Indications for Surrogacy

The following are the primary indications for gestational surrogacy:

1. Not having a uterus as a result of a hysterectomy or being born without a functional uterus
2. Significant uterine abnormalities, including uterine scarring (Asherman's Syndrome) and inability to develop a thick, supportive uterine lining
3. Significant medical conditions that make carrying a pregnancy risky for a woman's health (such as hypertension)
4. Chronic reproductive loss

Some couples may find a surrogate who is a family member or friend, but the majority will have to work with a third-party facilitator to help them find a surrogate. Regardless of who the surrogate is, it is critical to have legal and psychological counseling as well as a thorough screening that includes a skilled medical evaluation.

The Gestational Surrogacy Process for Intended Parent and Surrogate

Once the surrogate has been selected and surrogacy screening completed, the cycles of the surrogate and intended parent will be synchronized. The intended mother or supplier of the eggs (egg donor) undergoes the treatment for a routine IVF cycle while the surrogate's uterus is being prepared to receive the embryos. The surrogate's cycle normally includes Lupron injections, oral estrogen, and vaginal progesterone.

Concerns of Gestational Surrogacy

Because both surrogates and intended parents have concerns about the risk of high-order multiple births, we will thoroughly explain the risks along with the high success rates of IVF surrogacy. Our usual recommendation is to limit the number of embryos transferred to two, depending on the age of the intended mother, the quality of the embryos, and the personal preference of both the intended parents and the surrogate. Any additional embryos of good quality can be cryopreserved.

Age and the Success of Gestational Surrogacy

Although the quality of the surrogate uterus is important to a successful gestational surrogacy cycle, most physicians feel that the critical factors are age and the quality of the eggs. Generally, the younger the age of the intended mother the better. When the intended mother is over 39 years old, the optimal treatment may include using both an egg donor as well as a surrogate. Most of our intended parents over age 39 use egg donors with a gestational surrogate.