A GUIDE TO SURROGACY FOR INTENDED PARENTS
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A Guide to Surrogacy for Intended Parents
Step 1:
We require:
  • Your medical and personal history
  • Detailed reports of past surgery and procedures performed
  • Past IVF cycles and obstetric history
  • Documents such as passport, address proof for identification purposes

Step 2:

Our team of experts will review your details and we give you our opinion towards your treatment.
 
Step 3:
Once you register with us we will help you choose the appropriate surrogate mother.
 
Step 4:
Synchronisation of your cycle with that of the surrogate lady is indeed simple and its execution needs simple maths! Both you and the Surrogate lady are cycled to synchronize your periods by putting you both on birth control pills. Sometimes synchronisation requires the use of GnRH analogues.

After you are matched, the surrogate mother will undergo further screening.  Medical screening includes but is not limited to the following:
  • She may require a hysteroscopy if the ultrasonography demands it. It is the visualization of the uterine cavity through a thin scope inserted through the cervix to determine the shape and size of the uterus.
  • Current pap smear and annual medical check up.
  • Trial transfer where we will determine the angle of the cervix and the length of the uterine cavity so we know how to place the catheter with the embryos.
  • Psychological evaluation by a psychologist familiar with surrogacy issues .The program psychologist will explore the motivations, attitudes and commitment of the surrogate lady to the surrogacy process.
Some of these tests will also be required of her partner/spouse where applicable.

Step 5:
Controlled ovarian stimulation will be initiated in order to stimulate the ovaries. The initial part of the stimulation can be started in your place of residence provided you have a reproductive emdocrinologist, a responsible gynaecologist or a fertility doctor looking after you and following up on your follicular monitoring.
 
Step 6:
Usually the ovarian stimulation lasts for 9 to 11 days. Although it is ideal for you to reach Mumbai by Day 1 of stimulation, without facilities for ovarian follicle monitoring at your place you may come by the 6 th day of stimulation under special circumstances.

Step 7:
The surrogate lady is cycled to match your periods. In case you are using frozen embryos or using donor eggs, then cycling is done accordingly. The cycling is either with Oestrogen & Progesterone (or with hormone injections to develop the lining in case the lining does not respond well to tablets.).

Step 8:
The Gestational surrogacy agreement is signed between you and the surrogate mother before the embryo transfer.

Step 9:
Oocyte retrieval

The genetic mother or the egg donor undergoes an oocyte retrieval procedure under general anaesthesia to obtain eggs. IVF/ICSI is performed with sperm obtained either from the genetic father or a donor. In case of donor eggs, we can select eggs from an existing egg bank.

Step 10:
Embryo transfer

Embryo transfer will be performed between Day 2 to Day 5 of embryo formation into the well primed uterus of the surrogate mother.  Embryo transfer is performed when the uterine lining of the surrogate lady is ready. Luteal phase support is given with injection / tablets. 

Step 11:
Pregnancy Test

A serum bhCG test is performed 14 days after the embryo transfer. The report will be sent to you via email. If the test is positive it is repeated every 4th day till it crosses 20,000 iu.

Duration of treatment:
If the wife/female partner is the genetic mother, her stay in Mumbai is required for approximately 20 days. If a donor egg is used then she may avoid coming to Mumbai if she so desires. If the husband is the genetic father he needs to come here for 2-3 days. For those opting for a donor egg or donor embryo, they may come here directly around the time of expected date of confinement of surrogate lady. Frozen embryos can also be shipped to our Centre from within the country.

Success rate

You can expect a success rate of about 40-50%. With two cycles of surrogacy that are covered in the agreement, your chances of having a baby reach about 60-70%. 

Nurturing the pregnancy through the 9 months:

  • Once the pregnancy test is positive, great care of the surrogate mother is taken throughout the nine months  both medically and nutritionally.
  • Regular obstetric screening, routine ultrasound scans and blood investigations are preformed in order to monitor the health of the surrogate mother and the fetus. The reports are sent to you by email.
  • Although the surrogate mother is at a low risk of acquiring infectious diseases, an infectious disease screen of the surrogate lady and her husband are performed periodically.
  • Since the top most concern for you is the medical and genetic health of the baby we perform soft marker screening for congenital abnormalities. a triple marker screen in the II trimester rules out Downs syndrome, Edwards and Pataus syndromes. These are common chromosomal abnormalities causing morbidity and mortality in the baby.
  • Timely information is provided to you during the 9 months via email so that you can stay connected to your baby.
  • Tetanus toxoid vaccination is given to the surrogate mother and nutrition is supplemented with high protein diet supplemented with iron, calcium and vitamins throughout the pregnancy.

Department of Assisted Reproduction (IVF) and Genetics
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