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  • Print publication year: 2004
  • Online publication date: May 2010

34 - The management of infertility with surrogacy and egg donation

from Part III - Management of specific disorders

Summary

Surrogacy

Until recently, women born with severe abnormalities of development of the Müllerian duct system have been unable to have their own genetic children. Adoption or childlessness have been their only options. The introduction of gestational or in vitro fertilization (IVF) surrogacy during the 1990s as a treatment option has changed the prognosis for women in this situation. Now, women with congenital absence or severe malformations of the uterus, or hysterectomy and abnormalities of the uterus incurred as a result of trauma or cancer treatment, have a chance of having their own genetic child, albeit gestated by another woman. As IVF surrogacy has become increasingly acceptable as a treatment option, both to the medical profession and to the general public (British Medical Association, 1996; Bromham, 1992, 1995), these young women can now have their own children, provided, as most of them do, they have normally functioning ovaries. However, some who have survived the treatment of a malignancy in childhood may have lost not only their uterine function, but also their ovarian function. This section reviews the indications for IVF surrogacy and the selection and management of women seeking this treatment, particularly relating to those with congenital abnormalities. The following section discusses the use of egg donation.

Indications

The main indications for considering treatment by IVF surrogacy are:

congenital absence or abnormality of the uterus

hysterectomy following malignancy or haemorrhage

recurrent abortion

severe medical problems precluding pregnancy and childbirth

repeated IVF failure.

Congenital absence of the uterus and following hysterectomy are the commonest indications for surrogacy.

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