Treatment by in vitro fertilisation with surrogacy: experience of one British centre

Surrogacy has been an accepted form of treatment for certain forms of childlessness for centuries.1 Until recently, “natural surrogacy” was the only means of helping certain women to have babies. In vitro fertilisation surrogacy is now accepted in the United Kingdom as a treatment option for infertile women with certain clearly defined medical problems (box).

In 1985, despite opposition from the BMA, Mr Patrick Steptoe and Professor Robert Edwards, the pioneers of in vitro fertilisation, first proposed treating a patient by in vitro fertilisation surrogacy at Bourn Hall Clinic. After extensive discussions with the independent ethics committee they treated the first couple in the United Kingdom, and the child was born in 1989. In 1989, the clinic's ethics committee drew up guidelines for the treatment of women by in vitro fertilisation surrogacy, and the full programme was formalised in 1990 (table 1). Since then 49 “genetic couples” have received treatment. This review describes our experience of in vitro fertilisation surrogacy since 1989 and discusses some ethical and legal issues.