Assisted Reproduction Technologies and Practices: Advancing Health and Reproductive Justice in Family Formation

Assisted reproductive technologies (ARTs) offer vital family formation opportunities for people with infertility, unmarried and single individuals, and LGBTQ+ individuals and couples. At the same time, they pose significant risks for others – especially women who provide their services in contractual third-party reproduction (egg donors and surrogates).

ARTs and related commercial arrangements have given rise to a multi-billion dollar, largely unregulated global fertility industry that amplifies global inequities. We're only just beginning to apply feminist, reproductive justice, and disability rights perspectives in order to understand the implications of ART practices. Concerns include:

• Lack of accurate information about health risks for egg donors and surrogates, as well as frequent conflict of interest among the clinicians who oversee their treatment
• Aggressive marketing targeting young women at universities in the United States to “donate” eggs, with higher payment offered for “Ivy League” eggs
• Insufficient information about health risks and success rates of egg freezing, which is now widely available as an employee benefit
• The recruitment of women drawn by limited economic opportunities in countries such as Ukraine, Georgia, Mexico, Colombia, and Kenya to become surrogates for foreigners
• The movement of fertility markets after surrogacy practices are found to be exploitative in certain countries to new fertility “hubs” where there is little or no regulation
• The large-scale use of genetic de-selection during fertility treatment to choose the “best” embryos, potentially furthering notions based in eugenic legacies that people with disabilities have no place in families and the world
• Social and economic factors that lead young women to increasingly assume their future childbearing will necessitate IVF or other expensive technologies and social arrangements

This landscape of assisted reproduction poses an urgent societal question: How can we ensure expanded options for family formation for everyone and, at the same time, avoid new forms of marginalization and health risks for those who make these options possible?

Since the early 2000s, Our Bodies Ourselves (OBOS) has collaborated with a broad coalition of groups working to engage and educate the public and advocate for responsible practice and governance of assisted reproduction. In 2016, OBOS created Surrogacy360.org, an educational website that serves as a clearinghouse for information on commercial international surrogacy and the effects on all parties: intended parents, gamete donors, surrogates, and people born of surrogacy. The site promotes transparency and best practices and policies by addressing the health, legal, and ethical aspects of surrogacy arrangements. Our close collaborator, the Center for Genetics and Society, is now overseeing Surrogacy360.org.

Our Bodies Ourselves’ current work on assisted reproduction includes:

• Raising awareness and educating people about ARTs and the potential rise of market-driven eugenics.
• Engaging with allies on key surrogacy bills as they arise across the country and encouraging regulations that protect surrogates, egg providers, people born through these arrangements, and intended parents.
• Participating in global organizing efforts to oppose heritable genome editing. As scientific institutions convene to discuss whether to proceed with altering the genes of future children and generations OBOS joins a coalition of groups insisting that the voices and perspectives of those in the disability rights, reproductive rights and justice, LGBTQ+ rights, racial justice, and Indigenous sovereignty movements be at the center.
• Highlighting the work of our colleagues at Center for Genetics & Society, We Are Egg Donors, and the Donor Sibling Registry.

Together with our long-standing networks – both domestic and global – we are working to ensure that biotechnologies hold promise rather than harm for the human future.

Together with our long-standing networks – both domestic and global – we are working to ensure that biotechnologies hold promise rather than harm for the human future.

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