On most occasions surrogacy is done with the intended parents own eggs and sperm. This usually happens when the lady does not have a uterus (genetic or surgical removal) or has a defective uterus (septum, bicornuate, arcuate, or due to infection like Tuberculosis). Another reason we use surrogacy is when the couple has had numerous failed IVF cycles.
The intended parents first decide to proceed with self-cycle surrogacy at our centre, they sign the contract and the tentative dates are decided. The lady is put on pills to be able to synchronize with the surrogate’s menstrual cycles. The surrogate is also prepared to build the endometrium. Once the intended parent (lady) periods start, hormones are injected to make multiple eggs. This usually goes on for 10-12 days. The lady needs to stay in the city for minimum of 7 days provided she takes a few of these injections at home. All this is discussed and explained to the couple beforehand. There is regular communication through e-mail and telephone.
The eggs are retrieved under anesthesia, they are fertilized with the husband’s sperm, it is to be noted here that if time does not permit the husband may leave his semen sample in his earlier visits and the same can be frozen.
After fertilization of the eggs and sperm, the embryos take 2-3 days to develop. We are doing both cleavage and blastocyst transfer depending on the total no. of eggs retrieved, no. of grade A embryos formed and previous history. The embryos are then transferred into the surrogate under the ultrasound guidance. The decision regarding the no. of embryos depends on the age of the intended lady and previous treatment history. We usually transfer 2-3 cleavage stage embryos or 1-2 Blastocysts.
Following embryo transfer the surrogate is given hormonal supplements like estrogen and progesterone. She is asked to take rest and the pregnancy test is done 2 weeks later. Both her co-ordinator and the centre co-ordinator pay regular visit to ensure that the instructions are being followed.