1. The Future for Surrogacy Globally
Sam Everingham
Director
Families Through Surrogacy
The Future for Surrogacy Globally

2. Overview Community Attitudes Changes in availability
Trends in surrogacy law globally
Changes in use globally & by Swedes
Stabilising Factors
Pressures on surrogacy
Outcomes for Children

3. Community attitudes

4. Swedes Support Surrogacy

5. Changes in availability

6. New Developing Markets
India closes to LGBTI
Greece opens to foreigners
Cambodia closes
Laos & Kenya open
1990s
2000s
2010
2011
2013
2014
2015
2016
Thailand/Nepal boom
Thailand, Nepal & India close
Ukraine booms
IPs engaging in USA

7. Impact of Market Closures
Greater pressure on US, Canada & UK surrogacy
Increasing wait times to locate surrogate
Lower cost US options
Growth of hybrid programs
Eg Canadian surrogate + US IVF

8. 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, Thailand

9. Trends in surrogacy law

10. Legal Status & Who is Eligible

11. Other Countries Accepting Foreigners
Country
Legal status
General Eligibility
USA
Legislation specific to surrogacy in some states granting legal parentage
Some states allow access to gay couples, singles, and heterosexuals of any age
Ukraine
Grants legal parentage
Heterosexual married couples who meet general medical criteria
Canada
Legislation specific to surrogacy in some provinces granting legal parentage
Combined age of intended parents must be <110
Greece
Legislation specific to surrogacy granting legal parentage
Heterosexual couples and single females

12. Changes in use

14. Five Largest User Nations
USA
Israel
China
Australia
Canada

15. Largest European User Nations
Overall
France UK
Spain
Sweden
Germany
Per capita
Ireland
Norway
Sweden

16. Surrogacy Usage Globally
~ 10,000 engage in agency-facilitated surrogacy globally each year
~255 Swedish engaging per year
Most Swedes engaging in Ukraine, USA & Georgia.

17. Where Are Swedes Mostly Engaging?
NOW
USA
Ukraine
Thailand
Georgia
2011
USA
India

18. Stabilising factors

19. Agency Support
Surrogates who carry without agency support often find it very difficult
So….
Independent Surrogacy can be tough on all parties
Countries with good professional support (eg US, Ukraine) predicts far better surrogate experience

20. Professionals with Long Experience Producing Better Outcomes
30 years experience
USA
Canada
Greece
Small no. of agencies
Large no. of agencies
Ukraine
Georgia
Russia, Kenya
No experience

21. Published IVF Success Rates

22. pressures

23. Lack of Options Higher demand for surrogates in fewer countries
Countries with smaller populations (eg Georgia) don’t have sufficient surrogates

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

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

26. Outcomes for children

27. 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

28. 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