What Gestational Surrogate Needs to Know

Serving as gestational surrogate for an infertile couple to create a family is a something not everyone can do. It requires investment of emotions and few other complexities to deal with. 

There are certain things a gestational surrogate needs to know,

First, any woman serving as surrogate needs to that there is great range of medical information available.  

1. Eggs of surrogate are not used in gestational surrogacy

The eggs, or oocytes, come from either the intended mother or a third-party egg donor. This is why we call it “gestational surrogacy,” not “traditional surrogacy.”

2. Necessary routine tests

Gestational surrogate would need to undergo vaginal ultrasound that allows the physician to examine the uterus. There are chances the surrogate may be asked to have a hysteroscopy — in which a tiny camera painlessly examines your uterus — or other procedure to determine the general health of your uterus. Routine blood tests will be given to rule out the presence of communicable diseases such as AIDS, herpes, and hepatitis. You will be asked to provide an up-to-date pap smear, and might be requested to have a mammogram done.

3. Embryo formation

As a gestational surrogate, you will be given several medications to help prepare your uterus to receive the embryo. These medications may include standard birth control pills (at the beginning of your menstrual cycle). You will be started on estrogen at about the time the intended mother or the egg donor is being induced to ovulate if the embryo transfer cycle is a coordinated or “fresh,” one. Then, just before her eggs are harvested, you will begin on another hormone — progesterone — to further prepare for implantation. 

Normally, you will be required to continue to take hormones, usually by injection, even if the embryo transfer is what we call a “frozen” cycle, where the embryos have already been created and are frozen for future use by the intended parents. Remember, this is meant to be general guidance here, and is not meant in any way to be giving medical advice or instruction.

4. In Vitro Fertilization, or IVF

In this, hormones are given to the intended mother or the egg donor to induce ovulation, and her eggs are harvested via aspiration guided by vaginal ultrasound. Then, from 50,000 to one million sperm are mixed with the eggs and incubated, so that fertilization can occur. When the timing is right, the resulting embryos are transferred into your uterus, as the gestational surrogate. 

5. Embryo transfer

The embryo is carefully flushed in the liquid medium for transfer through your cervix into your uterus. Sometimes, the doctor will use ultrasound to help with placement of embryos, and afterward you may be asked to remain lying-down for a period of time.

6. Blood tests

After two weeks of embryo transfer, a simple blood test will be performed to confirm pregnancy — at which point both estrogen and progesterone medication may be continued.

Dr Neeraj Pahlajani