Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 6/2023

13.05.2023 | Assisted Reproduction Technologies

Surrogates’ experience during the COVID-19 pandemic: mental health, social support, and relationship with intended parents

verfasst von: Samantha Yee, Jacob L. Fine, Emma A. Lindsay, Tali L. Laszlo, Clifford L. Librach

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 6/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To examine surrogates’ mental health, social support, and relationship with intended parents (IPs) during the COVID-19 pandemic from March 2020 to February 2022.

Methods

Data were collected between April 29, 2022 and July 31, 2022, at an academic IVF center in Canada using an 85-item online anonymous cross-sectional survey that included three standardized scales measuring mental health (PHQ-4), loneliness, and social support. Eligible surrogates actively involved in surrogacy during the study period received email invitations.

Results

The response rate was 50.3% (338/672); 320 submitted surveys were analyzed. Two-thirds (65%) of respondents experienced mental health concerns during the pandemic and were significantly less comfortable about seeking mental health support than those without concerns. Nonetheless, 64% were highly satisfied with their surrogacy experience; 80% received a high level of support from their IPs, and 90% reported a good relationship with them. The final hierarchical regression model identified five significant predictors, explaining 39.4% of the variance in PHQ-4 scores: a prior mental health history, COVID-19 impact on personal life, surrogacy satisfaction, loneliness, and social support.

Conclusions

COVID-19 created an unprecedented challenge to surrogacy care, increasing surrogates’ risk of experiencing mental health symptoms. Our data show that IP support and the surrogate-IP relationship were fundamentals to surrogacy satisfaction. The findings are relevant to fertility and mental health practitioners in identifying surrogates who are more susceptible to mental health challenges. Fertility clinics should ensure adequate psychological screening of surrogate candidates and proactively offer mental health support services.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Dar S, Lazer T, Swanson S, et al. Assisted reproduction involving gestational surrogacy: An analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Hum Reprod. 2015;30:345–52.CrossRefPubMed Dar S, Lazer T, Swanson S, et al. Assisted reproduction involving gestational surrogacy: An analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Hum Reprod. 2015;30:345–52.CrossRefPubMed
2.
Zurück zum Zitat Alipour Z, Kheirabadi GR, Kazemi A, et al. The most important risk factors affecting mental health during pregnancy: a systematic review. East Mediterr Health J. 2018;24:549–59.CrossRefPubMed Alipour Z, Kheirabadi GR, Kazemi A, et al. The most important risk factors affecting mental health during pregnancy: a systematic review. East Mediterr Health J. 2018;24:549–59.CrossRefPubMed
3.
Zurück zum Zitat Dadi AF, Miller ER, Bisetegn TA, et al. Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC Public Health. 2020;20:173.CrossRefPubMedPubMedCentral Dadi AF, Miller ER, Bisetegn TA, et al. Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review. BMC Public Health. 2020;20:173.CrossRefPubMedPubMedCentral
4.
5.
Zurück zum Zitat American Society for Reproductive Medicine (ASRM). Recommendations for practices using gestational surrogates: a committee opinion. Fertil Steril. 2022;118:65–74.CrossRef American Society for Reproductive Medicine (ASRM). Recommendations for practices using gestational surrogates: a committee opinion. Fertil Steril. 2022;118:65–74.CrossRef
6.
Zurück zum Zitat Romero-Gonzalez B, Puertas-Gonzalez JA, Mariño-Narvaez C, et al. Confinement variables by COVID-19 predictors of anxious and depressive symptoms in pregnant women. Med Clin. 2021;156:172–6.CrossRef Romero-Gonzalez B, Puertas-Gonzalez JA, Mariño-Narvaez C, et al. Confinement variables by COVID-19 predictors of anxious and depressive symptoms in pregnant women. Med Clin. 2021;156:172–6.CrossRef
8.
Zurück zum Zitat Dang HAH, Viet NC. Gender inequality during the COVID-19 pandemic: income, expenditure, savings, and job loss. World Dev. 2021;140:105296.CrossRefPubMed Dang HAH, Viet NC. Gender inequality during the COVID-19 pandemic: income, expenditure, savings, and job loss. World Dev. 2021;140:105296.CrossRefPubMed
9.
Zurück zum Zitat Lin S. Generalized anxiety disorder during COVID-19 in Canada: gender-specific association of COVID-19 misinformation exposure, precarious employment, and health behavior change. J Affect Disord. 2022;302:280–92.CrossRefPubMed Lin S. Generalized anxiety disorder during COVID-19 in Canada: gender-specific association of COVID-19 misinformation exposure, precarious employment, and health behavior change. J Affect Disord. 2022;302:280–92.CrossRefPubMed
10.
Zurück zum Zitat Abulaiti A, Abudurexiti M, Nuermaimaiti A, et al. Analysis of the incidence and influencing factors of postpartum depression and anxiety: a cross-sectional study in Xinjiang from 2018 to 2021. J Affect Disord. 2022;302:15–24.CrossRefPubMed Abulaiti A, Abudurexiti M, Nuermaimaiti A, et al. Analysis of the incidence and influencing factors of postpartum depression and anxiety: a cross-sectional study in Xinjiang from 2018 to 2021. J Affect Disord. 2022;302:15–24.CrossRefPubMed
11.
Zurück zum Zitat Kneebone E, Beilby K, Hammarberg K. Experiences of surrogates and intended parents of surrogacy arrangements: a systematic review. Reprod BioMed Online. 2022;45:815–30.CrossRefPubMed Kneebone E, Beilby K, Hammarberg K. Experiences of surrogates and intended parents of surrogacy arrangements: a systematic review. Reprod BioMed Online. 2022;45:815–30.CrossRefPubMed
12.
Zurück zum Zitat Toledano SJ, Zeiler K. Hosting the others’ child? Relational work and embodied responsibility in altruistic surrogate motherhood. Fem Theory. 2017;18:159–75.CrossRef Toledano SJ, Zeiler K. Hosting the others’ child? Relational work and embodied responsibility in altruistic surrogate motherhood. Fem Theory. 2017;18:159–75.CrossRef
13.
Zurück zum Zitat Yee S, Hemalal S, Librach CL. “Not my child to give away": a qualitative analysis of gestational surrogates’ experiences. Women Birth. 2020;33:e256–65.CrossRefPubMed Yee S, Hemalal S, Librach CL. “Not my child to give away": a qualitative analysis of gestational surrogates’ experiences. Women Birth. 2020;33:e256–65.CrossRefPubMed
14.
Zurück zum Zitat Riddle M. Psychological assessment of gestational carrier candidates: Current approaches, challenges, and future considerations. Fertil Steril. 2020;113:897–702.CrossRefPubMed Riddle M. Psychological assessment of gestational carrier candidates: Current approaches, challenges, and future considerations. Fertil Steril. 2020;113:897–702.CrossRefPubMed
15.
Zurück zum Zitat Filippetti ML, Clarke ADF, Rigato S. The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. BMC Pregnancy Childbirth. 2022;22:68.CrossRefPubMedPubMedCentral Filippetti ML, Clarke ADF, Rigato S. The mental health crisis of expectant women in the UK: effects of the COVID-19 pandemic on prenatal mental health, antenatal attachment and social support. BMC Pregnancy Childbirth. 2022;22:68.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Friedman LE, Gelaye B, Sanchez SE, et al. Association of social support and antepartum depression among pregnant women. J Affect Disord. 2020;264:201–5.CrossRefPubMed Friedman LE, Gelaye B, Sanchez SE, et al. Association of social support and antepartum depression among pregnant women. J Affect Disord. 2020;264:201–5.CrossRefPubMed
17.
Zurück zum Zitat Lebel C, MacKinnon A, Bagshawe M, et al. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5–13.CrossRefPubMedPubMedCentral Lebel C, MacKinnon A, Bagshawe M, et al. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5–13.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Bedaso A, Adams J, Peng W, et al. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health. 2021;18:162.CrossRefPubMedPubMedCentral Bedaso A, Adams J, Peng W, et al. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health. 2021;18:162.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Hughes ME, Waite LJ, Hawkley LC, et al. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26:655–72.CrossRefPubMedPubMedCentral Hughes ME, Waite LJ, Hawkley LC, et al. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26:655–72.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Kroenke K, Spitzer RL, Williams JBW, et al. An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics. 2009;50:613–21.PubMed Kroenke K, Spitzer RL, Williams JBW, et al. An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics. 2009;50:613–21.PubMed
21.
Zurück zum Zitat Zimet GD, Dahlem NW, Zimet SG, et al. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988;52:299–307.CrossRef Zimet GD, Dahlem NW, Zimet SG, et al. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988;52:299–307.CrossRef
23.
Zurück zum Zitat Hohman MM, Hagan CB. Satisfaction with surrogate mothering: a relational model. J Hum Behav Soc Environ. 2001;4:61–84.CrossRef Hohman MM, Hagan CB. Satisfaction with surrogate mothering: a relational model. J Hum Behav Soc Environ. 2001;4:61–84.CrossRef
24.
Zurück zum Zitat van den Akker O. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod. 2007;22:2287–95.CrossRefPubMed van den Akker O. Psychological trait and state characteristics, social support and attitudes to the surrogate pregnancy and baby. Hum Reprod. 2007;22:2287–95.CrossRefPubMed
25.
Zurück zum Zitat Yee S, Goodman CV, Librach CL. Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases. Reprod BioMed Online. 2019;39:249–61.CrossRefPubMed Yee S, Goodman CV, Librach CL. Determinants of gestational surrogates’ satisfaction in relation to the characteristics of surrogacy cases. Reprod BioMed Online. 2019;39:249–61.CrossRefPubMed
26.
Zurück zum Zitat Kleinpeter CH, Hohman MM. Surrogate motherhood: personality traits and satisfaction with service providers. Psychol Rep. 2000;87:957–70.CrossRefPubMed Kleinpeter CH, Hohman MM. Surrogate motherhood: personality traits and satisfaction with service providers. Psychol Rep. 2000;87:957–70.CrossRefPubMed
27.
Zurück zum Zitat Takeda T, Yoshimi K, Kai S, et al. Association between serious psychological distress and loneliness during the COVID-19 pandemic: a cross-sectional study with pregnant Japanese women. Int J Women’s Health. 2021;13:1145.CrossRef Takeda T, Yoshimi K, Kai S, et al. Association between serious psychological distress and loneliness during the COVID-19 pandemic: a cross-sectional study with pregnant Japanese women. Int J Women’s Health. 2021;13:1145.CrossRef
28.
Zurück zum Zitat Giurgescu C, Wong AC, Rengers B, et al. Loneliness and depressive symptoms among pregnant black women during the COVID-19 pandemic. West J Nurs Res. 2022;44:23–30.CrossRefPubMed Giurgescu C, Wong AC, Rengers B, et al. Loneliness and depressive symptoms among pregnant black women during the COVID-19 pandemic. West J Nurs Res. 2022;44:23–30.CrossRefPubMed
29.
Zurück zum Zitat Battulga B, Benjamin MR, Chen H, et al. The impact of social support and pregnancy on subjective wellbeing: A systematic review. Front Psychol. 2021;12:710858–710858.CrossRefPubMedPubMedCentral Battulga B, Benjamin MR, Chen H, et al. The impact of social support and pregnancy on subjective wellbeing: A systematic review. Front Psychol. 2021;12:710858–710858.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Riddle MP. The psychological impact of surrogacy on the families of gestational surrogates: implications for clinical practice. J Psychosom Obstet Gynaecol. 2022;43:122–7.CrossRefPubMed Riddle MP. The psychological impact of surrogacy on the families of gestational surrogates: implications for clinical practice. J Psychosom Obstet Gynaecol. 2022;43:122–7.CrossRefPubMed
Metadaten
Titel
Surrogates’ experience during the COVID-19 pandemic: mental health, social support, and relationship with intended parents
verfasst von
Samantha Yee
Jacob L. Fine
Emma A. Lindsay
Tali L. Laszlo
Clifford L. Librach
Publikationsdatum
13.05.2023
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 6/2023
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-023-02824-w

Weitere Artikel der Ausgabe 6/2023

Journal of Assisted Reproduction and Genetics 6/2023 Zur Ausgabe

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Menopausale Hormontherapie für Frauen über 65?

07.05.2024 Klimakterium und Menopause Nachrichten

In den USA erhalten nicht wenige Frauen auch noch im Alter über 65 eine menopausale Hormontherapie. Welche positiven und negativen gesundheitlichen Konsequenzen daraus möglicherweise resultieren, wurde anhand von Versicherungsdaten analysiert.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Nodal-negativ nach neoadjuvanter Chemo: Axilladissektion verzichtbar?

03.05.2024 Mammakarzinom Nachrichten

Wenn bei Mammakarzinomen durch eine neoadjuvante Chemotherapie ein Downstaging von nodal-positiv zu nodal-negativ gelingt, scheint es auch ohne Axilladissektion nur selten zu axillären Rezidiven zu kommen.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.