Health
Surrogacy: New path to parenthood and the questions it raises
By Abayomi Ajayi
For couples who have spent years trying to have a child, surrogacy can appear to be the final frontier. After failed IVF cycles, repeated miscarriages or a medical condition that makes pregnancy unsafe, having another woman carry the pregnancy may offer a chance to become parents without exposing the intended mother to further risk.
But surrogacy is far more than a fertility procedure. It sits at the intersection of medicine, law, ethics, finance, family and culture. In Nigeria, where there is no single comprehensive federal law governing every aspect of surrogacy, those intersections can quickly become complicated.
At its simplest, surrogacy is an arrangement in which a woman becomes pregnant and gives birth to a child for another individual or couple who intend to raise the child. Modern surrogacy is generally gestational.
An egg from the intended mother or an egg donor is fertilised with sperm from the intended father or a donor through in vitro fertilisation. The resulting embryo is then transferred into the surrogate.
The surrogate carries the pregnancy but, in gestational surrogacy, has no genetic relationship with the baby. That distinction is crucial because it separates three roles that normally belong to one woman: genetic contribution, pregnancy and parenthood.
One woman provides the egg, another carries the pregnancy, while the intended parents become the people who raise the child. Depending on whether donor eggs or sperm are used, the child may be genetically related to both intended parents, one of them or neither.
The need for surrogacy often arises from an inability to carry a pregnancy rather than simply an inability to conceive. A woman may have functioning ovaries and produce eggs but be unable to safely sustain a pregnancy because of a missing or severely damaged uterus, serious medical conditions, repeated pregnancy loss or previous obstetric complications. Women who have undergone certain cancer treatments or major reproductive surgery may also consider it.
This distinction matters because IVF can address some problems with conception, but it cannot make every uterus capable of safely carrying a pregnancy.
Surrogacy therefore extends what IVF can achieve. Instead of transferring an embryo into the intended mother’s uterus, reproductive medicine allows it to be transferred into another woman’s uterus.
The surrogate is not simply a woman carrying somebody else’s baby, so informed consent is central to ethical surrogacy. A potential surrogate should understand the medical procedures, pregnancy risks, the possibility of miscarriage or failed treatment, financial arrangements and what happens if complications arise.
She should also understand what is expected of her during pregnancy and which medical decisions remain hers as the woman carrying the pregnancy.
The intended parents need informed consent too. They must understand that IVF does not guarantee pregnancy or a live birth and should confront difficult possibilities before treatment begins.
In ordinary circumstances, the woman who provides the egg, carries the pregnancy and gives birth is the same person. Surrogacy separates these functions. The egg provider may be the genetic mother, the surrogate the woman who gives birth, and the intended mother the woman who plans to raise the child.
Genetic motherhood, gestational motherhood and legal parenthood can therefore become separate concepts. This has consequences for custody, parental responsibility, birth registration, inheritance, medical decision-making and the child’s legal identity.
A surrogacy arrangement should never be treated as a simple private agreement. A contract can set out the intentions and obligations of the parties, but it cannot automatically override questions of bodily autonomy, child welfare, public policy or applicable law.
Surrogacy can involve substantial costs, including IVF, medical treatment, antenatal care, delivery, transportation and compensation. But there is an important ethical difference between compensating a surrogate and exploiting her economic circumstances.
A woman may agree to become a surrogate because she needs money, but financial motivation alone does not establish exploitation. The critical questions are whether she has genuine freedom of choice, understands the risks and is treated fairly throughout the process. Payment should never become a justification for treating a woman’s body as a commodity.
A potential surrogate should undergo appropriate medical and reproductive assessment to determine whether pregnancy is reasonably safe. Her previous pregnancies, general health, infectious disease status and obstetric history are relevant, as is her psychological readiness. The aim is to avoid exposing her to unreasonable medical risk.
The same principle applies to embryo transfer. IVF can produce several embryos, but transferring multiple embryos can increase the risks associated with multiple pregnancies.
Where clinically appropriate, a single embryo transfer may reduce those risks. The objective should not simply be to achieve pregnancy but to achieve a healthy pregnancy while minimising avoidable harm.
What happens if the intended parents separate, or if the child is born with a disability? These questions become particularly important when donor eggs or sperm are used. The child may grow up knowing that the people who raised them are not genetically related to them, or that the woman who carried them was not their genetic mother.
An intended mother may struggle emotionally with another woman carrying her child. A surrogate may develop an emotional attachment to the pregnancy even though she entered the arrangement intending to hand the baby to the intended parents. These possibilities do not mean surrogacy is inherently harmful. They simply show why counselling and psychological preparation matter.
Birth registration should not be left until delivery. Surrogacy can complicate questions about who should be recorded as a parent and what documentation is required to establish parentage. The issues become even more complex when intended parents live outside Nigeria or when the child is born abroad.
Ultimately, embracing surrogacy responsibly means looking beyond the desire for a child and recognising the responsibilities created by the process. The medical question is whether treatment can be safely provided. The legal question is who will be recognised as the child’s parents. The ethical question is whether everyone is treated fairly and gives genuine consent. The financial question is whether compensation is transparent and free from exploitation. And the social question is how the child, surrogate and intended parents will live with the arrangement long after IVF has ended.
Surrogacy can offer a path to parenthood for people who might otherwise have limited reproductive options. But its promise also demands safeguards. The technology has moved ahead; the harder task is building the laws, protections and public understanding needed to ensure it is used responsibly.
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