Ezenwa Beatrice Nkolika, Ibrahim Usman Olaitan, Moronkola Olaolu Aziza, Fajolu Iretiola Bamikeolu, Ndukwu Lilian, Oleolo-Ayodeji Khadijah Omobusola, Ibe Adaku Akunna, Ezeaka Veronica Chinyere
Department of Paediatrics, College of Medicine University of Lagos, Lagos, Nigeria.
Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Lagos, Nigeria.
Niger Med J. 2024 Nov 6;65(5):792-799. doi: 10.60787/nmj-v65i3.515. eCollection 2024 Sep-Oct.
Surrogacy involves a woman (surrogate) who consents to carry a pregnancy on behalf of an individual or a couple who cannot conceive for medical reasons. Surrogacy is gaining popularity in Nigeria among infertile couples, partly because surrogacy provides an easier means to having children than adoption. Surrogacy can be either gestational or traditional. Though surrogacy gives hope to infertile individuals, it also comes with peculiar challenges that affect the newborn with medical, ethical, and legal dimensions that caregivers need to be aware of. We present three sets of preterm triplets conceived by Invitro fertilization (IVF), carried by gestational surrogacy, and managed in our facility. This case report highlights challenges encountered while managing these neonates to create awareness and suggest solutions and guidance to neonatal practitioners. Topmost challenges include the unsustainability of feeding with the mother's own milk, lack of kangaroo mother care, abandonment of care by commissioning parents, delay in getting consent for treatment/procedures, determining the legal status of the child vis-à-vis simple issues such as changing the name of the child from that of the surrogate to that of the commissioning parents. The hospital's legal and welfare departments were key resource units and were involved early in managing these neonates. One baby from each set of triplets was successfully discharged home to the commissioning parents. In conclusion, surrogacy is becoming increasingly common as a means of becoming parents for infertile individuals. There is an urgent need for proper regulation and legal framework for surrogacy and assisted reproduction in Nigeria.
代孕是指一名女性（代孕者）同意代表因医学原因无法受孕的个人或夫妇孕育胎儿。在尼日利亚，代孕在不孕夫妇中越来越普遍，部分原因是代孕比收养提供了一种更简便的生育方式。代孕可以是妊娠代孕或传统代孕。尽管代孕给不孕者带来了希望，但它也带来了一些特殊的挑战，这些挑战在医学、伦理和法律层面影响着新生儿，护理人员需要对此有所了解。我们展示了三组通过体外受精（IVF）受孕、由妊娠代孕孕育并在我们机构接受治疗的早产三胞胎。本病例报告强调了在管理这些新生儿过程中遇到的挑战，以提高认识，并为新生儿从业者提出解决方案和指导意见。最主要的挑战包括无法持续用母亲自己的母乳进行喂养、缺乏袋鼠式护理、委托父母放弃护理、在获得治疗/程序同意方面的延迟、确定孩子相对于一些简单问题（如将孩子的名字从代孕者的改为委托父母的）的法律地位。医院的法律和福利部门是关键资源单位，在早期就参与了这些新生儿的管理。每组三胞胎中的一个婴儿已成功出院回到委托父母身边。总之，代孕作为不孕者成为父母的一种方式正变得越来越普遍。尼日利亚迫切需要针对代孕和辅助生殖制定适当的监管和法律框架。
