- GS - Gestational Surrogate
- TS - Traditional Surrogate
- IP - Intended Parents
- IM - Intended Mother
- ED - Egg Donor
- RE - Reproductive Endocrinologist
- ER - Egg Retrieval
overview of Gestational Surrogacy process
Gestational Surrogacy can be a wonderful alternative to multiple IVF treatments which have failed to produce a positive result. It allows a woman to have either her own biological child or through egg donation, a child that has no genetic bond shared with the Surrogate Mother. It can be a wonderful experience for both the IPs (Intended Parents) and the GS (Gestational Surrogate). In this article I will explain what Gestational Surrogacy is and the process involved.
There are two types of Surrogacy. Gestational Surrogacy, in which the Surrogate has no biological connection to the embryo, and Traditional Surrogacy, in which the Surrogate is also the biological mother. (compare TS and GS)
IPs or GS can either go through an Agency or Independent. An Agency can have great benefits for both parties, but can cost as much as twice as much as going Indy. The Agency will usually deal with all the paperwork, lawyer, finding a GS, payments and any other matters that may arise. Of course it depends on the Agency, some are more involved than others, make sure you check out several before committing to one. If you go Independent, there are some websites that have classifieds that you can place an ad or look through ads. Going Indy is less expensive and can be a more rewarding experience. (compare Agency vs Indy)
When choosing an IP or GS, talk to several prospects and, above all else, make sure you are 100 percent comfortable with your choice. There will be nervous feelings, but if your gut is telling you there is a red flag, then listen to it! Communication is KEY. Don't be afraid to talk to your GS or IP about things that are bothering you. It is much better to clear the air than let things build up over time.
Once you are matched with a GS or IP the real journey begins. The IPs must find a RE (reproductive endocrinologist), most have already been working with one. The GS will have several tests and procedures to go through. A psychological exam and consultation with a therapist. The RE will do several tests and blood work. Once the GS is approved by the RE, both the IM (intended mother) and GS will have many Dr. appointments with poking and prodding galore.
When all of the preliminary groundwork is done the IM and GS will start "cycling". This is when the actual IVF cycle starts. If the IPs have frozen embryos then it will just be the GS who starts the cycle. If the IPs are using egg donation, the the donor will start the cycle. If the IPs are doing a fresh egg retrieval then the IM will start the cycle of medications to do the ER (egg retrieval). If doing a fresh ER, the GS must be at the same stage in her "menstrual cycle" as the "donor" (ie. IM or ED). This is usually done with lupron and other drugs to put the GS's ovaries to "sleep". A drug induced state of menopause. This allows the Dr. to manipulate the GS's cycle to be at the right stage to accept the embryos that will be transfered. When it gets close to ER, the GS will start other medications. Estrogen and progesterone since her body was "shut down" it can not make these hormones and they are needed for a pregnancy to occur and be maintained. The progesterone is most often in the form of a shot. I call it "the BIG one". The progesterone is in oil (PIO), it is thick and there is alot of it. The needle is pretty big as well. The GS, husband of the GS, or friend must give this shot in the hip. Sometimes you don't feel it and sometimes it hurts pretty good. Either way it is not pleasant. If a pregnancy is achieved the GS must continue to take the daily shot for 4 months, or the pregnancy will be lost. Some Dr.s will use progesterone suppositories, but don't count on it. Dr.s like to measure things to make sure the meds are in the system, the suppositories do not get into the blood system very well (but is absorbed by uterus extremely well, better than the PIO), therefore the Dr. can not measure the amount very well in the blood. This is the reason some Drs only use the PIO shots.
After the ER, (click for more info on the ER process) the eggs will undergo fertilization in the laboratory with the embryologist. It is very important not only to have a good IVF Dr. but make sure the Embryologist is a GREAT one. He (or she) is the one who is in charge of and who knows everything about the eggs, sperm and embryos. The IVF Dr. does NONE of this work. Once the Dr. lets you know when the transfer will be, the IPs and GS will go into the transfer room and watch the Dr. transfer the embryos into the GS's uterus (click for more info on transfers). This only takes a couple minutes. Some Drs will suggest bedrest for the GS some will not. (Personally, I do not believe in bedrest. In my experience, I did both and when I rested for 4 DAYS it did not work... when I walked around ALL DAY after the transfer I got pregnant with triplets!) In about two weeks or so the GS will go in to take a blood test to see if it worked or not, but trust me, most GS's already know because of a little thing called "home pregnancy test". If it worked, the GS keeps up the PIO shots and gets an ultrasound in a few weeks. If it did not work, and sometimes it doesn't for no reason at all, you may start the cycle process again the following month. Some Dr.s like to have time between ER but I have seen great results doing back to back ER.
If a pregnancy did result the GS will stay under the Dr's care until around 10 -12 weeks of pregnancy. At that time she is released to see the OB/gyn agreed upon by IPs and GS. The IPs may go to every Dr. appt or only the special appointments. Most appointments are boring and not much happens, but some IPs want to be there. This must be talked about before contracts are even signed because some GSs may not want that much contact.
When it come time for delivery, depending on what the IPs and GS have agreed upon, the IPs will be in the delivery room with the GS or may give the GS her privacy. In my experience, this was the BEST part of the entire process. Seeing my IPs face when their babies were handed to them was more than AMAZING...it is indescribable.
There will be days of joy and days of frustration. Ups and Downs. It will not be a piece of cake on either side, but, I an tell you whether it "worked" or not, you will have a life changing experience and in my case, friends for life.