Medical Evaluation of the Surrogate Mother

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Medical Evaluation of the Surrogate Mother

Surrogacy is a unique and wonderful family building option that often is described as third party reproduction. Individuals turn to surrogacy for a variety of medical and social reasons: infertility; multiple pregnancy losses; being part of a same sex male couple or being a single male.

Surrogate mothers, also known as gestational carriers, are caring, compassionate women who love being pregnant and want to give the gift of family to those who yearn to become parents.

One of the major concerns intended parents might have as they embark on surrogacy is whether the woman they are matched with is a good candidate from health, obstetrical and mental health perspectives. They want to be reassured she will be able to get pregnant, have a successful pregnancy, deliver a healthy baby to term, and not harm herself in the process.

HRC Fertility works with many surrogacy agencies that recruit and select surrogate mothers. Together we have developed guidelines for medically clearing potential surrogate mothers. It’s our job as fertility specialists to ensure that your surrogate mother can help you fulfill your dream of having a baby as well as have a healthy outcome for herself.

Potential surrogates typically will undergo the following evaluations:

Social disease and drug screening–surrogate mothers and their partners will be screened for a variety of sexually transmitted and infectious diseases, including but not limited to HIV, syphilis, herpes, hepatitis, cytomegalovirus (CMV), gonorrhea and chlamydia. If unknown, they will be tested for RH factor and to ascertain their blood group. In addition, they will undergo urine testing for an prescription or illegal drug usage that could harm the surrogate mother and the baby.

Medical assessment–the focus of the medical evaluation is the health of the surrogate mother’s uterus and her ability to have a healthy pregnancy. Gestational carriers are not providing the egg for the pregnancy; either the intended mother or an egg donor provides the egg.

Surrogate mothers generally are between ages 21-45, have had at least one successful pregnancy, and have raised that child/children. They should not have had more than give vaginal or two cesarean deliveries, though exceptions can be made with clearance from the surrogate’s own OB. The agency and/or fertility specialist will want copies of all their obstetrical medical records to review them for other medical conditions or concerns.

Evaluation of the uterus–A key component of the evaluation is making sure the surrogate mother has a healthy, receptive uterus and will have a successful embryo transfer. There are several procedures doctors can use to determine this:

  • Vaginal ultrasound: examination of the uterus and surrounding organs
  • Hysteroscopy or sono-hysterogram (HSG): equal options offered at the doctor’s discretion
  • Mock cycle/trial transfer (optional): similar to a “test run” of an embryo transfer where the doctor can take measurements from the cervix to the transfer spot in the uterus, determine the best transfer location and verify there will be no unexpected issues or “bumps” in the road. Also the doctor can determine the best type of catheter to use for the transfer.
  • Pap smear

Psychological testing–a licensed psychologist will talk to the surrogate mother to get a sense of her motivation and psychological readiness to assist another family-to-be.

Our goal at HRC Fertility is to make sure everyone involved in the surrogacy process knows the health of the surrogate mother is optimal to start the baby making journey. Once that hurdle is passed, the surrogate mother and intended parents can focus on creating a strong and life-changing relationship with each other.

References

http://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/fact-sheets-and-info-booklets/gestational-carrier-surrogate/

https://www.verywell.com/mock-embryo-transfer-procedure-1960216