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Surrogacy procedure

Outlines the IVF surrogacy procedure for both natural and stimulated cycles.

What does IVF surrogacy procedure involve?

The procedure for IVF surrogacy in itself is a straight forward. It involves the commissioning woman undergoes IVF treatment, fertilizing her eggs with her partners sperm. Then subsequent embryo transfer into the host uterus.

Ovarian stimulation using fertility drugs

The commissioning woman will have to undergo ovarian stimulation using fertility drugs. She will undergo cycle monitoring by scans and blood tests. When the follicles are mature an hCG injection is given and about 36 hours later egg collection is performed by vaginal ultrasound guidance under light sedation or a general anesthetic. The eggs will then be inseminated with her partners sperm. All resulting embryos of good quality are then frozen for a minimum period of six months. The commissioning woman may have to undergo more than one cycle of IVF treatment to generate enough embryos to have a fair chance of success.

Repeat HIV tests

HIV tests are then repeated at the end of six months and if negative, the frozen embryos are thawed and transferred to the host’s uterus. An alternative is to freeze the genetic male sperm for a minimum period of six months and repeat the HIV test before starting treatment. If the test is negative, inseminate the eggs with the frozen thawed sperm and resulting embryos can be transferred.

The 6-months quarantine of either embryos or sperm is required by the Human Fertilisation and Embryology Authority (HFEA) in the UK.

Embryo transfer

Embryo transfer can be performed either in a natural or a hormone replacement cycle.

Natural cycle frozen embryo transfer

Natural cycle frozen embryo transfer is recommended if the host menstrual cycles are regular and she ovulates regularly. Either she was sterilized or her male partner has had a vasectomy. The menstrual cycle is monitored by ultrasound scan and blood or urine test to check her hormones. Frozen embryos are then thawed and replaced 2-3 days after ovulation.

Hormone replacement frozen embryo transfer

Hormone replacement frozen embryo transfer is recommended if the host menstrual cycles are irregular or there is concern about the possible occurrence of a pregnancy as a result of a natural intercourse between the host and her male partner.

The host is given a drug (GnRh agonist) to lower her hormone, and then she will be given. Hormone treatment to prepare her endometrium (lining of the womb) for embryo transfer.

How many embryos are transferred?

Because multiple pregnancy imposes increased risk to both the mother and the babies, most clinics will restrict the number of embryos to be transferred, to one or two.
