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Ayala A, Álvarez Plaza C, Rivas AM. Bridging Reproductive and Productive Work: The Case of Surrogates in California. Med Anthropol 2024:1-22. [PMID: 38865595 DOI: 10.1080/01459740.2024.2364244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
In this article, we explore the perspectives of commercial gestational surrogates in California, USA. Women who gestate for others reveal themselves as important agents in the process of giving meaning and cultural legitimacy to their practice, thus demonstrating their capacity to act in their own interest and resignify their work in their own terms. To them, surrogacy is more than wage labor. They assert the importance of their experience as a source of professional skills, downplaying its monetary value and placing it within favorable moral frameworks, thus finding cultural legitimacy. In doing so, they bridge the divide between traditional female reproductive work (unpaid emotional, relational, and care work) and productive work (paid professional work in the public sphere). They achieve this without subverting the underlying values of western kinship. The results shed light on employability and entrepreneurship of surrogates in the fertility industry of California.
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Affiliation(s)
- Ariadna Ayala
- Social Anthropology and Social Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
| | - Consuelo Álvarez Plaza
- Social Anthropology and Social Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
| | - Ana María Rivas
- Social Anthropology and Social Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
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Luo Y. Unraveling Informality and Precarity: New Labor Law Strategies for the Global Reproduction Network of Cross-Border Surrogacy. Asian Bioeth Rev 2024; 16:185-203. [PMID: 38586575 PMCID: PMC10994879 DOI: 10.1007/s41649-023-00262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/31/2023] [Accepted: 09/26/2023] [Indexed: 04/09/2024] Open
Abstract
This paper provides an analysis of the complex global reproduction networks driving the rapidly expanding cross-border surrogacy industry in Asia's reproductive bioeconomy. It sheds light on the unique features of informal surrogacy networks, notable for their flexible business ties and non-standardized surrogate mother recruitment. These factors contribute to heightened vulnerability for surrogate mothers operating within these networks. While previous literature has underscored the merits of labor law in regulating the surrogacy industry, its application in informal cross-border surrogacy remains under-examined. To address this gap, this research delves into innovative labor law strategies with potential to better regulate the surrogacy sector. Drawing inspiration from progressive labor regulations and supply chain strategies in Bulgaria and Australia, the proposed model aims to redefine the traditional employment relationship. This shift is aimed at bolstering protection for surrogate mothers and enforcing accountability throughout the surrogacy business network. The model further advocates for a collective framework that fosters collaboration and mandates the documentation and registration of surrogacy contracts. Moreover, it underscores the critical significance of international collaboration in bridging regulatory gaps and distributing accountability across consumer and supply states.
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Affiliation(s)
- Yingyi Luo
- Royal Melbourne Institute of Technology, Melbourne, Australia
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Aderaldo JF, Rodrigues de Albuquerque BHD, Câmara de Oliveira MTF, de Medeiros Garcia Torres M, Lanza DCF. Main topics in assisted reproductive market: A scoping review. PLoS One 2023; 18:e0284099. [PMID: 37527215 PMCID: PMC10393141 DOI: 10.1371/journal.pone.0284099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/19/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Infertility affects around 12% of couples, and this proportion has been gradually increasing. In this context, the global assisted reproductive technologies (ART) market shows significant expansion, hovering around USD 26 billion in 2019 and is expected to reach USD 45 billion by 2025. OBJECTIVES We realized a scoping review of the ART market from academic publications, market reports, and specialized media news, to identify the main terms and characterize them into the main topics in the area. DESIGN We apply an LDA topic modeling process to identify the main terms, and clustered them into semantic synonymous topics. We extracted the patterns and information to these topics and purposed a factor/consequence correlation to them. RESULTS We found 2,232 academic papers and selected 632 to include in the automatic term detection. We also included 34 market reports and seven notices produced by specialized enterprises. Were identified 121 most relevant cited terms covering 7,806 citations. These terms were manually aggregated into 10 topics based on semantic similarity: neutral terms (37.2%), economic aspects (17.6%), in vitro fertilization (IVF) commodities & cross-border reproductive care (CBRC) (10.6%), geographic distribution (9.5%), social aspects (7%), regulation (6%), trends & concerns (3.9%), accessibility (3.4%), internet influence (2.9%), and fertility preservation for non-medical reasons (2%). DISCUSSION The analysis indicates a market with expressive complexity. Most terms were associated with more than one topic, indicating the synergism of this market's behavior. Only seven terms related to economic aspects, surrogacy and donation represent around 50% of the citations. Except for the topic formed by generic terms, the topic of the economic aspects was the most represented, reflecting macro perspectives such as a-la-carte standard of treatments, many clinics operating on a small/medium scale, and the recent formation of conglomerates. The IVF commodities & CBRC topic brings an overview of gametes pricing and transnational surrogacy, and its regulation. The topic of geographic distribution indicates that that the Asia-Pacific (APAC) market has the most significant growth potential in all fields. Despite the increase in supply and demand for infertility treatments and technological advances in recent decades, the success rate of IVF cycles remains at around 30%. Terms referring to research and development or technical improvement were not identified in a significant way in this review. CONCLUSIONS The formation of topics by semantic similarity proved to be an initial path for the elaboration of in-depth studies on the dynamics between several factors, for this, we present the panel classifying main terms into factors (demand, pent-up demand, or distributive) or ART market consequences. Through this approach, it was possible to observe that most of the works addresses economic aspects, regulation and geographic aspects and that topics related to research and improvement have not been addressed. In this way, we highlight the need to deepen the analysis of market elements that may be related to increased efficiency of IVF in the technical field.
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Affiliation(s)
- Janaina Ferreira Aderaldo
- Applied Molecular Biology Lab (LAPLIC), Biochemistry Department, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
- Januário Cicco´s University Hospital (MEJC), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | | | | | - Mychelle de Medeiros Garcia Torres
- Applied Molecular Biology Lab (LAPLIC), Biochemistry Department, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
- Januário Cicco´s University Hospital (MEJC), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Daniel Carlos Ferreira Lanza
- Applied Molecular Biology Lab (LAPLIC), Biochemistry Department, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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Chin AHB. Should Singapore legalize surrogacy to better protect all parties involved? J Forensic Leg Med 2023; 93:102464. [PMID: 36493695 DOI: 10.1016/j.jflm.2022.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Alexis Heng Boon Chin
- Singapore Fertility and IVF Consultancy Pvt Ltd., 531A Upper Cross Street, #04-95, Hong Lim Complex, 051531, Singapore.
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Brandão P, Garrido N. Commercial Surrogacy: An Overview. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2022; 44:1141-1158. [PMID: 36580941 PMCID: PMC9800153 DOI: 10.1055/s-0042-1759774] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/25/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Surrogacy is the process in which a woman carries and delivers a baby to other person or couple, known as intended parents. When carriers are paid for surrogacy, this is known as commercial surrogacy. The objective of the present work is to review the legal, ethical, social, and cultural aspects of commercial surrogacy, as well as the current panorama worldwide. METHODS This is a review of the literature published in the 21st century on commercial surrogacy. RESULTS A total of 248 articles were included as the core of the present review. The demand for surrogate treatments by women without uterus or with important uterine disorders, single men and same-sex male couples is constantly increasing worldwide. This reproductive treatment has important ethical dilemmas. In addition, legislation defers widely worldwide and is in constant change. Therefore, patients look more and more for treatments abroad, which can lead to important legal problems between countries with different laws. Commercial surrogacy is practiced in several countries, in most of which there is no specific legislation. Some countries have taken restrictive measures against this technique because of reports of exploitation of carriers. CONCLUSION Commercial surrogacy is a common practice, despite important ethical and legal dilemmas. As a consequence of diverse national legislations, patients frequently resort to international commercial surrogacy programs. As of today, there is no standard international legal context, and this practice remains largely unregulated.
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Affiliation(s)
- Pedro Brandão
- Department of Reproductive Medicine, Instituto Valenciano de Infertilidad, Valencia, Spain
| | - Nicolás Garrido
- University of Valencia, Valencia, Spain
- IVI Foundation, Valencia, Spain
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McLean L, Ros ST, Hollond C, Stofan J, Quinn GP. Patient and clinician experiences with cross-border reproductive care: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:1943-1952. [PMID: 35339328 DOI: 10.1016/j.pec.2022.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This review analyzes the experiences of patients and clinicians with regards to international cross-border reproductive care (CBRC) for the purpose of conception. METHODS Electronic databases PubMed, Embase, Web of Science, and Scopus were searched using 'medical tourism' AND 'assisted reproductive technology' from 1978 to 2020. RESULTS Predominant patient motivators for CBRC were cost and legality of assisted reproduction technology (ART) in one's home country, followed by cultural factors like shared language, religion, and cultural familiarity. Clinicians suggested global laws for CBRC would reduce the potential for exploitation of vulnerable populations but believed the enactment of international regulations unlikely and, even if enacted, difficult to enforce. CONCLUSIONS While patient and clinician experiences with CBRC varied, patients frequently cited financial and legal reasons for pursuing CBRC, while many providers had concern for the patient's safety. CLINICAL PRACTICE IMPLICATIONS This review recommends clinicians involved in family planning counsel patients seeking treatment abroad by: (i) informing patients of the risks and benefits of treatment abroad, (ii) establishing guidelines and standards for clinicians on resuming patient care post-CBRC, and (iii) creating a directory of reputable CBRC clinicians and experts.
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Affiliation(s)
- Laura McLean
- Morsani College of Medicine, University of South Florida, Tampa, USA.
| | - Stephanie T Ros
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | | | - Jordan Stofan
- Morsani College of Medicine, University of South Florida, Tampa, USA
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Tober D, Kroløkke C. Emotion, embodiment, and reproductive colonialism in the global human egg trade. GENDER WORK AND ORGANIZATION 2021. [DOI: 10.1111/gwao.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Diane Tober
- Assistant Professor at University of California, Department of Social and Behavioral Sciences Institute for Health and Aging, Bixby Center for Global Reproductive Health, and Department of Anthropology, History and Social Medicine. University of California San Francisco San Francisco California USA
| | - Charlotte Kroløkke
- Associate Professor at the Institute for the Study of Culture University of Southern Denmark Odense Denmark
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Stuhmcke A. Reflections on autonomy in travel for cross border reproductive care. Monash Bioeth Rev 2021; 39:1-27. [PMID: 33453036 DOI: 10.1007/s40592-020-00125-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2020] [Indexed: 11/27/2022]
Abstract
Travel for reproductive health care has become a widespread global phenomenon. Within the field, the decision to travel to seek third parties to assist with reproduction is widely assumed to be autonomous. However there has been scant research exploring the application of the principle of autonomy to the experience of the cross-border traveller. Seeking to contribute to the growing, but still small, body of sociological bioethics research, this paper maps the application of the ethical principle of autonomy to the lived experience of infertile individuals who cross borders for reproductive care. It examines their choices as patient, consumer and traveller. It suggests that their experience evidences a contradictory autonomy, which offers them both choice and no choice in their final decision to travel. The paper argues that this lack of meaningful autonomy is enabled by a medicalised framework of infertility which prioritises technology as the cure to infertility. This both shapes expectations of infertile individuals and limits their options of family creation. Ultimately, the paper suggests that sociological bioethics research shows that the liberatory credentials of technology should be questioned, and identifies that this field demands greater scholarly attention.
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Affiliation(s)
- Anita Stuhmcke
- Faculty of Law, University of Technology Sydney, Sydney, Australia.
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Hudson N, Culley L, Herbrand C, Pavone V, Pennings G, Provoost V, Coveney C, Funes SL. Reframing egg donation in Europe: new regulatory challenges for a shifting landscape. HEALTH POLICY AND TECHNOLOGY 2020. [DOI: 10.1016/j.hlpt.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hunter BM. Going for brokerage: strategies and strains in commercial healthcare facilitation. Global Health 2020; 16:49. [PMID: 32471459 PMCID: PMC7260813 DOI: 10.1186/s12992-020-00578-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The formation of domestic and global marketplaces during the past 50 years has opened up new commercial opportunities for third-party activity in healthcare systems. Commercial mediation of access to healthcare is one recent area of activity that sees companies and individuals offering to organise healthcare and travel in return for payment. With varying degrees of control over the location, type, cost and experiences of healthcare provisioning, these intermediaries occupy potentially influential positions in healthcare systems and yet much of their work is poorly understood. METHODS Drawing on social science theories of brokerage, this article presents a novel analysis of commercial healthcare facilitation. It focuses on facilitation companies and their workers as central, intermediating actors for people to access healthcare in markets characterised by complexity. Semi-structured interviews were conducted with people working in domestic and international healthcare facilitation in London and Delhi, and data were analysed using a framework approach that emphasises the structural features and personal agencies for this area of work. RESULTS Findings point to an institutional environment for commercial healthcare facilitation marked by competition and the threat of obsolescence. The activities of rivals, and the risk that users and providers will bypass intermediaries, compels facilitation companies to respond strategically and to continuously pursue new populations and activities to mediate - to go for broke. These pressures percolate into the lives of people who perform facilitation work and who describe a physical and mental burden of labour incurred by onerous processes for generating and completing facilitation work. The need for language interpretation services introduces an additional set of relations and has created further points of tension. It is an environment that engenders mistrust and anxiety, and which incentivises exploitation and a commodification of users whose associated commissions are highly prized. CONCLUSION Brokerage analysis provides valuable insights into the strategies and strains for commercial mediation of access to healthcare, and the findings indicate opportunities for further research on the contributions of interpreters, diplomatic and business networks, and new technologies, and on the growth of new forms of mediation in domestic and overseas settings.
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Affiliation(s)
- Benjamin M Hunter
- Department of International Development, King's College London, London, UK.
- Department of International Development, University of Sussex, Brighton, UK.
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Whittaker A, Inhorn MC, Shenfield F. Globalised quests for assisted conception: Reproductive travel for infertility and involuntary childlessness. Glob Public Health 2019; 14:1669-1688. [PMID: 31204900 DOI: 10.1080/17441692.2019.1627479] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The global movement of people across international borders to undergo assisted reproductive treatment is common, although there is little accurate data. In this article, we synthesise findings from our own empirical research on reproductive travel in addition to a review of clinical, ethical, legal, and regulatory complexities from studies on reproductive travel since 2010. Motivations for travel include legal and religious prohibitions; resource considerations; lack of access to gametes and reproductive assistors; quality and safety concerns; and personal preferences. Higher risks to mothers and children are associated with multiple embryo transfer and subsequent multiple and higher order pregnancies and the average older age of women undertaking reproductive travel. The potential exploitation of other women as providers of oocytes or surrogacy services, the lack of equity in access to assisted reproduction and the ambiguous legal status of children conceived from international reproductive travel are important ethical considerations. A range of significant legal issues remain given variable and limited international regulation. Scholarship on this trade necessarily engages with issues of power and gender, social inequities, global capitalism and the private decision-making of individuals seeking to form families. Research gaps remain given recent changes in the organisation, demands and destinations of the trade.
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Affiliation(s)
- Andrea Whittaker
- School of Social Sciences, Faculty of Arts, Monash University , Melbourne , Australia
| | - Marcia C Inhorn
- Anthropology and International Affairs, Council on Middle East Studies, The MacMillan Center, Yale University , New Haven , CT , USA
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