Until the late 1970s when advances in reproductive medicine led to the birth of the world’s first “test tube” baby, that right remained unfulfilled for countless thousands around the globe. Subsequent rapid advances in assisted reproductive technologies occurred simultaneously with changes in morality attendant to the relative successes, especially in the west, of the women’s, men’s rights, and gay rights movements and the post-Cold War democratization of much of the planet. These transformations have meant that not only those with infertility problems - the population assisted reproductive technology first served - but also single women, single men, and gay and lesbian couples have turned increasingly to reproductive medicine to start a family. Nowhere has reproductive medicine had greater success than in the United States which has growing numbers of innovative fertility clinics whose success rates are the envy of the world and a legal climate generally favorable to the kind of contractual arrangements necessitated by such now common occurrences as ovum or egg donation, sperm donation, gestational surrogacy, and embryo donation (sometimes incorrectly referred to as embryo adoption).

However, all is not a panacea. As is common with fields where there is rapid technological change, reproductive law has not kept pace with the developments in reproductive medicine. This has meant that within the fifty states of the United States there are wildly different legal regimes governing subjects such as ovum or egg donation; sperm donation; gestational surrogacy; embryo donation; and, for those with successful pregnancies via gestational surrogacy, pre-birth orders; post-birth orders; post-birth adoptions; and second parent or co-parent adoptions. These variations often leave intended parents bewildered. At the same time, perhaps sensing profits to be made in this growing field, many attorneys with an incomplete or poor comprehension of reproductive medicine have styled themselves experts without any real knowledge of the complex medico-legal issues involved. To make matters worse, some intended parents engage the services of gestational surrogacy and egg or ovum donation agencies whose operations are completely unregulated by state law and whose owners, in many cases, financially exploit, via corruption or ignorance, the vulnerability of those who are desperate to have a child or children by assisted means. The unhappy result of this state of affairs is that intended parents who enter into egg, sperm, or embryo donation agreements or surrogacy arrangements often sign poorly drafted documents with sometimes devastating consequences. For example, in the case of a successful gestational surrogacy, some intended parents suddenly find themselves unable to get their names on their child’s birth certificate instead of the names of the surrogate and her husband if she has one.