UC Irvine

While gestational surrogacy has grown in popularity in the last decade, the surrogacy process is far from homogeneous. This lack of standardization can cause problems between surrogates and intended parents and can be troublesome for healthcare providers.

The purpose of this study was to understand the current practices regarding discussion of potential pregnancy complications and prenatal testing in an attempt to determine how these decisions are made. This study also examined how comfortable surrogates felt expressing their opinions with the intended parents regarding these topics.

Surveys were distributed through four surrogacy agencies and included several topics that could pose a potential conflict between the surrogates and intended parents. One hundred and eleven participants were included in this study. Decisional topics included carrier screening, fetal anomalies, and screening/testing options. The number of topics discussed by the surrogates varied, with about 1/3 of participants reporting that they discussed most or all of these topics before being matched with the intended parents. Decisions during the pregnancy were most often made by medical professionals, followed by the gestational surrogate and intended parent(s) together. Most participants felt comfortable voicing their opinions and that their opinions were considered throughout the surrogacy experience. These results indicate that surrogates generally feel comfortable and empowered throughout their experience.

The results of this study revealed overall positive experiences for the surrogates. Having standardized guidelines may increase satisfaction with the surrogacy process and be beneficial in preventing serious conflicts between surrogates and intended parents. Given the recent increase in prenatal screening and testing options, standardized guidelines are needed to assist genetic counselors with facilitating discussions between surrogates and intended parent(s).