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Psychological and Ethical Issues in Third Party Assisted Conception and Surrogate Motherhood

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Pathways and Barriers to Parenthood

Abstract

The continuing increase in babies born via third party assisted conception (AC) and surrogate motherhood across the world shows the success of -and medical and social demand for—third party interventions in family building. However, with the increasing use of such interventions world-wide, commercialisation and commodification have proliferated. This in turn has led to inequality in access to AC services, in choice of third party input, and in questionable human rights and psychosocial welfare issues. Transitioning to parenthood using third party AC and surrogate motherhood, in addition to requiring equality in access, also demand accuracy of birth and genetic information. In the absence of accurate record keeping, continuing practices of anonymity, and marginalization of the contribution of donors and surrogates, psychological, social, health and ethical questions are raised for donors, recipients and potentially for (genetic, gestational) part, half and full offspring, siblings and others in the extended family such as grandparents.

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References

  • Agnafors, M. (2014). The harm argument against surrogacy revisited: Two versions not to forget. Medicine, Health Care and Philosophy, 17(3), 357–363.

    Article  Google Scholar 

  • American College of Obstetricians and Gynecologists. (2008). Surrogate motherhood. ACOG committee opinion No. 397. Obstetrics and Gynaecology, 111, 465–470.

    Article  Google Scholar 

  • Barton, M., Walker, K., & Wiesner, B. (1945). Artificial insemination. British Medical Journal, 1, 40–43.

    Article  PubMed  PubMed Central  Google Scholar 

  • BBC. (2016, August 25). India unveils plans to ban surrogacy. BBC News. Retrieved from http://www.bbc.com/news/world-asia-india-37182197.

  • Birenbaum-Carmeli, D. (2016). Thirty-five years of assisted reproductive technologies in Israel. Reproductive Biomedicine and Society Online, 2, 16–23.

    Article  PubMed  Google Scholar 

  • Blyth, E. (1994). “I wanted to be interesting. I wanted to be able to say ‘I’ve done something interesting with my life’”: Interviews with surrogate mothers in Britain. Journal of Reproductive and Infant Psychology, 12(3), 189–198.

    Article  Google Scholar 

  • Blyth, E., Crawshaw, M., Frith, L., & van den Akker, O. B. A. (2017). Gamete donors’ reasons for, and expectations and experiences of, registration with a voluntary donor linking register. Human Fertility, 20(4), 268–278.

    Article  PubMed  Google Scholar 

  • Blyth, E., & Frith, L. (2015). Access to genetic and biographical history in donor conception: An analysis of recent trends and future possibilities. In K. Horsey (Ed.), Revisiting the regulation of human fertilisation and embryology (pp. 136–152). London: Routledge.

    Chapter  Google Scholar 

  • Bos, H., & van Balen, F. (2010). Children of the new reproductive technologies: Social and genetic parenthood. Patient Education and Counselling, 81(3), 429–435.

    Article  Google Scholar 

  • Brazier, M., Campbell, A., & Golombok, S. (1998). Surrogacy review for health ministers of current arrangements for payments and regulation. Report of the review team. Cm 4068. London: Department of Health.

    Google Scholar 

  • Brinsden, P. R. (2003). Gestational surrogacy. Human Reproduction Update, 9(5), 483–491.

    Article  PubMed  Google Scholar 

  • Bromfield, N. F. (2016). “Surrogacy has been one of the most rewarding experiences in my life”: A content analysis of blogs by US commercial gestational surrogates. IJFAB: International Journal of Feminist Approaches to Bioethics, 9(1), 192–217.

    Google Scholar 

  • Carone, N., Baiocco, R., & Lingiardi, V. (2017). Single fathers by choice using surrogacy: Why men decide to have a child as a single parent. Human Reproduction, 32(9), 1871–1879.

    Article  PubMed  Google Scholar 

  • Chliaoutakis, J., Koukouli, S., & Papadakaki, M. (2002). Using attitudinal indicators to explain the public’s intention to have recourse to gamete donation and surrogacy. Human Reproduction, 17(11), 2995–3002.

    Article  PubMed  Google Scholar 

  • Crawshaw, M., Blyth, E., & van den Akker, O. B. A. (2012). The changing profile of surrogacy in the UK—Implications for policy and practice. Journal of Social Welfare and Family Law, 34(3), 267–277.

    Article  Google Scholar 

  • Crawshaw, M., Frith, L., van den Akker, O. B. A., & Blyth, E. (2016). Voluntary DNA-based information exchange and contact services following donor conception: An analysis of service users’ needs. New Genetics and Society, 35(4), 372–392.

    Article  Google Scholar 

  • DasGupta, S., & Dasgupta, S. D. (Eds.). (2014). Globalization and transnational surrogacy in India: Outsourcing life. Maryland: Lexington Books.

    Google Scholar 

  • Domar, A. (2015). Creating a collaborative model of mental health counselling for the future. Fertility and Sterility, 104(2), 277–280.

    Article  PubMed  Google Scholar 

  • Egliston, K., McMahon, C., & Austin, M. (2007). Stress in pregnancy and infant HPA axis function: Conceptual and methodological issues relating to the use of salivary cortisol as an outcome measure. Psychoneuroendocrinology, 32(1), 1–13.

    Article  PubMed  Google Scholar 

  • EpiHealth. (2016). http://www.epihealthnet.org/. Accessed 12/05/2016.

  • Frith, L., Crawshaw, M., van den Akker, O. B. A., & Blyth, E. (2017). Searching for ‘relations’ using a DNA linking register: Constructions of identity, relatedness and kinship by adults conceived following sperm donation. BioSocieties, 1–20.

    Google Scholar 

  • Frith, L., Blyth, E., Crawshaw, M., & van den Akker, O. B. A. (2018). Secrets and disclosure in donor conception. Sociology of Health and Illness, 40(1), 188–203.

    Article  PubMed  Google Scholar 

  • Gardner, D. K., & Lane, M. (2004). Ex vivo early embryo development and effects on gene expression and imprinting. Reproduction, Fertility, and Development, 17(3), 361–370.

    Article  Google Scholar 

  • Golombok, S., Blake, L., Casel, P., Roman, G., & Jadva, V. (2012). Children born through reproductive donation: A longitudinal study of psychological adjustment. Journal of Child Psychology and Psychiatry, 54(6), 653–660.

    Article  PubMed  Google Scholar 

  • Golombok, S., Murray, C., Jadva, V., Lycett, E., MacCallum, F., & Rust, J. (2006). Non-genetic and non-gestational parenthood: Consequences for parent–child relationships and the psychological well-being of mothers, fathers and children at age 3. Human Reproduction, 21(7), 1918–1924.

    Article  PubMed  Google Scholar 

  • Golombok, S., Readings, J., Blake, L., Casey, P., Marks, A., & Jadva, V. (2011). Families created through surrogacy: Mother–child relationships and children’s psychological adjustment at age 7. Developmental Psychology, 47(6), 1579–1588.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harper, J., Kennett, D., & Reisel, D. (2016). The end of donor anonymity: How genetic testing is likely to drive anonymous gamete donation out of business. Human Reproduction, 31(6), 1135–1140.

    Article  PubMed  Google Scholar 

  • HFEA. (2004). Disclosure of Donor Information Regulations 2004/1511. http://www.legislation.gov.uk/uksi/2004/1511/pdfs/uksi_20041511_en.pdf. Accessed 23/11/2018.

  • HFEA Act. (2008). SCHEDULE 6 Amendments relating to parenthood in cases involving assisted reproduction. https://www.legislation.gov.uk/ukpga/2008/22/schedule/6. Accessed 23/11/2018.

  • Imrie, S., & Jadva, V. (2014). The long-term experiences of surrogates: Relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reproductive Biomedicine Online, 29(4), 424–435.

    Article  PubMed  Google Scholar 

  • Inhorn, M., & Serour, G. (2011). Islam, medicine, and Arab-Muslim refugee health in America after 9/11. The Lancet, 378(9794), 935–943.

    Article  Google Scholar 

  • Jadva, V., & Imrie, S. (2014). Children of surrogate mothers: Psychological well-being, family relationships and experiences of surrogacy. Human Reproduction, 29(1), 90–96.

    Article  PubMed  Google Scholar 

  • Jadva, V., Murray, C., Lycett, E., MacCallum, F., & Golombok, S. (2003). Surrogacy: The experiences of surrogate mothers. Human Reproduction, 18(10), 2196–2204.

    Article  PubMed  Google Scholar 

  • Koudstaal, J., Braat, D. D. M., Bruinse, H. W., Naaktgeboren, N., Vermeiden, J. P. W., & Visser, G. H. A. (2000). Obstetric outcome of singleton pregnancies after IVF: A matched control study in four Dutch university hospitals. Human Reproduction, 15(8), 1819–1825.

    Article  PubMed  Google Scholar 

  • Kroløkke, C. H., & Pant, S. (2012). “I only need her uterus”: Neo-liberal discourses on transnational surrogacy. NORA-Nordic Journal of Feminist and Gender Research, 20(4), 233–248.

    Article  Google Scholar 

  • Kumar, P., Inder, D., & Sharma, N. (2013). Surrogacy and women’s right to health in India: Issues and perspective. Indian Journal of Public Health, 57(2), 65–70.

    Article  PubMed  Google Scholar 

  • MacCallum, F., Lycett, E., Murray, C., Jadva, V., & Golombok, S. (2003). Surrogacy: The experience of commissioning couples. Human Reproduction, 18(6), 1334–1342.

    Article  PubMed  Google Scholar 

  • Markens, S. (2012). The global reproductive health market: US media framings and public discourses about transnational surrogacy. Social Science and Medicine, 74(11), 1745–1753.

    Article  PubMed  Google Scholar 

  • Markens, S. (2016). Third-party reproductive practices: Legislative inertia and the need for nuanced empirical data. Journal of Law and the Biosciences, 3(3), 666–672.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mascarenhas, M., Flaxman, S., Boema, T., Vanderpoel, S., & Stevens, G. (2012). National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 Health Surveys. PLOS, Dec 8th.

    Google Scholar 

  • Ombelet, W., De Sutter, P., Van der Elst, J., & Martens, G. (2005). Multiple gestation and infertility treatment: Registration, reflection and reaction—The Belgian project. Human Reproduction Update, 11(1), 3–14.

    Article  PubMed  Google Scholar 

  • Orlov, S., & Orlov, D. (2007). Commercial surrogacy: Commodification or choice? University of Toronto Medical Journal, 84(3), 177–179.

    Google Scholar 

  • Pande, A. (2016). Global reproductive inequalities, neo-eugenics and commercial surrogacy in India. Current Sociology, 64(2), 244–258.

    Article  Google Scholar 

  • Parkinson, J., Tran, C., Tan, T., Nelson, J., & Serafini, P. (1999). Perinatal outcome after in-vitro fertilization surrogacy. Human Reproduction, 14(3), 671–676.

    Article  PubMed  Google Scholar 

  • Pritchard, S. (2012). Israel gives gay men the right to conceive children via a surrogate. BioNews, 659.

    Google Scholar 

  • Purewal, S., Chapman, S., & van den Akker, O. B. A. (2017). A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies. Journal of Psychosomatic Obstetrics and Gynecology, 27, 1–17.

    Google Scholar 

  • Purewal, S., & van den Akker, O. B. A. (2007). The socio-cultural and biological meaning of parenthood. Journal of Psychosomatic Obstetrics and Gynaecology, 28(3), 79–86.

    Article  PubMed  Google Scholar 

  • Raes, I., Ravelingien, A., & Pennings, G. (2013). The right of the donor to information about children conceived from his or her gametes. Human Reproduction, 28(3), 560–565.

    Article  PubMed  Google Scholar 

  • Riggs, D. W., & Due, C. (2010). Gay men, race privilege and surrogacy in India. Outskirts, 22.

    Google Scholar 

  • Royal College of Obstetricians and Gynaecologists. (1987). Donor insemination. London: RCOG.

    Google Scholar 

  • Ruiz-Robledillo, N., & Moya-Albiol, L. (2016). Gestational surrogacy: Psychosocial aspects. Psychosocial Intervention, 25(3), 187–193.

    Article  Google Scholar 

  • Savasi, V. M., Mandai, L., Laoreti, A., & Cetin, I. (2016). Maternal and fetal outcomes in oocyte donation pregnancies. Human Reproduction, 22(5), 620–633.

    Google Scholar 

  • Scheib, J. E. (2003). Choosing identity-release sperm donors: The parents’ perspective 13–18 years later. Human Reproduction, 18(5), 1115–1127.

    Article  PubMed  Google Scholar 

  • Schieve, L. A., Meikle, S. F., Ferre, C. C., Peterson, H. B., Jeng, G., & Wilcox, L. S. (2002). Low and very low birth weight infants conceived with use of assisted reproductive technology. New England Journal of Medicine, 346, 731–737.

    Article  PubMed  Google Scholar 

  • Sharma, B. (2006). Forensic considerations of surrogacy—An overview. Journal of Clinical Forensic Medicine, 13(2), 80–85.

    Article  PubMed  Google Scholar 

  • Shelton, K. H., Boivin, J., Hay, D., van den Bree, M. B., Rice, F. J., Harold, G. T., et al. (2009). Examining differences in psychological adjustment problems among children conceived by assisted reproductive technologies. International Journal of Behavioral Development, 33(5), 385–392.

    Article  Google Scholar 

  • Shetty, P. (2012). India’s unregulated surrogacy industry. The Lancet, 380(9854), 1633–1634.

    Article  Google Scholar 

  • Shidlow, R. (2011). Of family and finance. Israeli citizens without rights and HFEA remuneration. BioNews, 637.

    Google Scholar 

  • Söderström-Anttila, V., Wennerholm, U. B., Loft, A., Pinborg, A., Aittomäki, K., Romundstad, L. B., et al. (2016). Surrogacy: Outcomes for surrogate mothers, children and the resulting families—A systematic review. Human Reproduction Update, 22(2), 260–276.

    PubMed  Google Scholar 

  • Stapleton, A. C. (2016, April 20). Sperm donor lied about criminal and mental health history, lawsuit alleges. CNN updated 1407 GMT (2207 HKT). http://edition.cnn.com/2016/04/19/health/sperm-donor-criminal-mental-health-history/. Accessed February 2017.

  • Strathern, M. (2002). Still giving nature a helping hand? Surrogacy: A debate about technology and society. Journal of Molecular Biology, 319(4), 985–993.

    Article  PubMed  Google Scholar 

  • Strathern, M. (2005). Kinship, law and the unexpected: Relatives are always a surprise. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • van den Akker, O. B. A. (2001). The acceptable face of parenthood: The relative status of biological and cultural interpretations of offspring in infertility treatment. Psychology, Evolution and Gender, 3(2), 137–153.

    Article  Google Scholar 

  • van den Akker, O. B. A. (2003). Genetic and gestational surrogate mothers’ experience of surrogacy. Journal of Reproductive and Infant Psychology, 21(2), 145–161.

    Article  Google Scholar 

  • van den Akker, O. B. A. (2005). A longitudinal pre pregnancy to post delivery comparison of genetic and gestational surrogate and intended mothers: Confidence and gynecology. Journal of Psychosomatic Obstetrics and Gynecology, 26(4), 277–284.

    Article  Google Scholar 

  • van den Akker, O. B. A. (2007). Psychosocial aspects of surrogate motherhood. Human Reproduction Update, 13(1), 53–62.

    Article  PubMed  Google Scholar 

  • van den Akker, O. B. A. (2012). Reproductive health psychology. London, UK: Wiley.

    Book  Google Scholar 

  • van den Akker, O. B. A. (2017). Surrogate motherhood families. London, UK: Palgrave MacMillan.

    Book  Google Scholar 

  • van den Akker, O. B. A., Crawshaw, M. A., Blyth, E. D., & Frith, L. J. (2015). Expectations and experiences of gamete donors and donor-conceived adults searching for genetic relatives using DNA linking through a voluntary register. Human Reproduction, 30(1), 111–121.

    Article  PubMed  Google Scholar 

  • Wilkinson, S. (2003). The exploitation argument against commercial surrogacy. Bioethics, 17(2), 169–187.

    Article  PubMed  Google Scholar 

  • Yeung, E. H., Sundaram, R., Bell, E. M., Drushell, C., Kus, C., Xie, Y., et al. (2016). Infertility treatment and children’s longitudinal growth between birth and 3 years of age. Human Reproduction, 31(7), 1621–1628.

    Article  PubMed  Google Scholar 

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van den Akker, O. (2019). Psychological and Ethical Issues in Third Party Assisted Conception and Surrogate Motherhood. In: Taubman – Ben-Ari, O. (eds) Pathways and Barriers to Parenthood. Springer, Cham. https://doi.org/10.1007/978-3-030-24864-2_7

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