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Surrogacy Is Not the Answer to Infertility: Ethical, Emotional, and Legal Insights

Surrogacy Is Not the Answer to Infertility: Ethical, Emotional, and Legal Insights

  • June 29, 2024
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Introduction: The Growing Challenge of Infertility

Infertility is a painful burden to bear and a growing problem globally. The World Health Organization estimates that currently, about 1 in 6 adults around the world experience infertility. This significant statistic underscores the widespread impact of infertility, affecting millions of individuals and couples in their quest to build a family.

As infertility rates rise and medical technology advances, couples are turning to new, alternative ways of bringing children into the world. One such method is surrogacy—a process by which one woman becomes pregnant to give the child to someone else at birth. Surrogacy has been hailed as a great option for couples trying to start a family. But the truth is, surrogacy treats children and women as commodities to be bought and sold, rather than as human beings with intrinsic value.

Understanding Infertility

Common Causes

Infertility can stem from various factors affecting both men and women. For women, common causes include ovulation disorders, fallopian tube damage or blockage, endometriosis, and age-related factors. For men, infertility is often due to low sperm count, poor sperm motility, or genetic defects.

Treatment Options

Several treatment options exist for couples facing infertility. These include medication to induce ovulation, surgical procedures to address anatomical issues, and assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intrauterine insemination (IUI). Each treatment has its success rates and considerations, often depending on the underlying cause of infertility.

Signs and Symptoms

The primary symptom of infertility is the inability to conceive after a year of regular, unprotected intercourse. Women may also experience irregular or absent menstrual cycles, while men might notice changes in sexual function or physical signs like pain, swelling, or lumps in the testicles.


While not all cases of infertility can be prevented, certain lifestyle choices can improve reproductive health. Maintaining a healthy weight, avoiding tobacco and excessive alcohol use, managing stress, and seeking early treatment for sexually transmitted infections (STIs) can all contribute to better fertility outcomes.

The Basic Facts about Surrogacy

Types of Surrogacy

In traditional surrogacy, the pregnant woman is both the biological mother and the gestational mother of the child. In gestational surrogacy, the surrogate is impregnated with an embryo to which she is unrelated. The embryo may be biologically related to both, one, or neither of the intended parents. Today, gestational surrogacy is the most common form of surrogacy.

Commercial vs. Altruistic Surrogacy

Surrogacy can be commercial (in which surrogates are paid a fee) or altruistic—where compensation is limited to expenses, such as health care and travel. Although commercial (or for-profit) surrogacy is a pricey process that costs tens of thousands of dollars, demand for it is soaring. The global commercial surrogacy market is expected to grow significantly, driven by increasing infertility rates and advancements in reproductive technology.

Ethical and Moral Concerns

While surrogacy may appear as a viable solution for infertility, it raises several ethical and moral concerns. The practice often treats children and women as commodities, reducing the sacred process of childbirth to a commercial transaction.

Exploitation of Women

Commercial surrogacy can exploit economically disadvantaged women, who may feel compelled to become surrogates due to financial necessity. This creates a power imbalance and raises questions about the true voluntariness of their participation.

Emotional and Psychological Impact

Surrogates may face significant emotional and psychological challenges. Bonding with the child during pregnancy, only to relinquish the baby at birth, can lead to lasting emotional trauma. Similarly, intended parents may struggle with feelings of detachment and the complexities of forming a family through surrogacy.

Legal and Social Implications

The legal landscape surrounding surrogacy is complex and varies widely across different countries and even states. Disputes over parental rights, custody issues, and the enforcement of surrogacy contracts can lead to protracted legal battles. Additionally, children born through surrogacy may face social stigma and identity issues.

Alternatives to Surrogacy


Adoption remains a viable and compassionate alternative for couples facing infertility. It provides a loving home to children in need and fulfills the desire of couples to become parents without the ethical complications associated with surrogacy.


Fostering allows couples to care for children temporarily, providing a safe and nurturing environment until a permanent solution is found. This can be a fulfilling way to support children in need while also exploring the possibility of adoption.

Support and Counseling

Infertility can be an emotionally draining experience. Seeking support from counseling services, support groups, and mental health professionals can help couples navigate their feelings and make informed decisions about their family-building journey.

Case Studies, Scenarios, and Examples on Surrogacy

Case Study 1: The Baby M Case

Background: In 1985, William and Elizabeth Stern entered into a surrogacy contract with Mary Beth Whitehead. The arrangement was a traditional surrogacy, meaning Whitehead would use her egg and Stern’s sperm. Upon giving birth, she was to surrender the baby to the Sterns.

Conflict: After giving birth to Baby M, Whitehead experienced profound emotional attachment and refused to give up the child. This led to a highly publicized legal battle in New Jersey, where the court had to decide on the enforceability of surrogacy contracts and the best interests of the child.

Outcome: The court initially ruled in favor of the Sterns, granting them custody while recognizing Whitehead’s parental rights. However, the New Jersey Supreme Court later invalidated the surrogacy contract, highlighting the ethical and emotional complexities of surrogacy arrangements.

Case Study 2: The Case of Baby Manji

Background: In 2008, Japanese couple Dr. Ikufumi and Yuki Yamada entered into a gestational surrogacy agreement in India. An Indian surrogate carried and delivered the baby, using the Yamada’s genetic material.

Conflict: During the pregnancy, the Yamadas divorced, and Yuki Yamada expressed disinterest in the child. Dr. Ikufumi wanted to take custody of the baby, but Indian law did not recognize single men as legitimate parents, and Japanese law did not recognize surrogacy births.

Outcome: The legal wrangle led to Baby Manji staying in limbo for months. Eventually, the Supreme Court of India intervened, allowing Dr. Ikufumi to take his daughter to Japan. This case highlighted the legal ambiguities and cross-border challenges of surrogacy.

Scenario 1: Exploitation in Commercial Surrogacy

Background: A young woman from a rural village in a developing country decides to become a surrogate to escape poverty. She is promised a substantial sum of money that could transform her family’s life.

Conflict: Throughout her pregnancy, she receives inadequate medical care and support. The agency handling the surrogacy pays her only a fraction of the promised amount and withholds the rest until she delivers the baby.

Outcome: After giving birth, the woman suffers from postpartum depression and long-term health complications, but the agency provides no further support. This scenario demonstrates how commercial surrogacy can exploit vulnerable women, treating them as mere means to an end.

Scenario 2: Emotional Impact on Intended Parents

Background: A couple unable to conceive due to severe infertility decides to use a gestational surrogate. They choose a surrogate through a reputable agency, and everything proceeds smoothly throughout the pregnancy.

Conflict: After the baby is born, the couple experiences unexpected emotional detachment. The mother feels disconnected because she did not carry the child, while the father struggles with guilt over the process.

Outcome: They seek counseling to navigate their feelings and build a bond with their baby. Over time, with professional help, they begin to feel more connected, but the initial emotional turmoil underscores the psychological complexities of surrogacy for intended parents.

Example 1: Positive Experience with Altruistic Surrogacy

Background: A close friend offers to be a surrogate for a couple who has struggled with infertility for years. The surrogacy is altruistic, meaning the surrogate receives no financial compensation beyond medical expenses.

Outcome: Throughout the pregnancy, the surrogate and the intended parents maintain a close, supportive relationship. After the baby is born, the surrogate is happy to see her friends finally achieve their dream of parenthood. The child grows up knowing the story of their birth, and the families remain close. This example highlights a positive surrogacy experience rooted in genuine altruism and emotional support.

Example 2: Legal Complications in Surrogacy

Background: A same-sex couple from a country where surrogacy is illegal travels abroad to engage in a surrogacy arrangement. They choose a surrogate in a country with more lenient laws and successfully complete the process.

Conflict: Upon returning to their home country with the newborn, they face legal hurdles in obtaining parental rights and citizenship for their child. Their home country’s laws do not recognize the surrogacy arrangement, leading to a protracted legal battle.

Outcome: After years of legal proceedings, they manage to secure parental rights and citizenship for their child. However, the stress and uncertainty during this period take a significant emotional toll on the family. This example illustrates the complex legal challenges of cross-border surrogacy.

These case studies, scenarios, and examples underscore the multifaceted nature of surrogacy, highlighting its ethical, emotional, and legal complexities. While surrogacy can offer a path to parenthood for some, it is essential to consider the profound implications it holds for all parties involved. Exploring alternative family-building options and providing comprehensive support can lead to more ethically sound and fulfilling outcomes.

Curated List of Online Resources on Surrogacy and Infertility

General Information on Infertility

  1. World Health Organization (WHO) – Infertility: Comprehensive information on the prevalence, causes, and treatments for infertility globally.
  2. Mayo Clinic – Infertility: Detailed overview of infertility, including symptoms, causes, and treatment options for both men and women.
  3. American Society for Reproductive Medicine (ASRM): Resources and guidelines on infertility and reproductive health.
    • ASRM – Infertility

Surrogacy Information and Ethics

  1. Surrogacy Laws by Country – Family Lives: Overview of surrogacy laws and regulations in different countries.
    • Family Lives – Surrogacy Laws by Country
  2. Council for Responsible Genetics – Surrogacy: Ethical considerations and policy discussions related to surrogacy.
    • Council for Responsible Genetics – Surrogacy
  3. Human Rights Watch – Surrogacy: Human rights perspectives on commercial and altruistic surrogacy.
    • Human Rights Watch – Surrogacy

Support and Counseling for Infertility and Surrogacy

  1. Resolve: The National Infertility Association: Support, education, and advocacy for individuals and couples dealing with infertility.
  2. Path2Parenthood – Surrogacy: Resources and support for intended parents, surrogates, and donor-conceived families.
  3. Mental Health America – Infertility: Information and resources on the emotional impact of infertility and support options.
    • Mental Health America – Infertility

Legal Resources on Surrogacy

  1. Legal Information Institute (LII) – Surrogacy Law: Legal definitions and case law related to surrogacy in the United States.
    • LII – Surrogacy Law
  2. International Surrogacy Laws – Hague Conference on Private International Law (HCCH): Resources on international legal frameworks governing surrogacy.
    • HCCH – International Surrogacy Laws
  3. ABA Center on Children and the Law – Surrogacy: Legal resources and guidelines for surrogacy practices.
    • ABA Center on Children and the Law

Medical and Ethical Journals on Surrogacy

  1. Journal of Assisted Reproduction and Genetics: Peer-reviewed articles on assisted reproduction technologies, including surrogacy.
  2. Bioethics Journal – Surrogacy Ethics: Scholarly articles exploring the ethical dimensions of surrogacy.
  3. Reproductive Biomedicine Online: Research articles and reviews on surrogacy and other reproductive technologies.

These resources provide a comprehensive foundation for understanding the multifaceted issues surrounding infertility and surrogacy, including medical, ethical, legal, and emotional perspectives.


While surrogacy may seem like a promising solution to infertility, it is fraught with ethical, emotional, and legal challenges that cannot be overlooked. Treating women and children as commodities undermines their inherent value and dignity. Exploring alternative paths to parenthood, such as adoption or fostering, and seeking support can provide more ethically sound and fulfilling options for couples facing infertility. Ultimately, the decision to pursue surrogacy should be made with careful consideration of its profound implications on all parties involved.

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