Introduction

From its beginnings, surrogacy has been dogged by controversy. Even the terminology has been met with controversy (English et al., 1991). In the United Kingdom arrangements where the surrogate is also the genetic mother of the child have been defined as ‘partial’, ‘straight’ or ‘genetic’ surrogacy, and arrangements where the surrogate is not genetically related to the child have been called ‘full’, ‘host’ or ‘gestational’ surrogacy.

In the United States surrogacy originally described an arrangement in which intended parents attempted conception through the use of a woman’s egg, and that woman underwent inseminations with the intended father’s sperm. In this case the surrogate was providing both the genetics and the gestation. As in vitro fertilization emerged as a viable treatment option, another surrogacy option emerged wherein a couple or individual worked with a woman who would carry a genetically unrelated embryo that was transferred to her. In this scenario the surrogate contributes only the gestation. In 2006 1 per cent of all fresh ART cycles in the United States involved a gestational surrogate (for a total of 1,042 cycles); additional cycles were performed involving donor eggs (CDC, 2006). In the UK the number of surrogate births, although rising, is harder to estimate due to a number of more informal home-insemination arrangements. In this case IVF is not required and so the surrogate birth goes unregistered as such.