IVF Surrogacy: How a Gestational Carrier Can Help Infertile Couples
In some cases, infertility is not the result of an inability to conceive, but an inability to support the developing fetus during gestation. For women who, for medical reasons, cannot carry a pregnancy to term, motherhood is still possible, thanks to IVF technology and the generosity of women who are willing to carry a fetus that is not theirs. Surrogacy with a gestational carrier offers infertile couples the opportunity to become parents, despite an inability to become pregnant.
Understanding Traditional and IVF Surrogacy
Traditional surrogacy involved the artificial insemination of the surrogate with the sperm of the intended father. In these arrangements, the surrogate shared a genetic link to the child she carried, resulting in extremely complex and controversial ethical and legal issues. This type of surrogacy is therefore rarely practiced in today's fertility clinics. Fortunately, in vitro fertilization technology allows for a procedure known as gestational or IVF surrogacy. This involves the transfer of embryos created from the eggs and sperm of the intended parents into the uterus of a gestational carrier. Unlike a traditional surrogate, a gestational carrier has no genetic link to the child she carries.
Indications for IVF Surrogacy
When a woman has a good supply of healthy eggs but is medically unable to carry a pregnancy to term, gestational surrogacy may be an option. Possible indications for IVF surrogacy include absence or malformation of the uterus, a history of recurrent pregnancy loss, or any medical condition that makes pregnancy dangerous or impossible for the mother.
Choosing a Gestational Carrier
Unlike egg donation, which is generally kept anonymous, gestational surrogacy involves a long commitment and unique relationship between the parents and the carrier. For this reason, it is important for patients to select a gestational carrier with whom they feel comfortable and share common ground. A number of interviews and meetings may be held for the parents and the surrogate to get to know each other before an agreement is made to move forward.
Gestational carriers should be between the ages of 21 and 35 and must have already delivered a live infant at full term. Medical and psychological screening will be required for the intended parents, the gestational carrier, and her partner. These are to ensure that there are no conditions present that may jeopardize the carrier, the fetus, or the agreement.
Once a gestational carrier is selected and the screening process is complete, legal documents must be drawn up, specifying the rights and responsibilities of each party, as well as how disputes will be settled. Even if the carrier is someone who is known to the parents, such as a family member, these documents are imperative.
The IVF Procedure
When all of the agreements have been made and the parties are ready to move forward, the IVF surrogacy procedure can begin. Like egg donation, gestational surrogacy requires synchronization of the two women's cycles. While the mother is receiving fertility medication to stimulate the development of ovarian follicles, the gestational carrier will also be given medications to control the progression of her cycle and keep it as close as possible to that of the mother. Both women will be closely monitored during this process.
Once the oocytes are ready to be collected, the egg retrieval procedure will take place, followed by in vitro fertilization with the father's sperm. The embryos are then placed in incubation and observed as normal.
As in standard IVF, the embryo transfer procedure takes place three to five days after fertilization. The only difference is that the selected embryos are placed into the uterus of the gestational carrier instead of the mother.
Pregnancy and Childbirth
During pregnancy, the intended parents will provide emotional and financial support for the gestational carrier as outlined in the contract. The amount of communication and interaction between the parties varies by case and should be one of the issues agreed upon before the procedure is begun.
Once the child is born, he or she is returned to the biological parents.
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