WHAT IS KNOWN ALREADY
Because no research has been conducted on single fathers who used surrogacy, their characteristics, motivations and experiences are unknown.
STUDY DESIGN, SIZE, DURATION
This study used a cross-sectional design as part of a larger, multi-method, multi-informant investigation of single father families created by surrogacy. Multiple strategies were used to recruit participants (i.e. from an association of gay parents, Facebook groups of single parents and snowballing) between November 2016 and April 2017. Data were obtained from 33 Italian single fathers (Mean age = 47.33 years, SD = 4.63), most of whom self-identified as gay (n = 24, 72.7%).
PARTICIPANTS/MATERIALS, SETTING, METHODS
In-depth semi-structured interviews were conducted in family homes (n = 20, 60.6%) or over Skype (n = 13, 39.4%). Each interview lasted approximately 40 min and was audio recorded, transcribed verbatim and analyzed using thematic and qualitative content analysis, with the aid of the software package MAXQDA. Where appropriate, a two-sided Fisher's exact test was used to compare the gay and heterosexual fathers, and illustrative quotations were reported.
MAIN RESULTS AND THE ROLE OF CHANCE
Although all of the single men had experienced mature relationships, about one-third of the fathers (n = 10, 30.3%) had never thought of having a child and the majority of the heterosexual men (n = 7, 77.8%, P = 0.05) had tried to conceive in previous relationships. The gay and heterosexual men differed in their preferred path to parenthood (P = 0.01), with the former (n = 17, 70.8%) having always preferred surrogacy and the latter (n = 6, 66.7%) having considered or attempted conception via casual sex with women. Irrespective of their sexual orientation, most of the fathers chose surrogacy because they wanted a genetic relation to their child (n = 28, 84.8%) and because they felt that surrogacy would be more secure compared to adoption, upon their return to Italy due to Italian laws (n = 26, 78.7%). The majority (n = 20, 60.6%) were satisfied with their decision to ‘go it alone’, although nearly all (n = 16, 80%) would have preferred to have a child within the context of a relationship. After their child's birth, the majority received support from both their parents/siblings (n = 21, 63.7%) and friends (n = 24, 72.7%).
LIMITATIONS, REASONS FOR CAUTION
The risk of socially desirable responding should be taken into account when interpreting the findings, given the ethical concerns surrounding single fatherhood and surrogacy. Furthermore, fathers with a negative surrogacy experience were less likely to participate in this research. The small sample and participant characteristics of older age, an Italian nationality, a mainly gay sexual orientation and high income may limit the generalizability of the findings.
WIDER IMPLICATIONS OF THE FINDINGS
This study is the first to provide insight into the reproductive experience of single men seeking surrogacy. The findings warn practitioners and policy-makers against making assumptions about people with access to fertility treatments on the basis of marital status, gender or sexual orientation.