While I’ve always felt the word “industry” is a mechanical, clunky term to apply to a process which is mostly a matter of the heart, surrogacy (and egg/sperm donation) is, in fact a business, and it is one that is not formally regulated. Most U.S. infertility clinics and surrogacy agencies have a general set of guidelines that they follow when handling surrogacy, egg donor, and sperm donor arrangements. These guidelines consist of a loose set of ideals which most respectable clinics/agencies use to establish standards for quality of care, service, and safety. Still, because there are no federally-mandated, hardfast laws, these guidelines are more like house rules; they are open to interpretation and can be amended or ignored altogether. The Erickson scandal exposes the dangers of leaving third-party reproduction as an unregulated industry; however, there are also potential dangers that could occur with regulation, as it may open the door for laws which are too strict, thereby further complicating the already difficult process of becoming parents via surrogacy, egg donation, and/or sperm donation.
Case in point – the Nadya Suleman scandal, otherwise known as the Octomom debacle – in which she became pregnant with and subsequently delivered octuplets after an irresponsible IVF transfer (which she agreed to) while under the care of Dr. Michael Kamrava. There are no federally-mandated regulations regarding the number of embryos which may be transferred during IVF, but respectable reproductive endocrinologists generally follow the suggested, but unofficial guidelines established by the American Society for Reproductive Medicine (ASRM). This case opened the door for extremist “rights to life” activists and politicians here in my state of Georgia to push hard for legislation which would have severely crippled infertile couples’ and their physician’s decisions regarding the IVF transfer and cryogenic storage of embryos. There are cases in which it might be prudent to transfer a high number of embryos to have even a small chance of a successful pregnancy of just one baby to occur; the proposed regulations would not have allowed this – and other necessary medical actions – to be an option. Thankfully, due to the outcry and commitment of the infertility community (to include patients, physicians, and supportive politicians) and the strong presence of RESOLVE, Georgia SB 169 (titled “Ethical Treatment of Human Embryos”) was massively revised to exclude any language which criminalized the basic, safe, and necessary handling and treatment of embryos. Given the severity of the original draft, this was considered a huge victory, especially because it would have established a precedence for other states with similar “personhood” propositions to follow suit.
It is necessary to rehash the aftermath of the Suleman case because the current Erickson baby-selling scandal has and will have similar effects and implications:
- it underscores the fact that there is a need for some degree of mandated regulation regarding third-party reproduction,
- it provides an unfortunate and convenient backdoor for extremist Right to Life activists to disguise mandated regulations as personhood legislation (which has the potential to severely cripple women’s rights, family-building options, and physicians’ methodologies and practices),
- it tarnishes the reputations of all who are involved with Assited Reproductive Technology (ART) and third-party reproduction: patients, physicians, attorneys, donors, surrogates, and advocates. We do not deserve to be blanketed by the negative reputation of the few who have little ethical and moral regard, yet in the eyes of the opposition, we are all one and the same. I do believe that this will gain as much notoriety as the Octomom scandal and the Baby M case, and I have no doubt that it will be yet another indelible smear in the face of surrogacy and ART.
So, where do we go from here? How do we acheive regularization which establishes guidelines for safety and ensures that professionals are held to high ethical standards without jeopardizing the reproductive freedoms and family-building methods needed by the infertile, gay, and single communities?
Above all, I believe that this is the ultimate question which will need to be addressed and answered in the fallout of this case (well, aside from WTF was she THINKING?).