Announcement of the Νational Authority of Medically Assisted Reproduction concerning requirements of surrogate mothership according to the Code of Conduct for Assisted Reproduction.

SUBJECT: Age limit 45 years for the surrogate mother.


In the article 9 par. 1 of the Code of Conduct (GG B 293/7.2.2017) are foreseen the requirements for surrogate mothership as follows: 1) above 25 years and up to 45 years of age, 2) having at least 1 child and 3) not having undergone more than 2 cesareans according to national standards of the European Society of Human Reproduction and Embryology (ESHRE) and of the American Society of Reproductive Medicine (ASRM).

According to par. 2 of article 1 law 3305/2005, during the application of the Medically Assisted Reproduction methods, the best interest of the child to be born  must be taken mostly into account. It has been displayed in bibliography that pregnancy in an advanced age is associated to a high amount of both mother and child morbidity (newborn of low weight) and fatality. Pregnant women older than 50 years run three times the risk to suffer premature labor, giving birth to children of low weight compared to pregnant women aged 20- 29 years old. Children born with a low weight undergo high risk to suffer from metabolic syndrome and cardiovascular diseases during their adult life. It has been proven that pregnant women above 45 years old are of high risk to undergo complications like hypertension and diabetes of pregnancy. Especially for pregnant women above 55 years old the frequency of hypertension is 60% compared to an amount of 26% to women aged 50-54 years old.

In January 2015 a guideline for surrogate mothership was published by the ASRM and the Society of Assisted Reproduction. It was suggested that the surrogate mother should be between 21 and 45 years old. In case of pregnancy over 45 years of age everybody concerned should be informed on possible dangers of a pregnancy for a woman of advanced age. The gestational carrier should undergo a complete medical evaluation by a qualified medical professional confirming that she can carry out the pregnancy. In the woman’s written consent all pregnancy complications , including the possibility of prolonged bedding, should be included.

In conclusion article 9 paragraph 1 of the Code of Conduct for the Assisted Reproduction (GG B 293/7.2.2017) conforms with the international guidelines aiming at the best interest of the child to be born and the safety of the pregnant woman.