Surrogacy is when a woman carries a pregnancy that she will give to another person or couple at birth. There are two types of surrogacy: traditional surrogacy, and gestational surrogacy.
Traditional surrogacy is when a surrogate carries a pregnancy in which she was also the egg donor. At delivery, she is the birth mother, the genetic mother, and the legal mother. Because of the potential legal issues with this type of arrangement, the Regional Fertility Program does not participate in this form of surrogacy.
Gestational surrogacy is when a surrogate carries a pregnancy that does not come from her own eggs. She is the birth mother but also the legal mother. An adoption by the intended parent / parents has to occur at the time of birth.
Pregnancy is not risk-free for any woman at any age. In countries where surrogates can be paid, she is being compensated financially to take those risks. In Canada, she can only be paid for expenses that directly relate to the pregnancy.
Surrogacy can only be performed in Canada if it is medically indicated. There are two major indications. The first is that the intended parent / parents do not have a uterus or have a uterus which has been determined to not be able to sustain a pregnancy. The second major indication for surrogacy is that some medical conditions would put a woman’s life or health at significant risk should she carry a pregnancy.
To be a surrogate is a very significant commitment by both the surrogate and her family. Many intended parents have difficulty finding a surrogate. At the Regional Fertility Program, we will accept surrogates who have been recruited through a surrogacy agency. Intended parents can use both egg donation and surrogacy if both are indicated.
The intended parent / parents will be reviewed by a physician at the Regional Fertility Program to ensure that there is a reasonable chance of a successful pregnancy. We will make every effort to do as much of the screening as possible on both the intended parents and the surrogate before they attend an egg donor / surrogacy information session. This session will discuss the process of IVF, the potential risks and complications of IVF and pregnancy, and how we are going to coordinate the person producing the eggs with the person carrying the embryo. Ideally the information session should be as close as possible to the treatment cycle.
All forms of third party reproduction require that all participants and their partner attend a counseling session. This is to ensure that the appropriate decisions are made by all parties.
A legal contractual agreement between the surrogate, her partner, and the intended parent / parents must be completed before treatment can be started. This legal agreement is undertaken independent of the Regional Fertility Program. The surrogate will need an independent legal opinion of this contract. An outline of issues that should be considered will be provided by the Regional Fertility Program. It is recognized that in Canada, there is no case law directly applying to surrogacy or surrogacy arrangements. The courts may find surrogacy contracts invalid and therefore not enforceable and rule in “the best interest of the child.”
In the eyes of many, surrogacy arrangements may be controversial. This is one of the many emotional and psychological issues that need to be dealt with before, during, and after such arrangements are executed. The psychologist, nurses, and physicians, at the Regional Fertility Program undertake to provide such counseling to help all members of the consenting agreement to be aware of the relevant issues and to help work them through. The Regional Fertility Program physicians and psychologist do reserve the right to refuse treatment if it is felt to be inappropriate. Ongoing counseling may be required during and even after the pregnancy as there is still limited experience with surrogacy motherhood to date.