Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
Open Access

Abstract

New Ethical Horizons in Gestational Surrogacy

John D Loike and Ruth L Fischbach

Gestational surrogacy occurs when a woman allows a 4-7 day embryo that was not generated from her own egg to develop in her uterus. In this paper, we review emerging scientific evidence to show how maternal-fetal cell exchange (microchimerism) may affect the future health of both surrogate and fetus/child. In light of these findings, we propose that four aspects of gestational surrogacy be examined: (1) the medical health and psychological outcomes of maternal-fetal cell exchange in surrogacy, (2) surrogacy laws and contractual agreements between the various parties, (3) provisions of a more comprehensive genetic family history and genetic screening from all parties involved, and (4) appreciation of the ethical and social complexities of surrogacy. We support gestational surrogacy provided that there is comprehensive informed consent. To be comprehensive, consent should include our current understanding of  microchimerism with respect to the medical, legal, genetic, and ethical elements of surrogacy