Gestational surrogacy can make the dream of parenthood come true
Infertility may result, not from the inability to conceive, but to support the developing baby during the pregnancy. Motherhood is still possible thanks to the generosity of women who are willing to carry a baby that is not theirs. This is gestational surrogacy.
Fertility Specialists of Texas works with local and national surrogacy agencies to assist couples in the opportunity to become parents. The process is very similar to those used in donor egg cycles with embryo transfer into the recipient’s uterus. The woman producing the eggs undergoes an IVF cycle and we fertilize those eggs. At the same time, the gestational carrier prepares her uterus for conception with estrogen and progesterone. On the day of transfer, we place a resulting embryo in the uterine cavity of the gestational carrier.
Starting with a gestational carrier
We have relationships with many of the country’s most highly regarded surrogacy agencies. The surrogacy agency conducts the initial recruitment and screening of potential surrogates. It also provides legal referrals and offers administrative assistance during the process. The physician then meets the surrogate and performs an extensive medical screening exam. The process of being a gestational surrogate or gestational carrier involves finding a woman with the following traits.
- Had healthy pregnancies
- Would like to participate in the joy of helping another family have a child
Finding a gestational carrier
We do not underestimate the issues with finding a carrier. A woman who needs to use a gestational carrier often struggles with the emotional issues of being unable to carry her own child. There is also the additional financial burden and challenge of finding a woman who is willing to do this for her.
After passing both screenings, a gestational carrier is available to be matched. Once the agency has matched a couple or individual with a gestational carrier, medical treatment begins. Prior to delivery of the child, the surrogacy attorney files a declaration with the State Courts. This defines that the legal parents are the biological or intended parents and not the gestational carrier.
The first steps of the gestational surrogacy cycle coordination
1. Synchronizing the cycles
Like the female partner, the carrier will take birth control pills to synchronize the two cycles. Instead of medication to stimulate egg development, the carrier requires a medication called Lupron (GnRH agonist). This suppresses ovulation. She also take hormone injections (estradiol and progesterone) to prepare her uterine lining for implantation.
2. Ovulation induction and monitoring of the female partner
We time the start of the ovarian stimulation using oral contraceptive pills (OCP). The female partner takes OCP for 2-4 weeks prior to the beginning of the stimulation. She begins injections of gonadotropins (Follistim, Gonal-F), according to a schedule from the clinic.
Once the follicles (containing the eggs) are ready or mature, the female partner takes an injection of human chronic gonadotropin (hCG). This hormone replaces the woman’s normal LH surge. It is necessary for the final maturation of the eggs so that the sperm can fertilize them.
3. Building the carrier’s lining with hormonal injections
Approximately 4 to 6 days before the anticipated embryo transfer, daily injections of progesterone begin to optimize the gestational carrier’s endometrium for implantation.
4. Egg retrieval
At Fertility Specialists of Texas, we accomplish the egg retrieval non-surgically using a vaginal ultrasound probe to guide a needle into the ovaries. The procedure does not require general anesthesia. Our team performs with IV sedation. An anesthesiologist administers the sedation to maximize comfort and safety.
The final steps of the gestational surrogacy cycle coordination
5. Sperm processing
To comply with Federal regulations, the male partner collects sperm for freezing before the IVF cycle is initiated. He collects a sample after his infectious disease screening. After the egg retrieval, our team prepares the frozen sperm sample for IVF.
6. In vitro fertilization
In vitro fertilization (IVF) literally means “fertilization in glass.” Our team removes the follicular fluid from the ovaries and examines it in our lab for the presence of eggs. These eggs are isolated and placed in culture media where they further mature. A few hours later, the processed sperm are placed around each egg.
7. Embryo transfer to the carrier’s uterus
At Fertility Specialists of Texas, we perform all embryo transfers under trans-abdominal ultrasound guidance. The ultrasound allows for the accurate placement of the embryos approximately 1.5 centimeters from the top of the uterus. We transfer the embryos via a thin plastic tube called a catheter. The catheter is carefully guided into the upper part of the uterus where the embryos are placed. The transfer is a painless procedure and the patient remains resting for 30 minutes, after which she is sent home.
8. Post Embryo Transfer Management and Follow-up
To ensure an optimal environment for implantation, The Carrier continues the hormone injections of progesterone and estradiol during the post-embryo transfer phase. Ten days after the transfer (assuming day 5 embryo transfer), we perform a pregnancy test. If the test is positive, the hormone injections continue for an additional 8 weeks until the placenta is fully functional. A second pregnancy test occurs approximately 8 days after the first to confirm that the pregnancy is ongoing. Confirmation of a clinical pregnancy is made by ultrasound about 2 to 3 weeks later.
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