Domestic and international surrogacy laws: implications for cancer survivors.

Much of the focus in the new field of oncofertility has been on preserving cancer patients’ fertility prior to treatment that is likely to diminish their fertility or render them sterile. Less attention, however, has been paid to the logistics of using frozen eggs, embryos, or ovarian tissue following cancer treatment. It is usually assumed that, following some manipulation, the frozen eggs, embryos, or ovarian tissue will be transferred back into the women’s bodies via assisted reproductive technology (ART) so that they can become pregnant. Some women, however, cannot utilize this technology because their cancer treatment has left them unable to gestate. If these women desire biological children and have banked eggs, embryos, or ovarian tissue, then the only option available to them is surrogacy. Our goal in this chapter is to examine the availability of surrogacy1 to cancer patients. To this end, we will provide an overview of both domestic and international surrogacy laws and discuss their impact on cancer survivors and others seeking surrogacy. This chapter is divided into five parts. In the first part, we present the types of cancers and cancer treatments that can leave a woman unable to gestate. In the second part, we outline different types of surrogacy arrangements. The third part is where we examine surrogacy laws in the United States, explaining how early surrogacy cases led to different state laws. We explore international surrogacy laws in the fourth part, categorizing them by degree of regulation and highlighting one country that exemplifies each category. In the last part, we discuss surrogacy tourism as an option for cancer survivors and underscore the importance of fully informing cancer patients about surrogacy, including potential legal barriers in utilizing it, before they make fertility preservation decisions prior to cancer treatment.