Are frozen embryos in laboratory test tubes “People”, or are they “Property?”

Alternative means of childbear­ing, which include but are not limited to surrogacy, have become increasingly popular in recent time. According to the Society for Assisted Reproduc­tive Technology, in 2011 alone, there were 1,593 babies born in the U.S. to gestational surrogates as reported by Reuters (2013).

Gestational surrogacy has proven to be one of the most viable options for women in whom carrying a preg­nancy to term is contraindicated.

In surrogacy, various methods are used to form a viable embryo for pregnancy.

i. With a donor’s egg

ii. With donor’s sperm

iii. With donor embryo

These factors associated with these methods affect the cost of surrogacy in Ghana. The average surrogacy cost in Ghana is GHC 150,000. This amount includes all the expenses from the required tests of intended parents and surrogates to the birth mother’s fee. Surrogacyforall.com stipulates that singleton pregnancy costs between $49,000 and $105,000 in the USA, while twin pregnancy poses an additional cost of $5,000.

One report by BBC, (2018) states that financially and socially vul­nerable women can be targets for surrogacy recruitment, since they are attracted by the huge sums of money on offer. For instance, a surrogate in Ukraine can earn up to $20,000 (£15,507); more than eight times the average yearly income.

Despite being a seemingly lucrative venture considering the money involved, there have been reports of poor treatment of surrogate mothers, with some agencies refusing to pay surrogates if they do not obey strict requirements or if they miscar­ry. Exploitation concerns have led to many countries shutting down their previously booming surrogacy in­dustries. In 2018, a report by ohchr. org, stated that the UN warned that “commercial surrogacy….amounts to the sale of children”.

What is Surrogacy?

According to Dr. Owusu-Ansah, Surrogacy is when someone carries a child for a woman, who due to com­plications, is unable to do so natu­rally. The child is carried till delivery. Wikipedia, (2021) has also defined Surrogacy as “an arrangement, often supported by a legal agreement, whereby a woman (the surrogate mother) agrees to bear a child

 another person or persons, who will become the child’s parent(s) after birth.”

Types of surrogacy

The term “surrogacy” is gener­ally used to describe a couple of different scenarios.

• A gestational carrier car­ries a pregnancy for an individual or couple using an egg that is not the carrier’s. The egg may come from either the intended mother or a donor. Likewise, sperm may come from the intended father or a donor. Pregnancy is achieved through in vitro fertilization (IVF).

• A traditional surrogate both donates her own egg and carries a pregnancy for an individ­ual or couple. The pregnancy is usually achieved through intrauter­ine insemination (IUI) with sperm from the intended father. Donor sperm may also be used.

According to the Southern Surrogacy agency, gestational car­riers are now more common than traditional surrogates. This is due to the fact that once a traditional surrogate donates her own egg, she is technically also the biolog­ical mother of the child, and has genetic ties to the said child.

How does surrogacy work?

Gestational surrogacy helps those who are unable to have children become parents. It’s a process that requires medical and legal expertise, as well as a strong support process throughout the journey.

Through IVF, embryos are created in a lab at a fertility clinic. Sometimes the intended parents use their own genetic materi­al. Sometimes, an egg donor is required. At the fertility clinic, 1-2 embryos are implanted into a

for

 another person or persons, who will become the child’s parent(s) after birth.”

Types of surrogacy

The term “surrogacy” is gener­ally used to describe a couple of different scenarios.

• A gestational carrier car­ries a pregnancy for an individual or couple using an egg that is not the carrier’s. The egg may come from either the intended mother or a donor. Likewise, sperm may come from the intended father or a donor. Pregnancy is achieved through in vitro fertilization (IVF).

• A traditional surrogate both donates her own egg and carries a pregnancy for an individ­ual or couple. The pregnancy is usually achieved through intrauter­ine insemination (IUI) with sperm from the intended father. Donor sperm may also be used.

According to the Southern Surrogacy agency, gestational car­riers are now more common than traditional surrogates. This is due to the fact that once a traditional surrogate donates her own egg, she is technically also the biolog­ical mother of the child, and has genetic ties to the said child.

How does surrogacy work?

Gestational surrogacy helps those who are unable to have children become parents. It’s a process that requires medical and legal expertise, as well as a strong support process throughout the journey.

Through IVF, embryos are created in a lab at a fertility clinic. Sometimes the intended parents use their own genetic materi­al. Sometimes, an egg donor is required. At the fertility clinic, 1-2 embryos are implanted into a

 gestational carrier, who carries the baby(ies) to term. Gesta­tional carriers have no genetic relationship to the children they deliver.

Surrogacy and the Law

Many countries do not have legislations on Surrogacy and this presents with many chal­lenges. For instance, the case of baby Gammy as reported by the BBC (2016) shocked the world, when it was alleged the commissioning parents had intentionally left Gammy, who had Down’s syndrome, in Thai­land, while taking his non-dis­abled twin sister Pipah home to Australia. A court later ruled, according to Telegraph, (2016), that he had not been aban­doned, although it emerged the commissioning father had previous convictions for child sex offences, playing into wider concerns regarding the welfare of surrogate children.

In Ghana, there is currently no law regulating the practice of surrogacy. According to the SurrogacyLawyers.com, “Re­gardless of the law in Ghana or any other destination, the surrogate is always the legal mother. Whether or not one of you is the legal parent will depend on the circumstances surrounding the insemination or embryo transfer, and wheth­er the surrogate is married or in a civil partnership. Thus, it is essential that you get advice before you start the process and preferably, before you select the surrogate. A Parental Order extinguishes any legal rights that the surrogate and

 her husband have for the child and makes you the legal parents. If you do not apply for a Parental Order by the time the child is 6 months old, you may need to consider alterna­tives such as adoption. This deadline has been extended in some cases.”.

According to Dr. Owusu-Ansah in an interview with naaoyooquartey. com, “all proceedings are covered by a written agreement between all parties involved including medical staff, surrogate, commissioning par­ents etc”. He further emphasized that some surrogates become a bit resistant after delivery because they feel they haven’t been adequately compensated or well treated during the 9-month period, whilst others feel an emotional bond to the child after delivery. “That’s why consent forms are signed before the process begins to prevent conflicts. If there’s any issue, discussions can be held to resolve any contentions”.

The challenge here is that legis­lation concerning surrogacy varies hugely from country to country and is shaped by history, culture and social values. For instance, in Germany and France, surrogacy is seen as violating the dignity of women, using them as the means to someone else’s end. Therefore, the practice is completely forbid­den. Other jurisdictions like the UK view surrogacy as a gift from one woman to another, and allow it on an “altruistic”, expenses-only basis. Others still, such as California, Russia and Ukraine, permit com­mercial surrogacy, viewing it as an expression of a woman’s autonomy to engage in surrogacy of her own free will. Ukraine, is one of the few countries in the world where the law approves and duly regulates the

 usage of Assisted Reproductive Technology (ART) services; surro­gacy and egg donation in particular. Article 123 of the Family code of Ukraine confirms the child born from surrogate mother as a result of usage of assisted reproductive technologies belongs to the Intend­ed Parents and their names come in baby’s birth certificate. The total cost of a surrogacy program with Self Eggs starts from Euro 40,000 “Success Package” with up to four Embryo Transfer Attempts, while “Guaranteed Surrogacy” Packages are also available at affordable costs (tentative 50,000- 56,000 USD).

Georgia is another trending destination for Surrogacy, here a heterosexual couple is qualified to get the surrogacy. They do not pro­hibit any couple for having surro­gacy, but it is the duty of the clients to verify from their home country as the baby is their property. The cost for surrogacy is between USD 38,000- 40,000 for self-eggs and donor’s eggs respectively.

In India, Surrogacy exits for only Indian citizens. The cost of surrogacy in India is INR 13,00,000 to 15,00,000 [USD 20,000 – 23,000] with own eggs or donor eggs.

Some international surrogacy destinations, such as Kenya and Nigeria, remain unregulated. Kenya, currently has a bill on surrogacy which is yet to be passed. The cur­rent surrogacy legislation in Kenya makes it an attractive destination for “reproductive tourists and espe­cially Egg Donation and Surrogacy Programs”. The total cost for self-eggs or Caucasian / African Donor Surrogacy program is $45,000

FROM DR. RAPHAEL NYARKOTEY OBU, PHD & LAWRENCIA AGGREY-BLUWEY

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