Surrogacy and Gestational Carrier
Surrogacy is defined as the use of a third party female to provide the eggs for a conception and to carry the pregnancy until delivery.
A couple who decides to use surrogacy must make some large sacrifices. The female partner will not have any genetic contribution to the pregnancy and will not get to carry or deliver the pregnancy.
Potential candidates for surrogacy are those women who are in need of BOTH viable eggs and a host uterus. If a woman only needs viable eggs, a better choice is egg donation. If she has viable eggs but is need of a host uterus than a gestational carrier is a better and safer option.
Surrogacy IVF Procedure
Surrogacy uses a straightforward IVF cycle. The surrogate takes fertility medication to stimulate her ovaries; the eggs are retrieved and fertilized with the fresh or frozen sperm of the male partner from the couple desiring pregnancy. The embryos created are transferred into the uterus of the surrogate.
Surrogacy Pregnancy Rates
Surrogacy: Who are the best candidates
A “perfect” surrogate is a woman under 30 years old who is in a stable monogamous relationship. She should have her own children. A surrogate should have a history of pregnancies without complications and vaginal deliveries.
Some of these recommendations are to maximize the chances for delivery of a healthy child. Some of the recommendations are to lessen the risks of having a problem with a surrogate such as one who refuses to give the baby to the couple for whom she carried the baby.
Surrogates can be women who the couple has a relationship with beforehand or who are obtained from a surrogacy agency. A sister or friend who serves as a surrogate is usually a better choice if such a person is available.
A surrogate should undergo the same testing as a woman who has infertility. This includes testing of ovarian reserve, uterine cavity assessment and testing for transmissible diseases. In addition, testing for common genetic mutations and a chromosome analysis is reasonable.
Surrogacy: Legal information
Surrogacy is the riskiest form of third party reproduction. Because the surrogate is considered a genetic parent and since she delivers the baby, several problems have occurred. As of January 1, 2005, the Illinois legislature passed the Gestational Surrogacy Act which was meant to facilitate surrogacy in Illinois and protect the rights of all parties involved.The act defines requirements for a woman to be a surrogate:
- She must be at least 21 years of age;
- She must have given birth to at least one child;
- She must have completed a medical evaluation;
- She must have completed a mental health evaluation;
- She has had independent legal consultation
- She has a health insurance policy that covers pregnancy, the post-partum period and covers major medical treatments and hospitalizations
The intended parents(s) must also satisfy some requirements:
- The intended parents(s) must contribute at least one of the gametes
- The intended parents(s) must have a medical need for the surrogate as evidenced by a qualified physician’s affidavit
- The intended parents(s) must have completed a mental health evaluation and
- The intended parents(s) must have independent legal consultation
If all the requirements are met, it allows the couple desiring a baby to become the legal parents of the baby and provides for some enforcement if any of the provisions are violated.
Gestational Carrier or Host Uterus?
A gestational carrier is defined as the use of a third party female to provide a uterus to carry a pregnancy until delivery. The embryos are created without any genetic contribution from the carrier or host. Typically, at least one of the gametes (sperm or eggs) is from the couple who is trying to have the baby.
Gestational carrier IVF procedures
A gestational carrier cycle can be performed in one of two ways.
The first method is similar to an egg donation cycle. The gestational carrier serves as the “recipient”. The couple attempting to have a child serve as the egg and sperm “donors”.
Medications are used to synchronize the menstrual cycles of both women. The intended parent uses fertility medication to stimulate the development of eggs. The gestational carrier takes medication to prepare her uterus. At the appropriate time, the eggs are removed from the “donor” female are fertilized with her partners sperm (or with donor sperm). The embryos created a cultured in the laboratory for several days and then placed into the uterus of the gestational carrier.
An alternative method uses cryopreservation of embryos. In this technique, the couple trying to have a baby goes through a standard IVF cycle. All of the embryos are cryopreserved (frozen). These embryos are then later thawed and placed into the uterus of the gestational carrier after hormonal preparation.
Gestational Carrier Pregnancy Rates
The chance for success is dependent mostly on the couple who are attempting to produce the child and NOT on the carrier. It is presumed that an acceptable carrier candidate has been found. The age of the female partner who provides the eggs is of utmost importance. In addition, the number of embryos transferred, the ovarian reserve and whether fresh or frozen embryos are used are all important considerations.
Gestational Carrier: Who are the best candidates?
A “perfect” gestational carrier is a woman who is in a stable monogamous relationship. She should have her own children. A gestational carrier should have a history of pregnancies without complications and vaginal deliveries. Her age is less important than it is with a surrogate. However, it should be noted that older women do have a higher incidence of pregnancy complications. This needs to be taken into consideration.
Gestational carriers, like surrogates, can be women who the couple has a relationship with beforehand or who are obtained from an agency. A sister or friend who serves as a gestational carrier is usually a better choice if such a person is available.
Gestational Carrier: Screening
A gestational carrier should have a uterine cavity assessment and testing for transmissible diseases.