Termination in Surrogacy

In the last several months I’ve noticed a trend in potential surrogates decisions regarding termination when completing their applications. These young women seem to prefer not to terminate a pregnancy for fetal anomalies such as Down’s Syndrome or other chromosomally abnormal conditions. The medical community knows there can be multiple anomalies that cannot be tested for and there is a high rate of false positive evaluations, despite the rigorous procedures one most go through.

That all being said, when faced with a life altering decision, even if discussed and agreed ahead of time, minds can change. Many individuals and couples are choosing to test their embryos for chromosomal abnormalities and one such evaluation can be done for Down’s Syndrome. There are a few cells taken from an embryo (a fertilized egg) and analyzed by just a few qualified laboratories in the country. The fees are nearly $5,500 for the screening to be done, none of which insurance will likely pay for, so it’s an out of pocket expense adding up to a great deal of money for most. The procedure is done carefully and the results garner some nail biting during the wait. It is not uncommon to have some abnormal embryos even in the very young and healthy population, which many don’t know. No test is 100% but this one is not that far off. So when a Surrogate Mother is working with an individual or couple and the group finds out there is an abnormality, it is a tough road ahead.

We follow the guidelines and have each Surrogate Mother and Intended Parent questioned about their wishes. Each Surrogate Mother and her husband or partner should have an in person psychological evaluation prior to any cycle. Most IP’s will also be required to have a psychological consultation as well.  They should absolutely be on the same page and never match those not in sync. After looking at applications, Facebook pages dedicated to surrogacy, and other social media outlets, it really seems as if more are opting NOT to terminate for Downs-like conditions.

There are understandable reasons for these decisions BUT can we think about the long term for a minute?

When a child is born with what one would call life altering care needs, they won’t always be young. Many of those children are so well cared for, they are just like anyone else, living a normal life span and as such, their parents may get to an age where they cannot provide a suitable environment for their child. Decisions will need to be made for a change in living situation which can affect so many. Many of these adult children will outlive their parents and as such, a guardian must be named. That responsibility can be more than overwhelming for the siblings or other relatives. At that time, there may be a need to transfer care to the state if those individuals are unable to care for their relative. As many know we cannot rely on each state to have the best alternative to a home environment for each individual.

State funding isn’t enough to help, they keep reducing key funding for those with disabilities or other special needs and they keep increasing the costs of care. I know some of you are thinking, it’s a life and you’re right. Do we think about the babies that are born and realize they become adults all too quickly and we must account for their long term care?

I know this is a very personal and highly emotional topic, not meant to draw criticism but raise awareness of these very difficult decisions. These matches must be made carefully after full disclosure and transparency of each party’s wishes. No Surrogate Mother and her support system should compromise their beliefs just to make a match and Intended Parents should not feel as if they have no decision making capabilities with their child.


Article composed by Fertility Source Companies Vice President of International and Major Client Relations, Nancy Block RN