Before embarking on my current exploration into transnational surrogacy and the use of Assisted Reproductive Technologies (ART’s) more broadly, I had no real conception of the potential these technologies held. I knew that parents could select traits that desired their children to have, but this was only because I have personally encountered this trend. A couple I know have recently become the parents of a set of twins whose characteristics they had chosen (including their sex, eye color, height, etc.) prior to the implementation of their embryos into their biological mother using in vitro fertilization (IVF). Although hearing that this level of choice in offspring was alarming, I did not stop to consider all of the far-reaching effects this kind of technology can have. After doing some research, it seems that ART’s have the capability to create a dystopian reality in which babies are produced as a result of selective breeding based on socially constructed realities instead of scientific fact. Considering that I personally know about half a dozen people who were born using IVF (surely more that I am just not aware of), it seems strange that I am only now learning some of the significant negative effects this process can have on the women and children involved. According to the American Academy of Pediatrics (2012), an infant born of IVF is two to four times more likely to have birth defects than a naturally conceived baby. This is absolutely shocking to me, for this seems like a very big risk to take, especially considering that there are so many children without birth defects who are desperately awaiting adoption. Furthermore, when IVF is talked about in the media and in informal social settings (in my experience), it seems that these significant risks are not discussed or even acknowledged. This points to the strength of the desire parents have to obtain children who are biologically related to them, and the social construction of biological-relatedness as an utmost priority. Furthermore, in the case that the eggs used in an IVF procedure are harvested from a separate female (other than the women who will carry the embryos to term), the egg donor must undergo hormonal stimulation, and the long-term implications of this process for women’s health is still unknown (Swerdlow and Chavkin, 2017). It seems preposterous that doctors and their associated clinics are allowed to market egg ‘donation’ to college students without first having an understanding of risk (Jordan, 2013).  In the case of surrogacy, women who are implanted with embryos from a third-party, are at an increased risk of incurring gestational hypertension and preeclampsia (Klatsky et al., 2010). Finally, and what surprised me most, was that although research is still ongoing, there have been studies which show that the gestational environment has the potential to alter a fetuses epigenome (Swerdlow and Chavkin, 2017). I am not sure what shocks me most, that surrogates can have a genetic impact on the baby they give birth to, or that ART’s have been so widely used despite a lack of conclusive evidence in regard to its long-term effects. Clearly more research needs to be done before these technologies can be employed safely and ethically. It is preposterous that the transnational surrogacy, which completely depends on the use of ART, flourishes globally despite a lack of real data on the effect of these processes. 


Jordan, Emily Rose, ‘An Awful Alternative to Work-Study’, Columbia Spectator, New York, 27 March 2013, <> [accessed 17 April 2021].  

Klatsky PC, Delaney SS, Caughey AB, Tran ND, Schattman GL and Rosenwaks Z, ‘The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies,’ Obstetrics & Gynecology 116: 6 (2010), pp. 1387–92.

Swerdlow, Laurel, and Wendy Chavkin, ‘Motherhood in Fragments: The Disaggregation of Biology of Care’, in Miranda Davies (ed), Babies For Sale? (London, 2017), pp. 19-32.

The Dark Side of ART

3 thoughts on “The Dark Side of ART

  • April 18, 2021 at 11:16 pm

    Hi Grace, I found your blog really interesting. One thing i would like to say is on the issue of adoption. I have four children myself as you already know and I have do feel privileged that I was able to have them, even though it wasn’t plain sailing as I some issues with some of my pregnancies and have also had two miscarriages. However, I do also know some who have not been able to have children or have had still births. I remember watching a program a while back on adoption and from what I have seen and read the process is very long and is extremely difficult to go through. I understand why there is such a process, ie, for safety reasons and the child’s welfare, but I wonder if the process wasn’t as long and as hard to go through, then maybe some would rather choose to go that way rather than IVF. I would be very interested on your thoughts on this.

    • April 21, 2021 at 6:33 pm

      Hi Karen, Thanks for your comment and I am glad you liked my post. I appreciate your personal reflections and I am so sorry to hear about your miscarriages, I cannot imagine how difficult it must be to have to go through that and I am very glad to know you have four children now. I did a project on foster care and adoption in high school and although it was centered around the US context, it gave me an idea of how long and hard adoption processes can be. In many cases it seems that the arduous nature of the process does not always succeed in protecting children, and I do agree with you that an easier process might actually benefit all people involved (children could find homes faster, parents could find children faster and maybe more people would opt to adopt instead of using IVF). The whole thing is very strange and upsetting to me and part of the reason I have decided to write about it is because of the massive impact bad experiences with adoption/foster care or care in general can have on the long-term wellbeing of children, it just seems like something must be done.

  • April 22, 2021 at 5:49 pm

    Hi Grace – sorry for back tracking a bit, but after your presentation I wanted to find out a bit more. Unfortunately, I don’t think ART is the only field that flourishes in the absence of concrete evidence and data, but you’re right in saying it has potentially drastic implications. I think you’ve settled on a really challenging topic, not in the least because of how “new” it is, but also the ethical dilemmas that are sure to come up. For such a deeply personal matter, it’s hard to see how any academic literature will not have an agenda behind it.

    One comment I do have though, is on IVF. I hadn’t realised until recently, but in the UK, the way you get allocated the opportunity for IVF attempts is through a postcode lottery. Depending on where you live, you get a different number of tries. I also know a couple who have been through the absolute ringer because of IVF, not only the hormones, but the continual emotional rollercoaster of losing the implant, and even miscarrying at very early stages.

    Adoption has its own issues, as I’m sure you’re aware. The process here is extremely lengthy, and not by any means straightforward. If you’re interested in a charity who works in fostering and adoption in the UK, I’d recommend looking at ‘Home for Good’, as they may bring some UK based case studies to your attention (although I appreciate you’re looking at the US and its connections).

    All in all, it is a highly complicated, emotionally-charged topic you’ve chosen to dive into; so, good luck, and make sure to guard your heart while reading!

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