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Pressures to expand, advancing technologies, and increased public exposure of in vitro fertilization (IVF) compels ongoing evaluation of the medical, ethical, and legal proprietary of this high tech infertility treatment, especially when used to build nontraditional families. Recently, the University of Iowa’s Center for Advanced Reproductive Care considered the possibility of adding gestational carrier (popularly known as “surrogacy”) services to our program. The IVF Ethics Committee considered practical realities and inherent ethical issues including the number of invested parties, significant economic costs, risks taken on by the gestational carrier, and the potential for free market exploitation. The Committee resolved that efforts to combat these concerns should include a push for industry self-regulation with restrictions on reimbursement, better professional guidance on this topic from professional organizations, collaborative research on program development, trends, and outcomes, and uniform laws to protect all parties involved. With this in mind, the Committee and program physicians approved moving forward with careful institution of this program in collaboration with handpicked surrogacy agencies.

Establishment of a clinical gestational carrier program: medical, ethical, legal and policy issues