If you’re considering becoming a surrogate, you are probably asking, “What exactly is the surrogacy medical process?” After all, any medical procedure can seem complicated and even a little intimidating — and the ones involved in surrogacy can seem even more so.
However, the surrogacy medical process is nothing to be afraid of, especially when you work with a trusted medical professional to complete the necessary steps. Proper research and understanding of the IVF surrogacy process before you begin is important to making sure surrogacy is right for you, and this article is a great place to start.
Each surrogacy is unique but, in general, there is a similar step-by-step process for IVF surrogacy, involving screening, testing, preparation, embryo transfer and pregnancy. Learn more about the seven different steps below.
1. Medical Screening
Before any woman can begin the surrogacy medical process, her surrogacy professional (usually her surrogacy agency and the intended parents’ fertility clinic) must make sure she is physically ready for the challenges of surrogacy. Some of this screening is done during a woman’s initial application to become a surrogate, while the rest of the screening is done after she has been matched with intended parents.
So, what exactly does this screening process involve?
- Pap smear and physical
- Bloodwork to check for infectious diseases and conditions that could endanger your ability to be a surrogate
- Hysteroscopy, which is an examination of your uterus and fallopian tubes with a thin scope inserted through the cervix
- Saline sonogram, through which your uterus is flushed to check for fibroids or any other obstructions that would interfere with your pregnancy
- And more
Each medical professional has different standards for prospective surrogates, so what screening steps you have to take will depend upon their particular program. You will also have to complete social or psychological screenings before beginning.
2. Mock Cycle
Before the embryo transfer can take place, your medical professional will need to prepare your body for the IVF surrogacy process. This usually occurs through a mock cycle.
In a mock cycle, you will receive the same medications as those you will take for the embryo transfer process. Your reproductive endocrinologist will then monitor your hormone levels during your cycle to ensure that you are responding appropriately to your medication. You will likely need to undergo bloodwork and ultrasounds to check the lining in your uterus.
Your professional may also do a trial transfer, so the doctor can prepare for inserting the catheter to your body’s specifications during the actual transfer.
3. Preparation for Embryo Transfer
After your professional has completed your mock cycle, they will know more about your body’s needs. Therefore, they can proceed with a transfer process that has the highest chance of succeeding.
If the intended parents are using frozen embryos, the embryos will usually be transferred five days after your mid-cycle. If the intended parents are using fresh embryos, your cycle will need to be synced with that of the intended mother or the egg donor. You may need to take birth control pills and Lupron injections to shut down your hormone production and give your doctors more control over you cycle. Through this, doctors can ensure your uterus is ready at the exact time the embryos are ready for transfer.
At the same time that you are taking fertility medications for a fresh embryo transfer, the egg donor or intended mother will also take fertility medications to stimulate her production of eggs. Healthy, viable eggs will then be retrieved to create embryos for the IVF surrogacy procedure. After screening any viable embryos, the fertility clinic will determine which are the healthiest and when the best time for transfer is.
4. Embryo Transfer
Once the reproductive endocrinologist determines that you and the intended parents’ embryos are ready for transfer, you will complete the relatively quick and painless IVF surrogacy procedure. At this point, you will have stopped taking Lupron injections and started taking progesterone to maintain an appropriate level of hormones for a successful implantation and a stable pregnancy. Progesterone may be administered orally or through intramuscular injections. You will also be taking estrogen replacements at this time, and will generally continue taking these medications until the twelfth week of pregnancy.
Five days past your mid-cycle, your reproductive endocrinologist will transfer the agreed-upon number of embryos to your uterus. The procedure itself is quick and relatively painless; a thin, flexible catheter will be inserted through your cervix, through which a syringe will place the embryos directly in your uterus.
You will often be required to rest for a few hours at the clinic after transfer and a few days after you leave to increase the chances of a successful implantation.
5. Confirmation of Pregnancy
About nine days after the embryos have been transferred, you will return to the intended parents’ fertility clinic to test for your pregnancy through a HCG screening. This test measures your pregnancy hormone levels, and any count over 50 will indicate a positive, stable pregnancy (with counts over 200 possibly indicating a multiples pregnancy).
You will also undergo another HCG test about two days later to ensure that your pregnancy hormones are increasing, as they should double every two days. While you may have taken at-home pregnancy tests before this to measure your HCG levels on your own, these clinic tests will officially confirm your pregnancy.
If you are not pregnant after your first embryo transfer, remember that it’s normal to require another embryo transfer process if the first doesn’t succeed. How many surrogacy IVF transfers you complete will be determined early on in your surrogacy contract.
6. Six-Week Ultrasound
If your pregnancy is confirmed at the clinic, you will follow up with an ultrasound six weeks later to check for a heartbeat. Only once a heartbeat is heard can you start receiving your surrogate compensation.
Once a heartbeat is heard, you will be able to work with your local OBGYN to receive the remainder of your prenatal care. Depending on your fertility clinic and the agreement with the intended parents, you may need to complete another ultrasound at 12 weeks.
7. Prenatal Care & Delivery
Like any other pregnancy, you will need to receive appropriate prenatal care for an IVF surrogacy pregnancy. This can be completed by your local, trusted OBGYN. Depending on the intended parents’ location, they may attend these appointments with you or you may send them updates after each appointment. Once your pregnancy is complete, you will give birth with the intended parents present and complete your surrogacy medical process.
As you can see, there are some important and sometimes complicated steps involved in the surrogacy medical process, but they are all to ensure that your safety and that of the baby’s is protected throughout. Your surrogacy professional will fully explain what your personal surrogacy treatment will look like, based on your surrogacy goals and preferences, before you commit to becoming a surrogate.
During the IVF and surrogacy medical processes, you will work closely with all of your surrogacy professionals to make sure appropriate steps are followed and your surrogacy journey is as successful as possible. Remember, they will all support you to make sure that your expectations for surrogacy are met.