EXPLORING THE LANDSCAPE OF ALTRUISTIC SURROGACY IN BRAZIL: AN IN-DEPTH ANALYSIS OF PARTICIPANT DEMOGRAPHICS OVER 8 YEARS

Problem Statement:
In Brazil, gestational surrogacy (GS) has emerged as a pivotal solution for individuals unable to undergo pregnancy. While ethical guidelines have sanctioned this practice since 1992, total inclusivity was established only in 2013, allowing various cases, such as male homosexual couples, single males, and couples with medical impediments, to partake in altruistic surrogacy. This study aims to comprehensively assess an 8-year experience of in vitro fertilization (IVF) cycles within a Brazilian surrogacy program.

Methods:

A retrospective analysis of 139 IVF transfer cycles conducted from 2016 to 2023 at Neovita Reproductive Center in São Paulo, Brazil, was performed. Variables scrutinized encompassed participant demographics, embryo quality and IVF results.

Results:

Evaluation of 139 surrogacy-associated embryo transfers yielded 68 pregnancies, involving 89 gestational carriers (GC) and 81 intended parents (IP). Demand for GS has shown an upward trend, with 84% of IPs hailing from Brazil and 16% internationally. IPs had an average age of 40.61 years, whereas GCs averaged 33.28 years. Embryos predominantly derived from donated oocytes (88.4%), with an oocyte mean age of 27.06 years. Notably, 67.6% of embryos attained top-quality classification, while 17.2% underwent biopsy, confirming euploidy. Each procedure saw an average transfer of 1.57 embryos. Surrogacy indications were diverse, with male homosexual couples representing 46.7%, single male parents 16.5%, and maternal medical conditions 10.2%, among others. The overall live-birth rate per IP was 47.1%, exhibiting higher rates among subgroups like male homosexual couples (50%), maternal medical conditions (80%), and single male parents (64%). The mean gestational age at birth was 35.2 weeks, with 38% of infants delivered before 37 weeks and an average birth weight of 2671.62 grams.

Conclusion:

This study presents the largest cohort of surrogacy cases in Brazil, demonstrating the feasibility and success of surrogacy as an option for individuals confronting infertility or medical gestational barriers. The data underscores the escalating demand for surrogacy and advocates for broader access to such treatments in Brazil and globally. Our findings emphasize the mounting requirement for surrogacy as a solution for reproductive challenges and reinforce the imperative to enhance its availability not only in Brazil but on a global scale.