Chapter 28

Surrogate Mothering

The word "surrogate" means substitute or replacement and a surrogate mother is one who lends her uterus to another couple so that they can have a baby. In the West where fewer and fewer babies are offered for adoption, surrogacy is gaining popularity, despite controversial legal and ethical issues.

Which kinds of women need surrogates? The commonest reason is a woman who has no uterus. The uterus may be absent from birth (Mullerian agenesis); or may have been removed surgically (hysterectomy for life-saving reasons, such as excessive bleeding during a caesarean). Other women who may wish to explore surrogacy include those whose uterus is incapably damaged because of utrine tubercullosis or a hermanni's syndrome; or those who have had multiple miscarriages; or who have failed repeated IVF attempts for unexplained reasons.

Women who agree to become surrogates may do so for compassionate reasons. These include a sister, mother or close friend of the couple. They may also do so for financial remuneration - and this could be a woman, with or without children, known or unknown to the couple, who rents her womb for a fee.

There are two main kinds of surrogacy:

  1. The surrogate mother provides the egg. In this case, the surrogate is inseminated artificially by the husband's sperm. In this case, the infertile woman has no genetic relationship to the baby.
  2. More commonly, the infertile woman provides the egg, which is then either transferred to the surrogate mother by GIFT along with her husband's sperm; or fertilised in vitro by IVF with her husband's sperm and an embryo transfer performed to the surrogate's uterus, which then acts as an incubator for the next nine months.
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Credits: How to Have a Baby: Overcoming Infertility