Surrogacy: Your baby, her body

Surrogacy is a major life decision that must be taken only after great deliberation

Sometimes your own body is unable to host your baby and you need to find a substitute home where your baby can grow for the first nine months of his or her life. This arrangement, in which a woman carries a pregnancy and gives birth to a baby for another woman, is called surrogacy.

For couples who opt for surrogacy, they are choosing to share an intimate part of their lives with an outsider, who is helping them fulfill a cherished dream. So every step of the way should be taken with utmost care and caution.

If you are considering opting for surrogacy, the discussion that follows will help you decide.

Will the baby be genetically ours?

This is the first question that most couples ask. Yes, the baby will be yours—completely or partially, depending on whether both the partners are capable of producing healthy sperm and egg. Here’s a look at the various scenarios of surrogacy.

IVF or gestational surrogacy

This is the most common form of surrogacy. In this, the surrogate woman carries the pregnancy in her womb but genetically the child is of the couple. The egg of the wife [genetic mother] is fertilised in the laboratory by the husband’s sperms [genetic father] by IVF/ICSI procedure. This fertilised embryo is then transferred into the surrogate woman’s uterus and she carries the pregnancy for nine months. Thus, in this scenario, the surrogate only carries the baby of the couple and the child is not genetically linked to the surrogate woman.

Gestational surrogacy with an egg donation

In cases where the genetic mother’s ovary does not produce egg, the couple can opt for egg donation from a donor. This egg is fertilised with the sperm of the husband [genetic father]. The fertilised embryo is then transferred to the uterus of the surrogate woman. Thus you can say that half the genes are that of the original couple.

Traditional natural surrogacy

This is generally not preferred. In this, the surrogate woman is inseminated [washed semen of the male partner is put in the uterus of the surrogate] or IVF/ ICSI procedure is performed on the surrogate with sperms from the genetic father. The child that results is genetically related to the surrogate and to the male partner but not to the female partner. Since biologically the surrogate is the child’s mother, it’s likely that she gets emotionally attached to the baby; this can also lead to legal issues later, hence it’s not recommended.

How do we know whether surrogacy is for us?

Surrogacy is not something that is done if the woman is too busy to carry her own pregnancy or if she is anxious about how pregnancy and child birth will affect her appearance. It is ethical to do it for genuine reasons only. It is suggested in the following cases:

In women whose ovaries are producing eggs but they cannot carry the baby in their uterus. For example, in case of congenital absence of uterus, or if the uterus has been removed due to severe bleeding or cancer, or if the uterus has ruptured during Caesarean section or during a previous pregnancy.

If there is a birth defect in the uterus, or if it is damaged, there is a risk of rupture during pregnancy. A woman who has had tuberculosis of the uterus may also be advised to go for surrogacy.

Women who have had repeated miscarriages, or if the couple has made several attempts at IVF but have failed due to unexplainable causes

If the genetic mother is suffering from some health problems like diabetes, heart trouble, or kidney disease, surrogacy should be considered. In such conditions, the mother is capable of bearing the child in her uterus but there is a risk to her life as well as the baby’s.

How should we choose the right womb for our baby?

This is the most important part of the whole process. Since this woman is going to grow your baby in her womb, you have to make sure you select the candidate with care and caution. There are women who do this for financial needs coupled with the desire to fulfill someone’s dream of becoming parents.

The ideal age for a surrogate candidate is between 21 – 35 years. This is the most fertile period of reproductive age group. For women below 21 years and above 35 years, there is higher chance of miscarriage and other pregnancy complications.

It is better if the surrogate is married and has had previous normal pregnancies, where she delivered healthy babies of her own. This ensures that the fertility potential is tested. Moreover,  the risk of an emotional attachment to the child is also minimum. Some couples prefer to choose the surrogate from among their family and friends but this has often not proven to be a good decision.

The best approach is to choose a woman who is not known to you. Then, after the child is born and handed over to the parent, you do not maintain contact with each other.

Once you zero in on the surrogate, a detailed medical, surgical, personal and family history is taken to ensure that the surrogate can carry the pregnancy without any complications. A physical and gynaecological examination is then carried out. Routine as well as specialised investigations are done to assess the physical fitness of the surrogate. The surrogate and her partner are screened for infectious diseases like Hepatitis B, Hepatitis C, HIV and VDRL.

Are there any risks involved—medical or otherwise?

A surrogacy is treated as a high risk pregnancy and is cared for very meticulously. Appointments are scheduled with the consultants every two weeks for the first eight months and every week in the last month.

To safeguard yourself and your unborn child, it is advised to have a detailed financial and legal agreement made between the couple and the surrogate. There are certain things to be discussed and clarified at the start itself, before the procedure is done. Here are some things you need to bear in mind:

How much will you pay the surrogate?

What if the couple loses the baby during child birth?

Who will bear the health costs if the surrogate falls ill during pregnancy?

Is the couple willing to allow the surrogate to stay in touch with the child in the future?

Will the child be told about the surrogacy?

Once everything has been discussed and agreed mutually between the couple and the surrogate and the same has been legally documented, surrogacy can be a smooth and fruitful experience for both, the couple as well as the surrogate.

This was first published in the October 2013 issue of Complete Wellbeing.

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