Psychosocial assessment of interpersonal relationships in altruistic surrogacy counselling

In an altruistic surrogacy arrangement, interpersonal relationships are crucial, particularly as many arrangements may be based on pre-existing relationships between intended parent/s and surrogate (and partner if applicable). Thus, if interpersonal difficulties were to occur, they could adversely impact the surrogacy itself and long-term extended family and friendships. In Australia, surrogacy is altruistic, with legal requirements for independent pre-surrogacy counselling of all parties to the surrogacy. This study aims to describe the application of an implications and assessment counselling protocol (IAC), including validated psychometric testing, and an assessment of suitability of parties legally required for surrogacy in the state of New South Wales (NSW). Pre-surrogacy relationships are assessed using observation, clinical interview, and psychometric measures to highlight potential interpersonal problems. From the comprehensive interpersonal assessment, preventive measures may be recommended by the surrogacy counsellor to ameliorate potential relationship issues during the surrogacy. In total, 87 consecutive arrangements (N = 322), 80 gestational and 7 traditional surrogacies, comprising 61 intended mothers (IM) (5% single), 110 intended fathers (IF) (47% same sex male relationships), 87 surrogates (S) and 64 partners (SP) (94% male) consented to participate. As part of the IAC protocol, two psychometric tests [Personality Assessment Inventory (PAI), Psychological Entitlement Scale (PES)] were completed by 98% of the 322 parties. Findings from the interpersonal scales of the PAI (Warmth and Dominance), five PAI sub scales, and the PES were used to assess interpersonal dimensions. Overall, 97% of the 87 cases were assessed as suitable to proceed, including 29% with qualified approval. However, in 11 cases assessed as suitable to proceed, there were individual interpersonal test scores at least one standard deviation from the mean, indicating possible relationship disparities. The findings of this study demonstrate the application and value of psychometric testing, as an integral part of clinical assessment in surrogacy counselling.