Exploring the revolutionary path to parenthood through cutting-edge science and human generosity
The dream of having a child and forming a family is a universal aspiration. However, for some, this path is interrupted by biological barriers. For women without a uterus, with severe uterine conditions, or for single men and same-sex male couples, biological parenthood seemed, for a long time, an impossible dream.
Gestational surrogacy emerges as a revolutionary technique of assisted reproduction that rewrites this narrative, offering a viable and safe path to parenthood.
This practice, in which one woman generously agrees to carry and give birth to a child for another person or couple, is a complex and beautiful symphony that harmonizes cutting-edge science, robust ethical frameworks, and profound human solidarity. In Portugal, the approval of Law No. 90/2021 in December 2021 established the legal framework for this practice, reflecting a growing global openness to this reproductive possibility and sparking essential reflections on its implementation1 .
This article delves into the universe of gestational surrogacy, exploring its concepts, the latest scientific advances, and the essential guidelines that ensure this journey is undertaken with responsibility and success.
Comprehensive health assessment of all parties involved
Creation of embryos using intended parents' or donors' genetic material
Transfer of viable embryo to surrogate's uterus
At its core, gestational surrogacy is a Medically Assisted Reproduction (MAR) technique in which a woman (the surrogate) agrees to become pregnant and carry a child for the intended parent(s), who will be legally recognized as the child's parents from the moment of birth1 .
In gestational surrogacy, the embryos are created using the eggs and sperm of the intended parents (or donors). The surrogate has no genetic connection to the baby.
Portuguese law specifies that surrogacy must be altruistic. The surrogate cannot receive payment beyond reimbursement of pregnancy-related expenses.
The success of gestational surrogacy is intrinsically linked to the effectiveness of In Vitro Fertilization (IVF). One of the most critical and costly stages of IVF is controlled ovarian stimulation, where hormones are administered to stimulate the ovaries to produce multiple eggs.
Traditionally, hormone dosage is determined by physicians based on general guidelines, which can lead to suboptimal outcomes. The Opt-IVF clinical trial in 2025 evaluated an innovative clinical decision support tool to make ovarian stimulation more efficient, safer, and more successful3 .
402 women undergoing IVF were randomly divided into two groups: intervention (Opt-IVF) and control (conventional treatment).
Used the Opt-IVF tool to determine daily FSH dosage and ideal timing for medications based on a personalized mathematical model.
Underwent conventional treatment with dosages determined by physician according to standard practice.
Used initial patient data and ultrasound scans to map Follicle Size Distribution (FSD) and calculate optimal FSH doses.
The results of the trial demonstrated clear superiority of the personalized approach. The table below summarizes the main findings:
| Outcome Measure | Intervention Group (Opt-IVF) | Control Group (Conventional) | Significance |
|---|---|---|---|
| Cumulative FSH Dose | Significantly Lower | Standard Dose | Reduced cost & risk |
| Number of Mature (M2) Oocytes | Higher | Standard | More quality eggs |
| Number of High-Quality Blastocysts | Significantly Higher | Standard | More viable embryos |
| Clinical Pregnancy Rate | Increased | Standard | Higher success |
| Antral Follicle Count (AFC) | AMH (ng/dL) | Age Groups | ||
|---|---|---|---|---|
| Age 21-30 | Age 31-35 | Age >35 | ||
| <6 | <0.8 | 150 IU | 150 IU | 150 IU |
| 6-10 | 0.8-1.4 | 150 IU + 75 IU | 150 IU + 75 IU | 150 IU + 75 IU |
| 10-20 | 1.5-4.0 | 150 IU + 75 IU | 150 IU + 75 IU | 225 IU + 75 IU |
Adapted from 3
Behind every successful IVF cycle, whether for surrogacy or not, is a sophisticated laboratory equipped with high-precision reagents and materials. The quality and consistency of these components are fundamental to ensuring reproducible and reliable results, a critical factor when the dream of a family is at stake5 .
Preserve sensitive biological materials like enzymes and proteins used in culture media5 . Ensure long-term stability and effectiveness of essential components.
Provide necessary nutrients for embryo development in vitro. Using validated media is crucial for health and proper division of embryos.
Used in sample preparation for genetic analysis (PGT). Ensure uniform and contamination-free cell lysis, vital for accuracy of genetic tests5 .
Tubes and plates pre-filled with measured culture media or reagents. Reduce human error and variability in sample preparation5 .
The consistency and quality of laboratory materials directly impact the success rates of IVF procedures, making standardized, high-quality reagents and equipment essential components of modern assisted reproduction laboratories.
While science provides the tools, the success of a surrogacy journey also depends on a robust psychological and social framework. Research and clinical experience highlight the importance of a multidisciplinary follow-up throughout the process1 .
Longitudinal studies from countries with more experience in surrogacy do not suggest negative psychological impacts in the long term for the surrogate or for the child's development. However, the literature emphasizes that all parties must be fully informed not only of the medical risks but also of the potential psychological challenges, such as the bonding process with the baby during pregnancy and the postpartum period1 .
A qualitative study that served as the basis for Portuguese guidelines revealed the importance of in-depth evaluation and continuous monitoring of both the surrogate and the intended parents in several dimensions1 :
This careful and humanized approach is what transforms a complex medical procedure into a harmonious and successful journey, protecting the rights and well-being of the surrogate, the intended parents, and, above all, the child who will be born1 .
Gestational surrogacy is far more than a simple medical procedure; it is a testament to human generosity and the power of science to fulfill profound desires. It is a journey that begins with the solidary gesture of one woman and is realized through the precision of algorithms like Opt-IVF, which optimize the creation of life in the laboratory.
Advanced technologies like Opt-IVF and quality laboratory materials ensure the best possible outcomes.
Robust legal and ethical guidelines protect all parties involved in the surrogacy process.
The altruistic gesture of surrogates creates families and fulfills dreams of parenthood.
In this intricate and beautiful symphony, each element has a crucial role: science offers the instruments, law and ethics provide the score, and the surrogate and intended parents are the musicians who, together, create the unique melody of a new family. As society continues to evolve and science advances, this practice promises to remain a beacon of hope, always guided by responsibility, empathy, and the unwavering commitment to the well-being of the new life that is generated.