At times, some women may find it difficult, if not impossible, to conceive a baby and carry it safely till the due date. This could be due to a number of reasons. In such situations, certain fertility treatments may be recommended that require the services of a gestational carrier. Often, this might be the only option available for individuals or couples who desire a biological child but are unable to conceive or carry a pregnancy to full term successfully.
In this article, we shall explore the various aspects of gestational surrogacy. This includes an overview of the entire process, the situations where this is a viable option and the emotional and legal aspects of using a gestation carrier.
Gestational surrogacy is a procedure carried out via IVF (In-vitro Fertilization). A gestational carrier is an unrelated person who acts as a surrogate for the biological or intended mother and carries the baby to full term till it is delivered on the due date. In other words, an embryo, created in a laboratory from the egg and sperm of the biological or intended parents, is implanted into the uterus of the gestational carrier. The job of the gestational carrier is to safely carry the baby for the entire duration of the pregnancy period and deliver the baby to the biological or intended parent once it is born.
Essentially, being a surrogate carrier means carrying a baby for another person. However, there are different types of surrogacy.
Traditional surrogacy was the earliest type of surrogacy. Here, the sperm was donated by the biological or intended father, while the eggs belonged to the carrier and not the intended mother. This meant that while the intended father was the biological father of the baby born through surrogacy, the intended mother would not be the biological mother. Instead, the surrogate or carrier would be the biological mother. This led to legal and emotional complications. Sometimes, babies born via traditional surrogacy would be involved in extensive custody battles in court when the carrier would refuse to give up parental rights on delivery. Nowadays, this form of surrogacy is not allowed.
Gestational surrogacy, on the other hand, is quite different from traditional surrogacy. In this form of surrogacy, there is an embryo transfer, which means that the eggs and sperm collected from the intended parents are fertilised in the lab of a fertility centre and implanted into the uterus of a woman selected as the gestational surrogate or carrier. Here, the intended parents are the biological parents of the baby, while the gestational surrogate or carrier has no genetic link to the baby. The role of the gestational carrier will be to carry and deliver the baby to the intended/biological parent(s) once it is born. This form of surrogacy has no legal or emotional implications and is legally allowed in most countries.
Being a surrogate involves a lot of effort. Sometimes, a woman may offer to become a gestational carrier without compensation for the time and effort put into the process. Only the medical bills will be paid. In such cases, this form of surrogacy will be termed altruistic surrogacy. However, when the surrogate expects to be monetarily compensated after carrying and delivering the child, then this form of surrogacy will be termed commercial surrogacy, as the surrogate was paid for her services.
Each country has laws and regulations regarding the different forms of surrogacy, so please be informed before undertaking this procedure.
Here are the people for whom gestational surrogacy might be a good option:
● The intended father or mother may have fertility issues and may be unable to conceive a child despite extensive fertility treatments, with numerous unsuccessful IVF and IUI cycles.
● The intended mother has uterine abnormalities that prevent successful implantation or carrying of the baby to full term.
● The intended mother has undergone a hysterectomy procedure, whereby the uterus has been removed.
● The intended mother has a serious medical issue that could put her life or the baby’s life at risk if she gets pregnant.
● Single persons or same-sex partners who biologically cannot get pregnant by themselves.
Gestational surrogacy is a lengthy process that requires both physical and mental preparedness. This brief overview will provide a step-by-step guide, outlining the key stages and considerations.
Ideally, gestational surrogacy is an option that should be considered once all other IVF options have been ruled out. The legal, physical and emotional implications of this procedure are pretty high. Often, intended parents will need extensive medical and legal consultations before opting for this procedure. During this stage, intended parents may undergo medical and psychological screenings. This is to safeguard them from any potential problems in the future.
The next step involves finding an ideal candidate to take on the role of the gestational carrier. Again, this step is vital as the health of the baby depends on the overall health of the carrier. Here are some considerations that should be borne in mind while selecting gestational surrogates:
● The surrogate ought to be young, preferably between the ages of 21 and 45.
● The surrogate should have had at least one successful pregnancy but not more than five. It is preferable that the prior deliveries were vaginal. However, if there have been caesarean deliveries, it should exceed more than three.
● The surrogate should be physically fit and healthy, with no medical issues that could put them or the baby at risk.
● The surrogate must have a complete understanding of the procedure, including the risks and complications that may arise by agreeing to carry a non-biological child.
Once a candidate has been selected, they too shall have to undergo medical and psychological screenings. In addition to this, blood tests will be performed to rule out illnesses and STDs. This will ensure that the ideal gestational carrier is selected.
Once the gestational carrier has been selected, the procedure for implantation can begin. Via IVF, the sperm and eggs will be collected from the biological parents and fertilised in a lab. This process typically takes a few days. Once the embryo is ready, it will be transferred to the gestational carrier’s uterus using a thin catheter. Sometimes, more than one embryo may be implanted. This procedure usually takes about an hour. After careful monitoring, the surrogate is usually discharged on the same day as the procedure. Pain meds may be prescribed if required. The surrogate will be advised to rest for a few weeks after the embryo transfer so as to ensure the implantation is successful.
During the pregnancy period, regular check-ups will be performed to assess the health of the surrogate and the baby. During this period, wellness checks and emotional counselling must be performed so as to safeguard the surrogate, the baby and even the intended parents from any complications that may arise once the baby is born. If all goes according to plan, a healthy baby will be delivered and handed over to the intended parents once the pregnancy reaches its full term.
As with any medical procedure, gestational surrogacy has a few risks, such as:
● Despite successful implantation, there is no real guarantee that the pregnancy will be carried to full term. The surrogate may have serious health issues due to the pregnancy and may need to terminate the pregnancy.
● Legal difficulties may arise because of any sort of ambiguity in the surrogacy contract. This is usually in the case of commercial surrogacy.
● Humans are unpredictable, and bearing a child takes a huge toll on a person's emotions. Emotional difficulties may arise if the gestational carrier is unable to give up the baby due to attachment issues.
For countless people, gestational pregnancy is the only way through which they can enjoy being the parents of their own biological child. By being fully informed of the procedures and the risks, both the intended parent(s) and the gestational carrier can be safeguarded from any potential legal, physical and emotional difficulties.
Gestation surrogacy is an IVF procedure that involves finding an unrelated surrogate or carrier to carry the embryo created from the fertilised sperm and eggs of the intended parents.
In gestational surrogacy, the carrier has no genetic link to the baby she carries to full term. Her eggs were not used for this procedure. However, in traditional surrogacy, the eggs of the carrier are used during the procedure, thus creating a genetic link between the carrier and the embryo. In most countries, traditional surrogacy is not allowed.
The legal aspects of using a gestational carrier differ from country to country. However, most countries allow the use of a gestational carrier with no genetic links to the baby.