Mental health counseling in third-party reproduction in the United States: evaluation, psychoeducation, or ethical gatekeeping?

The role of mental health professionals (MHPs) in third-party reproduction has grown and evolved in service to patient care and the needs of medical infertility practices. The need for mental health evaluation and psychoeducation has increased as the psychosocial considerations for the stakeholders and families created through gamete donation and surrogacy are increasingly understood and considered. The conflicting definitions of these roles of evaluation and psychoeducation often leave MHPs in the role of de facto ethical gatekeepers in third-party reproduction. Both the medical team and the MHP need to clarify their role effectively, for themselves, as well as any intended parent.