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Systematic review

To investigate the risks and benefits for infertile Australian families considering accessing cross-border surrogacy

Birth rate Childbirth Surrogacy International surrogacy Australia
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apo-nid71848.pdf 1.43 MB

Multiple models of surrogacy exist internationally, each contributing different protections to surrogacy arrangements. Commercial surrogacy arrangements can be successfully managed without necessarily resulting in exploitation of, or harm to the involved parties. It is possible for Australians to engage in Cross Border Surrogacy (CBS) in a manner consistent with Reproductive Technologies Accreditation Council guidelines and current Australian Assisted Reproductive Technology practices.

All surrogacy arrangements must first and foremost be designed to protect the wellbeing and interests of the child to be born through surrogacy.

Surrogacy services are inextricably linked to egg, sperm and embryo donation services. It is impossible to properly examine CBS without a concurrent examination of donor practices.

Counselling professionals working in surrogacy must understand the legal, medical, logistical and emotional aspects of undertaking a surrogacy arrangement both within Australia and overseas. Fertility counsellors must have capacity to prepare IPs with current and accurate information about surrogacy in Australia and overseas, provide appropriate and unbiased counselling and support ethical and safe decision making.

Regular psychosocial counselling or “checkins” provided during the surrogacy arrangement can facilitate healthy and successful relationships between IPs and surrogates, and ensure that all parties are coping with the surrogacy.

IPs should be provided with sufficient opportunity to undertake a domestic surrogacy arrangement, within the Australian regulatory framework. IPs and surrogates contemplating involvement in domestic surrogacy must have access to clear and comprehensive information to enable a fully reasoned decision about the process of the arrangement.

Current Australian legislative frameworks provide insufficient and inconsistent protection for the parties involved in domestic or cross border surrogacy arrangements. Legislative change is imperative for the wellbeing of IPs, surrogates and the children who will be born from surrogacy. Regulatory reform is necessary to ensure sufficient surrogates are available domestically to meet a rapidly growing demand for surrogacy arrangements. Legislative frameworks must be consistent across Australia. Medicare funding for domestic surrogacy would increase affordability.

CBS is a potentially unsafe form of fertility treatment: medically, ethically, psychologically and legally. For IPs who determine that they wish to engage in a cross border arrangement, it is critical that access to impartial support and advice services is available, to examine the risks of travelling overseas for surrogacy. IPs must be given sufficient information about the various CBS options, so if they do choose to engage in a cross border arrangement, they select a country which has clear regulatory frameworks which are protective of themselves and their surrogates, and is provided within treatment practices consistent with what would be offered in Australia. 

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