Surrogacy and ethics in women with cancer

• Published in: Best practice & research. Clinical obstetrics & gynaecology 2019-02, Vol.55, p.117-127
• Main Author: Carr, Susan V.
• Format: Article
• Language: English
• Subjects: Assisted reproduction; Medical ethics; Reproductive cancer; Surrogacy
• ISSN: 1521-6934; 1532-1932
• DOI: 10.1016/j.bpobgyn.2018.11.001

Women diagnosed with gynaecological cancer may face unwanted loss of fertility as well as all the other life-changing issues with which cancer and its treatments are associated. The decision to harvest and store gametes has to be made before commencement of treatment, and advances in these techniques have made this successful. Fertility sparing therefore must be discussed and offered at an early stage post diagnosis. Surrogacy is currently an evidence-based method of assisted reproduction, with mainly desirable outcomes for the commissioning mother, surrogate and child, without impacting on the cancer treatment and long-term survival. Surrogacy is therefore ethical as long as the autonomous rights of both the commissioning mother and gestational carrier are equally observed, they both have equal legal protection and due attention is paid to the short- and long-term welfare of any resulting offspring. •Surrogacy is a viable option for women potentially infertile due to cancer.•Delay in commencing treatment has no deleterious effect on cancer outcomes.•Multidisciplinary care includes the need for ethically delivered counselling.•Options for fertility-sparing interventions are being offered only to a minority of patients with cancer.