We usually advise you to meet the surrogate once the pregnancy test is positive. We always respect your wishes on choice of your surrogate for e.g., being vegetarian. We however do not encourage you to select the surrogate based on her physical characteristics. The surrogate’s physical attributes has no impact on the child’s features. The center would like to choose the surrogate on her overall health and the thickness of her endometrial lining (Endometrium).
Once positive you are free to meet the surrogate. We advise you to meet the surrogate at the center itself. You can also be present at the time of the ultrasound scanning. All her reports and progress will be regularly communicated to your through emails. You can also schedule a visit with our Medical Director, Dr Kaberi Banerjee, at the center to know about her progress. Our aim is to help you go through this journey in a transparent and pleasant way.
Selection of surrogate, preparation of surrogate and after care of surrogate.
The surrogate is selected as per the ICMR guidelines. A surrogate mother should not be over 45 years of age. Before accepting a woman as a possible surrogate for a particular couple’s child, the ART clinic must ensure (and put on record) that the woman satisfies all the testable criteria to go through a successful full-term pregnancy.
A relative, a known person, as well as a person unknown to the couple may act as a surrogate mother for the couple. In the case of a relative acting as a surrogate, the relative should belong to the same generation as the women desiring the surrogate.
The lady first indicates her willingness to become a surrogate mother. It is ensured that she understands the entire process and her involvement and responsibilities that are associated with it. She is then medically tested blood test like – Haemoglobin, TSH, Rubella, Prolactin and the viral markers like HIV, HCV, HBsAg and VDRL are carried out. The husband is also interviewed to ensure that he understands the process and is willing to co-operate with his wife. His viral markers are also tested. The surrogates’ co-ordinator and centre co-ordinator are involved in this process.
A mid cycle scan to check the endometrial thickness is carried out to ensure that she is a fit candidate for surrogacy. Our criteria for selection of the surrogate is that the mid cycle endometrial thickness should be more than 10mm and triple layer. Once selected the contract is explained to her and her husband. They are asked to sign it along with the intended parents.
The preparation starts from day 21 of the previous cycle in which the surrogacy is planned. It is popularly called the Lupride + Progynova protocol (Estradiol Valerate). Inj Luprolide acetate 0.5-0.6 mg is started from day 21. She is asked to take it daily till she gets her period. This injection is quite painless and is like the daily insulin injections which the diabetic patients take. It is given to ensure that the hormones are down regulated and the surrogate can be synchronized with the intended parent (ladies ‘) menstrual cycle. It also gives a wider window of implantation.
Once the periods start, a scan is done to ensure that she is adequately down regulated (no cyst and thin endometrium). The leuprolide injection is halved and oral estrogens, usually in a dose of 6mg daily is started. This goes on for about 2 weeks. Once the endometrium reaches 10 mm vaginal progesterone is started to prepare a receptive endometrium. Embryo transfer is done under USG guidance, usually 2-3 days after egg collection.
Post Procedure: –
We don’t believe in the policy of keeping the surrogates in surrogate homes. We firmly believe that surrogates will do better if they are kept in their own homes with their families and children.
Following et the surrogate is given hormonal supplements like estrogen and progesterone. She is asked to bed rest and the preg test is advised 2 weeks later. Both her co-ordinator and the centre co-ordinator pay regular visit to ensure that the instruction are being followed.
Our director Dr. Kaberi Banerjee takes personal care of the surrogates. They are asked to visit the centre every 2-4 weeks for there ante-natal check ups. They are provided iron calcium supplements and tetanus inj. Monthly stipend is provided for healthy nourishment. Guidance on eating healthy and maintaining hygiene is given. USG are done regularly to note the growth of the baby and its weight. If at any point it is felt that the growth is sub optimal or there are any complications the surrogate is admitted in hospital.
We are proud that all our intended parents and surrogates complete this journey in a pleasant environment and with utmost satisfaction.
A 31 years old female came to our OPD from Nanital with primary amenorrhea and primary infertility. We had advised the hormonal profile and the ultrasound pelvis. Her hormonal profile showed low serum FSH, LH and Estradiol. Ultrasound showed bilateral small sized ovaries with hypoplastic uterus. She was diagnosed as a case of hypogonadotropic hypogonadism. The husband’s semen analysis was normal.
In view of the above diagnosis, we recommended donor egg surrogacy and trial with self-eggs also to the couple. As her FSH and LH levels were low, we stimulated her ovaries as well along with ovaries of the donor. Her and donor’s eggs were extracted which were fertilized in the IVF laboratory. Seven good embryos (grade A) of patient herself were formed out of which 3 embryos were transferred in the surrogate and 4 embryos were frozen in one vial. Three Day 2 Embryos were transferred in the surrogate. After 14 days of luteal support, beta HCG was done which came positive.
A 29 years old female came to our OPD from Shimla with primary infertility. Her hormonal profile showed very low serum FSH, LH and Estradiol. Ultrasound showed absent ovaries with no uterus. Her karyotype showed 46 XY which means she was genetically male. But phenotypically she was looking as a beautiful female. The couple had love marriage. She was diagnosed as a probable case of Swyer syndrome, or XY gonadal dysgenesis. The husband’s semen analysis was normal.
In view of the above diagnosis, we recommended donor egg surrogacy to the couple. We stimulated the ovaries of the donor and extracted the eggs from her. The fertilization of the eggs was done with the husband’s sperms in the IVF laboratory. Three resulting good embryos (grade A) were transferred in the uterus of the surrogate and 6 grade A embryos were frozen in 2 vials. After 14 days, beta HCG was positive which confirmed the pregnancy.
STAR STORY OF THE MONTH
A 39-year-old female with more than 13 years of infertility
Previous treatment – 3 failed cycles of IVF with own eggs, and 2 failed cycles of IVF with Donor Egg
In our clinic –
Outcome – Surrogate delivered 2 healthy live babies at 9th month of pregnancy.
We wish her the very best!
(Please remember each patient is different and needs different treatment approach)
Dear Dr. Banerjee,
I would like to take a moment to thank you and let you know how much I appreciate everything that you have done for me during this process of having a baby. You have given me the most precious gift that anyone could ever give with the birth of my beautiful baby boy Nathaniel.
During my dealings with you I told many people about you and the respect I have for you and everything you had done for me, I will continue to tell people of my journey that without you would never have been possible.
Once again I can’t express in words that it means to me to have met you and gone through this process of having my baby with you as my doctor. I don’t think that I could ever thank you enough for making my dreams come true by giving me the git that you have made possible and making my life complete.