Kent Law School, Eliot College, University of Kent, Canterbury, United Kingdom.
Womens Health Issues. 2018 May-Jun;28(3):239-250. doi: 10.1016/j.whi.2018.01.004. Epub 2018 Mar 9.
Surrogacy is growing worldwide. Although recently some countries have sought to ban it, between 2010 and 2014 the number of babies born to gestational surrogates having in vitro fertilization treatment in California doubled, and in Canada it grew by 35%. This work seeks to fill identified knowledge gaps about the similarities and differences in the practices and outcomes of gestational surrogacy, which in California operates on a commercial basis, whereas in Canada it is illegal to pay a surrogate. The paper focusses on the period from 2010 to 2014, for which comparable American and Canadian national assisted reproduction technology information exist.
A retrospective data analysis was performed using information on gestational surrogate multiple births obtained from the Centers for Disease Control and Prevention National Assisted Reproductive Technology Surveillance System (NASS) and Canada's Assisted Reproduction Registry-Better Outcomes Registry and Network (CARTR-BORN). Multiple birth rates and transfers of multiple embryos were compared using relative risk analysis. Adherence to voluntary American Society for Reproductive Medicine-Society for Assisted Reproductive Technology and Canadian Fertility and Andrology Society embryo transfer guidelines was modelled.
Among gestational surrogates, when donor ova embryos obtained from women aged less than 35 years were used, embryo transfer guideline adherence was 42% in California and 48% in Canada.
Regardless of where on the commercial/noncommercial boundary North American surrogates reside, they are more likely to receive more donor ova embryos per in vitro fertilization transfer than other in vitro fertilization patients. An altruistic desire to assist childless couples and individuals create families along with clinic practices seem to play major roles in treatment decisions privileging the transfer two or more embryos.
代孕在全球范围内呈增长趋势。尽管最近一些国家试图禁止代孕，但在 2010 年至 2014 年间，在加利福尼亚州通过体外受精治疗出生的代孕婴儿数量翻了一番，而在加拿大则增长了 35%。这项工作旨在填补关于代孕实践和结果异同的知识空白，加利福尼亚州的代孕业务是商业化运作的，而在加拿大，向代孕者付费是违法的。本文重点关注 2010 年至 2014 年期间的情况，因为这期间有可比的美国和加拿大国家辅助生殖技术信息。
使用从疾病控制与预防中心国家辅助生殖技术监测系统（NASS）和加拿大辅助生殖登记-更好的结局登记和网络（CARTR-BORN）获得的关于代孕多胎妊娠的信息，进行了回顾性数据分析。使用相对风险分析比较多胎出生率和多胚胎转移。对美国生殖医学学会-辅助生殖技术协会和加拿大生育与男科协会胚胎转移指南的自愿遵守情况进行了建模。
在代孕者中，当使用年龄小于 35 岁的女性捐赠的卵子胚胎时，加利福尼亚州的胚胎转移指南遵守率为 42%，加拿大为 48%。
无论北美代孕者处于商业/非商业边界的哪一边，她们在体外受精转移中接受的捐赠卵子胚胎数量都可能多于其他体外受精患者。帮助无子女的夫妇和个人组建家庭的利他愿望以及诊所的实践似乎在优先考虑转移两个或更多胚胎的治疗决策中发挥了重要作用。
