Egg Donation & Surrogacy

Surrogacy

Surrogacy is a legal and ethical arrangement in which a woman (the surrogate mother) carries the baby of another couple (the genetic parents or commissioning couple - the egg and sperm belong to them). The commonest form of surrogacy is gestational surrogacy wherein the female partner of the infertile couple is treated with hormones to yield more eggs which are retrieved and fertilized with her husband's sperm in vitro (in the laboratory). The embryos thus formed are then transferred to the uterus of a surrogate mother who gets pregnant and hands over the baby to the infertile couple after delivery. Sometimes, if the female partner is of advanced age or has poor quality eggs it might be necessary to have an egg donor to improve the chances of pregnancy. The child thus born would be genetically related to both (husband and wife) or one parent (egg donor and husband).

Surrogacy is indicated in patients with repeated implantation failures at IVF, recurrent miscarriages owing to insufficiency or birth defects in the womb (absent uterus, some cases of bicornuate uterus, intrauterine adhesion, cases of hysterectomy where the uterus has been surgically removed for cancer or other disorders such as severe hemorrhage and bleeding after delivery) or in cases where the mother suffers from some medical disorder such as hypertension or severe diabetes making it risky for both mother and child (increased maternal and perinatal morbidity and mortality).

Screening Criteria for Surrogates - We at Apex hospital prefer to recruit young surrogates in the age group of 21-35. They may be single, married, widowed or divorced. Legal proof of their marital status is ensured. They are screened for any medical or health problems. A detailed history is taken for medical illnesses, past pregnancies, ease of normal or cesarean delivery, health of children born and previous attempts at surrogacy. We also subject them to a complete cardiologist screen with 2-D echocardiography to avoid unpleasant surprises during the pregnancy. Once they are certified fit by the cardiologist they are subjected to the complete pathology work up including: Hemoglobin, sugar, clotting profile, HIV, Hepatitis B and C, VDRL for syphilis, Hb electrophoresis for thalassemia and other special tests if requested by the couple. This is followed by a social and home screen (surprise visits by our social worker) to rule out homes which are unhygienic, signs of physical or domestic violence, alcoholism in the husband, etc. Also, detailed evaluation is done for alcohol, drug or nicotine abuse. Only after all the above criteria are fulfilled the surrogate is placed on a waiting list.