In recent years, general willingness to procreate and actual fertility rates have declined. By 2050, for various reasons, half of the pregnancies in developed countries could occur through surrogacy. With increased environmental pollution and life stressors, many women of childbearing age are more reluctant to conceive. Economic factors also play a role, as many women choose to devote themselves to their careers instead of being pregnant wasting time. This leads to the possibility that they may have their own children through surrogacy. Additionally, the sexual minority community is growing and many within it desire biological families, but cannot achieve this goal without surrogate support. However, surrogacy presents many problems.

The most important concern with surrogacy is the health of the mother and the baby. The surrogate mother must ingest certain drugs to prime her uterine environment for conception, such as doxycycline and lupron. However, these drugs can harm her health and cause  Gestational diabetes and Damage to reproductive organs. The child too is exposed to the same risk, as they are not born through natural means, but in an artificial, drug-assisted way. 

Physical health is not the only concern. Surrogacy can cause mental distress for both the surrogate mother and child. The surrogate, who has experienced the miraculous state of being pregnant, will probably have deep affection for the newborn, but must surrender the baby to the new mother or father. This is likely to result in emotional deprivation for the surrogate mother. The video “BABY” published by Chen KaiGe in 2020 tells the story of Shan who felt a strong bond with the baby during her pregnancy, and decided she wanted to keep him, but the baby's biological mother, Jia, was obviously unwilling to give up the baby. As a result they started a series of disputes. In the end, the baby was returned to the child's biological mother, but the surrogate fell into deep pain because of the emotional relationship with the child. Similarly, a child who has lived in the uterus of the surrogate for nine months will also have a natural emotional attachment to the gestational mother. This bond will be severed rather abruptly at birth, resulting in potential harm to the baby’s future mental health. A study done by the University of Cambridge suggests that it’s more difficult for children to deal with the idea that they grew in an unrelated woman’s womb, than with the concept that they are not biologically related to one or both parents. 

Moreover, surrogacy presents complex legal issues. If it becomes apparent that the child being conceived is disabled or born with disease, some biological mothers may abandon it, causing the child to become orphaned. According to Reuters, in China, around 10,000 children are abandoned each year, many of them are abandoned because they were born with a disability or a disease . Conversely, the intense emotional bonds formed during pregnancy may cause the surrogate mother to rethink her decision and even forfeit the payment she had been expecting, resulting in another kind of legal tangle. It is not uncommon for surrogate mothers and contractual parents to fight for custody and head to court for an often-contentious battle.

The final consideration comes from the perspective of social ethics. Surrogacy is an act of human objectification. In other words, surrogacy treats people like commodities. When a person's uterus can be measured in money, it leads to exploitation of the weak by the strong. Once the surrogacy is contracted, a woman (especially a disadvantaged one) can sometimes be perceived as evolving from a human being into a "human uterus," a marked price commodity awaiting a transaction. For example, according to Toutiao.com, nineteen women in Nigeria were finally rescued from forced surrogacy 'baby factories' in 2019. Surrogacy can certainly be contrary to women's liberation.

The disadvantages of surrogacy are obvious. It appears clear that surrogacy alone cannot solve the problem of diminished fertility. Of course, surrogacy can work well for couples who have no health risks and no other options, but that surrogacy should be considered very carefully. If developed countries want to completely solve the problem of low fertility rates, they should guide people to change their perspectives (actively promoting natural fertility) and improve natural environments (controlling pollution), rather than through surrogacy.