Surrogacy in Ukraine: theoretical and applied problem

The article analyzes the Ukrainian experience of carrying out the procedure of surrogacy. The modern world does not stand still constant progress in all spheres of human activity has given rise to a large number of new rights that have entered the fourth generation of human rights. Surrogacy belongs to the newest generation of human rights, despite the fact that it has a long history of its origin and development, which can be traced back to biblical texts, the laws of King Hammurabi and others. The use of another woman’s womb was acceptable for couples who could not conceive their own child. It clearly illustrates the existence of surrogacy, which has more than 3,800 years. The article analyzes the progressive development of modern technology of IVF, which has opened new opportunities for humanity in case of infertility to have biologically native children. The main problems that exist in the research institute, which are related to each participant of the procedure, are highlighted. The analysis of foreign judicial practice is carried out, which allows to form certain conclusions that will have practical application in domestic realities. The legal regulation of surrogacy is considered, the need to change the age requirement for a surrogate mother and the requirements for the presence of a native child for the future surrogate mother are emphasized. Today, this institution is of particular importance to humanity, as there are many cases of infertility among couples who want to have a child and surrogacy becomes the only chance for them to have a biologically native child. The urgency of the outlined topic is intensified due to the fact that Ukraine has become a real center of surrogacy due to the availability of the procedure and loyal legislation, which allows for an altruistic and commercial form of its conduct. However, the low level of regulation of surrogacy has had a negative impact at all stages of the procedure and needs immediate improvement in order to preserve the interests of each participant, but above all, the child born with this method of assisted reproductive technology. The importance of all the issues outlined is also intensified in connection with the coronavirus pandemic, which has brought many problems into the research institute.

Human trafficking and surrogate motherhood: challenges

Owing to modern scientific advances prospective parents, among other opportunities, enjoy the opportunity, which has not been available before. It consists in giving birth to a child by using another woman’s reproductive capacity when the situation seems hardly improvable. The paper examines surrogate motherhood as one of the reproductive methods through the prism of human trafficking. It aims at studying and differentiating such legal phenomena as the sale of human beings and surrogate motherhood, which is provided primarily on a paid-for basis, whose consequences (transferring irrevocably a child from one person to another), are externally similar. The comparative legal and formal legal methods have been employed to provide a general description of international experience in regulating surrogate motherhood. Examples of absolutely opposite ways of pursuing state policy on the legalization of this type of reproductive methods in foreign countries are suggested: from a complete ban to legislative approval and even further simplification of the applying procedure. It has been proved that there is no connection between acknowledgement of the legality of this procedure and the geographical location of states, the level of their economic development, the specifics of the legal system, and the like. It has been stated that none of the countries can be considered a universal example of solving these issues. Based on the example of Ukrainian legislation, the author suggests distinguishing between the objective aspect of selling human beings and surrogate motherhood, which is provided, first of all, for a fee. It is emphasized that due to the peculiarities of reproductive technologies only a child should be the object of trade, not a person’s gametes, zygote, embryo or fetus. When a child is sold, in view of the objective aspect, the child is illegally transferred from one person to another. In legal surrogate motherhood agreements the object of the agreement concluded between the surrogate mother and the future parents is not the child, but the service related to embryo implantation, pregnancy and childbirth, id est, a long process. Based on criminal law, there have been modelled the peculiarities of surrogate motherhood and its assessment used in determining the signs of human trafficking largely depending on genetic relationship between a child and customers (potential parents), as well as a child and a surrogate mother. The mental element making the distinction between surrogacy and the trafficking of newborns is described. It is emphasized that qualifying as «trafficking in human beings» necessitates the proof of direct intent to unlawfully «transfer» a child, primarily in return for a fee. It has been concluded that the legal regulation of surrogacy requires further improvement and consolidation at the legislative level. Investigators and prosecutors should investigate all the circumstances that were associated with the surrogacy methods applied in order to establish whether child trafficking occurred in each specific case.

The Effects of Sperm and Seminal Fluid of Immunized Male Mice on In Vitro Fertilization and Surrogate Mother–Embryo Interaction

The latest vaccination campaign has actualized the potential impact of antigenic stimuli on reproductive functions. To address this, we mimicked vaccination’s effects by administering keyhole limpet hemocyanin (KLH ) to CD1 male mice and used their sperm for in vitro fertilization (IVF). Two-cell embryos after IVF with spermatozoa from control (C) or KLH-treated (Im) male mice were transferred to surrogate mothers mated with vasectomized control (C) or KLH-treated (Im) male mice, resulting in four experimental groups: C–C, Im–C, C–Im, and Im–Im. The pre-implantation losses were significantly lower in the Im–C group than in the C–Im group. At the same time, the resorption rates reduced markedly in the C–Im compared to the Im–C group. Embryo and placenta weights were significantly higher in the Im–Im group. Although the GM-CSF levels were lower in the amniotic fluid of the gestating surrogate mothers in the Im–Im group, they were strongly correlated with embryo mass. The number–size trade-off was only significant in the Im–Im group. This suggests a positive, cooperative effect of spermatozoa and seminal fluid from immune-primed males on embryo growth and the optimal distribution of surrogate mother maternal resources despite the negative impact of males’ antigenic challenge on the IVF success rate.

Is There a Moral Intention to Reproduce Someone Else?

"Moral intentions could be used as criteria for actions. In medical practice, moral intentions take an interesting form when the problem is related to post-mortem reproduction. This paper will attempt to 1) interpret the problem of intentions from principalist perspective in medical ethics; 2) relate the problem of intentions to post-mortem reproduction; 3) develop an existentialist account for intentions and post-mortem reproduction. Peter Zhu’s case is the latest ethical challenge in post-modern reproduction. Its moral sensitivity is high due to his presume intent to reproduce and the possibility for post-mortem reproduction using donors’ material and a surrogate mother. If we presume that the concept of presume intent lies with the general idea for intentions, we must tackle the problem from the perspective of respect for autonomy. The problem with intentions is that the prospective intentional action to reproduce belongs to one person only. Yet it appears that someone else is going to perform this action and someone else will finish it. Who should we hold responsible for this action: the person who intended to do it or the person who is intending to perform it and finish it? In Peter Zhu’s case, there are participants with different intentions that are with different moral value. The existentialist account of post-mortem reproduction and intending to reproduce will try to present why we should be careful with respect for autonomy. The ethical and existential consequences of such reproduction are that the future child would be brought to a life of suffering and vagueness. "

What makes a parent in surrogacy cases? Reflections on the Fjölnisdóttir et al. v. Iceland decision of the European Court of Human Rights

The present commentary analyses and discusses the Fjölnisdóttir et al. v. Iceland decision of the European Court of Human Rights (ECtHR) of 18 May 2021. The case concerned an Icelandic couple who had been recognised as the legal parents of a child born by a surrogate mother in California. In contrast to most other surrogacy cases decided by the ECtHR, however, the child had no biological link to either of the intended parents. The ECtHR thus found that a ruling of the Supreme Court of Iceland which had rejected the recognition of the legal parenthood of the intended parents under Icelandic law had not violated Art. 8 of the European Convention on Human Rights, despite the fact that joint adoption by the intended parents was not possible in this case. The present commentary argues that this decision overexaggerates the importance of the biological link, creating injustices at the expense of the child concerned. In conclusion, the commentary calls for a more consistent and holistic framework to protect the best interests of the child and to prevent abuses of transnational commercial surrogacy.

Surrogacy and HIV: features of a clinical case in comorbid cancer

Introduction. A significant increase in the quality and increase in the life expectancy of HIV patients during treatment with antiretroviral drugs necessitates the implementation of the reproductive function in these patients. The participation of a surrogate mother in the treatment of infertility in HIV-infected potential parents, vided by the Russian legislation, requires additional solutions to a number of clinical and organizational problems. The aim was to substantiate a surrogacy program as a method of choice for the treatment of infertility in patients with HIV-positive status and comorbid cancer and also a multidisciplinary approach to organizing it on the example of a specific clinical situation and based on the analysis literature data.Materials. We report a case of using a surrogacy program for a married couple with a positive HIV status in the 4th stage of the disease using the husband's sperm and donor oocytes. The use of donor oocytes in this situation is due to the onset of menopause against the background of a comorbid severe cancer that required multiple courses of chemotherapy.Conclusion. Potential biological parents with a positive HIV status in stage 4 of the disease may have a comorbid oncological pathology, which in itself, as well as its treatment, contributes to a decrease in fertility, and for the future biological mother, it is an obstacle to independently carrying a pregnancy. In this regard, the surrogacy program is the method of choice for the treatment of infertility in this clinical situation. It is advisable for obstetricians-gynecologists (reproductologists) to inform the surrogate mother about the potential risks of infection with the participation of genetic parents with HIV-positive status at various stages of IVF and about preventive measures during gestation in conjunction with the infectious disease specialist of the regional centers for the prevention and control of AIDS.

MEDICAL ASPECTS OF SURROGATE MOTHERHOOD

Surrogacy is associated with a wide range of factors that increase maternal and perinatal risks. The use of in vitro fertilization and embryo transfer technologies determines the higher frequency of multiple pregnancies that enhances the risk of cesarean section, premature birth, low body weight in newborns, etc. in case of surrogacy. Genetic differences and immunogenetic reactions increase the risk of pre-eclampsia, placental pathology, abortion, intrauterine growth retardation. Hormonal disbalance under the effect of adverse factors during surrogate pregnancy may initiate prenatal reprogramming of morphogenesis through epigenetic mechanisms. This can affect the organogenesis and predispose to susceptibility to various diseases. Psychological factors and emotional link between a surrogate mother and a fetus are associated with increased levels of hormones of stress-releasing systems, which affect the formation of neurohumoral systems of the fetus and can modulate its mental development.

Surrogacy in India: ethics versus incentive

The word surrogacy has its origin among the Latin term “surrogatus” which suggests a lady acts as a substitute for a pregnant woman. Surrogacy has been in practice form last thirty years. The surrogacy regulated by business can be classified as then, altruistic surrogacy and commercial surrogacy. The paper aim to conduct systematic review on surrogacy. The literature review was conducted using PubMed and alternative search engines. Further, additional information concerning the constitutional articles was collected from search engines like legal service of India, prsinndia.org, icmr.nic.in, Press Information Bureau, Wikipedia, IJCM and Indiankanoon. In India, surrogacy is legally recognised since 2002. This paper looks into various aspects of surrogacy. Factors faced by the surrogate mother such as exploitation, psychological conditions, human rights, dignity and respect, feminism and religious issues are explored. The paper discuss the economic benefit is mostly enjoyed by the medical practitioners. The Indian government tried to curb the problems by updating the law to overcome the challenges but with time government introduce the surrogacy bill in 2016 which addressed many issues and still in 2020 it address various aspects of surrogacy to prevent the exploitation.