Surrogate Pregnancy: All You Need to Know

For many people, their journey to parenthood does not always turn out how they thought it would. Some have experienced a long road of infertility, while others knew right from the start that there could be complications. There are a number of routes individuals and couples can take to achieve their dreams of parenthood, with surrogacy gaining popularity as the science, technology, and laws surrounding the process continue to improve.

What Is Surrogacy?

Surrogacy is the process in which a Surrogate carries a baby to term for Intended Parents.

When talking about surrogacy, we need to distinguish between gestational surrogacy and traditional surrogacy. In gestational surrogacy, the Surrogate is not genetically related to the baby; instead, an embryo is transferred to the Surrogate’s womb through IVF. Before being transferred to the Surrogate, the embryo is created using either the egg and/or sperm of the Intended Parent(s) or an egg from an Egg Donor and/or sperm from a donor.

On the other hand, the traditional surrogacy involves the Surrogate being artificially inseminated with the sperm from either the Intended Father or a donor. Traditional surrogacy has lost popularity in recent times due to the emotional and legal implications of the genetic connection between the Surrogate and baby.

What Does Surrogate Pregnancy Look Like?

The stages of surrogate pregnancy include the following:

Medical Screening

A series of medical tests are completed before the surrogacy agreement is signed to ensure the medical compatibility and eligibility of the Surrogate. The exams typically include:

• Pap smear test to check the health of the cervix.
• Uterine check-up to check the thickness of the uterine walls and to determine if fibroids and cysts are present.
• Bloodwork including Sexually Transmitted Infections testing.

Mock Cycle

Some clinics will complete a mock cycle before the embryo transfer. The Surrogate will take medications and be monitored just as she will be during the real cycle. The purpose of the mock cycle is to determine how the Surrogate’s body responds to medications. If the testing process goes well, the real cycle will be initiated.

Preparing for Embryo Transfer

An embryo transfer requires preparation of the uterus. The Surrogate will need to take several medications that will help her body build a thick uterine lining (also known as endometrium) to receive the embryo.

There may be some differences during this part of the process based on whether a fresh or frozen cycle is performed. Fresh cycles may be a bit more complicated because the cycles of the Intended Mother or Egg Donor and Surrogate need to be coordinated. Syncing the menstrual cycles of these involved parties is typically facilitated with contraceptive pills and Lupron injections.

Once the Intended Mother or Egg Donor and Surrogate’s cycles are regulated, the Surrogate will start on estrogen. This typically occurs about the same time ovulation is being induced in the Intended Mother or Egg Donor. Just before the egg retrieval, the Surrogate will start on progesterone to continue preparing her body for implantation. If the embryos are frozen, the medications and transfer will be coordinated with the Surrogate’s cycle.

Embryo Transfer

The embryo is transferred using a catheter while a doctor monitors the placement via ultrasound. Once the transfer has been completed, the Surrogate will be asked to lie down for a bit for the embryo to settle (and to assure that the Surrogate is fine after the process).

Confirmation of Pregnancy

About two weeks after the embryo transfer, a pregnancy blood test (beta hCG) will be performed to confirm pregnancy. If the test is positive, it will be repeated 48 hours later to see if the hCG has doubled (hCG levels double every 48-72 hours).

At this point, the Surrogate will continue taking medication (even if blood tests are positive), often until the end of week 10 or week 12 of the pregnancy.

Six-Week Ultrasound

An ultrasound will be done around week six to confirm pregnancy and to check for a heartbeat. Sometimes a second ultrasound is done two weeks after this one.

Prenatal Care

Around 10 weeks, the gestational carrier will be released to her obstetrician and will continue with regular check-ups. In a non-risk pregnancy, the frequency of the appointments will be every 4 to 6 weeks during the first 32 weeks. During this period, there will be two big milestones. The first trimester screen and nuchal translucency occurs around week 11 or week 12 and the week 20 ultrasound to evaluate fetal anatomy. Then the gestational carrier will have appointments every 2 to 3 weeks from week 32 to week 37 and finally, every week from week 37 until birth.

Is There Any Difference Between a Surrogate Pregnancy and Natural Pregnancy?

So what are the differences between a Surrogate pregnancy and natural pregnancy? In all honesty, not very much! Particularly if you are able to use both the egg and sperm of the Intended Parents to create an embryo to be transferred to the Surrogate’s womb (aka if you’re able to go the route of gestational surrogacy). From there, the fetus will develop just as naturally as if it was traditionally conceived in the Intended Mother’s womb, and when born will be genetically linked to both Intended Parents, despite being birthed from the Surrogate’s body. The biggest difference is simply that the child is growing in another woman’s body and therefore another party is involved, but it is just an alternative method to growing your family. There are still medical examinations, some dietary restrictions, physical activity limitations, and everything that is expected during pregnancy for the Surrogate.

Of course there are a few more differences with a traditional surrogacy, with the Surrogate being genetically linked to the child, but that doesn’t lead the child to being any less the Intended Parents’.

Surrogacy is an incredible journey that both begins and ends with love and kindness. If you are interested in joining the Surrogate community, as Intended Parents, a Surrogate, or an Egg Donor, the team at Simple Surrogacy is here to help. Contact us today!