- Women's Health
IVF and Surrogacy - What Kind of Drugs are These Women Taking?
With other options available such as adoption would you consider IVF?
Types of Surrogacy
Before explaining the medication needed to for IVF and surrogacy it is important to understand the types of surrogacy that exist. More medication is required for certain one type then is for the other.
Traditional Surrogacy involves using the egg of the actual surrogate and the sperm of a donor. The sperm can be from the father who will take over the care of the child after it is born or from an unknown donor. Usually this type of surrogacy takes place in homes, since most clinics will refuse to deal with a surrogate who is using her own eggs for legal purposes. In this type of pregnancy there usually is no extra medication other then prenatal vitamins and involved.
Gestational surrogacy uses eggs that are not of the surrogate mother and sperm from either the father to be or an unknown donor. This type of surrogacy as well as standard IVF involves quite a bit of medication and will be what I am discussing in this article.
I would like to point out that this article is not a debate on surrogacy, but rather information that potential surrogates and women planning to undergo IVF should take into consideration if this is a choice that are going to make.
Furthermore I will just refer to the procedure of IVF for the rest of this article as it is the procedure that women will go though whether it be for their own child or as a surrogate.
It is important for women undergoing IVF to be free of infections as even a small infection can significantly lower the chance of success. For this reason it is important to take an antibiotic prior to the start of treatment. This is usually taken for only a few days and is used during the same time as birth control.
The side effects of antibiotics tend to be minor unless you have a sever allergy. Usually people will only experience diarrhea or upset stomach.
Keep in mind that antibiotics can lower the effects of birth control. If you are a woman who is going though IVF for the purpose of surrogacy you should use a backup method of birth control just to make sure you don't get pregnant prior to your IVF.
Many people don't eat properly. In pregnancy this can be especially true with nausea, vomiting and cravings that make you eat strange foods. Taking a prenatal vitamin not only protects the baby from stealing nutrients from places like your bones, but also ensures that the baby gets everything they will need to develop and mature. Prenatal vitamins are not just important for women doing surrogacy but for all pregnant women.
This vitamins contain concentrations which are not present in other multivitamins. When babies are developing they require a higher level of folic acid to avoid neurotubule defects as they grow, prenatal vitamins offer this. They also have lower concentrations of Vitamin A as too much preformed Vitamin A can cause liver damage and birth defects. There is no need to worry about the Vitamin A found in fruits and veggies because it is processed differently by the body.
With all this said you don't want to be taking unnecessary vitamins. If you eat a lot of vegetables and fruit on a daily basis you may be able to get away with just taking folic acid while you are pregnant and avoid all the binders and chemicals in store bought vitamins. Tracking your diet is the best way to find out what you are lacking and what you are getting enough of. Talk to you MD about what will be best during your pregnancy.
Birth Control Pills
Before the appointment to get the in-vitro fertalization (IVF) treatment women are asked to use birth control pills to regulate their cycles. This allows the doctors to make sure that women start taking their other medications at the appropriate time in their cycles and are able to be matched up with egg donors if fresh eggs are being used.
Depending on the type of pill and the age of the woman there are a wide range of side-effects to be considered. Most women have no side effects from birth control pills and the ones that do generally experience mild effects. Some mild side effects include; acne (which actually improves in some women), breast tenderness or swelling, spotting between periods, nausea and vomiting, eye changes that can cause contacts to no longer be comfortable, bloating, headache, sex drive changes (usually lowers sex drive) and weight gain (however this is not usually attrubuited to the birth control pills themselves).
There is a chance of more sever side effects, however they are normally attributed to pills that contain a higher estrogen content. some of these side effects are; depression, migrains, breast lumps, heavy bleeding between periods, high blood pressure and high cholesterol. There is also an increase chance of blood clots in lungs and legs. Heart attack and stroke are also risks to consider when choosing a birth control. Finally liver damage and allergic reaction can occur as well.
There is actually debate as to whether estrogen is necessary during IVR, however most women are prescribed it anyway as it doesn't decrease the odds of proper implantation and continued pregnancy. Usually this school of thought is applied. Another option is to go without estrogen supplements as the body is ready for pregnancy due to the birth control pills and progesterone injections, once implantation has occurred women will start producing their own healthy levels of estrogen. As mentioned before tests have been done proving that taking or not taking estrogen is the way to go. Most will prescribe it an state it increase IVF success, your MD knows what's best for your situation.
If estrogen supplements are going to be used there are two different ways they are normally take, either orally or vaginally. Both methods usually use the same dosage and tablet.
There are a large range of mild side effects from taking estrogen, some of these include; acne, bloating, breast tenderness or swelling, cramps which are like period cramps, hair loss, increase in blood sugar levels, weight changes and spotting. These effects are noticed by at least 1% of people taking the medication and most can be managed or are short term.
Some side effects are more sever such as the chance of; heart attack, stroke or blood clots. Most of these sever side effects are managed by taking blood thinners during the period of time that the estrogen is being taken.
- Estrogen Affects IVF Success
Even a tiny amount of extra estrogen can hurt IVF success.
When progesterone is used the chance of implantation dramatically improves. Most women are given a supplement prior to and during the first 3 months of pregnancy with IVF.
During the first few days that progesterone injections are used there are common mild side effects. These side effects include; depression, nausea and vomiting. Cramping and abdominal pain have also been reported with these injections. More serious side effects can occur and are but are not limited to; swelling of the legs, chest pain, vision changes, vomiting, numbness of the body and fainting. When people experience the more serious side effects they are encouraged to seek medical attention immediately.
There are other symptoms of progesterone injections that are not listed on the packaging of the medication. These have been told to me by people who are actually taking injections. Severe itching can occur depending on the type of progesterone you are using. There are a few different kinds so if you experience this issue talk to you MD about switching to another type. Also a painful lump can form at the injection site (which is usually in the leg or backside). Make sure that the needle you are using is the proper length to get the medication into your muscle and that its not to long as to hit your bone. Ouch!
Something to Prevent Blood Clotting
With all of the medications that a woman must take to get pregnant and maintain that pregnancy there is a great risk of stroke and blood clotting. One of the surrogates I know states that her blood actually gets thick with all the drugs. The way that they avoid this is to give the women drugs such as aspirin to thin the blood and avoid clotting.
Although aspirin is only taken as long as the other medications are taken, about three months, there are still risks to both woman and baby during this time. Taking a blood thinner during pregnancy can be extremely dangerous in the event of a miscarriage, as the mother would have the possibility of bleed-out due to a lowered ability to clot. This is especially an issue if the blood thinner is taken after 32 weeks as a bleed out during birthing is possible.
Taking this during pregnancy can also cause issues with the baby. Aspirin can cause a premature closing of blood vessels in the babies heart which leads to high blood pressure in the lungs and trouble during birth.