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Meeting with the surrogate

Posted by on Sep.27, 2016

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.

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The truth about surrogacy!

A lot of controversy has been found to surround the topic of Gestational Surrogacy, much of it due to the brouhaha between those actually dealing with these cases and those on the outside, trying desperately to sneak a peek and gain some understanding into the matter. Meanwhile the government has yet to decide and impose laws regarding this matter, even though India is already a hub for gestational surrogacy and as consultants in a private New Delhi clinic we deal with such patients on a daily basis. More often than not they are international as surrogacy in India is far cheaper for them than anywhere else.

We go through life in stages. First we are born, go to school, college, get a job, fall in love, get married, have kids, raise a family, retire, get old and what happens thereafter. Now imagine our patients, infertile couples, who are born just like everyone else, who go through life’s stages just like most people except that after they get married they are unable to have kids. So they try, they try one after the other doctor, procedure, drug, you name it. They keep trying. They never give up because you never know which treatment cycle will click. So if they’re lucky they conceive, if not they keep trying. They go round and round in circles unable to move on to the next stage of life because what will they do? With no family to raise, what do they do with themselves? Jobs last only so long. Most working couples these days come home to the sounds of silence. For some it becomes unbearable. So the process continues.

Imagine living majority of your adult life stuck in one phase. Terrible isn’t it? A to top it all, society never ceases to torment instead of empathizing.

This is where surrogacy becomes an option. Without going into too much scientific detail, in properly chosen patient’s, surrogacy can fulfill their dreams of having a baby. In a recent discussion at a recent India Woman’s Summit, Dr Kaberi Banerjee, Director and Senior Consultant in Reproductive medicine at Advanced Fertility and Gynecology Centre, Lajpat nagar-4, South Delhi, spoke against the various myths and exaggerations surrounding this topic. First and foremost being that Surrogates are not bonded laborers. They are adults, in compos mentis, married, with families of their own, otherwise healthy, but in need of financial aid in order to have a better life by setting up small businesses, educating their children, purchasing land, opening up shops etc. They Volunteer for surrogacy and are explained each and every aspect of it. Often being uneducated it is said they don’t understand clearly what they are doing, but that is not true. They are well aware of what they are doing, what it means to the other party and how it will benefit their own selves and their family. They are explained the entire process from A-Z including the financial settlement in details.

It is a mutually beneficial situation for both parties. The surrogates, most that we have at our center, have turned their lives around for the better with the money obtained from a successful pregnancy. IT is an opportunity, their womb being the resource. We are quite careful with our surrogates and they are given the best of care at NO expense of their own. It is false that surrogates are made to pay for illnesses/surgeries etc. Each and every aspect of care is covered by the clinic, be it a visit to the physician or the dentist. All medications are given free of cost by the clinic to the surrogate. All antenatal visits,ultrasounds, delivery charges are covered by the clinic. These women possess more inherent fecundity than subfertile couples and thus there is no question or need, whether by law or otherwise, of transferring more than 2-3 embryos in them.

Routine home checks are also conducted to make sure they are living in clean hygienic conditions and are getting adequate nutrition and care. The commissioning parents are given regular updates regarding the surrogate’s condition. Following delivery postnatal care is given to the surrogate till she finds herself fully recovered.
The fact of the matter is, it is difficult to formulate laws with regards to surrogacy, but that is no reason to abandon the procedure altogether. Uterine transplants to achieve pregnancy is nowhere near being an everyday procedure and thus the need for surrogacy. It gives all kinds of women, with or without uteri, a chance to have their own baby. These days, the cost of the procedure is quite reasonable, both for Indian and international patients. We have patients of all categories starting from middle classes to the very well off.

Instead we must strive to create strict laws and policies so that surrogates are treated in the correct manner and get what they deserve. They ought not to be exploited or cheated. The treatment given to them must be scientific and state of the art. All consents must be taken properly with full explanation to both parties of the implications. The media must be officially instructed to report only the facts and nothing based on heresy. They have a responsibility to listen to and report the absolute truth, instead of creating negative hype based only on the malpractices of a few practitioners or quacks. Such people are there in every field, but that is no excuse to generalize and say that all IVF doctors are doing what the malpractitioners are. Instead take a look at the genuine centres as well. Report their success rates, meet their patients and take the feedback.
There are few words, if any, that can describe the pure love and joy on the faces of the commissioning parents when they see and hold their baby for the first time and all the times thereafter. Everyone who is fit to raise a child deserves one. Whether the child grows in her own womb or another woman’s, what does it matter? Both are mothers.

Case 1:

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.

 

Case 2:

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 –

  1. We suggested for Surrogacy with Donor Eggs.
  2. Started IVF stimulation (Antagonist Protocol) of the egg donor and prepared the surrogate for the embryo transfer.
  3. 3 Grade A embryos transferred in the surrogate
  4. Positive pregnancy test after 2 weeks of embryo transfer
  5. Transvaginal ultrasonography – Intrauterine twin live pregnancy!

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)

 

Surrogacy services India fertility issues

1. OPTIMISING NATURAL FERTILITY

  •  As age increases, time needed to conceive also increases
  • Women > 35 years of should consult a doctor after trying to conceive for a period of six months. (The deciding age of women will vary with ethnicity)
  • Fertile period is a day 6 time period which ends around the time of ovulation and correlates with the changes in cervical mucus. Daily or alternate day intercourse during this time period increases the chances of pregnancy.
  • Coital position or resting after intercourse does not have any impact on fertility.
  • Smoking , alcohol consumption, high level of caffeine intake, use of recreational drugs and vaginal lubricants should be avoided in couples who are trying to conceive.

2.  USE OF CLOMIPHIENE CITRATE IN INFERTILE WOMEN

  • Clomiphiene citrate(CC) is the first line drug In cases of anovulatory infertility.
  • Cycle fecundity rates increases with CC + IUI in cases of unexplained infertility.
  • Side effects of CC are mild such as mood swings (64%-78%), vasomotor symptoms, visual disturbances, breast tenderness, pelvic discomfort, nausea are very uncommon. There is an increased incidence of multiple pregnancies (10%).
  • Adjuvants like metformin, glucocorticoids, exogenous gonadotrophins are effective in inducing ovulation when used along with CC.
  • Further evaluation is needed to rule out other contributing factors after 3-4 failed CC cycles.
  • CC cycles need to be monitored regularly.

 5 MILLION BABIES BORN THROUGH IVF IN THE PAST 35 YEARS

Researchers now estimate that 5 million IVF babies have been born since the birth of the first IVF baby(Louise Brown). According to Dr. David Adamson, IVF has become a sort of mainstream in the last 6 years as stigma around infertility has decreased and the technology has improved. The data obtained by these researchers is only from two-third of the reported IVF cycles worldwide. In 1990, a little more than a decade after the first IVF birth, about 95,000 babies were born. By 2000, the figure had grown to 1 million and by 2007 it has climbed to 2 million. This has been mainly due to improved ability to culture the embryos and increase the success rates.

 

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