SURROGACY: A NIGERIAN EXPERIENCE

Managing Lab Test Results of GC

  • A positive result should be confirmed before contacting individual
  • Any individual who tests positive to HIV I &II, HIV group O antibody, Hepatitis B, Hepatitis C, should NOT be a GC EXCEPT
  1. Careful counseling
  2. Informed consent
  3.  Documentation of risks in the medical records

Varied Opinions

FDA

  • Embryos created by such individuals can still be transferred into a GC
  • Tissue has to be labeled to indicated the associated increased risk
  • Physicians transferring the embryos are aware of the status of the result
  • Does not require the GC be informed of lab results

ASRM

  • Gestational Carrier must be informed of the test results
  • Provide appropriate counseling before such embryos can be transferred

Quarantining Embryos

All potential GC should be offered the option of cryopreservation and quarantining embryos derived from the genetic parents for 180 days (6 months).

Record Keeping

FDA

  • Records to be maintained for at least 10 years
  • Protection of confidentiality

GC should be assured that their confidentiality will be protected, this includes their medical report

ASRM

  • Records should be kept permanently
  • Including: all initial tests and subsequent test results
  • Clinical outcome of each cycle must be recorded
  • A mechanism has to be in place to ensure future medical reference for the offspring produced

Legal Issues and Informed Consent

  • GC and Partner; Intended Parents
  • Must have ongoing legal advisers
  • Considerations for single embryo transfers
  • Considerations for quarantining embryos
  • Behavior of the GC e.g. smoking, sexual preference
  • Compensation of the GC
  • Legal Contract and agreement

Trend of Patients Treated over the Years at MART

Categories of Patients for Treatment

Conclusion

There is a steady increase in the use of surrogacy in reproduction globally. Third Party reproduction needs to have global standards, but considering cultural peculiarities uniformity is necessary to protect all parties involved. Psychological evaluation is VERY important and psychosocial impact has a significant impact. Most importantly, legal Consideration is vital.

References

  • American Psychological Association Nov. 2014
  • Practice Committee of ASRM and Practice Committee of Society for Assisted Reproductive Technology. Fertil Steril 2013; 99
  • Society for Assisted Reproductive Technology Female & Male Donor Forms Nov. 2014
  • Elizabeth A (Ebbie) Stewart, MD, Abigail Delaney MD: World Health Organization- Gestational Surrogacy draft guidelines Sept. 2015:
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