Recently, a colleague sent me a new report published in the journal Fertility and Sterility, which is the professional journal of the American Society of Reproductive Medicine. The report is a retrospective cohort study on all assisted reproductive technology cycles reported to the Society for Assisted Reproductive Technology via their Clinic Outcome Reporting Systems.  Data was gathered on embryo transfers done to U.S. gestational surrogates from 2014 to 2020 and compared surrogacy between surrogates and commissioning parents in both domestic and international arrangements.

First, it struck me as strange, that the report referred to the patients who were in fact the intended parents. Seems to me the surrogate mother and by extension, the baby(s) she carried would be the patient. But this is just another example of diminishing the mother-child dyad and centering the moneyed interests as the focus of the report.

The actual results were striking too, in reporting not only the rise in international purchasing parents using American women, but also who these people are who are hiring American women.

Of 40,177 embryos transferred during 2014 to 2020, 32% of these arrangements were foreign contracts. In 2014, the figure was 22%. In 2019, it was 39.8%. And then in 2020, the figure decreased to 31.8%, which was probably due, in part, to the Covid travel bans.  The profile of the international intended parent(s):

  • More likely to be a male (41.3%) and over 42 years of age
  • Largely from China (41.7%) then France (9.2%) and Spain (8.5%)
  • International parent(s) chose young Hispanic women as surrogates at a higher rate
  • U.S. gestational carriers for international arrangements were younger than 30 years (42.8%)
  • Cycles for international arrangements more often used donor eggs (67.1%)
  • More often used intracytoplasmic sperm injection (67.1%)
  • Preimplantation genetic testing used (79.0%)

As many countries prohibit surrogacy, these restrictive (and good) laws only encourage the explosion in Big Fertility here in the U.S. I can see all sorts of ethical and legal risks in the role the U.S. plays in the international reproductive tourism landscape. First, it should be a red flag that many of these arrangements are with single men.  My pedophile, baby trafficking radar is on high alert.  Second, the high percentage of Chinese nationals hiring women to buy a baby that has the bonus of U.S. citizenship, what is commonly referred to as “anchor babies.”  As we fight for the abolition of the baby trade, we would do well to close our borders to these international nefarious arrangements that exploit women at home. What a big dent we could make in the multi-billion-dollar baby markets if we just closed our borders. Seems like something our State Department should investigate.

From Fertility and Sterility Vol 121 No 4

Author Profile

Jennifer Lahl, CBC Founder
Jennifer Lahl, CBC Founder
Jennifer Lahl, MA, BSN, RN, is founder and president of The Center for Bioethics and Culture Network. Lahl couples her 25 years of experience as a pediatric critical care nurse, a hospital administrator, and a senior-level nursing manager with a deep passion to speak for those who have no voice. Lahl’s writings have appeared in various publications including Cambridge University Press, the San Francisco Chronicle, the Dallas Morning News, and the American Journal of Bioethics. As a field expert, she is routinely interviewed on radio and television including ABC, CBS, PBS, and NPR. She is also called upon to speak alongside lawmakers and members of the scientific community, even being invited to speak to members of the European Parliament in Brussels to address issues of egg trafficking; she has three times addressed the United Nations during the Commission on the Status of Women on egg and womb trafficking.