Surrogacy is an arrangement in which a woman carries a baby for another couple. The couple in question may face several infertility related issues and therefore seek the help of another woman (gestational surrogate) who undergoes the embryo transfer process and carries the pregnancy to term for them. Gestational surrogacy is possible with the intended mother’s egg or with an egg donor and the treatment is combined with IVF/ICSI. From the medical perspective, the process is very similar to egg donation or recipient treatment cycles. In this medical procedure, a fertilized egg is implanted in the woman who carries it to full term. This is a process that must be done with full consent and proper information of all the parties involved.
There are two main types of surrogacy in practice, traditional and gestational surrogacy. Traditional surrogacy uses the surrogate’s own eggs for the fertilization process. This means that the surrogate will be genetically related to the child that she gives up. Gestational surrogacy uses the adoptive mother’s eggs. This way the baby and surrogate are not genetically related. Gestational surrogacy is preferred because it prevents legal complications from arising in the future.
In almost all cases, the gestational surrogate is always known by the couple and is never anonymous like in the case of an egg or sperm donation. The intended parents of the child will also be involved with the pregnancy right from the time of pregnancy till taking over parental responsibilities after delivery. All gestational surrogates must undergo intensive screening procedures such as blood tests, medical evaluation, uterine evaluation, genetic screening and psychological screening. If everything goes as planned, surrogacy is a medically low risk procedure with a high success rate.
There are a number of situations that make it impossible for a woman to carry her own child to full term.
The first set of conditions includes those that affect the uterus. Mllerian agenesis is a congenital condition that causes a woman to be born without a uterus. A hysterectomy is the surgical removal of the uterus and is usually performed to address cancer. Asherman’s syndrome causes the formation of scar tissue after inter-uterine surgery. Malformations in the uterus can prevent IVF or increase the occurrence of miscarriages.
The second set of conditions is those that make carrying a fetus to full term difficult or impossible. Inexplicable and, therefore, untreatable repetitive miscarriages make gestation impossible. Additionally, it includes circumstances where the mother has any medical conditions that would make pregnancy life threatening for her, baby or both such as heart disease, breast cancer, severe diabetes, and others.
Only a qualified fertility doctor can recommend gestational surrogacy. They may recommend a suitable facility or run one themselves. The prospective couple will need to undergo psychological screening to ensure that they fully comprehend the procedure, the risks, and potential complications, both short and long term. The couple will then be shown profiles of surrogates for them to select a suitable one.
It is possible to use someone you know; however, there can be complications later in terms of the future role in the child’s life. A meeting will be arranged with the surrogate. If there is an understanding, surrogacy lawyers are brought in to draft the agreements and represent parties interests.
Once these prerequisites are in place, the next step is synching menstrual cycles through hormone therapy and preparing the surrogates womb for implantation. Sperm and eggs will be taken, fertilized, and monitored for viability of resulting embryos. The best embryos will be implanted into surrogate’s uterus. These will be monitored until a heartbeat is detected. This is a highly specialized process and needs to be undertaken by experts who take extreme caution at each step to develop a healthy baby.