an independent government body that can regulate industry practices and ensure women get the information they need to make fertility decisions that are right for them.

the American Society for Reproductive Medicine lifted the experimental label in 2013, a move that normalized the use of egg freezing as part of infertility treatment. However, they did not recommend the procedure’s use for delaying childbearing. There wasn’t enough evidence, the committee wrote, that the benefits of this type of egg freezing outweighed potential financial and emotional risks, and it warned that “marketing this technology for the purpose of deferring childbearing may give women false hope.”

“Nonetheless, companies like Facebook and Apple began offering egg freezing as a perk to their employees. This and a host of other factors — the increase in the average age of marriage and childbearing, technological advancements in egg freezing and the legalization of same sex marriage — have pricked the ears of venture capital funds and private equity firms eager to cash in.”

Today, fertility companies and standalone egg-freezing centers cater to people who “aren’t necessarily infertile but want the ability to decide when to have children without worrying about declining fecundity (ability to have babies). Doctors know that while the uterus doesn’t age, eggs do. — a leading reason why females over the age of 35 often have trouble getting pregnant. Egg freezing allows people to keep their eggs young while they get older.”

Fertility start-ups in the USA were giving “free hormone tests that indicate how many eggs a woman has left, but not her overall fertility. The American College of Obstetrics and Gynecologists doesn’t endorse this test as a reliable predictor of reproductive ability in people who are fertile. But the fact that their directive is being ignored is a sign that some level of additional oversight is needed, because self-regulation isn’t cutting it.” Bottom line, the U.S. would be wise to follow the UK’s example to establish an analogous agency to body regulate the all aspects of assisted reproductive technology. It could also require that clients be educated on the effectiveness of tests and procedures offered at these centers — and even ensure that clinics follow standards of care. More

IVF & Surrogacy

Australia – Fertility Specialist comments on new online tool

Dr Bill Watkins, a Fertility Specialist and a clinical IVF director from Tasmania commented on two recent changes regarding IVF in a radio interview. One, a recent change in law now requires IVF clinics in Australia to publish their performance rates publicly which Dr Watkins says could cause IVF doctors and clinics to pick and choose their patients since they would not want their performance rates to be negatively affected. On the online tool that helps couples decide on IFV and which provider they choose, Dr Watkins said it would still be better to see a specialist since every person is unique. The online tool does not account for relevant factors like whether a person is a smoker, and ovarian reserve. Watkins also said most patients who come for IVF are not infertile. Most people also have a distorted view of IVF thinking that they can conceive through IVF when they are mid to late-40’s but the eggs are too old at that point.

Dr Watkins warns patients not to make use of IVF just because its trending and admits that there were times when he was confident a patient would conceive and they did not. He also recognizes the emotional and financial stress involved for couples. Doctors For Life holds the view that IVF should be procured only between married couples and if no other means exist — On condition that no embryos are destroyed in light of the fact that the gold standard of embryology development, the Carnegie Stages, of embryological development classifies the fertilization as the beginning of life for a human being. Listen to the interview podcast

IVF & Surrogacy

USA – Three things people should know about egg donation

The Center for Bioethics and Culture Network feels that women who consider donating their eggs should know three things about the process before the process. Firstly, Egg Donation Often Involves Coercion because egg donation often involves poorer women providing eggs to wealthier couples. The egg donor—even when informed of known risks and potential unknown risks—is often willing to risk to her health because of financial need. Money plays a very coercive and powerful role in the market of human egg donation.

Secondly, egg donation carries health and psychological risks that often go untold because medical complications that are known, are rarely documented in the medical literature, as the individuals and organizations that are tasked with safety and oversight are also the ones who stand to profit from egg donation. The medical process required for egg retrieval is lengthy and there are known medical risks associated with each step. Risks include Ovarian Hyper Stimulation syndrome (OHSS) due to superovulation, loss of fertility, ovarian torsion, stroke, kidney disease, premature menopause, ovarian cysts, and in some rare cases, death. When an egg donor experiences harm to her health, she often feels guilty for “being so stupid” for making a decision that brought about this harm. She feels used by those she thought were professionals who cared for her. Lastly, egg donation is often eugenic because the largest sums of money are generally offered for donors of very specific educational, physical, or ethnic traits, not only perpetuating but actually incentivizing. More

IVF & Surrogacy

Australia – Class action lawsuit against IVF clinic might be the biggest case yet

A class action was just lodged against Monash IVF Pty Ltd, the owner of IVF clinics in Australia. The legal documents were filed in the Supreme Court of Victoria against Monash IVF on behalf of patients who had embryos genetically tested with the IVF clinic between May 2019 and October 2020. The allegations were that the fertility provider might have destroyed healthy embryos through a faulty non-invasive genetic screening test (PGT-A test), meaning that embryos may have been incorrectly labelled as abnormal, generating false-positive results. The IVF patients are suing for tens of millions of dollars in compensation, with some concerned they may have been deprived of their chance of bearing offspring. More than 1,000 patients could be victims, making it one of the most significant class actions ever lodged against a fertility provider in Australia. More

IVF & Surrogacy

UK – Proposals introduce surrogacy contracts

Pre-conception authorization of surrogacy agreements (PASA) is gaining ground internationally and has already been in effect in several countries such as Israel, Greece and South Africa. The main goal of PASA is to ensure that the intending parents automatically become the parents after the child’s birth by doing away with the old Roman law of “the mother is always the legal parent”. It also provides for a signed agreement between surrogate mother and intending parents with an authority who gives permission before conception of the future child. PASA hopes that by regulating and facilitating surrogacy safely & effectively, this would prevent people from travelling abroad where the risk of commodification, exploitation and commercialization is greater. A list of countries who offer surrogacy will also be available.  

Two Dutch Ethicists argue that the PASA proposals in the UK and The Netherlands would not protect women and children against commodification, commercialisation and exploitation especially now since regulation will encourage the process and even make overseas surrogacy transactions more attractive since they won’t fully close it off. The other concern is that children born from Surrogacy will in the future, sue the state for failing to protect their human rights and dignity. Such lawsuits are already taking place in the context of adoption and donor-conception. The decision to regulate comes as advocates for surrogacy claim it happens anyway and it’s here to stay so it’s better to regulate than discourage and prevent. Commercial surrogacy leads to mothers and children being treated as instruments to fulfil the wishes of others and are seen as commodities to be traded on the ‘reproductive market’.

Women who struggle financially will see no other option but to offer her ‘reproductive services’, and thereby exposing themselves to potentially exploitative abusive practices. It is widely recognized that economic inequalities are increasing and with the coronavirus crisis, the process is expected to accelerate making the risks of exploitation even greater than before. With the rise of new reproductive technologies and the advent of the internet, a worldwide reproductive market was created where pregnancy can be outsourced. In this market, various instances of commodification of children and exploitation of surrogate mothers have come to light. In South Africa, the PASA system does not accept commercial surrogacy arrangements, it is open to same-sex couples and single individuals, and at least one of the intending parents must be genetically related to the future child (although exceptions to this rule are possible); and intending parents are to be recognized as the child’s legal parents from the moment of birth. The revision of the PASA do not aim to encourage or discourage surrogacy, but to offer better protection to all involved. Article, Research Article.

China – Chinese model abandons surrogate-born children

A wave of outrage swept through Chinese social media a popular model and actress, Zheng Shuang, has been accused by her estranged former partner of abandoning two children whom she commissioned from two surrogate mothers in the United States. She was immediately dumped by the luxury goods firm Prada as a brand ambassador and government regulators have blacklisted her. The former couples’ parents suggested abandoning the babies at a hospital while the others said to put them up for adoption. The actress expressed annoyance that they could not be aborted. The Chinese Government said: “Surrogacy is banned in China as it uses women’s uteruses as a tool and sells life as a commercial product. As a Chinese citizen, the act of travelling to the US on a legal loophole is not abiding the law.” More

IVF & Surrogacy

South Africa – Essentials and non-essentials during the covid-19 pandemic

Amrita Pande, an associate professor in the sociology department at the University of Cape Town, questions whether SA can justify investments in cutting-edge reproductive technology as essential during the pandemic while our health system is in a permanent state of crisis. Fearing that critical and scarce resources like personal protective equipment; hospital beds; operating rooms and emergency care, would be burdened if we pursue treatments that are not life-threatening. The causes of infertility, such as sexually transmitted infections, and poor medical treatment during an earlier birth or abortion, require affordable preventable measures rather high-cost and high-tech interventions that such patients cannot afford. More