A surrogate or carrier is a woman who carries a pregnancy for another couple or woman. There are two types of surrogacy or carrier arrangements. In traditional surrogacy, the surrogate is inseminated with sperm from the male partner of the intended parent couple (donor sperm may be used as well). In this case, the surrogate is donating her uterus and eggs. In gestational surrogacy, the surrogate carries a pregnancy created by transferring one or more embryos created with the sperm and egg of the intended parents (though donor sperm and/or donor eggs may also be used).
Use of a gestational carrier is indicated for a woman who has normally functioning ovaries but who lacks a uterus secondary to surgery, or has congenital uterine abnormalities. Gestational surrogacy is also an appropriate treatment for women with a medical contraindication to pregnancy such as diabetes, heart, or kidney disease. Gestational surrogacy has been used in women with poor obstetrical outcomes and recurrent miscarriage.
Gestational surrogates can be relatives or friends of the intended parents who volunteer to carry a pregnancy for them. Alternatively, gestational surrogates can be identified through agencies that specialize in recruiting women to become surrogates. The surrogate undergoes extensive medical testing and a thorough medical history and physical exam is performed. Each prospective surrogate also undergoes a full series of psychological screening tests and an interview with a psychologist.
RMA of Philadelphia and Central Pennsylvania synchronize the cycles for both the surrogate and genetic mother. The genetic mother undergoes ovarian stimulation and egg retrieval. On the day of egg retrieval, the recipient’s husband or partner will produce a fresh semen sample. The sperm is then combined with the donor eggs. Intracytoplasmic sperm injection (ICSI) may be indicated if the semen analysis is abnormal. Typically, two or three of the resulting embryos are then transferred into the surrogate’s uterus, which has already been prepared with estrogen and progesterone.