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Surrogacy forms the basis of a multi-billion dollar industry in the United States and globally. The top surrogacy destination spots include India, Thailand, and the United States. Mexico, Uganda and, because of recent events in Ukraine, Romania, are emerging as major surrogacy centers.
The common factors are availability of biomedical expertise, availability of women with few economic alternatives, and few or no legal restrictions of the medical, commercial, and familial practices used in surrogacy.
In the global market, legal uncertainty makes surrogacy fraught for intended parents. Recent events have highlighted the birth of children who lack legal citizenship, legal parents, or who were born for parents of questionable fitness.
Surrogacy is also fraught for surrogates. Meaningful informed consent does not always occur. Any pregnant woman faces real risks of miscarriage, pregnancy-related conditions, and birth-related injury, illness, and death. The surrogacy setting can incentivize practices that subordinate risk to the goal of pregnancy. For example, high drug dosages to maximize egg production increases ovarian hyper-stimulation rates for women undergoing ovarian stimulation and in vitro fertilization. Fertility procedures increase multiple...