January 26th 2019


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Articles from this issue:

COVER STORY The Natural Family as an integrative social force in American history

EDITORIAL The Remnant, resistant, creative minority

ENERGY POLICY Enough hot air about carbon dioxide; let's talk LPG

CANBERRA OBSERVED Federal election: the media have done our duty at the polls for us

NSW ELECTION NSW is just starting to sizzle

NATIONAL AFFAIRS Archbishop Wilson free, but trial was no witchhunt

NATIONAL AFFAIRS Awaiting Hayne: full report sure to shake finance sector

LIFE ISSUES The unvarnished truth about surrogacy

HIGHER EDUCATION Massification: that's the name of the game

SOCIETY Dover Beach: a mordant post-Christmas reflection

IRELAND TODAY Celtic Tiger changed out of all recognition

MUSIC One note does not a monotone make

CINEMA Aquaman: High fantasy in ocean depths

BOOK REVIEW Uninformed consent

BOOK REVIEW A thoroughly modern movement

BOOK REVEW The foundation of a successful society

LETTERS

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LIFE ISSUES
The unvarnished truth about surrogacy


by Joan Smurthwaite

News Weekly, January 26, 2019

For nearly 40 years Australia has allowed the use of assisted reproductive technology (ART), in-vitro fertilisation (IVF), and embryo transfer (ET) to help heterosexual couples overcome infertility to have their own biologically related child. Around 15 years ago, the demand for children from same-sex couples and from single people led to fertility clinics using third-party human reproductive technology (HRT) and surrogacy.

In mid-November 2017, the changes to the federal Marriage Act that redefined marriage as being between any two persons, and earlier enacted anti-discrimination legislation expanded the eligibility criteria for surrogacy so that so-called LGBTQI+ persons have access to reproductive technology.

On August 23, 2018, the West Australian Minister for Health asked the WA Parliament to approve amending the WA Surrogacy Act (2008) to allow male couples and single men (homosexual or straight) to use surrogacy to sire children. Crucially the bill does not mention the need for women to serve as egg donors and as surrogates and consequently to risk their health (physical and mental) and wellbeing to produce these children.

These omissions do not mean that Australian health authorities have found out how to create new life without women or that the health of women and children is unimportant to them. But the 2018 Surrogacy Bill now provides an opportunity to reveal the unvarnished truth about surrogacy, which I have come to from my comprehensive research for over nine months of overseas and Australian publications and from my knowledge from the latest physiological texts.

Surrogacy enables anyone to obtain a child without even the requirement for him or her to have a biological connection to the child. Nor to accept any ongoing responsibility for the women involved. To sire a child under these circumstances, the unattached male will require the services of many females, including one to donate her eggs, and any number of “gestational surrogates” to be prepared for a fetal implantation and to grow and nourish the baby for 40 weeks gestation.

Overseas experience has shown it is not unusual for a woman who has acted as a surrogate, and in the dark as to the risks she faced (including ectopic pregnancy) in so acting, once the baby is born, later to respond to the same request from many other unattached males.

To operate, surrogacy requires a data­base to allow the intended parents to choose an egg donor with the characteristics they consider suitable to their needs. Information supplied includes age, health, body type, hair and eye colour, IQ and educational attributes, gene­tic background, sexual history, family health history and cultural background.

Once the choice is made, the egg donor will undergo the following interventions:

  • An ultrasound examination is made of the donor’s pelvis and uterus, to check for any abnormalities related to sexually transmitted diseases.
  • Her sexual cycle is synchronised with that of the surrogate who will carry the embryo developed in a laboratory. She will be prescribed contraceptives and be required to have a daily hormonal injection for two to three weeks, which will serve to block her normal cycle. This in turn imposes stress on the remainder of her endocrinal system so homeostasis (normalisation of endocrinal flow) can no longer be attained.

Guyton and Hall (Textbook of Medical Physiology, 2016) write in their Preface: “Our bodies are endowed with a vast network of feedback controls that achieve the necessary balances without which we cannot live. Physiologists call this high level of internal bodily control homeostasis. In disease status, functional balances are often seriously disturbed and homeostasis is impaired. This can impact on the whole body.”

This statement clearly describes the finely tuned internal feedback system that monitors, among much else, a woman’s sexual cycles. The synthetic hormones given to a female donor and/or surrogate deliberately interfere with that complex feedback system.

In all but one of the fertility clinics in Western Australia and in another that has been involved in research, the donor’s treatment regime from day one to three of her sexual cycle will include the use of powerful hormones to stimulate her ovaries in order to induce the maturation of a higher number of primitive eggs than normal. This includes inducing 10 to 12 follicles to develop sufficiently to produce estrogen, which in turn is responsible for the production of follicular tissue that produces progesterone.

On the one hand, a series of synthetic hormones is given to block the normal process of selecting a dominant follicle to reach maturity and lead to ovulation (see graphic on page 12) by blocking the receptor sites in the hypothalamus and anterior pituitary. On the other hand, a second series of synthetic hormones works to boost production and maturation of from 10 to 20 eggs, which are then are surgically removed. This is a process that creates a significant depletion of estrogen and progesterone supply within the donor’s blood stream; and interferes with the normal endocrinological and neurobiological balance that should exist within a fertile woman. Symptoms identified as side effects for the hormones prescribed attest to this.

In the meantime, the birth mother is also being prepared by:

  • Provision of hormones to block her normal sexual cycle to prevent one of her eggs being involved in a subsequent pregnancy.
  • Provision of hormones to prepare her endometrium for implantation of the fetus.
  • Use of steroids to prevent her body rejecting this “foreign body” once implantation occurs.
  • Subsequent hormonal injections to aid growth and development of the fetus at early stages.
  • A hormonal boost that will enable the birth of the baby at a pre-arranged time suitable for the intending parents.

To ensure there are no doubts about the child’s legal parentage, three months before the conception of the child, all parties sign a Surrogacy Pre-Conceptual Agreement and a Surrogacy Arrangement that give the intending parent(s) complete legal, financial and medical controls of the pregnancy. Mandatory abortions of fetuses with abnormalities do occur.

The terms of the contract are very coercive and display no empathy for the egg donor or the gestational surrogate. The child is frequently delivered by Caesarian section and a month later she or he departs with the intending parent(s).

While the health consequences for the egg donor and surrogate and child vary with each individual’s natural vitality and hormonal regime, several impacts and risks are well documented in studies that show big differences bet­ween natural conception and third-party pregnancy.

Heavy doses of gonadotropin hormones to obtain higher numbers of mature eggs (10-20) from the donor can lead to three different levels of ovarian hyper-stimulation. More severe cases are associated with high blood pressure, diabetes and kidney disease; ovarian torsion, formation of ovarian cysts and strokes; internal haemorrhage from surgery. If left untreated these can be fatal.

The temporary depletion of estrogen and progesterone may be extended if the drugs targeting the hypothalamus or anti-pituitary are too powerful. The result can be that the donor may develop endometriosis months after she has donated and lose her fertility and, consequently, suffer from premature menopause due to that loss of fertility. Crucially, her natural cycle has been disrupted and blocked to prepare her ovaries for application of synthetic hormones.

As for the health of the gestational surrogate/birth mother: she did her duty excellently but she is at risk of gestational hypertension, pre-eclampsia, strokes, diabetes, ectopic pregnancy, multiple births, and abnormally low levels of amniotic fluid. She may be exposed to excessive amounts of antibiotics during labour, induced labour, retained placenta and Caesarian section.

The sense of loss and abandonment she often feels is acute and lifelong. It is now well known that the abrupt separation of a child from her or his mother causes emotional instability, developmental and mental disorders and chronic physical illnesses. More­over, research by cellular microbiologists confirms that, for their mutual benefit, stem cells from the mother and from the fetus are continually being exchanged throughout the pregnancy.

Concerning the child: unfortunately the risk of stillbirth is four to five times that of a natural pregnancy. The risk is high of premature birth and low birth weight. Fetal abnormalities associated with amniotic insufficiency and from the drugs used to stimulate egg production are common. The extra costs involving pre and post-natal extended care for mother and infant are borne by the state.

Due to either Caesarean or early induction, there is a risk to the child of developing obesity, asthma, ADHD and other learning difficulties later in life. Studies by neonatal psychiatrists have found that infants suffer deep grief, which creates adjustment difficulties because surrogacy deliberately severs the mother-infant bond. These difficulties become obvious by the age of seven.

Clever marketing of surrogacy’s benefits hides its real costs and penalties. It is recommended that health authorities exercise due diligence using the following principles:

Do no harm. The drug regimes for egg donors, traditional and gestational surrogates require better monitoring, compliance and enforcement.

Exercise caution. Can the hormones prescribed for IVF procedures for women with infertility issues, including hormonal imbalance, really be considered safe to use on women who have a healthy sexual cycle?

Protect intergenerational equity. Long-term follow-up of egg donors, mothers and children during their developmental phases is crucial, including monitoring the identity issues that all youth face during their early teenage years.

Duty of care. It should be mandatory to include a clause in the surrogacy contract, where it is an unattached male who seeks to use surrogacy, stipulating that he will provide life-long health insurance for each egg donor and each surrogate involved in the conception and/or birth of the baby.

Joan Smurthwaite has a degree in Applied Science and a postgraduate Diploma in Epidemiology and Biostatistics. She spent 25 years as a research assistant in Public Health WA, including being WA’s first AIDS health officer.




























All you need to know about
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