Taraneh Khodaparast,1Bahar Moasses Ghafari,2Parsa Hasanabadi,3,*
1. Student, Sanandaj branch, Islamic Azad University, Sanandaj, Iran 2. Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran 3. Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
Introduction: Based on the World Health Organization (WHO) report, approximately 17.5% of the world population experience infertility. Assisted reproductive methods include drug treatment, surgical procedures, intrauterine insemination (IUI), In Vitro Fertilization (IVF), intracytoplasmic sperm injection or microinjection (ICSI), and donation . In the donation method, various subtypes such as surrogate uterus, embryo donation, ovum donation, and sperm donation are done . Surrogacy is an assisted reproductive method, in which traditional and gestational are its subtypes. The use of surrogacy has increased until now, and among all Assisted Reproductive Technologies (ART) in the United States of America, about 1.9% of births are due to surrogacy.
Methods: To determine the scope of this review, we searched in databases such as "pubmed", "Scopus", "Web of Science" with the keywords "surrogacy", "ethic", "legal" and other related MeSH terms up to September 2023. All of results included into our study for highliting the ethical and legal challenges of surrogacy.
Results: Although surrogacy is being done widely, some ethical and legal challenges exist. In some countries such as Ukraine, Greece, and Georgia, a surrogate receives a sum from the intended parents, recognized as “commercial surrogacy”. At the same time, commercial surrogacy is illegal in other countries, such as Italy, Spain, and the United Kingdom. In some other countries like Saudi Arabia, the United Arab Emirates, France, Germany, Austria, and Japan, all types of surrogacy are illegal. Beyond the legal status of surrogacy in countries, the ethical challenges of surrogacy are essential. Risks associated with delivery and pregnancy for a surrogate, autonomy, and access to care of surrogate, psychological problems of intended parents and surrogate, congenital disabilities of the child, child rights, intra-family sex cell donation, and gender discrimination are a few numbers of existing problems
Conclusion: The mentioned problems may have worse effects on surrogacy and reduce the rate of birth from this assisted reproductive method. Thus, the necessity of international regulation for surrogacy, determining risks and problems for surrogates and parents to reduce controversies between parties.