Surrogacy is an arrangement in which a woman agrees to conceive and deliver a baby for another couple who becomes the parents of the child. This fertility treatment is also a form of Assisted Reproductive Technology (ART).
The woman who gets pregnant on behalf of the commissioning parents is referred to as the gestational carrier or the surrogate mother. The surrogate mother carries and cares for the baby during the entire pregnancy period until delivery. As soon as the baby is born, she hands it over to the intended parents.
The child born via surrogacy is the natural and genetic offspring of his/her parents. This is a major advantage of the surrogacy treatment over adoption
Surrogacy treatment involves a legal agreement between the surrogate mother, the commissioning parents, and Genesis Fertility and Laparoscopy Centre.
Who needs Surrogacy?
Most couples opt for surrogacy in cases when the female partner is unable to conceive and/or complete the pregnancy to term. Fertility experts recommend the surrogacy treatment to couples where it is medically infeasible or too dangerous for the female partner to conceive and give birth. One essential factor to remember is that either egg or the Sperm should belong to the couple.
There are certain medical conditions where although the intended mother has a good ovarian reserve, she is unable to conceive and/or deliver a baby. Gestational surrogacy is offered to couples when women with either or more of the following issues:
- Genetic absence of the womb
- Anomalies of the uterus
- Women who have had a hysterectomy
- Adhesions in the uterine cavity
- Endometrial lining issues where the embryo fails to implant itself to the lining
- Some women are on prescribed medications (for some other medical condition) that are not safe to be consumed during pregnancy
- Medical problems – kidney disease, heart disease, heart defects, which the woman is stable on, but pregnant can pose a life threatening risk.
- Repeated implantation failures in natural pregnancy or ART fertility treatments
- Recurrent miscarriages
- Advanced maternal age
- Unexplained infertility
What happens during Surrogacy?
1. Initial Assessment – Thorough medical assessment, medical tests including blood tests and ultrasound scans +/- hysteroscopy are performed to examine the intended couple and establish the reasons for their ability to conceive and complete the pregnancy to term. These reports also help make a decision about the feasibility and probability of success rate
2. Finding a Suitable Surrogate – A surrogate mother is identified who also undergoes blood tests, ultrasound scans, and other medical tests to confirm that she is healthy, suitable to complete the pregnancy to term and deliver a healthy child.
3. Legal Contract – Genesis Fertility and Laparoscopy Centre facilitates a legal contract to be processed that serves as an agreement between the surrogate mother, the commissioning parents, and Genesis. This contract is duly signed by all three parties before the surrogacy treatment procedure begin. A responsible member of commissioning couple also needs to sign the contract agreeing to take responsibility of the child born, in case of unforeseen circumstances couple may face and succumb.
4. IVF cycle – Both intended mother/donor and the surrogate are started on cycle at the same time, wherever feasible. The intended mother/donor is given injections to stimulate the development of eggs. There are series of ultrasound scans and blood tests during this 10-12 days time. Once mature, eggs are retrieved by inserting a needle into the ovaries under the guidance of ultrasound scan. This procedure is performed under sedation. Surrogate is started on medication to prepare the lining of the womb, endometrium.
5. Egg Fertilization – The eggs are combined with sperms (male partner sperms or donor sperms) in a laboratory. The fertilized eggs form the embryos that are transferred to the womb of the surrogate mother. If the surrogate mother is not ready at that time, the embryos are frozen and transferred later.
7. Embryo Transfer and Implantation – Through the above mentioned ultrasound scans and blood tests, right time to transfer the commissioning couple’s embryo in the uterus of the surrogate mother is determined. Pregnancy occurs only when the embryo successfully implants itself to the lining of the womb.
Pregnancy is confirmed from the reports of the pregnancy tests that are conducted approximately 14 days after embryo transfer.
Are there any side-effects of Surrogacy?
The surrogacy procedure is performed as a part of an IVF cycle. The embryos that are formed when the eggs and sperms from the commissioning parents are combined in a laboratory are transferred to the surrogate mother instead of the intended mother.
The intended mother is prescribed ovulation stimulating medications before the egg retrieval procedure. This may lead to bloating, cramping, headache, breast tenderness, and mood swings. There is small risk o developing Ovarian Hyperstimulation Syndrome (OHSS) especially is she has polycystic ovaries.
The pregnancy risks are very similar to any other IVF cycle. Numerous studies have been conducted on the babies born through surrogacy and none has hinted towards any ill-effects on the new born. No physical or psychological harms have been reported even in the long run.
Surrogacy involves legal procedures between the three parties involved and these may become overwhelming for the intended parents. We at Genesis Fertility and Laparoscopy Centre, make the best of our efforts to ease all complications and provide a hassle-free procedure by offering transparent and clear guidance utmost for the couple seeking surrogacy fertility treatment.
Are there any alternatives to Surrogacy?
In same cases (1 to 7 in the list above) where the issue is with the uterus or the lining, the only alternative is Adoption. Rest of the 8-11, couple can try further attempts, only after thorough evaluation of reasons behind the failure
Dr Narmada Katakam
MD (OBG) (Osm) PGCertME (UK) DFSRH (UK) CESR (UK) FRCOG (UK) Fertility Specialist & Gynaecologist (Accredited by British Fertility Society, UK) Specialist in Minimal Access Surgery (Laparoscopy & Hysteroscopy)