Abstract
Surrogacy includes traditional surrogacy, in which the carrier contributes her own oocyte, and gestational surrogacy, in which the embryo is derived exclusively from the gametes of the intended parents or donors. In Brazil, only gestational surrogacy is legally recognized. It is governed by resolutions of the Federal Council of Medicine and the national health surveillance agency in the absence of specific federal legislation, and it requires altruistic, unpaid participation and compliance with carrier eligibility criteria. This Position Statement, developed by the Strategic Committee on Gestational Surrogacy of the Brazilian Association of Assisted Reproduction, addresses the clinical, bioethical, legal, and psychological dimensions of the practice and is intended to guide specialists throughout Brazil. Clinical indications include uterine absence or anomalies, contraindications to pregnancy, medical conditions that may be aggravated by pregnancy, and biological inability to conceive or carry a pregnancy. No universally validated protocol for carrier selection exists; current requirements include a maximum age of 50 years, at least one previous live birth, and satisfactory physical and mental health. Perinatal outcomes are comparable to those of conventional in vitro fertilization, although long-term data on cross-border arrangements remain scarce. The bioethical framework is based on autonomy, beneficence, non-maleficence, and justice. SBRA opposes simultaneous surrogacy arrangements because they are incompatible with the altruistic nature of the practice and supports gradual, age-appropriate disclosure of the child’s gestational origin. Legal challenges include the absence of statutory regulation, cross-border reproductive tourism, and the child’s right to know their origins. Continuous psychological support for all parties is mandatory and central to favorable long-term outcomes. Gestational surrogacy is a valid reproductive option for selected patients but requires rigorous oversight and must prioritize the best interests of the child within the Brazilian regulatory framework.