Submission to the Inquiry into Fertility Support and Assisted Reproductive Treatment

The Select Committee on Fertility Support and Assisted Reproductive Treatment
NSW Legislative Council
Parliament House
Macquarie Street
Sydney NSW 2000

July 24, 2025

Re: Submission to the Inquiry into Fertility Support and Assisted Reproductive Treatment

Dear Committee Members,

I am writing on behalf of The Center for Bioethics and Culture (CBC) to provide input to the NSW Legislative Council’s Inquiry into Fertility Support and Assisted Reproductive Treatment (ART). We welcome the opportunity to contribute to this important review. For over two decades, our organization has been engaged in global education and research on the ethical, medical, legal, and social implications of third-party reproduction and ART practices.

We submit this statement with particular concern for how ART—particularly surrogacy and egg donation—impacts the rights and wellbeing of women and children, and how market-driven models are increasingly shaping reproductive healthcare. We urge the Committee to consider how policies around ART can better protect vulnerable individuals, prioritize ethical medical practice, and ensure that human dignity and bodily integrity are not compromised in pursuit of reproductive solutions.

Ethical Foundations: Human Dignity, Consent, and Children’s Rights

ART and surrogacy raise fundamental ethical questions about the commodification of human life, consent under financial duress, and the rights of children to know their origins. These are not abstract concerns. International human rights law—including the United Nations Convention on the Rights of the Child—establishes a child’s right to identity, and to be cared for by their biological parents whenever possible. Yet ART practices often intentionally sever these bonds by design, particularly in surrogacy arrangements.

Surrogacy arrangements—especially commercial and cross-border ones—risk reducing women to gestational vessels and children to commissioned outcomes. This commodification violates both bodily autonomy and human dignity, and introduces contract law into spaces that should remain governed by family law and fundamental rights.

Risks to Women: Health, Autonomy, and Exploitation

ART procedures such as egg retrieval and gestational surrogacy pose significant physical and psychological risks to women. These include:

Elevated rates of preterm birth, gestational diabetes, postpartum depression, and other complications and health risks
Repeated hormone exposure without long-term safety data
Psychological trauma from relinquishing a child they carried

Surrogacy contracts often restrict the autonomy of the surrogate woman, binding her to lifestyle conditions and geographic restrictions, and limiting her rights to make decisions during pregnancy. We have documented cases, including in the U.S., where surrogate mothers experienced homelessness, health crises, or emotional trauma with little recourse or support.

Concerns about Market Influence and Commercialization

The fertility industry is a multi-billion-dollar sector globally. Where ART becomes commodified, profit incentives overshadow ethical medical care. Advertising of surrogacy, embryo adoption, and egg donation packages in a transactional language (“guaranteed baby,” “money-back IVF”) dehumanizes all parties involved.

Even where payments are framed as “reimbursement,” financial compensation introduces economic coercion. Women in financially vulnerable positions may feel compelled to undergo risky medical procedures or relinquish a child not out of free choice, but economic necessity.

Impact on Children Born through ART

Children conceived through third-party ART often face lifelong identity issues, particularly when donor anonymity, false parentage on birth certificates, or lack of access to medical history are involved. These children deserve transparency about their biological origins and the right to a truthful record of birth. Failing to provide this information not only violates their rights, but also deprives them of crucial medical and psychological knowledge.

Recommendations for Legislative Oversight and Reform

We urge the Committee to adopt a precautionary and child-centered approach to ART, and recommend a complete abolition of surrogacy. In cases of third-party conception, we recommend, at a minimum:

Prohibition of commercial surrogacy and compensation-based ART arrangements
Bans on ART advertising, especially online promotions that mislead or target vulnerable women
Clear birth certificates for any child born from third-party conception, naming each party involved in conception
Restrictions on donor anonymity, with mandatory access to identifying and medical information for donor-conceived children from time of birth
No public funding for third-party ART procedures that involve significant ethical and health concerns
Post-birth transfer of parentage only, with legal safeguards to protect the rights of the birth mother and child
Long-term independent research into the physical and psychological impacts on surrogate mothers, egg donors, and children
Clear opposition to cross-border surrogacy arrangements, particularly in jurisdictions with poor human rights records

Final Comments

Infertility is a profound struggle, but the ethical solution is not to shift that burden onto another woman’s body or commodify a child. True support for fertility means pursuing restorative reproductive health, ethical medical interventions, and family support—not market-driven outsourcing of reproduction.

We commend the NSW Parliament for taking this issue seriously and hope this Inquiry will mark a turning point in aligning fertility support policies with human dignity, child welfare, and ethical healthcare practice.

Sincerely,

Kallie Fell, R.N., B.S.N., M.S.
Executive Director
The Center for Bioethics and Culture