Surrogacy Medical Process | American Surrogacy Blog

What Happens After a Miscarriage in Surrogacy

It’s a situation no intended parent or surrogate wants to experience: a miscarriage. While fertility clinics and fertility doctors take every step to make sure an embryo and a surrogate are healthy before the transfer and implantation of the embryo, miscarriages do sometimes occur.

Miscarriages are still a rather taboo topic, but that doesn’t mean they don’t happen. They’re more common than you may think; between 10 and 25 percent of known pregnancies actually end in miscarriage. Rarely is a miscarriage someone’s “fault,” as it’s usually the result of an abnormal embryo that would not have survived to term anyway.

Experiencing a miscarriage during the surrogacy process can be even more devastating because of the time and effort put into creating an embryo and the past failures an intended parent may have had with their own fertility. A miscarriage can seem like an impossible setback, but know that your surrogacy specialist and fertility doctor will be with you as you cope with this loss and decide what to do next.

Intended Parents

For many intended parents, a miscarriage during surrogacy is a reminder of their own past miscarriages or inability to get pregnant. It is heartbreaking to see your dreams fail again, but it’s important to understand the vast scope of the surrogacy process and stay positive.

There is no dramatic difference in miscarriage rates for those who conceive an embryo via in-vitro fertilization. A miscarriage during surrogacy is a natural thing, although that will likely not come as any condolence to you in your grieving process.

If your surrogacy results in a miscarriage, it’s important to take the time you need to grieve (your surrogate will also need time to physically recover before another embryo transfer can take place). This is also a good time for you and your surrogate to reevaluate your thoughts before moving forward; it’s important that both of you are still committed and comfortable continuing the surrogacy process at a time that’s best for both of you. When you’re ready, your fertility clinic will begin the necessary steps for another implantation cycle.

Remember, miscarriage is a common occurrence, and it’s no one’s fault. Your fertility clinic will have usually prepared you for the possibility of a miscarriage, and American Surrogacy will always give you the support and counseling you need to get through this difficult time. We know that it takes time to heal from a difficult loss like this, which is why you and your surrogate have the right to decide together when to start the transfer process again.

Surrogates

If you experience a miscarriage as a surrogate, it’s common to feel like you’ve failed your intended parents. This is completely untrue; a miscarriage is not your fault but instead a natural phenomenon you have no control over. Still, this can be difficult to accept, especially because it’s your body that has expelled the pregnancy.

A miscarriage will not affect your ability to become pregnant again. Your surrogacy contract will state how many transfers you will complete for the intended parents, so it’s likely that you will have another embryo transferred whenever you are physically and emotionally ready. Depending on how far along your pregnancy was, this recovery period may take longer or shorter than you expect. However, it’s important that your emotional recovery is complete before you move forward with another embryo transfer.

It’s normal to feel a range of emotions after a miscarriage, even if the embryo was not genetically related to you. We can always provide you trained counseling to help you cope with these emotions and prepare for your next embryo transfer, whenever you’re ready. Usually, within the first three transfers you complete with your intended parents, one embryo will result in a successful pregnancy and birth — so, while it may be tempting to give up after this disappointment, remember that it’s highly likely you’ll find success in your subsequent transfers.

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Remember, surrogacy is a marathon — not a sprint. It’s a long process that will come with many emotional ups and downs, which is why American Surrogacy’s specialists will be there for you every step of the way. Miscarriage is always a difficult event to process but know that it’s not the end of the line. A successful surrogacy is possible, and we’ll help you complete it.

What to Expect When Testing for a Surrogate Pregnancy

Everyone knows: The surrogacy medical process is long and can seem to take forever. After months of testing and measuring cycles in preparation for the embryo transfer process, waiting for a positive pregnancy result after the transfer can seem like an impossible feat, no matter whether you’re the surrogate or the intended parent.

When you’re in the middle of the surrogacy medical process, your fertility specialist will explain in detail what to expect. But, what if you haven’t started the process or want more information on exactly what to expect when testing for a positive surrogate pregnancy?

You can read more below about what happens during the testing process for a surrogate pregnancy. As always, we recommend speaking to your surrogacy specialist and fertility specialist for more detailed information about what your personal medical process will look like.

The Clinical Process

After a surrogate’s embryo transfer process is complete, her fertility clinic will eventually test for her pregnancy with an hCG level blood test. hCG levels are the hormone levels that determine if a woman is pregnant or not. How high a surrogate’s level needs to be, however, will depend upon her individual situation, including when the embryos were transferred during the incubation period and how many days have passed since the transfer was completed.

But, how long before you can expect a result?

How long a surrogate needs to wait before a beta blood test will depend on the fertility specialist’s instructions, but the first testing process usually occurs anywhere between eight to 12 days after transfer. If hCG levels indicate a surrogate might be pregnant, she’ll return a couple of days later for another blood test to see if the levels keep rising. Ideally, hCG levels should double every 48 to 72 hours.

If her levels rise enough, the fertility specialist will likely confirm the pregnancy. This is usually confirmed after the third beta appointment.

Home Pregnancy Tests: Are They Worth It?

If you’re a surrogate who is part of online support groups, you may see other surrogates post pictures of multiple home pregnancy tests from different testing times. But, if all surrogates know for sure at a fertility clinic testing whether their pregnancy is positive or not, why do they do this?

Taking home pregnancy tests is just another way for surrogates to track their increasing hCG levels. Typically, women will wait three days after an embryo transfer to take a pregnancy test — although it can take at least five days after transfer for a positive pregnancy test to show up. From there, surrogates may take a test twice a day to compare the results; if a pregnancy line is getting darker, it’s usually a sign that their hCG level is rising and they are, indeed, pregnant.

While some surrogates will wait until their clinic beta testing just to be safe, other surrogates are anxious to see whether the embryo transfer worked. This comes from the desire and hope riding on their pregnancy, so it make sense that they want that validation, even if they wait to tell intended parents until a medical confirmation.

However, it’s important to note that just because a home pregnancy test comes back positive does not mean a pregnancy is in the clear. You may receive a false positive reading, or there may be other medical issues that arise later on. So, while home pregnancy tests are a good way to relieve anxiety after an embryo transfer, it’s always a good idea to rely on your fertility clinic for a secure medical result.

If you ever have any questions about testing for your surrogate pregnancy and the process involved, we encourage you to reach out to your fertility specialist for accurate, personalized information.

What is Preimplantation Genetic Screening in Surrogacy?

You may have heard that an important part of the surrogacy medical process is the preimplantation genetic screening, or PGS. But what exactly is PGS, and why does it need to occur?

PGS is the medical process that determines whether an embryo is healthy enough to be transferred to a surrogate’s uterus. Rather than chance a miscarriage or the birth of a child with a genetic condition, PGS allows fertility professionals to gauge the health of an embryo ahead of time — reducing the likelihood of unsuccessful results.

PGS examines the specific chromosomal makeup of each embryo. This is where genetic disorders or conditions can be detected. If an embryo does not have the proper number of chromosomes (26 — 13 from each parent) or seems to have another abnormality in chromosomes, it is known as an aneuploid or abnormal embryo. These embryos are usually not suitable for implantation, and a fertility specialist will seek out another normal embryo instead.

PGS is usually completed in all surrogacy processes, no matter the genetic history of the intended parents or gamete donor (some intended parents who have already completed IVF will have completed this screening, as well). While the screening does help to confirm whether either parent is a carrier for a genetic condition or passes on increased chromosomal abnormalities because of their age or other factors, it’s also completed for the safety of the surrogate. By screening multiple embryos from the intended parents, fertility specialists can choose the healthiest one for transfer — eliminating the need to transfer multiple embryos “just in case.” This protects the surrogate from the risks of carrying multiples.

So, how does PGS work?

The PGS process takes place after embryos have been successfully fertilized and incubated. About 5 to 7 days after the fertilization process, fertility specialists remove certain cells from the embryo that will eventually develop into the placenta (this does not impact the development of the embryo). These cells are passed along to a laboratory, where specialists examine them for chromosomal abnormalities. Results are usually made available to the fertility clinic and intended parents after 7 to 10 days.

While intended parents have the chance to choose their fertility clinic, they usually will use the genetic screening company that their clinic has already developed a partnership with.

It’s important to note that PGS does not screen for specific diseases but just for at-risk embryos with genetic abnormalities (some chromosomal conditions, like Down’s syndrome, are easy to detect by counting chromosomes). To identify diseases, intended parents and their fertility clinic may instead choose to complete pre-implantation genetic diagnosis, which screens for single-gene defects. Both PGS and PGD can be performed at the same time.

Keep in mind that neither of these processes are a replacement for prenatal screening later on in a pregnancy.

Why is PGS in surrogacy so important?

While genetic screening can be important in every in-vitro fertilization pregnancy, it’s especially important in surrogacy. Because the woman carrying the child is not the intended mother, it’s important that her safety is protected, as well. Completing PGS makes sure only the best embryos are transferred to her uterus, decreasing the chance that she experiences a miscarriage or other pregnancy complications later down the line.

It’s also helpful for the intended parents, who may have already gone through years of infertility before deciding on surrogacy. By only transferring the best embryos, they reduce the chance they will experience more disappointment if an embryo does not successfully implant.

When you work with American Surrogacy and the fertility clinic for your surrogacy process, we will coordinate to make the embryo transfer process as safe and efficient as possible. Your surrogacy specialist will always be there to offer you advice and support, especially if your genetic screening and IVF process takes longer than anticipated.

To learn more about how American Surrogacy will coordinate with your fertility clinic, or to learn more about the medical process of surrogacy in general, please contact us today.

The Truth About Genetic Modification of Embryos

A U.S. team of scientists made headlines this summer when they were the first to successfully correct a disease-causing mutation in a human embryo. While the embryo was not and never intended to be transferred into a uterus for implantation, the announcement did open up a larger discussion about genetic modification of embryos and its future moving forward.

There is a lot of confusion today in the U.S. about genetic modification of human embryos and an even greater ethical conversation about this practice. If you are considering entering into the surrogacy process, whether as an intended parent or a prospective surrogate, it’s important you understand the realities of this scientific find and what it may mean for surrogacy moving forward.

The best source for information about genetic modification of embryos will always be a fertility specialist, as they can explain in detail not only which processes are possible but which are available at their own organization. But, to help you grasp the basics of the process, we’ve answered a few of your questions below.

What Kind of Genetic Modification is Available?

In the U.S. today, it is illegal to perform genetic modification on a human embryo for the purpose of implanting it in a woman. While research is allowable for scientists as long as they destroy the experiments and don’t receive federal funding, genetic modification for intended parents is not a possibility.

But, just because an intended parent cannot genetically modify their embryos does not mean they are limited to unhealthy possibilities. In fact, it is common today for embryos created in vitro to undergo preimplantation genetic screening. This screening tests for chromosomal abnormalities and certain genetic diseases, which means intended parents can avoid transferring an embryo that is not desirable — i.e., one that has a genetic disorder or another mutation that will prevent it developing to term.

Your fertility specialist can give you a better idea of what kind of screening and testing can be done to ensure a healthy embryo for transfer.

Could Genetic Modification Play a Role in Creating “Designer Babies?”

One of the concerns that people have about scientists moving forward with genetic modification of human embryos is what they see as a potential for “designer babies” — embryos that are modified for not only dangerous mutations but also characteristics like eye color, height and more.

However, the National Academy of Sciences (an organization of leading researchers) explicitly states that genetic modification should never be used for enhancement purposes. In addition, researchers have not yet isolated genes for those kinds of traits, making any modification of them impossible. Any researchers who are testing genetic modification focus on more critical characteristics, like disease-causing genes, and are well aware of the ethical concerns of focusing on more superficial traits.

When Can I Expect Genetic Modification to be Available?

While genetic modification could theoretically be applied to thousands of genetic diseases, the testing behind approval of this technique will take years — especially because of the restrictive U.S. laws and lack of funding regarding this technique. Therefore, it’s likely that genetic modification for many traits and diseases will not be available until at least the federal laws on the practice are changed.

In the meantime, methods like preimplantation genetic screening and egg, sperm and embryo donations can help reduce the likelihood that a child is born with genetic diseases and disorders. For more information about how you can have the healthiest child possible through the surrogacy process, contact a surrogacy professional and a fertility clinic.