Here at the CBC, we are always keeping up with studies that come out on the issues that matter most to our work.  Recently, I was alerted to a new study published in April, 2024, in the Journal of Reproductive Immunology, titled, “Surrogacy: An important pathway to parenthood. A call for international standardization”.  This report is authored by physicians in Israel.

Some background on Israel laws on surrogacy I think are important to understand the context for this new paper. For years, Israel only permitted surrogacy arrangements for married heterosexual couples, but in 2021, the Israel Supreme Court legalized surrogacy for gay couples. For those who recall the 2015 earthquake in Nepal, many stories were written about the surrogates who were trapped in the rubble of their homes, who were pregnant, largely carrying babies for gay couples in Israel.  One gay man said, “Israel is very advanced and liberal when it comes to gays, until you want children,” Amir said. “A straight couple, a single woman, even lesbian couples can have children together. We just can’t.”  In the aftermath of this earthquake, more pressure was put on the Israeli government to change their laws to allow surrogacy for gay couples.

With this in mind, I was curious to read this new published paper out of Israel.  Most of it is the same rhetoric we often hear around the need for regulation, because regulation many argue is supposed to protect against exploitation of women and children and basically protects all the stakeholders in these commercial contract pregnancy arrangements.  But what stood out to me were two things.  First, the abstract says, “Evidence indicates that medical outcomes are comparable to conventional pregnancies, suggesting a viable reproductive solution for intended parents.” I immediately turned to the section of the paper on “Medical outcomes” where they used two papers for their citations from 2015 and 2016.  I reviewed these studies, but none of their cited literature supported their claim. 

The 2015 study showed data from Canada of, “333 (IVF) cycles, 155 did not achieve a pregnancy, 36 resulted -in a miscarriage and 142 were ongoing pregnancies or had resulted in a live birth.” There is no mention of pregnancy complications.  The 2017 paper reported, “Although the use of gestational carriers was associated with improved implantation, pregnancy, and live-birth rates, there were concomitant increases in the risks for multiple birth and preterm delivery.”  

My second thought was then how did a paper written in 2023 and published in 2024, pass peer-review, knowing that since then there have been at least two different papers published in 2015, and 2017, and the peer-review study Kallie Fell and I published in 2022 – all pointing out the risks of a gestational surrogate pregnancy.  And the clincher is that the research we published specifically compares the woman’s gestational surrogate pregnancy with her “conventional pregnancy”, which showed that the risks of the surrogate pregnancy were many and those risks were statistically significant.

To try and correct a glaring error, I contacted the editorial Board of the Journal, asking for a correction, or if I could write a letter to the editor in response.  To date, no one has responded to my query.  For those who want to keep up with current data please use the Comprehensive Report on the Risks of Assisted Reproductive Technology. If anyone has access to Donald Trump, please give him this report too!

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.