Even advocates of surrogacy should agree that regulations are needed
Restrictive policies fuel a dangerous underground surrogacy trade.
BY Samuel Burke August 16, 2024
In Europe, commercial surrogacy is largely banned and seen as a form of body commodification, similar to organ trafficking. Only a few countries permit highly regulated altruistic surrogacy, which limits reimbursement to just expenses and no additional compensation—resulting in limited participation. Demand for surrogacy, however, is soaring due to delayed childbearing, increasing medical challenges, and the growth of LGBTQ+ family-building. The surrogacy market, valued at $14 billion in 2022, is projected to skyrocket to $129 billion by 2032, according to Global Market Insights.
Currently, only a few European countries, such as Ukraine and Greece, permit commercial surrogacy. These nations operate in a legal gray area with minimal oversight, leading to a largely unregulated industry fraught with issues like trafficking women, falsified documents and sham embryo transfers.
Before the 2022 invasion, Ukraine was a global surrogacy hub estimated to have 2,000-2,500 surrogacy contracts annually. Despite the ongoing conflict, the industry continues, with some women still carrying pregnancies in war-torn Ukraine. Controversially, Ukrainian surrogates now leave their families behind and travel to places like Greece and Northern Cyprus (recognized only by Turkey) to complete pregnancies. The women often live with multiple surrogates in the same dwellings while they wait to give birth.
Advocates for reform argue that current practices neglect the welfare of surrogates. Wes Johnson-Ellis, co-founder of the U.K. non-profit My Surrogacy Journey (MSJ), asserts that surrogates should not have to leave their families to move to another country for the pregnancy to help others build theirs.
Pregnancy and birth are vulnerable times for surrogates. They need their support network and family close by to ensure they are fully supported,” Johnson-Ellis says.
MSJ frequently assists families who’ve faced trying circumstances with other agencies. One couple pursuing surrogacy in Cyprus believed their surrogate was Cypriot. However, she was actually from Eastern Europe and returned to her native country, where she gave birth prematurely according to Johnson-Ellis. Tragically, the baby did not survive.
“They are still fighting to have the baby’s body exhumed and sent back to their home country for a proper burial,” says Johnson-Ellis.
Last August, Greek authorities raided the Mediterranean Fertility Institute in Crete and arrested staff amid allegations of trafficking nearly 100 women from Eastern Europe to act as surrogates. Officials also accused the company of falsifying adoption papers for clients from countries where surrogacy is illegal. The institute is now closed and has not responded to inquiries about these allegations. Advocates for affected families, many from Australia, claim they paid for a surrogacy program that was never fulfilled.
The Republic of Georgia had also emerged as a popular surrogacy destination in Europe, but last year, the Georgian prime minister announced that commercial surrogacy would be restricted to Georgian citizens only. This has left the legality of programs in Georgia in limbo, affecting intended parents from around the world who had turned to the country for surrogacy.
Scandals and swiftly shifting surrogacy laws have sent intended parents in Europe scrambling to relocate their embryos to countries with more stable or established surrogacy frameworks, primarily in the Americas.
The United States is the top destination for commercial surrogacy due to its well-established legal framework and advanced medical care. However, it is also the most expensive, with total costs for IVF and surrogacy—including medical, legal, and agency fees—averaging $190,000 to $230,000.
Those high costs have traditionally made Canada a more affordable surrogacy option, with costs for IVF and surrogacy averaging $60,000 to $100,000. Although commercial surrogacy is banned, Canadian law permits altruistic surrogacy, similar to the U.K., Denmark, and the Netherlands. This lower cost has dramatically increased demand, leading to average wait times of 10 to 18 months and driving hopeful parents to seek commercial surrogates in Latin America.
Argentina, Colombia, and Mexico are attracting intended parents as alternatives to Europe, with costs typically under $80,000. Mexico City, in particular, has become a popular choice due to its low costs and progressive surrogacy laws.
“Confidence in Mexico is shifting,” says Johnson-Ellis of My Surrogacy Journey, which has launched a service guiding families there. “Mexico actually has more guardrails and regulations in place than the U.S. and has even had the support of the Mexican Supreme Court since 2021.” He points to Mexico City’s practice of issuing pre-birth orders that recognize the intended parents as the legal parents and even list the surrogate as the gestational carrier, not the biological mother when she’s used donor eggs.
The surrogacy boom in the Americas is coming at Europe’s expense. Advocates argue that Europe’s ban on commercial surrogacy limits access to services and, ironically, increases the exploitation and coercion of women.
“With a commercial model, everyone knows where they stand,” Johnson-Ellis says. “There’s no gray. It’s very black and white. And I think with surrogacy, you need black and white.”
