The recent announcement by popular television Anderson Cooper that he will be co-parenting via surrogacy a baby boy, Wyatt, elicited nearly universal congratulations. What could be happier than the birth of a child?

The happy announcement, however, blurs some difficult questions about a largely unregulated surrogacy industry that critics say puts women's health at risk and leads to the commodification of children. A plethora of ethical questions accompanies the birth of the child. But since most Americans seem to view both in vitro fertilization (IVF) and surrogacy as unalloyed goods, those questions are often not discussed—or even raised.

But they are important questions. We as a society ought to feel comfortable candidly discussing them.

First, surrogacy usually involves mystery. Who is the child's father? Who is the child's mother? Even if we know who provided the sperm, we still do not know who provided the other half of a surrogate child's genetic make-up: the surrogate who carried him or another woman who was paid to deliver eggs? And that's "eggs," in the plural, because surrogacy requires IVF—which, in turn, requires the manipulation of multiple eggs and sperm until a sufficient number of embryos are produced so as to increase the likelihood of uterine implantation.

Women generally produce only one egg at a time, once a month. But this biological reality makes for an inefficient supply chain-to-market process, so industry leaders tend to rely upon hyper-ovulation, in which a woman's reproductive system is prodded into producing upwards of a dozen eggs at one time. This is a painful and sometimes dangerous process. Jennifer Lahl, former nurse and outspoken critic of surrogacy, says the documented risks include loss of fertility, ovarian torsion, blood clots, kidney disease, premature menopause, ovarian cysts, chronic pelvic pain, stroke, reproductive cancers and, in some cases, death.