surrogacysurrogacy vahid f md 2006-1385 2006-1385
TRANSCRIPT
surrogasurrogacycy
surrogasurrogacycy
VAHID F MDVAHID F MD
2006-13852006-1385VAHID F MDVAHID F MD
2006-13852006-1385
DefinitionsDefinitions
Natural surrogacy or partial surrogacy
Gestational surrogacy , full surrogacy, or IVF surrogacy
Genetic couples , commissioning couple or intended parents.
Surrogacy host
Natural surrogacy or partial surrogacy
Gestational surrogacy , full surrogacy, or IVF surrogacy
Genetic couples , commissioning couple or intended parents.
Surrogacy host
IndicationIndicationIndicationIndication
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
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
CounseliCounselingng
CounseliCounselingng
for the Genetic couplesfor the Genetic couplesfor the Genetic couplesfor the Genetic couples
a review of all alternative treatment a review of all alternative treatment optionsoptions
the need for counselingthe need for counseling the need to find their own host(UK)the need to find their own host(UK) the practical difficulty and cost of the practical difficulty and cost of
treatment by gestational surrogacytreatment by gestational surrogacy the medical and psychological the medical and psychological
risks of surrogacyrisks of surrogacy
a review of all alternative treatment a review of all alternative treatment optionsoptions
the need for counselingthe need for counseling the need to find their own host(UK)the need to find their own host(UK) the practical difficulty and cost of the practical difficulty and cost of
treatment by gestational surrogacytreatment by gestational surrogacy the medical and psychological the medical and psychological
risks of surrogacyrisks of surrogacy
potential psychological risk to the childpotential psychological risk to the child the chances of having a multiple the chances of having a multiple
pregnancypregnancy the degree of control that the host the degree of control that the host
should have over the child of the genetic should have over the child of the genetic couple both during the pregnancy and couple both during the pregnancy and after after
the possibility that a child may be born the possibility that a child may be born with a handicapwith a handicap
the risks to the baby of the host smoking the risks to the baby of the host smoking and drinking during a pregnancyand drinking during a pregnancy
the possibility that the host may wish to the possibility that the host may wish to retain the child after birth retain the child after birth
the importance of obtaining legal advicethe importance of obtaining legal advice
potential psychological risk to the childpotential psychological risk to the child the chances of having a multiple the chances of having a multiple
pregnancypregnancy the degree of control that the host the degree of control that the host
should have over the child of the genetic should have over the child of the genetic couple both during the pregnancy and couple both during the pregnancy and after after
the possibility that a child may be born the possibility that a child may be born with a handicapwith a handicap
the risks to the baby of the host smoking the risks to the baby of the host smoking and drinking during a pregnancyand drinking during a pregnancy
the possibility that the host may wish to the possibility that the host may wish to retain the child after birth retain the child after birth
the importance of obtaining legal advicethe importance of obtaining legal advice
FOR THE HOSTFOR THE HOSTFOR THE HOSTFOR THE HOST
The full implications of undergoing treatment The full implications of undergoing treatment by IVF surrogacyby IVF surrogacy
The possibility of multiple pregnancyThe possibility of multiple pregnancy The possibility of family and friends being The possibility of family and friends being
against such treatmentagainst such treatment The need to abstain from unprotected sexual The need to abstain from unprotected sexual
intercourse during and just befor the intercourse during and just befor the treatmenttreatment
The normal medical risks associated with The normal medical risks associated with pregnancy and the possibility of caesarian pregnancy and the possibility of caesarian sectionsection
The full implications of undergoing treatment The full implications of undergoing treatment by IVF surrogacyby IVF surrogacy
The possibility of multiple pregnancyThe possibility of multiple pregnancy The possibility of family and friends being The possibility of family and friends being
against such treatmentagainst such treatment The need to abstain from unprotected sexual The need to abstain from unprotected sexual
intercourse during and just befor the intercourse during and just befor the treatmenttreatment
The normal medical risks associated with The normal medical risks associated with pregnancy and the possibility of caesarian pregnancy and the possibility of caesarian sectionsection
Implications and feelings of guilt on Implications and feelings of guilt on both sides if the host should both sides if the host should spontaneously abort a pregnancyspontaneously abort a pregnancy
The possibility that the host will feel a The possibility that the host will feel a sense of bereavement when she gives sense of bereavement when she gives the baby to the genetic couplethe baby to the genetic couple
The possibility that the child may be The possibility that the child may be born with a handicapborn with a handicap
Implications and feelings of guilt on Implications and feelings of guilt on both sides if the host should both sides if the host should spontaneously abort a pregnancyspontaneously abort a pregnancy
The possibility that the host will feel a The possibility that the host will feel a sense of bereavement when she gives sense of bereavement when she gives the baby to the genetic couplethe baby to the genetic couple
The possibility that the child may be The possibility that the child may be born with a handicapborn with a handicap
How and when to tell the How and when to tell the childchild
Breast feeding Breast feeding
How and when to tell the How and when to tell the childchild
Breast feeding Breast feeding
Relationship of genetic Relationship of genetic mothers to surrogate hosts.mothers to surrogate hosts.
Relationship of genetic Relationship of genetic mothers to surrogate hosts.mothers to surrogate hosts.
Relations Relations Sister to sisterSister to sister 35%35% Sister to sister in lawSister to sister in law 20%20% Stepdaughter to stepmother Stepdaughter to stepmother 5%5%
Friends to friendsFriends to friends 15%15% Through an organizationThrough an organization 25%25%
Relations Relations Sister to sisterSister to sister 35%35% Sister to sister in lawSister to sister in law 20%20% Stepdaughter to stepmother Stepdaughter to stepmother 5%5%
Friends to friendsFriends to friends 15%15% Through an organizationThrough an organization 25%25%
ResultsResultsResultsResults
Live birth rate = 37 – 43% per Live birth rate = 37 – 43% per genetic couple genetic couple
prematurity prematurity low Birth weight low Birth weight Lower rate of PIH and third Lower rate of PIH and third
trimester bleeding trimester bleeding Spontaneous abortion 40%.Spontaneous abortion 40%.
Live birth rate = 37 – 43% per Live birth rate = 37 – 43% per genetic couple genetic couple
prematurity prematurity low Birth weight low Birth weight Lower rate of PIH and third Lower rate of PIH and third
trimester bleeding trimester bleeding Spontaneous abortion 40%.Spontaneous abortion 40%.
ComplicationsComplicationsComplicationsComplications
The host may wish to keep the child .The host may wish to keep the child . An abnormal child may be rejected An abnormal child may be rejected
by both genetic and host parents.by both genetic and host parents. The question of whether it is ethical The question of whether it is ethical
to pay hosts(and if so how much).to pay hosts(and if so how much). The long term effects on the children The long term effects on the children
born as a result of gestational born as a result of gestational surrogacy are not known.surrogacy are not known.
The host may wish to keep the child .The host may wish to keep the child . An abnormal child may be rejected An abnormal child may be rejected
by both genetic and host parents.by both genetic and host parents. The question of whether it is ethical The question of whether it is ethical
to pay hosts(and if so how much).to pay hosts(and if so how much). The long term effects on the children The long term effects on the children
born as a result of gestational born as a result of gestational surrogacy are not known.surrogacy are not known.
The long term psychological effect The long term psychological effect on both the “genetic couple” and on both the “genetic couple” and “host surrogates” is not known.“host surrogates” is not known.
A few of “genetic women” have A few of “genetic women” have responded poorly to follicular responded poorly to follicular stimulation.stimulation.
The follicular responses of women The follicular responses of women with the Rokitansky-Kuster-Hauser with the Rokitansky-Kuster-Hauser syndrome were good.syndrome were good.
The long term psychological effect The long term psychological effect on both the “genetic couple” and on both the “genetic couple” and “host surrogates” is not known.“host surrogates” is not known.
A few of “genetic women” have A few of “genetic women” have responded poorly to follicular responded poorly to follicular stimulation.stimulation.
The follicular responses of women The follicular responses of women with the Rokitansky-Kuster-Hauser with the Rokitansky-Kuster-Hauser syndrome were good.syndrome were good.