Departments of Obstetrics and Gynecology and Psychiatry, Duke University Medical Center, Durham, North Carolina.
Obstet Gynecol. 2020 Mar;135(3):717-722. doi: 10.1097/AOG.0000000000003698.
The first child carried by a surrogate after in vitro fertilization in the United States was born in 1985. Since then, the number of such births has steadily grown. According to the Centers for Disease Control and Prevention, the number of gestational carrier cycles increased from 727 in 1999 to 3,432 in 2013, encompassing more than 18,000 children born over this period. Surrogacy offers an alternative to adoption. However, it also disrupts traditional notions of parentage and gestation and complicates the role of obstetrician-gynecologists (ob-gyns) in helping their patients navigate difficult ethical issues. Surrogacy legislation falls under the jurisdiction of each individual state, which results in a variety of approaches. In this article, we review the legal aspects of surrogacy important for specialist ob-gyns, including select landmark court cases, states' approaches to surrogacy legislation, and unique components of informed consent. We also provide clinical recommendations specific to the United States for working with gestational surrogates and intended parents, spanning preconception, prenatal care, and delivery.
美国首例通过体外受精（IVF）孕育的代孕婴儿于 1985 年出生。自此，此类婴儿的数量稳步增长。据美国疾病控制与预防中心（Centers for Disease Control and Prevention）的数据，代孕周期的数量从 1999 年的 727 例增加到 2013 年的 3432 例，涵盖了在此期间出生的 18000 多名儿童。代孕为收养提供了一种替代方式。然而，它也打破了传统的父母身份和妊娠观念，并使妇产科医生在帮助患者解决棘手的伦理问题时的角色变得复杂。代孕立法属于每个州的管辖范围，因此存在多种方法。本文回顾了对妇产科专家重要的代孕法律方面，包括选择具有里程碑意义的法庭案件、各州的代孕立法方法以及知情同意的独特组成部分。我们还为与代孕和准父母合作提供了特定于美国的临床建议，涵盖了孕前、产前护理和分娩。
