Kraftig ökning av Surrogatmödraskap i USA
I en vetenskaplig artikel publicerad augusti 2016 i tidskriften Fertility and Sterility presenteras statistik för antalet barn som fötts via surrogatmödraskap mellan åren 1999-2013. Mellan dessa år föddes drygt 18400 barn via surrogatmödraskap och det genomfördes ca 31.000 IVF försök i samband med surrogatmödraskap. Man har även sett en kraftig ökning både av antalet kliniker som erbjuder surrogatmödraskap i USA samt av antalet försök och barn som föds via denna metod. Även antalet par som kommer från andra länder än USA har ökat.
Ett argument som tidigare förts fram har varit att ex surrogatmödraskap i Indien skulle ha lett till att människor i USA istället skulle ha lett till att man åkte utomlands i större utsträckning för att bli förälder. Detta kan dock inte ses i statistiken, istället har antalet barn som fötts via surrogatmödraskap i USA stadigt ökat under den tid som surrogatmödraskap var tillgängligt i Indien för utländska par. Abstrakt till artikeln hittar du nedan tillsammans med fullständiga referenser. Artikeln i sin helhet hittar du här
Trends and outcomes of gestational surrogacy in the United States
Fertility and Sterility® Vol. 106, No. 2, August 2016 0015-0282
Kiran M. Perkins, M.D., M.P.H., Sheree L. Boulet, Dr.P.H., Denise J. Jamieson, M.D., M.P.H., and Dmitry M. Kissin, M.D., M.P.H., for the National Assisted Reproductive Technology Surveillance System (NASS) Group Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia
Objective: To evaluate trends and reproductive outcomes of gestational surrogacy in the United States.
Design: Retrospective cohort study. Setting: Infertility clinics. Patient(s): IVF cycles transferring at least one embryo. Intervention(s): Use of a gestational carrier.
Main Outcome Measure(s): Trends in gestational carrier cycles during 1999–2013, overall and for non-U.S. residents; reproductive outcomes for gestational carrier and nongestational carrier cycles during 2009–2013, stratified by the use of donor or nondonor oocytes. Result(s): Of 2,071,984 assisted reproductive technology (ART) cycles performed during 1999–2013, 30,927 (1.9%) used a gestational carrier. The number of gestational carrier cycles increased from 727 (1.0%) in 1999 to 3,432 (2.5%) in 2013. Among gestational carrier cycles, the proportion with non-U.S. residents declined during 1999–2005 (9.5% to 3.0%) but increased during 2006–2013 (6.3% to 18.5%). Gestational carrier cycles using nondonor oocytes had higher rates of implantation (adjusted risk ratio [aRR], 1.22; 95% confidence interval [CI], 1.17–1.26), clinical pregnancy (aRR, 1.14; 95% CI, 1.10–1.19), live birth (aRR, 1.17; 95% CI, 1.12–1.21), and preterm delivery (aRR, 1.14; 95% CI, 1.05–1.23) compared with nongestational carrier cycles. When using donor oocytes, multiple birth rates were higher among gestational carrier compared with nongestational carrier cycles (aRR, 1.13; 95% CI, 1.08–1.19).
Conclusion(s): Use of gestational carriers increased during 1999–2013. Gestational carrier cycles had higher rates of ART success than nongestational carrier cycles, but multiple birth and preterm delivery rates were also higher. These risks may be mitigated by transferring fewer embryos given the higher success rates among gestational carrier cycles. (Fertil Steril 2016;106:435–42. 2016 by American Society for Reproductive Medicine.) Key Words: Gestational carrier, surrogacy, in vitro fertilization (IVF), reproductive outcomes, multiple birth