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Surrogacy
Theissueofsurrogacycancausegreatmoral,ethicalandlegaldebatewithinthecommunity. Surrogacyarrangementsarecomplexandinvolvemedical,emotional,financialandlegalissues. However,withincreasingdemandforassistedreproductivetreatment(ART)andadeclineinthe numberofchildrenavailableforadoption,moreAustraliansareconsideringsurrogacyasameans tohavingachild.

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Surrogate mother
Asurrogatemotherissomeonewhogestates(conceivesandcarrieswithintheuterus)andthen givesbirthtoachildforanotherpersonorcouple,withthefullintentionofhandingthechildover tothatpersonorcoupleafterthebirth. InAustralia,thesurrogatemothermustnothaveanygeneticlinktothechildshecarriesforthe commissioningparentorparents.Therefore,hereggmaynotbeusedinthesurrogacy arrangement.Theeggandspermusedtoformtheembryofortransfertothewombofthe surrogatemothermustbeprovidedbythecommissioningparentorparents(thepersonorpeople forwhomthesurrogateisbecomingpregnant)oradonor. Insomecases,adonoreggmaybeusedinconjunctionwiththecommissioningfatherssperm,or donorspermmaybeusedinconjunctionwiththecommissioningmotherseggtoformanembryo fortransfertothesurrogateswomb.

Why do people consider surrogacy?

Surrogacyisnotacommonprocedurecomparedwithotherformsofassistedreproductive treatment.Asurrogacyarrangementcouldbeconsideredif: Awomanisunabletobecomepregnantasshehashadahysterectomyorismissingpart ofheruterus,uterinelining,ovariesorotherpartsofthegenitaltract. Awomanmayhaveahealthconditionthatmakespregnancydangerousorshemaynotbe abletocarryababytoterm. Acoupleinamalesame-sexrelationshipmaywishtohaveachildusingtheirsperm. Amanmaywishtohaveachild,buthavenopartner. Awoman,whohasembryosinstoragewithhermalepartner,diesandthemanwishesto usetheembryostohaveachild.

Manypeoplearguethatitisdifficulttocomparesurrogacywithotherreproductivemethodssuch aseggdonation,asthesurrogatemotherisundergoingalltheemotional,mentalandphysical feelingsofpregnancy.

Issues to consider
Thereareanumberofmedical,emotional,financialandlegalissuestoconsiderinmakinga surrogacyarrangementandoncethesurrogatemothergivesbirthandhandsoverthechild.Visit theVictorianAssistedReproductiveTreatmentAuthority(VARTA)websiteforinformationabout theseissues.

What are the key ingredients for a positive surrogacy arrangement?

Potentialfactorsthatcancontributetoapositiveoutcomefromasurrogacyarrangementinclude:

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Minimalriskfactorsstablementalandphysicalhealth,positivelifesituation,supportive partner Clearandopencommunicationbetweenallparties Allpartieshaveclearboundariesandrealisticexpectations Allpartieshaveknowledgeofthemedicalprocess,includingbeingrealisticaboutthe timelineitcouldbeupto12monthsbeforeembryotransferevenoccurs Realisticexpectationsabouttheemotionalresponsesandreactionsthatmayoccurduring theprocess.Emotionsshouldbemanagedwithcareandsensitivityanxiety,grief,guilt anddisappointmentandareallcommonfeelings Discussionsbetweenallpartiesregardingthefairandreasonableexpensesofthe surrogatethatshouldbecovered Commissioningparent(s)shouldbudgetformedical,counsellingandlegalcosts Agreeonapregnancyandbirthplanthatallpartiesarecomfortablewith,butremember thatthebirthmotherhastherighttomanageherownpregnancyasanyotherpregnant womandoes,despitewhatmaybeagreedtointhesurrogacyarrangement.

Surrogacy legislation
AllsurrogacyarrangementsinAustraliamustbealtruistic,whichmeansthatthesurrogatemother receivesnomaterialgainfromactingasasurrogate. MostAustralianstateshavespecificlegislationthatoutlinestherequirementsforsurrogacy.Inthe absenceoflegislation,statesandterritoriesarerequiredtoabidebynationalethicalguidelines issuedbytheNationalHealthandMedicalResearchCouncil(NHMRC). CheckwithyourlocalIVFclinicorlegaladvisorforthecurrentsurrogacylegislationinyourstateor territory.

Surrogacy legislation in Victoria

UndertheAssisted Reproductive Treatment Act 2008,therequirementsareasfollows. Thecommissioningparent(s): Mustbeinfertileorunabletocarryababyorgivebirth,or Thereisalikelymedicalrisktothemotherorbabyifpregnancyiscarriedout.

Thesurrogate: Mustbeatleast25yearsold Musthavepreviouslybeenpregnantandgivenbirthtoalivechild Mustnotuseherowneggsinthesurrogacyarrangement.

NOTE:itispreferredthatthesurrogatehasalreadycompletedherfamily. Allparties,includingthecommissioningparent(s),thesurrogateandthesurrogatespartner(if any),must: Undergoacriminalrecordcheckandachildprotectionordercheck Undertakecounsellingandobtainindependentlegaladvice.

Someclinicsalsorequireanydonorinvolvedinthearrangementtocomplywiththesame requirements.

What are the medical risks of surrogacy?

Therearecertainmedicalrisksofsurrogacy,whicharesimilaracrossallmethodsofassisted reproductivetreatment.Thesecaninclude: EffectsonthechildbornasaresultofthetreatmentIVFtreatmenthasagreaterchance ofproducingmultiplebirths,whichincreasesthechanceofthebabybeingborn prematurelyandthereforetohavebelow-normalbirthweight.

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Effectsontheeggproviderreactionstofertilitydrugs,includinghotflushes,feelingsof depressionorirritation,headachesandrestlessness.Thereisalsothesmallriskofovarian hyper-stimulationsyndrome(OHSS),whichcancausestomachpains,nausea,vomiting, shortnessofbreathandfaintness.However,thisisextremelyrare. Effectsonthesurrogatetheusualrisksassociatedwithanypregnancyandbirth.These risksareincreasedwiththeageofthesurrogate.

ThereisalsotherareriskoftransferofHIVand/orhepatitis.Toeliminatethisrisk,mandatory screeningofeveryoneinvolvedinsurrogacyisrequired. Toenhancesafety,embryosarealsoquarantinedforsixmonths(althoughthistimeperiodmay varyfromclinictoclinic),attheendofwhich,beforeproceedingwiththeembryotransfer,any infectionsordiseasesarescreenedforasecondtime. Formoredetailabouttherisksinvolvedinsurrogacy,pleaseconsultyourfertilityspecialist.

Where to get help

Yourdoctor AnIVFclinicinyourstateorterritory VictorianAssistedReproductiveTreatmentAuthority

Things to remember

Surrogacyisnotasimplealternativetohavingachild.Theprocessandsurroundingissues arecomplex. SurrogacylegislationinAustraliamayvaryfromstatetostate.

This page has been produced in consultation with, and approved by:

VictorianAssistedReproductiveTreatmentAuthority
Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen preparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeof publication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformation maychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessional fordiagnosisandanswerstotheirmedicalquestions. Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au Copyight 1999/2012StateofVictoria.ReproducedfromtheBetterHealthChannel (www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth. Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout permission.

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