Gestational surrogacy has become a hot topic of discussion, in Spain, after the case of Spanish actress Ana Obregón. However, do you really understand how this process works? What its ethical and legal implications are?, and who can benefit from it beyond celebrities? In this article, we delve deep into this reproductive option and gain a clear understanding of the topic through an exclusive interview with Dr. Luis R. Hoyos, M.D., F.A.C.O.G. He is double board certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility, and expert in the field of gestational surrogacy in Florida.
Gestational surrogacy is a process where one person, who did not provide the egg used in conception, carries a fetus through pregnancy and gives birth to a baby for another person or couple.
The process begins with identifying individuals or couples who could benefit from the assistance of a surrogate mother. According to Dr. Hoyos, gestational surrogacy can benefit those who are unable to conceive conventionally due to various medical or psychological reasons. Potential beneficiaries include women without a uterus, those with severe uterine abnormalities, individuals with medical or psychological contraindications to pregnancy, or those with medical or psychological conditions that could jeopardize the well-being of the surrogate or the fetus. It is also considered in cases of multiple implantation failures after transfers of high-quality embryos.
The only type of gestational surrogacy practiced in the United States is one in which the surrogate provides only gestation and not the egg for pregnancy.
The identification of potential surrogate mothers is generally done through specialized agencies that act as intermediaries between patients, candidates, and fertility clinics. However, the final decision to approve a candidate rests with the sub-specialist physician. These agencies not only facilitate contact between the parties involved but also handle the legal aspects of the process. It is important to note that gestational surrogacy is not federally regulated in the United States and varies by state. In Florida, a pre-birth paternity agreement is recommended.
The selection of a surrogate mother is based on several criteria:
- Age between 21 and 45.
- Good health.
- Stable social environment.
- Prior uncomplicated pregnancy resulting in the birth of a healthy full-term baby.
- Preferably, no more than 5 prior births or 3 prior cesarean sections.
The primary motivation of surrogate mothers is often the desire to help others. However, in some cases, economic factors may also influence their decision. As for the medical and emotional risks for both the surrogate mother and the intended parents, it is important to highlight that inherent risks exist during pregnancy and childbirth. These risks are minimized through a rigorous selection process for the surrogate mother. Additionally, pre-process psychological evaluations are conducted to determine if both the surrogate mother and the intended parents are suitable candidates.
In the United States, gestational surrogacy accounted for 5.4% of assisted reproductive cycles in 2019.
Regarding legal and ethical requirements, as mentioned before, gestational surrogacy in the United States is not federally regulated but rather varies by state. In the specific case of Florida, requirements may vary, and the decision to use a surrogate mother lies with the sub-specialist physician. The requirements are the same for individuals from other countries. In fact, the United States is a popular destination due to its well-established regulations compared to other countries where gestational surrogacy may be less regulated or not allowed, leading to potentially unfavorable situations.
Dr. Luis R. Hoyos has worked with couples and individuals who have chosen gestational surrogacy to build their families. As a specialist in this field, his role is to determine who are suitable candidates for this option and guide them throughout the process along with his team.
In terms of recent research and advancements in the field of gestational surrogacy, Dr. Hoyos highlights the use of single embryo transfer as the most common approach.
“In the past, multiple embryo transfer was more common, but now we prefer single embryo transfer to reduce obstetric complications and increase the chances of a healthy baby at home.”
As for the future, uterine transplantation may be an alternative to gestational surrogacy, but it is still in its early stages of development and is only performed in highly specialized centers. While it is difficult to predict if uterine transplantation will become a common option in the future, gestational surrogacy continues to be a proven option in terms of safety and effectiveness.
“There will still be cases where uterine transplantation is not an option, so I don’t see gestational surrogacy disappearing from our practice. On the contrary, it would be best if countries that are not open to it open their doors to regulation and seek guidance from reproductive sub-specialists who have the best knowledge of the subject.”
In conclusion, gestational surrogacy is a reproductive option that can bring hope to those who cannot conceive conventionally. If you are considering this option, it is important to consult with specialized professionals in the field to obtain accurate information and appropriate guidance.