It takes careful planning and coordination to become pregnant as a gestational carrier. From a thorough medical screening to a precisely-timed embryo transfer, each step of the medical surrogacy process is crucial to achieving a successful pregnancy.
Here, learn more about the various medications and procedures involved in the surrogacy medical process.
Before the Surrogacy Treatment: Surrogate Medical Screening
When you find the perfect intended parents to carry for, you will likely be eager to move forward with the surrogacy process. But before signing legal contracts and beginning medical procedures, you will need to complete a final medical screening to ensure your body is truly ready for the journey ahead.
Generally, the surrogate medical screening includes:
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a review of your medical/social history
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a pap smear and physical exam
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an infectious disease screening and other bloodwork
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a hysteroscopy to determine the shape and size of your uterus and ensure the fallopian tubes are unobstructed
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a saline sonogram, which flushes the uterus with saline solution and allows your doctor to identify fibroids or anything else that might interfere with pregnancy
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and more.
American Surrogacy is required to screen prospective surrogates according to standards set by the American Society for Reproductive Medicine (ASRM). Once a physician confirms that you meet these standards, you will be ready to start preparing for the embryo transfer.
Preparing for Conception with Fertility Medications
In a traditional pregnancy, a woman’s body produces several different hormones to help prepare her uterus for conception and pregnancy. In surrogacy, this process is recreated using supplemental hormones and other fertility medications. These medications allow doctors to coordinate and control a surrogate’s cycle and ensure the highest chance of a successful pregnancy.
Every woman is different, and your course of treatment may vary depending on your physician and your individual circumstances. Here are some common medications you may be prescribed to help prepare your body for the embryo transfer:
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Doxycycline: an antibiotic used to treat low-grade pelvic infection and prevent the body from rejecting the embryo when it is implanted. Usually taken as an oral tablet administered before and after the embryo transfer.
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Lupron: used to prevent the surrogate’s natural cycle from interfering with the surrogacy process by temporarily “shutting down” the ovaries and preventing ovulation. Usually taken as a self-administered injection prior to the embryo transfer.
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Estrogen: a hormone used to thicken the uterine lining and coordinate the surrogate’s cycle with the intended mother’s or egg donor’s cycle. Usually taken in the form of birth control pills prior to the embryo transfer and through the first 12 weeks of pregnancy.
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Progesterone: the hormone produced by the ovaries after ovulation to help prepare the uterus for embryo implantation. Usually administered by intramuscular injection in the days prior to the embryo transfer and through the first 12 weeks of pregnancy.
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Aspirin: sometimes used to assist with cycle stimulation and improve the chance of implantation. Taken as an oral tablet during the first 12 weeks of pregnancy.
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Tetracycline: an antibiotic taken as an oral tablet a few days prior to the embryo transfer to prevent infection and rejection of the embryo.
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Medrol: a low-dose steroid used to suppress the autoimmune system and decrease the risk of embryo rejection.
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Prenatal vitamins: often taken before the transfer and throughout the entire pregnancy to ensure the surrogate and baby are getting the proper nutrients.
By taking these and other prescribed medications and following all instructions provided by your doctor, you can help prepare your body for a successful surrogate pregnancy.
IVF and Surrogacy: The Embryo Transfer Procedure
While your body is preparing for transfer day, your doctors will also be preparing the embryos using in vitro fertilization (IVF). In gestational surrogacy, IVF is used to combine the intended mother’s (or donor’s) eggs with the intended father’s (or donor’s) sperm.
In a traditional pregnancy, it takes a fertilized egg (embryo) about five days to transfer through the fallopian tube before implanting. To mimic this process in surrogacy, the embryos are incubated for five days following IVF and transferred to the surrogate’s uterus five days after her mid-cycle.
On the day of your embryo transfer, your doctor will transfer one or two embryos based on your agreement with the intended parents. A long, flexible catheter will be inserted through your cervix to place the embryo in your uterus. An abdominal ultrasound may be used to ensure exact placement.
The embryo transfer is relatively quick and painless, and anesthesia is not required. However, you will be required to be on bed rest for 48 hours and may need to rest for a few days following the procedure.
Monitoring and Confirming Your Pregnancy
A week or two after the embryo transfer, you will return to the fertility clinic for a pregnancy test. Your doctor will do an HCG to measure your pregnancy hormone levels and determine whether the transfer was successful. Remember that several embryo transfers may be required before you achieve a successful surrogate pregnancy.
If your HCG levels are positive, the fertility clinic will schedule additional blood tests and ultrasounds to confirm and monitor your pregnancy. Once a healthy pregnancy is confirmed and the fertility specialist feels comfortable, you will be released to your own OBGYN to begin receiving regular prenatal care.
Continuing Prenatal Care
Once a healthy pregnancy is confirmed with your six-week ultrasound, your experience will likely not be much different from any other pregnancy. However, you may continue taking certain hormones and medications through the first trimester, and you may have more frequent prenatal appointments to ensure the pregnancy remains stable.
At this point, your job is simply to remain healthy throughout your pregnancy — eat well, stay active, and get plenty of rest — and of course, enjoy the journey.
The surrogacy medical process may seem daunting at first, but American Surrogacy will be with you every step of the way. To learn more about medical surrogacy procedures or to begin your own surrogacy process, contact a surrogacy specialist today.