A surrogates journey through the clinic

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Becoming a surrogate is one of the most rewarding gifts a woman can give. Giving the chance to intended parents to hold their baby in their arms will be something that will never leave you. The law in the UK at present determines, that the woman who gives birth, is the legal mother and if she is married then her husband will be the legal father, regardless of the egg and sperm that have been used. So, we need to ensure that you understand the full implications of what it means to be surrogate and that includes taking a detailed medical history.

The first rule of medicine is to do no harm so at My Surrogacy Journey we want to ensure that if you are thinking of becoming a surrogate that you are safe to do so. For you to be eligible to become a surrogate you must be at least 21 years old and younger than 45. You must have a healthy BMI of less than 35. It is preferable that you have carried at least one pregnancy to term and that you had no major complications during your pregnancy. We are however able to discuss further if you wish to be a surrogate but are ‘childless by choice’. If you are taking anti-depressant medication, then you will need to stop taking them for a minimum of three months before starting treatment. This process should be supported by your doctor. You must not have had any new tattoos or piercings within 12 months of starting treatment. If you meet all the above criteria, you will be seen by our clinical lead at MSJ who will determine your medical history to ensure there are no underlying issues that could prevent you embarking on a surrogacy journey.

Once you are matched with your Intended Parent(s) and have spent time getting to know each other, then you will be referred to one of our partner fertility clinics. Your first stop at the clinic will be to see one of the Medical Consultants to further discuss your medical history and to ensure that you are clinically safe to proceed. This is usually carried out virtually and is preferable that your partner attends – if you have one. This consultation is extremely important as you are given lots of information about surrogacy treatment, so you can then make an informed decision if this is the right pathway for you.

There are a couple of tests that you will need to undergo, to ensure that clinically you are able to have the treatment needed to carry a pregnancy. The first being, Saline Infusion Sonography – this is a test to determine that you have no anomalies within your uterus that would prevent an embryo implanting. This is a vaginal examination whereby fluid is instilled into the uterine cavity so the doctor can clearly see the endometrium and the uterine cavity during a transvaginal ultrasound examination. Often, we may find small anomalies that could prevent an embryo implanting in your endometrium such as polyps or fibroids, but you will be advised at the examination if these could prove problematic.

The other required tests are mandatory screening tests that involve you having blood taken to be tested for certain virology conditions such as HIV, Hepatitis B & C and some sexually transmitted diseases such as chlamydia, gonorrhea and Sphyllis. If you are married or in an enduring relationship, then your partner will need to be tested also.

The clinic will require that you attend an implications counselling session with your partner and a separate session with your intended parents, this is to ensure that you fully understand the implications of the treatment you are about to undergo in the surrogacy pathway. For you to fully understand the implications of surrogacy treatment the consultant at the clinic and the surrogacy team will discuss all aspects of the treatment with you. This will include the medication you will need to take and how to take it. Your body will need to be triggered into thinking that you are producing an egg, so the endometrium responds and thickens. The ultrasound scans that you will need to have so the team can measure the endometrial thickness so we can be assured you have responded to the medication. All the scans that you will have will be trans-vaginal, you may need 1-2 scans depending on your response to the medication.

Pregnancy can be risky, so we need to be assured that you understand the risks associated with pregnancy and any potential complications. The clinics in the UK are bound by an elective single embryo transfer strategy so unless there are exceptional circumstances, only 1 embryo will be replaced.

Although the clinic may touch on the legal requirements that you will need to understand in order for you to be accepted as a surrogate, it will be the legal team that will support you with any questions you may have, however the clinic will want to see evidence of an ‘Intention Agreement ‘that you will draw up with your intended parents.

The embryo transfer is the nicest part of the journey through the clinic, this is the day you can share with your intended parents when you all get to see an image of the embryo that will be transferred. The embryo is now a collection of 2 different types of cells, one that will give rise to the fetus and the 2nd that will give rise to the placenta that will support the pregnancy. The embryo transfer is carried out in the lithotomy position, and a speculum will be inserted to enable the clinician to insert the small catheter that will be carrying the actual embryo. The procedure is not painful and can be like a smear test being carried out. One the procedure is over you will be able to go home shortly after.

You will carry on with all your medication and return to the clinic approximately 12 days later to have a pregnancy blood test carried out. It is important that the test is via blood and not urine as we do not want to risk having a false negative test. Once we know the outcome of your test you will be advised what to do with your medication moving forward and planning a pregnancy scan at around 7 weeks of pregnancy.

Always be open with your clinic and let them know if you have any concerns during your treatment,
as they are there to support you and your intended parents during a very exciting period.