Surrogacy is an assisted reproduction-based approach in which the intended parents assign the gestation and birth to another woman called the surrogate mother. The drivers of surrogacy refer largely to infertility, medical conditions, same-sex couples’ parenting, and cases of diversity regarding sexual identity and orientation. Surrogacy consists of a valid option for a variety of conditions or circumstances ranging from medical to social reasons.

Infertility ( especially uterine factor infertility), medical conditions, diversities regarding sexual identity and orientation, and matters of social nature reflect the basic drivers behind patients’ decision to pursue surrogacy. Women with a severe Müllerian anomaly or a congenital absence of uterus and/or vagina are usual candidates for surrogacy. The condition of Mayer-Rokitansky-Küster-Hauser Syndrome characterized by a female genotype and phenotype and accompanied with a congenital aplasia of the uterus and the vagina represents another category of patients requiring surrogacy.

Further to the above, Complete Androgen Insensitivity Syndrome (CAIS syndrome) where the uterus and ovaries are absent , as well as women who have undergone hysterectomy, presents as only few of the cases where surrogacy is imperative and women may choose this as a path to parenthood. Gestational surrogacy is also recommended in cases of Turner’s Syndrome due to the known cardiac and medical complications in these patients. Furthermore, surrogacy may present as an option for women with recurrent miscarriages or unidentified failure of infertility treatment. Heart or renal disease and severe Rhesus isoimmunization during pregnancy are valid reasons for the mother to avoid such high risk conditions and hence constitute solid grounds in opting for surrogacy.

Other indications for surrogacy are maternal medication for specific disease treatment that could potentially promote embryo’s teratogenesis or even severe genetic problems related to the intended parents. Social reasons towards optional surrogacy may correspond to highly driven career women and the stress experienced by the intended mother regarding the physical changes and the discomfort associated with her perception on pregnancy.
Finally, surrogacy may fulfill same-sex couples’ or even a single parent’s desire for a genetically linked family.


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