State Differences in Gestational Surrogacy, United States, 2009–2013 [13G

Abstract

INTRODUCTION: Gestational surrogacy policy in the U.S. varies by state, but there is little information on state differences in the prevalence and characteristics of in vitro fertilization (IVF) cycles using gestational carriers. METHODS: We used data from the National Assisted Reproductive Technology Surveillance System from 2009 to 2013 to calculate state-specific prevalence of IVF cycles using gestational carriers, number of infants born from gestational carrier cycles, proportion of gestational carrier cycles using donor oocytes, prevalence of gestational carrier cycles among non-U.S. residents, and prevalence of gestational carrier cycles performed in states other than intended parent's state of residence. RESULTS: Of the 648,457 IVF cycles performed in the U.S. during 2009–2013, 14,682 (2.3%) were gestational carrier cycles, resulting in 8,958 infants born. Over half of these cycles (50.2%) were performed in California, Connecticut, Texas, and Illinois; California had the highest number of gestational carrier cycles in the country (n=4,167, 28.4%). Nationally, 50.2% of gestational carrier cycles used donor oocytes. Non-U.S. residents accounted for 15.7% of gestational carrier cycles in the country. Overall, 29.1% of gestational carrier cycles by U.S. residents were performed in a state other than the state of residence of the intended parent; this proportion was highest in Connecticut where out-of-state residents accounted for 72.2% of all gestational carrier cycles by U.S. residents. CONCLUSION: States vary in the prevalence and characteristics of gestational carrier cycles, likely due in part to varying state policies on gestational surrogacy. Results of this analysis may be helpful to policy makers, health care providers, and patients considering gestational surrogacy.