Abstract
A surrogate mother is a woman who becomes pregnant and gives birth to a child with the intention of donating the child to another person or couple. Surrogacy has become a new ethical challenge. Various factors such as economic issues, social stigma, consequences of pregnancy and the commercialization of this issue play a big role in the acceptance of surrogacy. The aim of the study was to investigate the motivations effective in accepting surrogacy by volunteer women. The keywords of “surrogate, motivation, volunteer, gestational, infertility” were searched for in studies published between 1970 and 2023 in reliable databases, resulting in 130 articles, of which 58 articles were reviewed. This review article searched for studies published by researchers from 1970 to 2023 in Scopus, PubMed, ScienceDirect, Google Scholar, as well as other jurisprudential texts using alternative keywords. Financial need and independence, social factors, the process of psychological compensation and restorative motives, resolving loneliness due to previous failures, resolving the internal psychological conflicts and compensatory movement, unresolved unconscious feelings, interest in experiencing a different type of motherhood (attachment or curiosity), empathy, altruism and spiritualism (commitment and care) are among the effective factors in surrogacy volunteering. The lack of supporting regulations for surrogate mothers and biological parents causes the profiteering of middlemen and commercial agencies. It is necessary to review the relevant laws in order to preserve human dignity and prevent the vulnerability of the surrogate.
Keywords: Infertility, Islam, Gestational, Motivation, Surrogate, Volunteer  

Introduction
The importance of fertility and infertility in Iran and other societies
Infertility is a common problem that affects about 10-15% of couples (1). According to the statistics of the World Health Organization, around 60-80 million couples worldwide suffer from infertility (2). Infertility or childlessness is also a neglected global fertility issue for both sexes. It has been reported that 70 million couples are suffering from infertility worldwide and are increasing (3). The prevalence of infertility varies in different parts of Iran, but it is close to global statistics (4). A total of five systematic reviews (n=279717 women) were published between 2012 and 2023. Based on the existing literature, the prevalence of infertility in Iran (1990-2019) is 13.2% (ranged: 7.8-13.2%), while primary infertility is 10.6% (ranged: 3.09-18.3%), and secondary infertility is 3.2% (ranged: 2-3.2%) (5). Fertility is very valuable in most cultures and is part of women’s power and identity, thus the desire to have children is one of the most essential human incentives in life (6). Religious and cultural norms and values reinforce fertility, which is why Muslim countries can be described as family-centered societies in which marriage and childbearing are of great value (7). As Islam encourages fertility, it also supports infertility treatment and protects children necessitating care of pregnant women and children’s health. Supporting the application of infertility techniques requires the preservation of ancestry. Every newborn baby must have a specific parent and communicate with them (8). 
Birth of the baby can strengthen the foundation of the family, enhance the emotional needs of individuals, and ultimately lead to the continuation of the generation, and infertility is a reality that is incompatible with all of these. Therefore, in the list of 86 materials of stressful events, infertility is one of the most negative events that lead to the death of a child or spouse (9). In the Holy Quran, it has been encouraged to be a child in various verses (51-53 of Surah Al-Hijr). In other verses, the child is referred to as a divine blessing (72 of Surah an-Nahl), the ornament of life (46 of Surah Al-Kahf) etc. In addition to the words of many of the religious leaders, paying attention to the practice of the Ahl al-Bayt (AS) in having children is also a clear proof that the increase in generations is acceptable among the Muslim societies. Infertility causes frustration, stress, anxiety and depression in the life of couples (10). In many families, infertility with different causes (male, female or both) can lead to stressful experiences and serious psychological problems (11,12).

The importance of infertility techniques including surrogacy
With new developments and many efforts, medical science has succeeded in treating infertility using different techniques, one of which is “surrogate mother” (13,14). Assisted Reproductive Technology (ART) techniques, such as IVF and embryo freezing, were first adopted in the field of infertility treatment in Europe and the United States, and spread throughout the world in the 1980s. Then, changes have been made in IVF and ICSI, egg donation, surrogate uterus, genetic diagnosis before implantation and egg freezing (15). A surrogate mother is a woman who becomes pregnant and gives birth to a child with the intention of donating the child to another person or couple. 
The use of surrogates in the treatment of infertility and pregnancy through IVF is used in women with special conditions such as: lack of uterus, uterine abnormalities, serious medical problems with prohibition of pregnancy and homosexual couples (16). Herweck et al’s study on international gestational surrogacy cycles in the United States (US) showed that of 40,177 embryo transfers to a gestational carrier from 2014 to 2020, parents’ gestational carrier cycles increased each year from 2014 (n=2758, 22.0%) to 2019 (n=4905, 39.8%) with a decrease in 2020 (n=4713, 31.8%) (17). In the United States, the legal status of surrogacy varies greatly from state to state. Some states (e.g., California, Connecticut, Massachusetts, Texas) apply friendly provisions and make GS contracts enforceable, while others (e.g., New York, Michigan, Utah) restrict the practice; and under some conditions, they may criminalize GS contracts (18). Surrogacy process is illegal in countries such as Germany and Sweden, and there are special laws in countries such as France, the Netherlands, Denmark, Australia and some states of the US (19).
Surrogate mothers in Iran-Islamic Bioethics Perspectives
Surrogacy is one of the new issues of jurisprudence that has raised due to the progress of medical science, therefore there is no Quranic verse or hadiths in this regard, and thus no fatwa has been issued in this field by the jurists of the past era. Contemporary jurists, including Ayatollah Khamenei, Ayatollah Makarem Shirazi and Ayatollah Khoei, have ruled on the permissibility of this issue and they do not have much difference in this regard. Only a few jurists, including Ayatollah Tabrizi and Ayatollah Fazel Lankarani, have ruled that it is not permissible. Iran is the only Islamic country where embryo donation and surrogacy programs are carried out. These plans have been accepted and approved by rulings of clerical scholars (20,21). However, Sunni Muslim scholars consider the use of surrogacy illegal and oppose its implementation. One of their arguments is that a surrogate is a clear form of using a donated sperm from a foreigner (someone out of the marriage contract), in a woman’s womb, which leads to mixing of ancestry. Mufti Sheikh Ahmad Kuti, an Islamic scholar, believes that introducing a man’s sperm into the womb of a woman who is not married to him violates God’s limits (22). According to the interpretation of “transgressing God’s limits”, he refers to the verses of the Qur’an (verses 5-7 of Surah Al-Mu’minun).
Those who protect their chastity. Except from their spouses, or their dependents—then they are free from blame. And those who are faithful to their trusts and pledges (Surah Al-Mu’minun: 5-7).

Surrogacy can be done in two ways
Traditional surrogate uterus (genetic/partial/direct) of the surrogate mother’s egg with the sperm of the legal father artificially inseminated and these two will be the genetic parents of the future baby.
Gestational surrogacy (host/full surrogate) in which an embryo is transferred from the intended parents or from a donated egg or sperm into the surrogate, the woman carrying the child has no genetic connection to the child (23,24). Surrogacy may be commercial or altruistic. If the surrogate mother receives money for the contract of surrogacy, it is considered commercial, and if she does not receive compensation other than the reimbursement of medical expenses and other expenses related to pregnancy and insurance coverage, it is called altruistic (25). In Iran, since 2001, surrogacy was offered to couples as one of the infertility treatment methods (26). Nowadays, infertility clinics are active in Tehran and also in some big cities such as Isfahan, Shiraz, Tabriz, Mashhad and Yazd. Inside Iran, following the government’s latest pronatalist policies, assisted reproductive technologies are recognized as a tool to help the government realize its population growth policies (27). Choosing a surrogate mother plays a very important role in the treatment success. The person chosen as a surrogate mother can be a family member or an unknown and unrelated person. The surrogate mother must have discretion in all stages of pregnancy and her decision must be respected even if it is against the interests of the requesting couple (28). On the other hand, Dadkhah et al’s research has shown that surrogate mothers are generally from the weakest social strata and head of the household. They generally play a passive role in the relationships that govern the production of children and they are treated as a vessel carrying the fetus (29). 
In other studies, the motivations of the people under study were stated in two groups: Most of these people considered financial need as their main motivation in carrying others’ fetus. Some are motivated by helping their friends or relatives whose uterus is not capable of carrying and keeping the fetus due to some reasons (30,31). In the study conducted by Berend et al, surrogate mothers define surrogacy as a “labor of love”. Women often describe their surrogacy as a “shared love journey”. They hope for a lasting relationship with the couple they carry for them. Altruistic love and forgiveness are compatible with close interpersonal relationships rather than the profit market. Surrogates are appreciated and supported in their community, where they agree that giving life is a moral good. This position has contributed to the desire to have children again for others (32). Regarding the issue of surrogacy, various legal issues, social and cultural dimensions have been investigated, but the reasons and motivations of women volunteering for surrogate motherhood are limited and need further investigation.
Objective: This study was conducted with the aim of investigating the factors and motivations affecting the acceptance of surrogacy by volunteer women.

Materials and Methods
Protocol of survey
This review article was conducted from April to December 2023 in order to investigate the factors and motivations influencing the acceptance of surrogacy by volunteer women based on PRISMA flow-chart for better evaluation.

Information of data sources 
In this review, related articles were searched for in domestic and foreign scientific databases among studies published from 1970 to 2022 in Scopus, PubMed, Science Direct, Google scholar, Magiran, SID and Iran Medex databases and other jurisprudential texts using the keywords of motivation, surrogate mother, and rules.
Eligibility criteria for selecting and evaluating the quality of articles
First, articles having the keywords published from 1970 to 2023 on surrogate mother motivations were read. Then, the classification of motivations in the field of surrogacy was discussed. In this review, 58 articles extracted from 130 articles on infertility and the motivation of surrogate mothers were examined (Figure 1). If there were multiple reports of a study, the most complete one was considered. Also, other exclusion criteria were irrelevant research studies, insufficient data in the research, lack of access to the full text of articles and editorial studies.

Study selection and data collection process
To collect the data, first, articles that had one of the above keywords alone or in combination in the title or text were selected. Based on the inclusion criteria, abstracts of the articles published in Persian and English were studied. After removing the articles that did not meet the inclusion criteria, the full-text of all the eligible articles was studied. Then, their results were extracted according to the investigated factor and given to another researcher for review and correction. In total, out of 130 articles, 58 articles were selected and analyzed.

Results
In this study, related findings in the field of investigating surrogate mother’s motivations include the following: economic and social factors, psychological compensation process and restorative motivations, resolving loneliness due to previous failures, solving internal psychological conflicts, interest in experiencing a different type of motherhood (attachment or curiosity), empathy-altruism and spirituality (commitment and care) (Figure 2, Tables 1 and 2).

Table 1. A summary of the research background of articles from other countries about the motivation of surrogate mothers

Table 2. A summary of the research background of articles in Persian about the motivation of surrogate mothers

Financial need and economic independence:
A common assumption in psychosocial research is that if female surrogates are typical, then what conditions lead to the unusual selection of surrogates? A strong reason for this choice may be the financial problem. Almost every study of the surrogate’s motivations looks for sufficient financial hardship in the surrogate’s life. If the surrogate mother has no financial problems, she tries to have a family relationship with the intended parents, which can justify her altruistic motives (33). 
Some studies mentioned surrogacy as a way to avoid financial hardship, have more financial desires, meet severe financial needs, provide the necessities of life, and create a spirit of independence. Also, the financial and economic failures of the spouse may create tense living conditions and a chaotic social situation, therefore these women are forced to engage in various economic activities, including surrogate motherhood. By replacing the mother, these women can improve their living conditions and start a new life (54) in exchange for paying the cost of pregnancy, which includes months of physical conflict and transferring a baby from one woman’s womb to another woman’s arms, which is actually a basic exchange in intimacy. Physical and emotional dependencies and interdependencies are well documented in empirical sociological reports (34). Other surveys demonstrate that most surrogate mothers were poor women who were salespeople, elderly nurses, and even domestic servants, and as surrogate mothers gained various physical and psychological experiences in this field.
Khalaf et al state that handing over the fetus to the couple who owns the baby after delivery may cause anxiety in surrogate mothers and cause psychological problems. Delivering the baby after delivery exposes them to the risk of postpartum depression and feelings of anger and guilt. On the other hand, female surrogate mothers might do this without knowing the various aspects of the issue due to the financial need for the agreed amount to be paid by the couple who owns the baby (49). The study of Dadkhah et al in Iran indicated that surrogate women are generally from the lower social classes and head of the household. It is also possible that surrogate mothers have faced failures and irreparable damages in the society and personal life. This failure is either financial and economical, or biological and social, and they have had a stressful life. After a long time, these women can see the good side of life again and start a new life. Of course, this situation has led to the emergence and confrontation of two opposing worlds. These women in low-income environments may be exploited (29). There is a global discourse on surrogacy in some countries, such as India, which originates from a western perspective and sees surrogacy as the exploitation of women in low-income environments that poverty drives them to become surrogate mothers. The local perspective on surrogacy in India is complex. Majority of people consider paying a surrogate against social norms. The surrogate mother is also often judged morally, either as a “bad mother” for selling her child, or as a “noble woman” who has helped a childless couple and is compensated for her selfless act and service (59). By 2026, the surrogacy business will become one of the most profitable revenue-generating services. Surrogacy has become a booming business in several states of the United States of America, Canada, and Israel, where the use of surrogacy is allowed (60).

Social factors
The surrogacy is the union of science, society and service, made into a reality by the individual. Surrogacy results in a win-win situation for both the infertile couple and the surrogate mother. The infertile couple can fulfill their most important wish and the surrogate mother receives the appropriate reward. For example, in some countries such as India, infertility is known as a social stigma. Mental agony and trauma caused by infertility are strongly felt by the infertile couple. In fact, the factor that causes the individual and the society to show a great desire towards this issue is to eliminate the social stigma of infertility, and doing this is valuable for the society as well. This woman is known as a model woman in the society (61). Bhadaraka reports that the majority of Indian society saw the surrogate mother as a mixture of religion, culture, and science who followed noble services: (1) she showed a strong desire for society by doing something new, (2) she removed the stigma of infertility, (3) she performed her duty by doing something valuable for the society, and (4) she is an example of a model woman in the society (62). Another important social dimension is that the surrogate mother may be exposed to the risk of emotional suffering, but accepting the issue of surrogacy makes her worthy of respect and attention. According to the attitude of some women, their action has caused peace and serenity in families that were suffering from disorder and violence caused by childlessness (40). 
Another point is that surrogate pregnancy, even though it is altruistic, should be considered as a risky psychological experience. There are at least three psychological, social and physical challenges for each party. The risk of birth complications, medical risks, the relationship of surrogate mothers with the social context during pregnancy and delivery, and a close bond established between surrogate mother and the baby during pregnancy may increase the risk of depression and postpartum emotions, since this important bond cannot be easily eliminated. The study conducted in England by Jadva revealed that 32% of the surrogate mothers had emotional and psychological problems for several weeks after delivery (63). Even after the birth of the baby, surrogate mothers were extremely disappointed due to the loss of contact with the baby. They state that from the point of view of human rights, it is impossible not to expect complete lack of communication with the parent and baby couple (11).

The process of mental compensation and reparative motive
Resolving loneliness due to previous failures is one of the dimensions of the psychological aspect. Some women may not have family support, or they may be unhappy with their husbands and have had an unsuccessful married life. In order to eliminate loneliness, not to be far from the community and family, and to remove the loneliness gap, surrogacy appears as an opportunity and they step forward in this process. The choice of surrogacy is the answer to a personal crisis, such as illness, death of parents, or recent divorce. A sense of “existential emptiness” leads them toward surrogacy with the goal of “self-fulfillment” or “filling their lives with something meaningful”. Sometimes the feeling of loneliness and isolation leads them to choose surrogacy in order to create satisfactory social relationships (33). Some research has also shown that solving internal psychological conflicts and compensatory movement may be another motivation for women. Some researchers explicitly reject monetary motivation and try to look for “real” reasons for accepting surrogacy in events such as tragic losses or abuse in the surrogate’s past as a compensatory move. For instance, the search for unfortunate events in childhood, life history, personal relationships of the surrogate, life events related to the reproductive process such as pregnancy loss, abortion, divorce or death in the family can be investigated (64). Some researchers believe that accepting a surrogate may be a restorative motivation for people’s past events. For example, in Parker’s study, approximately 26% of the mothers who had a previous abortion requested surrogacy through a restorative process mechanism (39). Besides, the Kanefield’s study analyzed psychological compensation as the possibility of achieving “self-coherence” to repair “a damaged sense of self” (65).

Interested in experiencing a different kind of motherhood (attachment or curiosity)
Some researchers argue that “the bond between a pregnant woman and her unborn child is usually an integral and appropriate part of her pregnancy”. The claim that there may be no bond and attachment between the surrogates and the carried fetus and the baby is actually deceiving oneself and they are deceiving themselves by thinking that the child is from another couple.
The idea that she is only a caregiver or she is not a mother, is just a claim. When the surrogate mother realizes that an attachment has developed between her and the child, she becomes sad and depressed after abandoning the baby (66).

Maternal-fetal detachment theory (Baslin-gton’s theory)
Baslington’s theory of “mother-fetal detachment” discusses a framework for understanding how some women abandon their babies in the context of paid surrogacy. Some surrogate mothers learn not to get attached to the unborn child or, if feelings arise, to reduce the inner feelings by diverting emotions towards the couple (67). Of course, studies have also reported that surrogates are not saddened by separation from the infant, but each study emphasizes one or two cases in each sample in which a surrogate reports depression after abandonment (33). Ferolino et al’s study also reported high satisfaction with surrogacy process by surrogate mothers and that they had no psychological problems as a result of abandoning the child. The experiential dimension of giving-up the child is an area that needs more study. The experiences of mothers who performed commercial surrogacy for the first time were as follows: 1) performing an act of altruism, 2) experiencing a different type of motherhood, and 3) promoting a positive body image (36,68). In fact, most surrogates report a happy event and do not report any psychological problems as a result of the abandonment. They report high satisfaction with the process and that they would do surrogacy again. A small percentage of surrogacy arrangements end up in litigations (33). The findings of Jadva et al’s study revealed that surrogate mothers usually do not face major problems in their relationship with the ordering couple, in delivering the baby, or from the reactions of their surroundings. The emotional problems experienced by some surrogate mothers in the weeks after birth appear to have lessened over time. In general, surrogate mothers do not seem to experience psychological problems as a result of accepting surrogacy (68).

Empathy-altruism-spiritualism
In non-commercial surrogacy, it is believed that if a woman has a high altruistic motive, she can establish a “gift relationship” with an infertile couple (69). Research has proved that some surrogate mothers have high emotional empathy, which can help an infertile couple (23). In principle, it is better to change the classification of the motivation of past pregnancy surrogates and consider the bold act of surrogacy as a positive social action, which is a complex combination of internal motives (altruism) and external motives (money) (70). In a qualitative study conducted in Iran in 2022, an important dimension expressed by surrogate mothers is receiving the afterlife reward for their actions. The spiritual aspect of this act was considered very valuable among mothers, which seems to be the result of the social and cultural conditions governing the society. In one case, the surrogate mother stated “as long as they pray for me, that is enough”. In this study, surrogate mothers have a strong financial motivation, but besides this main motivation, they also give priority to the spiritual dimension. According to surrogate mothers, the prayers of infertile couples always accompany them, and they hope that with this benevolent behavior, they will gain God’s satisfaction and God’s servant’s satisfaction in the next world. Surrogate mothers have mentioned the blessedness of the obtained money and believe that this money is so blessed that it can overturn their material life and problems (27). In Ghane’s study, the results showed that surrogate mothers were very satisfied and pleased with their motherhood experience. Experience was considered success and divine grace. Also, “all the participants demonstrated a great desire to make the lives of other families happy. Although their own lives might be full of sadness, they were very happy to give a gift to another family (Feminine Sacrifice). They feel good that they convey the feeling of motherhood to a woman to make her happy and they believe that no woman on earth should be deprived of this beautiful feeling (54).

Spiritualism (commitment and care)
Surrogate mother’s religiosity strengthens the feeling of commitment and care of the fetus. Among the Muslim surrogate mothers, the spiritual dimension of helping others has a special place. The majority of surrogate mothers firmly believe in God and consider themselves committed to the child and God. Therefore, during pregnancy, they pray their daily prayers, recite Ayat al-Kursi (Verse 255 of Surah-e-Baqarah) and Quran every day for the child, and during this period, they strengthen their relationship with God. If the infertile couple insists on paying more attention to the divine laws, the child born of this mother will have a spiritual and God-loving approach. For example, a surrogate mother expressed: “Parents’ hope is in me. I cannot be indifferent at all”. Other surrogate mothers said that they are very committed to the child. They meditate in our behaviors and actions and do not consider any difference with the pregnancy of their own children, because from their point of view, this child is the trust of the people and the hope of a family depends on the fate of this pregnancy (27).

Discussion
The purpose of this study was to investigate the reasons and motivations of surrogate mothers for this appropriate decision and to understand the sense of obligation that these mothers feel in taking care of the child during pregnancy. The importance of socio-cultural background plays a key and decisive role in shaping these motivations and understanding them. Previous researches in this regard have mainly emphasized the motivations and financial reasons among surrogate mothers. In Karandikar et al’s study, the surrogate mothers were illiterate women aged 21 to 30, who had an average of 2 surrogates with financial incentives. Surrogates reported that family and wider community stigma forced them to leave home and relocate after surrogacy (71). In another study in India, commitment to surrogacy was generally determined by the surrogate’s husband. The purpose of their participation was to improve the social and economic status of the family. Surrogate mothers face problems and social condemnations because surrogacy is believed to be associated with extramarital affairs (72). In other studies, practices such as surrogacy in “transition economies” such as India have raised concerns about exploitation, commodification, and social stigma (similar to prostitution and slavery). Also, psychological challenges, violation of physical integrity, and jeopardizing of physical health, freedom (73) and humiliation of mothers have been common (64,74). Stephen Wilkinson has criticized the point of consideration regarding the exploitation and immorality of surrogacy. He believes that if we accept the argument of exploitation for banning surrogacy, the commercial performance of this practice remains very weak. This exploitation can occur in many different ways for poor women in society. Furthermore, the ban may be counterproductive, forcing potential surrogates to do other things that are more exploitative and/or harmful than surrogacy. Therefore, those who oppose exploitation should (rather than trying to stop specific practices like commercial surrogacy) focus on: 
1. Improving the conditions under which paid surrogates “work”. 2. Changing background conditions (in particular, unequal distribution of power and wealth) that create exploitative relations. This researcher believes that surrogacy empowers women and improves their status in society (59).
Other similar studies reported that the experience of being a surrogate mother causes “increased self-confidence” or “increased self-respect” (75,76). Purdy analyzed the ethics and performance of surrogate mothers with a “consequentialist” framework and believes that this practice empowers women and strengthens their position in society by providing a job that is less dangerous and more enjoyable than other jobs. Women are forced to try for more social recognition for reproductive work, and the result will be the birth of children, which, in addition to calm the infertile families, will increase social capital (77). Also, “normal” women are “naturally” prone to emotional bonding, and after giving birth and leaving the baby, they feel they regret and may feel depressed and show somatic or psychological signs of trauma loss (66). 
Some researchers believe that commercial surrogacy can also be an altruistic experience for gestational surrogates. Surrogates can be intrinsically motivated to sympathize with infertile couples. They understand the pain of childlessness. In line with the empathy-altruism hypothesis, if people have strong empathic concerns for others, they will help them regardless of what they can gain (78,79). According to the research findings in Iran, not only surrogate mothers are not an exploitative commodity, but they have altruistic and Godly motives. As a respected person, they give life and meaning to others and are considered to have a kind and helpful personality. There is a feeling of altruism that they can make another person happy and in return get a halal income that is approved by the society. 
Also, the desire to have a child is a natural and God-given instinct, thus it is not a process that can humiliate the surrogate woman. In the deep-rooted Islamic-Iranian culture of our society, the mother has a special and respectable place, and with such a view, surrogates are proud of their act of volunteering as surrogate mothers (27). Of course, the negative aspects are also mentioned, that in some situations, the strong biological relationship between the surrogate mother and the child has been challenging. Also, this pregnancy technology, which was once considered a private and family matter, has been transferred to the public and medical field (80,81). Some surrogate mothers, in addition to earning money, consider the result of their performance to be an important factor in their economic empowerment and independence in their personal and social life (77). On the other hand, the results of surveys on surrogacy show that the majority do not approve of this practice and consider surrogacy to be the least accepted among fertility technologies (33).

Conclusion
The use of surrogacy as a means of parenthood has increased. Most surrogate mothers have positive experiences of surrogacy and do not experience psychological problems caused by carrying an embryo for another person. At a glance surrogacy appears to be an attractive phenomenon especially for poor surrogate mothers and brings the infertile couple to their long-standing desire to have a child.  Financial need and independence, social factors, psychological compensation process and restorative motivations, resolving loneliness due to previous and subsequent failures, and altruism-spiritualism has been among the motivations for accepting the responsibility of the surrogate mother. The absence of a suitable law for surrogate mothers and biological parents (applicants) causes them to be profited and exploited by middlemen and commercial agencies. It is understandable that not having children makes couples frustrated. But in some nations, it causes issues such as national and citizenship problems, problems related to surrogate mothers, infertile couples, and children’s rights. It is suggested that considering the human dignity and vulnerability of the surrogate, it is necessary to observe some basic points: 
One is that the possibility of legal communication after birth between the surrogate mother and the intended family should be investigated.
Second, by examining the nature of international surrogacy, it exacerbates many of the potential commodification and exploitation concerns associated with surrogacy and, therefore, should be avoided.
Third, the governments have prevented the international surrogacy tourism and most of the centers should encourage the selection of the host mother from within the community.
Forth, the issue of new assisted reproductive technologies, including surrogacy, and the increasing development of its use, in addition to legal issues, has various social and cultural dimensions, therefore it is still necessary to carry out broader and deeper social research in the cultural and social dimensions of this phenomenon.

Conflict of Interest 
Authors declare no conflict of interest.