Moving from infertility to surrogacy is a big decision. Understanding all the options available to you is the best way to make the right decision.
Deciding to move from infertility to surrogacy is not an easy decision for most intended parents. This is understandable given that many intended parents have usually spent years trying to conceive without success. So, what options are left to them after failed IVF? One option might be surrogacy: another, egg/sperm donation.
Sometimes, surrogacy might be the last chance for the intended parents to have their own biological baby. Nevertheless, many IP’s usually feel terrified by the thought of another woman carrying their baby. They may also question if surrogacy is the right choice for them and their family. In any case, the intended parents should learn as much as possible about the surrogacy process. Let’s explore some of the major points of the process below.
Surrogacy is a form of assisted reproductive technology that involves a woman (called a surrogate) carrying the intended parents baby through pregnancy. (Note that “intended parents” can mean a couple or an individual.)
In addition, when we talk about surrogacy, it is vital to understand its two main forms: traditional surrogacy and gestational surrogacy.
Traditional Surrogacy:
In Traditional Surrogacy, the woman carrying the fetus also provides the egg which is often fertilized via Artificial Insemination (AI) using sperm from an intended parent or a sperm donor. Also, it should be noted that the traditional surrogate is genetically linked to the baby because she provides the egg for fertilization.
Gestational Surrogacy:
On the other hand, gestational surrogacy results from in vitro fertilization (IVF). The gestational surrogate has no genetic connection with the baby as she does not provide the egg. Instead, the egg comes from an egg donor or the intended mother. The egg is fertilized by the sperm of the intended father or a donor through in vitro fertilization and then transferred to the gestational carrier.
Nowadays, this form of surrogacy is the most common due to the emotional and legal implications of the genetic connection between the traditional surrogate and the baby. 
What Is IVF?
This is an assisted reproductive technology that involves two basic steps:
- creating an embryo by fertilizing an egg with sperm in a laboratory dish and
- transferring the resultant embryo to a uterus.
In gestational surrogacy, the embryo will be transferred to the uterus of the gestational surrogate who will then carry the baby until birth.
The IVF Surrogacy Process: What to Expect
The IVF process starts with the intended mother or egg donor taking medications to stimulate egg growth. Doctors then retrieve the eggs and fertilize them with sperm from the intended father or sperm donor. One of the resulting embryos will then be transferred to the surrogate who has been taking prescribed medications to prepare her endometrium for implantation.
This is the process in a nutshell. The actual process looks more like this:
- The surrogate completes medical and psychology screening to see if she has any conditions that may affect the fetus should the process be successful.
- A consent form is signed by the intended parents and the surrogate. The form will include all details related to the process.
- The intended mother (or the egg donor) is placed on fertility medications to stimulate the egg production.
- The eggs will be retrieved through a surgical procedure. (Multiple eggs will be retrieved because some of the eggs may not be suitable for fertilization.)
- The intended parents will also be asked to provide the sperm which will be used to fertilize the eggs.
- The eggs are fertilized using a lab dish.
- Depending on the kind of cycle completed, the embryos will either be transferred to the gestational carrier after 3 or 5 days following the IVF process (Fresh Cycle) or be placed in frozen storage for transfer at a later time (Frozen Cycle).
- Before the transfer, a Preimplantation Genetic Screening (PGS) may be performed.
- If the process is successful, the pregnancy will be carried to full term.
Fresh and Frozen Embryo Transfer
As noted above, there are two types of embryo transfers:
Fresh embryo transfer: the embryo transfer is usually performed three or five days after the retrieval.
Frozen Embryo Transfer: the previously created embryo is thawed, and then transferred to the uterus of the surrogate.
Fresh cycles are more complex than frozen cycles because the surrogate will need to synchronize her cycle with the woman providing the eggs.
Some fertility clinics prefer frozen embryo transfers because they are easier to work with. Also, the use of said transfers allows clinics to focus on the surrogate’s fertility treatment and preparation, which can increase the chances of pregnancy.
How Many Embryos to Transfer
Clinics in the United States will most often recommend implanting one embryo per transfer attempt.
The common belief is that pregnancy is more likely to occur if several embryos are transferred. However, statistical data demonstrates that transferring multiple embryos does not necessarily increase the chance of pregnancy
Reasons to Consider IVF surrogacy
There are many reasons why intended parents may turn to IVF surrogacy:
- No success with Artificial Insemination or In Vitro Fertilization techniques
- Medical problems or illnesses that affect the health of the uterus or prostate
- Previous surgeries or hysterectomy
- Conditions that prevent pregnancy or make pregnancy high-risk
- Same-sex couples
- The cause of infertility has not been determined
- Intended mother’s age
Wrapping Up
It is not easy to decide to embark on a surrogacy journey after attempting other forms of alternative fertility. Surrogacy should only be chosen after the intended parents have exhaustively investigated the process, the legal regulations, and the medical procedures involved.
