The Road To Surrogacy
Most people assume starting or growing a family will be easy. However, that is often not the case, with approximately 1 in 5 people in the US experiencing infertility. Assisted reproductive technology (ART), like in vitro fertilization (IVF), can help many couples become parents. However, if ART fails, other options should be considered. In some cases, surrogacy, where another woman carries the pregnancy, can help couples have a healthy baby.
A ticking clock
At birth, women are born with about 1-2 million eggs. By puberty, only 300,000-400,000 eggs remain, and even more are lost during each menstrual cycle. This means that women in the late 30s and 40s may not have enough remaining eggs to get pregnant successfully. Some women can experience primary ovarian insufficiency (POI), which means that fertility is reduced even earlier in life. Other reasons for poor egg quality and quantity include some cancer treatments, obesity, smoking cigarettes, severe endometriosis, and genetics.
When other options fail
Most women or couples who struggle to get pregnant don’t immediately jump to surrogacy. In some cases, fertility medications called ovulatory stimulants can be just what is needed to boost egg production during the cycle, allowing conception to occur. Other times, interventions like intrauterine insemination (IUI) or IVF can help achieve a pregnancy. If treatment fails, more advanced interventions are required. Surrogacy, where another woman carries the pregnancy, is a great option to consider.
Surrogacy 101
For women unfamiliar with surrogacy, the process may feel daunting. Although certain legal and ethical implications must be considered, surrogacy is relatively straightforward. The couple will typically start by contacting a surrogacy agency and will be matched with a woman interested in serving in this role. In some cases, a friend or family member can serve as the surrogate. The next decision couples must make is whether to use personal eggs and sperm, or a donor. In some cases, healthy embryos can be created, but the specimen doesn’t stick in the uterus once transferred. In this case, using personal eggs or embryos might be best. For older women or situations where the male partner also has fertility problems, donor eggs and sperm may be preferred. A third scenario is to use the surrogate’s eggs and insert sperm from the male partner or a donor to achieve pregnancy.
The transfer
If the use of a genetically related embryo is desired, the woman will undergo what is essentially the first step of the IVF process. Medication will be administered to encourage egg growth, and then the eggs will be extracted and sent to the lab to be mixed with sperm. The resulting embryos can then be transferred into the surrogate’s uterus. If a donor embryo is used, the process is much more straightforward. At the optimal time in the surrogate's cycle, the donated embryo is transferred into the uterus. If all goes according to plan, a positive pregnancy test should appear about 2 weeks later.
Ethical and legal concerns
Usually, couples will want to work with a lawyer to ensure the process goes smoothly. Paperwork guaranteeing a parental relationship is essential, especially in cases where the surrogate’s egg is used to create a baby. Understanding the genetics of the process is important as well. If a personal embryo is not used, parents-to-be must select a donor and understand that the resulting child will not be genetically related. Ensuring the donor has physical characteristics and a medical history that aligns with personal desires is important.
Your surrogate solution
When natural conception is not possible, some couples may eventually move on to surrogacy. There are multiple options available involving a combination of personal or donor eggs and sperm. A surrogate can be the solution needed to carry a pregnancy to term, allowing intended parents to build or grow a family as desired. This third-party option offers hope and joy.
