1. Surrogacy What You Should Know
Sam Everingham
Director
Families Through Surrogacy
Surrogacy What You Should Know

2. What is FTS? Not-for-profit organisation Global events Australia UK
Ireland
Hong Kong
Europe

3. What is FTS? Best-practice conferences & seminars
Events run by parents & surrogates
Focus on education
Website resources
Consultancy to assist intended parents

4. Overview Key Factors for Getting Started Options available
Typical Problems
Stabilising Factors
Outcomes for Children

5. Factors Needed Goodwill Professional expertise Support
Experienced provider
Good planning
Luck

6. Key Decisions for Getting Started
Timing – when do you want to be a parent? What size family do you want? Who will be a genetic parent? What relationship do you want with your surrogate? What is your budget?

7. Which Countries Allow For citizens + foreigners (legal)
For foreigners (no laws)
For citizens
Australia, Israel, South Africa, New Zealand, Netherlands, India, Thailand, UK, Czech Republic
USA, Canada, Ukraine, Greece, Georgia, Russia, Brazil
Kenya, Mexico, Albania, Laos

8. Legal Status & Who is Eligible

9. Other Countries

10. Changes in use

12. Surrogacy Usage Globally
~ 10,000 engage in agency-facilitated surrogacy globally each year
Within Europe, UK the 2nd largest user nation of cross-border surrogacy
Most UK couples going offshore using US or Ukraine

13. PROBLEMS

14. Impact of Market Closures
Greater pressure on US, Canadian & Ukraine surrogacy
Lower cost US options
Growth of hybrid programs
Eg Canadian surrogate + US IVF

15. Lack of Options Higher demand for surrogates in fewer countries
Countries with smaller populations (eg Georgia) don’t have sufficient surrogates
Increasing wait times
Poorer surrogate screening -> higher drop out, lower success
More use of countries with no laws (Kenya, Mexico, Laos)

16. Restrictive Laws Banning advertising - In Canada & Greece
Banning payment – in Canada & Greece
Excluding gay couples – in Greece, Ukraine, Georgia

17. Poorer Success with Altruistic
Parents using altruistic often report
Longer wait times to match with a surrogate ( mths)
Surrogates dropping out
Unsuccessful transfers / poor success rates
spiralling timelines, costs & stress as surrogates and donors are changed after repeated failure

18. Average Timelines - US About 18 Months IVF Physician
Surrogate Match, Legal, Medical
Surrogate
Waiting for a Surrogate
Pregnancy, Parental Rights Legal
IVF Physician
Surrogate’s OB/GYN
Donor
Selecting a Donor, Creating Embryos

19. Selecting a Donor, Creating Embryos
Timelines - Ukraine
About 17 Months
1.5 mths
3 months
9 months
3 months
Country exit
Surrogate
Wait for Surrogate
Legal, Medical
Pregnancy
IVF Physician
Surrogate’s OB/GYN
Donor
Selecting a Donor, Creating Embryos

20. Average Timelines - Canada
Months
4 months
4-6 months
2 - 8 months
9 months
Surrogate medicals, transfers and new attempts
Find Donor, Creae Embryos
Surrogate queque
Pregnancy, Parental Rights Legal
Donor Agency, IVF Physician
Surrogacy Agency
IVF Physician, Surrogacy Agency
Surrogate’s OB/GYN

21. Cost Containment
Surrogacy costs can typically increase 50% over ‘baseline’ costs
failed transfers
Early miscarriages
Switching from own to donor eggs
Pregnancy complications
Surrogate needing additional time off work

22. Desire for Twins
Increasingly surrogates will not accept double embryo transfer, as its harder on their bodies
Twin pregnancies come with far higher risks

23. Stabilising factors

24. Professional Support
Surrogates who carry without agency support often find it very difficult
So….
Independent Surrogacy can be tough on all parties
US, Canada, Greece & Ukraine offer professional support

25. Surrogate Compensation
Countries which can compensate surrogates tend to
Have better screen-out criteria
attract surrogates who are medically more suited

26. PGS testing of embryos increases success & is recommended

27. Cost Containment
Costs can typically increase 50% over ‘baseline’ costs
failed transfers
Early miscarriages
Switching from own to donor eggs
Pregnancy complications
Surrogate needing additional time off work

28. Higher Cost ‘Guarantee’ programs provide peace-of-mind & more popular
Cost Containment
Costs can typically increase 50% over ‘baseline’ costs
failed transfers
Early miscarriages
Switching from own to donor eggs
Pregnancy complications
Surrogate needing additional time off work
Higher Cost ‘Guarantee’ programs provide peace-of-mind & more popular

29. Outcomes for children

30. Surrogacy Outcomes for Children
Academic research shows
lack of a genetic or gestational link between parent and child has no negative effect on parent/child relationships or psychological well-being of mother, father or children1
no major psychological differences between 10 yr olds born via surrogacy vs children born via other ART or natural conception2
1 Golombok et al Human Reproduction 21, (7) pp. 1918–1924, 2006
2 Soderstrom-Anttila Surrogacy: outcomes for surrogate mothers, children and the resulting families—a systematic review
Human Reproduction Update, 22, (2) pp. 260–276, 2016

31. Surrogacy Outcomes for Children
Children in gay father families1 show
low levels of behavioral and emotional problems
significantly lower levels of internalizing problems than children in lesbian mother families
1 Golombok et al Child Development, 2017 Parenting and the Adjustment of Children Born to Gay Fathers Through
Surrogacy