Gestational Surrogacy

Surrogacy allows intended parents to have a genetically linked child. The most common reasons for surrogacy are a previous hysterectomy or medical conditions making being pregnant impossible or too risky for the intended mother. Most patients should expect a 25% to 50% probability of a successful pregnancy per cycle of Gestational Surrogacy at Bay IVF Center.

 

There are two kinds of surrogacy pregnancies. In Traditional Surrogacy, the surrogate is artificially inseminated with semen from the intended father. The surrogate provides both the egg and carries the pregnancy for the intended parents. The baby is genetically linked to the intended father and not the intended mother.

 

In Gestational Surrogacy, the intended mother provides the egg(s), the intended father provides the sperm and In Vitro Fertilization is performed to create their embryos. The embryos are then transferred into the surrogate's uterus. The resulting baby is genetically linked to the intended mother and intended father, and not the surrogate.

 

At Bay IVF Center, the wellbeing of the developing baby in the surrogate's body is very important to us. Ideally the surrogate should be a person emotionally invested in the pregnancy and the child's life (i.e., a close relative or a very close friend). A mature, emotionally stable surrogate carefully pre-screened by a surrogate agency can also be an excellent choice.

 

Since the physician care at Bay IVF Center is free and we only bill for the laboratory portion of the Gestational Surrogacy procedure, our treatment costs are significantly reduced compared with typical Gestational Surrogacy fees.

 

Finding a surrogate is the first step in initiating the Gestational Surrogacy treatment. You may decide to use one of the many surrogacy agencies nationwide. These agencies have pre-selected surrogates for you to choose from. The above document lists surrogacy agencies we have closely worked with and recommend. Your surrogate does not have to live locally or even in this country.

 

Gestational Surrogacy Procedure

 

The Gestational Surrogacy procedure is similar to In Vitro Fertilization: after the intended mother's ovaries have been stimulated, the eggs are aspirated, inseminated with sperm from the intended father, incubated and one or more of the resulting embryo(s) is/are transferred into the surrogate's uterus.

 

 

Below is a simplified example of a Gestational Surrogacy treatment sequence. Actual treatment is always individualized.

 

Medications are given as pills (oral contraceptives), vaginal capsules (progesterone), skin patches (Vivelle), or very small injections just under the skin (Lupron, FSH, HCG). The surrogate also takes one intramuscular injection (progesterone) once a day for four days.

 

This is an example of a Gestational Surrogacy treatment sequence. Actual treatment is individualized:

 

Intended Mother

Surrogate

 

 

Gestational Surrogacy treatment consists of the following five steps:

1. Ovarian Stimulation

    

   Lupron hormone injections are used to temporarily stop the intended mother’s own Follicle Stimulating Hormone (FSH) production to create a “clean slate” for ovarian stimulation. FSH injections are then added to stimulate production of high quality eggs (usually 6-14 eggs).

    

   During the 8 to 12 day ovarian stimulation, two to four ultrasound examinations and blood estrogen tests will be needed to follow the development of the eggs.

    

   When the eggs have become sufficiently mature, the intended mother will take an injection of Human Chorionic Gonadotropin (HCG) hormone. This medication completes the maturation process of the eggs.

    

   The ultrasound image below shows a stimulated ovary. Each of the grape-like follicles (dark circles) contains a microscopic egg.

    

   

    

    

   The surrogate also takes Lupron injections to start the synchronization process between the development of the future embryos and the surrogate’s uterine lining. The endometrial lining is stimulated with estrogen skin patches and progesterone vaginal capsules and four progesterone injections.

    

2. Egg Retrieval

    

   Thirty-six hours after the HCG injection, the egg retrieval procedure is performed in our center. This is normally a 5 to 10 minute procedure. We use conscious sedation for analgesia, and your partner is invited to join you for the egg retrieval.

    

   Using ultrasound guidance, a thin aspirating needle is passed through the top of the vagina into the follicles. Only the tip of the aspirating needle enters the follicles and the follicular fluid is aspirated from them. The fluid is examined under a microscope to identify the eggs. Since the ovaries are located just above the vagina, the tip of the needle does not penetrate the uterus, cervix, or the Fallopian tubes.

    

3. Fertilization

    

   The intended father collects a semen sample by masturbation either at home or at our clinic and the highest quality sperm are added to the eggs six hours after the egg retrieval. During the overnight incubation, sperm penetrate the egg shell and fertilize the eggs.

    

   If your infertility history suggests the possibility of male infertility significant enough to keep the eggs from being fertilized using this method, you will be scheduled for Intracytoplasmic Sperm Injection (ICSI) procedure. In ICSI, a single sperm is inserted directly into an egg using micromanipulators.

    

   The next day, the eggs are examined for signs of fertilization. A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm (see images below).

    

   The following day, embryos reach 4 cells, the day after, 8 cells and by the fifth day after the egg retrieval, the embryos should reach the blastocyst stage.

     Fertilized Egg

  Four Cell Embryo

   Eight Cell Embryo

       Blastocyst

4. Embryo Transfer

    

   Two to five days after the egg retrieval, the resulting embryo(s) is/are transferred into the surrogate’s uterus by passing a thin embryo transfer catheter through the cervix to the top of the uterus. This is a quick procedure not requiring any pain medications. Together with the surrogate, you will be able to decide the number of embryos to transfer.

    

   Additional embryos that are not transferred at this time can be cryopreserved and stored in liquid nitrogen for potential future use.

    

5. Establishment of Pregnancy

    

   A blood pregnancy test is scheduled two weeks after the egg retrieval. A fetal heartbeat ultrasound is performed two weeks and two days after a positive pregnancy test.

   

    

   The ultrasound picture on the left shows a six week pregnancy. The pregnancy sac is approximately 25 mm in diameter. The baby inside the sac is about 13 mm long, and yet it is possible to already distinguish the head and the "tail" portion of the baby's body as well as strong cardiac activity.

    

   The Surrogate takes estrogen and progesterone supplementation for the pregnancy for 6 to 8 weeks. By that time, the placenta produces enough of its own estrogen and progesterone so that the supplementation can stop.

For additional in-depth information, please see Gestational Surrogacy Treatment Protocol, Pregnancy Probability, Gestational Surrogacy Cost, and Gestational Surrogacy Prerequisites.

 

If you have any questions regarding Gestational Surrogacy or to request an appointment, please contact us by phone at 650-322-0500, via email at care@BayIVF.com, or use the Contact Bay IVF Center form on this page.