A Comparison of Three Surrogacy Agreement Cases Using AHP

This paper builds on the previous work of Knott, Ninassi and Eisenhardt＇s 2009 paper, ＂Using the Analytic Hierarchy Process （AHP） to Look at the Tradeoffs Among Stakeholders in the Case of Surrogacy, when the Initial Intention of the Parties Involved Change After the Pregnancy Has Ensued＂. This paper proposes a new methodology for analyzing cases involving stakeholders in disputed surrogacy arrangement. The methodology utilized is the Analytic Hierarchy Process, which allows users to weigh different criteria based on their own opinions and background. Three case studies involved a surrogacy arrangement among three stakeholders： the biological mother, the biological father and the surrogate mother. The base for the model was that all parties had entered into an agreement, and that after the agreement had been made, a situation changed, such that a decision as to who had parental rights over the fetus became an issue. The criteria used in the decision making process in the three case studies were legal, health and ethical. The criteria differed based upon each stakeholder＇s point of view. In this paper, the three models were developed using the AI-tP methodology and judgments were gathered for each of the three cases to derive the priorities for the criteria in each model. Each author took the role of one of the three stakeholders.

Some Aspects of Notarization of the Surrogacy Agreement:The Experience of Ukraine and the World

Relevance of the problem under research is due to the fragmentary character of the regulatory framework for concluding a surrogacy agreement both in Ukraine and foreign countries,which does not solve the full range of problems that arise in law enforcement practice.Moreover,there is no clear regulation for the notarization of the surrogacy agreement.The study aims to analyze the existing legal regulation of theoretical and practical aspects of the conclusion of a surrogacy agreement and draw certain conclusions and scientific provisions on the notarization of the surrogacy agreement.The leading research methods used for a comprehensive examination of surrogacy and surrogacy agreement were the following:normative semantic method,general logical methods of cognition,comparative and formal legal methods,generalization,historical method,systemic method,and structural and functional method.The research results proved the need for the legislative regulation of surrogacy.If a notarial form of the surrogacy agreement is implemented,it can significantly reduce the criminal component in this service and the risk of adverse consequences for the parties.There must be a separate law on the regulation of surrogacy adopted in Ukraine,which also concerns all other types of assisted reproductive technologies.

Outcomes of surrogate pregnancies in California and hospital economics of surrogate maternity and newborn care

AIM:To describe maternity and newborn charges for an economic analysis of surrogate pregnancies on the health care resource utilization.METHODS:A retrospective chart review of all women identified as being surrogates and the infants born from these pregnancies was performed between January 1,2012 and December 31,2013.Selected maternity diagnoses,mode of delivery,duration of hospitalization,and hospital charges were collected together with infants' birth weights,gestational age,length of hospital stay,and hospital charges.Charges associated with the in vitro fertilization cycles,artificial insemination,or embryo(s)transfer into the surrogate were not considered in the maternity charges.A ratio contrasting the maternity hospital charges for the surrogate carrier was compared as a ratio to the mean charges for 2540 infants delivered in 2013 after naturalconception and adjusted to the baseline hospital charges for both maternity and newborn care.RESULTS:Analysis of sixty-nine infants delivered from both gestational and traditional surrogate women found an increased in multiple births,NICU admission,and length of stay with hospital charges several multiples beyond that of a term infant conceived naturally and provided care in our nursery.Among singletons and twins(per infant)hospital charges were increased 26 times(P < 0.001)and in triplets charges were increased 173 times(P < 0.0001)when compared to a term infant provided care in a normal nursery at our center.CONCLUSION:Maternity costs for surrogates exceed those of women who conceive naturally,and these costs are especially magnified in women with triplets and multiple births.

Gestational carriers: A viable alternative for women with medical contraindications to pregnancy

Objective: Compare the efficacy of surrogate or gestational carrier (GC) cycles to that of autologous in vitro fertilization (IVF)/intracytoplasmic sperm injections (ICSI) in patients with gynecologic or medical co-morbidities contraindicative to pregnancy. Design: Retrospective cohort study. Setting: Infertility patients from a single university hospital-based program from 1998-2009. Intervention(s): 128 GC cycles from 80 intended parents were identified and compared with 15,311 IVF or ICSI cycles. Main Outcome Measure(s): The peak estradiol (E2), number of oocytes retrieved, cycle cancellation, ongoing pregnancy, and live-birth were compared between GCs and autologous IVF carriers. Indications for GC use were also identified. Multiple cycles contributed by the same patient were accounted for using multivariable generalized estimating equations and two-sided Wald p-values. Results: Uterine factors (67%) was the most common indication for using a GC, followed by non-gynecologic medical conditions including coagulopathies (13%), end stage renal disease (10%), cardiovascular disease (5%) and cancer (5%). Adjusting for age, ovulation induction in GC cycles had similar peak E2 levels and number of oocytes retrieved relative to IVF cycles (p = 0.23 and 0.43, respectively). Clinical pregnancy (49% vs. 42%, p = 0.28) and live-birth rates (31% vs. 32%, p = 0.74) were also comparable. A sub-analysis of GC cycles in those women with uterine factor indications, demonstrated significantly higher clinical pregnancy rates (OR = 2.0;CI = 1.2 - 3.5) with 60% greater odds of live-birth relative to IVF/ICSI cycles, however this odds was not statistically significant for differences in live-birth (CI = 0.9 - 2.9). Conclusions: GCs are a viable alternative to start families for patients with medical co-morbidities precluding pregnancy.

MEDICALLY ASSISTED HUMAN REPRODUCTIVE TECHNOLOGIES （ART） AND HUMAN RIGHTS -- THE EUROPEAN PERSPECTIVE

The present article examines how the progress of science, and in particular, medically assisted human reproductive technologies （ART） have provoked a revolution in the sphere of family relations, generating a series of ethical and legal conflicts. The article focuses on the European perspective, without ignoring the international sphere, given the globalization of the phenomenon. The emerging legal issues are analyzed through the filter of international human rights, not only an important aspect to take into consideration in the context of bioethics in general, but a ＂passage obligO＂ given that certain concepts find their explanation and coordinates in international human rights law. It is from this perspective that the relationship between ART and human rights is presented. The applicable international and European legal instruments and principles shall be mentioned, as well as a brief comparison of national legal frameworks in Europe The emerging bioethical and legal issues are examined in correlation with the response of the European Court of Human Rights through its case law aimed at balancing conflicting rights when faced with issues pertaining to ART. Lastly, the article presents in more detail the particular legal issues under debate in France and Italy, two European countries with specific legislation in the field.