Allowing compensated surrogacy arrangements in Australia may decrease the number of parents seeking help overseas and improve health outcomes for children born of such arrangements, according to research published in the Medical Journal of Australia.

Researchers from Stethoscope Research, the Canberra Fertility Centre and Monash University in Melbourne surveyed hundreds of participants in two surrogacy support groups about their experiences with overseas compensated surrogacy arrangements.

They found that 43% of the intended parents who completed the survey had undertaken compensated surrogacy overseas. There were high proportions of multiple pregnancies (55%) and premature births (45%) - and, therefore, possible short- and long-term adverse health outcomes for the children.

Additionally, overseas compensated surrogacy arrangements involved high rates of third-party egg provision often from anonymous donors, despite the fact that 71% (80/112) of respondents were "most comfortable with using an identity-release donor". An even higher proportion - 87% (92/112) - believed that using an identity-release donor "was in the best interests of their child".

However, "this option is not available when surrogacy is undertaken in places where gamete donation is anonymous," the authors wrote.

"Given it is illegal in Australia to compensate a woman for carrying a child, compensated surrogacy overseas is the route most Australian intended parents via surrogacy take", wrote the researchers, led by Dr Martyn Stafford-Bell, of Canberra Fertility Centre.

"Our data suggest that this exposes them, their babies and their surrogates to risks that are considered unacceptable in Australian assisted reproductive technology (ART) practice."

All Australian ART clinics must aim for a multiple pregnancy rate of less than 10%, must provide counselling, and ban anonymous gamete donation.

One in 10 respondents had experienced at least one pregnancy loss beyond 12 weeks' gestation and over half reported that a surrogate had a multiple pregnancy. For one in seven, overseas surrogacy did not result in the birth of a child.

"The high rates of multiple pregnancy and premature birth reported in this study show that surrogates and babies born as a result of surrogacy in the destination countries are at higher risk of short-term and long-term adverse health outcomes than parties involved in surrogacy in Australia, where the multiple birth rate in surrogacy arrangements is only around 5%.

"It is highly likely that a proportion of the respondents' children will have ongoing health care needs related to multiple and premature birth, the costs of which will be borne by Australian taxpayers.

"Such adverse outcomes could be avoided if access to surrogacy was facilitated within Australia", they concluded.

"This may require Australian states to consider reversing bans on advertising for a surrogate and compensated surrogacy and reviewing current Australian regulations to better protect and balance the safety, interests and rights of surrogates, intended parents and children born through surrogacy."