Background: Germany has no legislation on reproductive medicine, but more and more voices speak up for it. Such legislation should include regulations for surrogacy and oocyte donation.

Objectives: What is a fair balance between reproduction autonomy, medical possibilities and the risk of exploitation? How does this trade-off differ in the case of surrogacy and oocyte donation?

Methods: A synopsis of the literature from medicine, law, the social sciences and ethics is provided.

Results: Surrogacy and oocyte donation offer many couples the only chance to fulfill their desire to have children. Current research suggests that these practices do not pose risks to the welfare of the child. In the case of surrogacy, it is difficult to distinguish altruistic from commercial motivations. There is a considerable risk of exploitation resulting from social inequalities. Furthermore, surrogacy is much more invasive than oocyte donation.

Conclusions: There are strong reasons for the continuation of restrictive rules on surrogacy. However, oocyte donation should be allowed and regulated appropriately.