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surrogacy. VAHID F MD 2006-1385. Definitions. Natural surrogacy or partial surrogacy Gestational surrogacy , full surrogacy, or IVF surrogacy Genetic couples , commissioning couple or intended parents. Surrogacy host. Indication. After hysterectomy for cancer

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surrogacy

surrogacy

VAHID F MD

2006-1385

definitions
Definitions
  • Natural surrogacy or partial surrogacy
  • Gestational surrogacy , full surrogacy, or IVF surrogacy
  • Genetic couples , commissioning couple or intended parents.
  • Surrogacy host
indication
Indication
  • 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
for the genetic couples
for the Genetic couples
  • a review of all alternative treatment options
  • the need for counseling
  • the need to find their own host(UK)
  • the practical difficulty and cost of treatment by gestational surrogacy
  • the medical and psychological risks of surrogacy
slide6
potential psychological risk to the child
  • the chances of having a multiple pregnancy
  • the degree of control that the host should have over the child of the genetic couple both during the pregnancy and after
  • the possibility that a child may be born with a handicap
  • the risks to the baby of the host smoking and drinking during a pregnancy
  • the possibility that the host may wish to retain the child after birth
  • the importance of obtaining legal advice
for the host
FOR THE HOST
  • The full implications of undergoing treatment by IVF surrogacy
  • The possibility of multiple pregnancy
  • The possibility of family and friends being against such treatment
  • The need to abstain from unprotected sexual intercourse during and just befor the treatment
  • The normal medical risks associated with pregnancy and the possibility of caesarian section
slide9
Implications and feelings of guilt on both sides if the host should spontaneously abort a pregnancy
  • The possibility that the host will feel a sense of bereavement when she gives the baby to the genetic couple
  • The possibility that the child may be born with a handicap
relationship of genetic mothers to surrogate hosts
Relationship of genetic mothers to surrogate hosts.
  • Relations
    • Sister to sister35%
    • Sister to sister in law20%
    • Stepdaughter to stepmother 5%
  • Friends to friends15%
  • Through an organization25%
results
Results
  • Live birth rate = 37 – 43% per genetic couple
  •  prematurity
  •  low Birth weight
  • Lower rate of PIH and third trimester bleeding
  • Spontaneous abortion 40%.
complications
Complications
  • The host may wish to keep the child .
  • An abnormal child may be rejected by both genetic and host parents.
  • The question of whether it is ethical to pay hosts(and if so how much).
  • The long term effects on the children born as a result of gestational surrogacy are not known.
slide15
The long term psychological effect on both the “genetic couple” and “host surrogates” is not known.
  • A few of “genetic women” have responded poorly to follicular stimulation.
  • The follicular responses of women with the Rokitansky-Kuster-Hauser syndrome were good.