Event Review: Two Years On – Assessing the impact of surrogacy 'reforms' on future reproductive technologies

The symposium, entitled 'Two Years On: Assessing the Impact of Surrogacy "Reforms" on Future Reproductive Technologies', took place at the University of Greenwich and explored the Law Commissions' 2023 recommendations for surrogacy reform and the implications of this report on the regulation of existing fertility treatment and emerging reproductive technologies.

The symposium brought together five esteemed researchers: Dr Lottie Park-Morton (University of Gloucestershire), Dr Katherine Wade (University of Bristol), Natalie Richardson (University of Kent), Dr Natasha Hammond-Browning (Cardiff University), and Dr Victoria Adkins (University of Greenwich). Each shared their perspectives on the report, offering insightful discussions on the importance of law reform, especially in response to technological advancements like ectogestation.

The timing of the event was particularly pertinent given the Government's disappointing recent announcement that the proposed reforms will not be prioritised at this time (see BioNews 1289).

Dr Park-Morton, senior lecturer in law, opened the symposium by eloquently outlining the report's key proposals in a manner accessible to a lay audience. This provided helpful background for attendees less familiar with the details and offered an overview of recent developments to contextualise the recommendations.

A thorough analysis of the report revealed several unresolved issues, particularly regarding the disclosure of origin information and whether it would be appropriate for birth certificates to indicate that a child was born via surrogacy. This prompted reflection on the broader implications for those involved in surrogacy arrangements, especially the rights of the child to know their origins – a principle central to the recent proposals. The discussion highlighted the complexity of surrogacy and the difficulty of balancing the competing rights of all parties involved.

Building on this, Dr Wade, senior lecturer in law, turned to the topic of gamete donation. In a thoughtful discussion, she traced its evolution – from a previously unregulated practice to the current legal framework in which donor-conceived people can access identifying information about their donor upon turning 18. She also addressed the impact of increased access to direct-to-consumer genetic testing and how this has informed the Human Fertilisation and Embryology Authority's (HFEA) 2023 reform proposals, which include consideration of lowering the disclosure age.

Dr Wade noted that the Commissions' recommendation to establish a 'surrogacy register', allowing children to access information about surrogates and donors prior to age 18, could result in inconsistency between the legal treatment of surrogacy and gamete donation. She suggested that this discrepancy might encourage broader changes to gamete donation laws and that a single 'origin register' could be preferable to multiple, fragmented systems.

The discussion around the age of disclosure was particularly engaging, offering insight into how child law intersects with surrogacy. Consideration of concepts like Gillick competence and the role of openness in family formation further enriched this part of the conversation.

Natalie Richardson, a PhD candidate in law (and legal editor of BioNews!), followed with a discussion of egg freezing and highlighted how some of the report's recommendations diverge from existing regulations. One example was the proposed minimum legal age of 21 for those acting as a surrogate, while no comparable age restriction exists for other fertility treatments such as egg freezing. This raised questions about the rationale behind the Commissions' recommendations and generated discussion about the absence of an upper age limit.

Richardson also addressed the proposed role of the HFEA in regulating surrogacy advertising. She noted existing concerns about the lack of transparency regarding pricing and success rates in the advertising of fertility treatments like egg freezing. Currently, the HFEA has limited authority to regulate clinic advertising and therefore works in collaboration with other regulatory bodies to manage this (see BioNews 1099). Richardson pointed out the apparent tension in the Commissions' recommendation for the HFEA to take on this role, given its existing constraints.

In the second half of the symposium, Dr Hammond-Browning, senior lecturer in law, provided a compelling overview of uterus transplantation. She discussed how the procedure has evolved, current eligibility criteria, and the motivations that may lead someone to opt for transplantation over surrogacy.

One key takeaway was the stark variation in international attitudes towards surrogacy and uterus transplantation. For example, Sweden has taken a strong anti-surrogacy stance while leading globally in uterus transplant research. An especially interesting example involved a 2017 case where the transplant was performed in Serbia, IVF in Sweden, and birth in Italy – highlighting the phenomenon of reproductive tourism and the challenges of cross-border regulation.

The concluding speaker, Dr Adkins, lecturer in law, examined the implications of partial ectogestation on the Commissions' proposals. She challenged the view that surrogacy reform must be considered in isolation, instead highlighting how emerging technologies may intersect with, or even reshape, the conversation. Dr Adkins' reflections on societal attitudes that might exist, particularly potential preferences for human gestation over ectogestation via 'biobags', raised compelling questions. She discussed how partial ectogestation might improve outcomes for premature infants, prompting reflection on why human gestation might be considered preferable. Dr Adkins plans to explore these issues further in forthcoming publications stemming from her PhD research.

She also considered whether the development of ectogestation might catalyse reform in surrogacy law or shift focus entirely toward regulating this new technology. Dr Adkins concluded by observing the difficulty lawmakers face in keeping pace with scientific advancements.

Following the formal presentations, the speakers engaged in a panel discussion addressing audience questions. This generated a rich dialogue on several issues, including how partial ectogestation might intensify existing stigmas about maternal roles and decisions concerning gestation and birth. The conversation also touched on the influence of direct-to-consumer genetic testing on evolving policies around transparency and the right to know one's origins, extending the discussion to assisted reproductive technologies such as mitochondrial replacement therapy.

Overall, the symposium offered a comprehensive and thought-provoking examination of the Law Commissions' proposals and their implications for the future regulation of reproductive technologies. The event fostered meaningful discussion, deepened understanding of the proposed reforms, and encouraged reflection on the interconnected regulation of fertility treatments. It was an engaging and insightful experience that underscored the importance of open dialogue in shaping future policy.

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The past, present and future of UK surrogacy law will be discussed at next week's free-to-attend online event 40 Years of the Surrogacy Arrangements Act: What Next for Surrogacy?, taking place on Wednesday 16 July 2025.

Find out more and register here.