Sunday, September 30, 2007

Is surrogacy being used to exploit infertile couples ?

Surrogacy hogs the limelight today and we get a phone call or email practically every day from either an "intended parent" or a journalist who wants to cover this "boom in reproductive outsourcing "!

Unfortunately, very few are willing to think through the " real-life problems" associated with surrogacy. Even a busy IVF clinic like ours which performs over 400 IVF cycles every year will only see 1-2 patients every month who actually need surrogacy.

Not only is surrogacy extremely expensive, it's also full of and emotional and ethical minefields which most doctors do not want to discuss. Infertile patients can be so desperate, that they are happy to try anything new - and clutching at the surrogacy straw seems to be a logical thing to do when you have failed 5 IVF cycles.

However , it's often not medically needed. Not only do these patients end up wasting a lot of time , money and energy - they also expose themselves to potential legal battles and emotional blackmail. Moreover, since they are operating in a legal grey zone, they leave themselves open to exploitation - both by the doctor ( who can charge a bomb for the treatment) ; the surrogate; and the agency which organises the surrogate.

The key question you should ask yourself is - do you really need it in the first place ? While there is no disputing that surrogacy is a valid treatment option for women without a uterus, the real tragedy is that it is being overused and misused to treat women with repeated IVF failures - an especially vulnerable group, which is extremely easy to exploit !

Most women who fail repeated IVF cycles for unexplained reasons usually do so because of a genetic abnormality in the embryo. This is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for.

It's extremely rare that the reason for failed implantation is a damaged uterus. However, after failing repeated IVF cycles, these women have extremely poor self-esteem, nd it's easy for unscrupulous doctors to exploit them . Since the literature is so confusing ( and confused) about IVF failure ( because we really don't have the tools to pinpoint the causes in women), they come to the conclusion that their uterus is "defective"; or that they have "immunologic issues" which is causing them to "reject" their embryos.

Because many of them have reached the end of their emotional tether , they do not want to take any more medications or suffer from the crippling blow of another failed IVF cycle. They are more than happy to allow the surrogate to go through the IVF process, so they don't have to deal with the physical and emotional pain of another failure. And when there is a demand for this extremely lucrative option, it's hardly surprising that agencies and doctors will be more than happy to supply this option for well-heeled patients - even though they may not actually need this at all, and would be better served by considering alternatives such as donor eggs or donor embryos.

1 comment:

  1. Anonymous3:18 AM

    Thanks for the article. I have had repeated ivf failures and am getting some pressure from the family ti try surrogacy. this article strengthen my resolve to explore the reasons for the failure before giving in.


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