How does surrogacy work?
Surrogacy is an assisted conception treatment option that is of relevance to a certain subgroup of patients. First of all, to consider how the surrogacy works it is important to understand who needs this treatment. Patients who have had a hysterectomy either for benign causes or for malignant
Patients who have had a hysterectomy either for benign causes or for malignant causes are the ones who should bear in mind that they might need this, especially when they had not completed their family by the time the hysterectomy was performed.
The other group of patients would be those who have been through cancer treatments or who have been exposed to chemoradiotherapy and us as part of this treatment the pelvis could not be protected and that has damaged the lining the womb where the implantation of the embryo is unlikely or hasn’t happened after a few treatments; then surrogacy is something they want to have to consider.
The other group of patients could be those who have medical illnesses and some of these illnesses could worsen. Or, on some occasions, these diseases can be life-threatening and then the carrying of the pregnancy can be life-threatening. Then for such patients surrogacy should be considered, which will give them an option to have their family without increasing the morbidity from their medical illness or even making it life-threatening.
Surrogacy also gives a family building option to male gay couples who want to have families.
After seeing who actually needs surrogacy, the first step is involved is you need to see a fertility specialist to understand the complexities of surrogacy. This area tends to be more complex – more from a non clinical point of view rather than from a clinical point of view.
Once you’ve seen the consultant or fertility specialist and you feel that this is still the way that he want to go then the next step probably for you would be to identify suitable surrogate.
Once you’ve identified the surrogate, then as a commissioning couple, you will be going through the screening test for infections because when we are creating these embryos and replacing them back, you’re effectively acting as an embryo donor or the gamete donor.
So in order to minimise the risk of exposure to the host surrogate, you are screened for a range of conditions. You may also be advised to quarantine either the sperms or the embryos based on what you prefer for a certain period of time, so the possibility of transmitting infectious diseases can also be minimised.
Once you have quarantined the sperms your case will also be considered usually by the clinic and ethical committee, and once all these have been considered and the arrangement has been approved then you would actually start the process of the treatment.
Once you start the process, then based on the arrangement that’s in place as to
- who the gamete providers will be,
- who the surrogate is,
- whether the surrogate wishes to have a frozen embryo transfer, or
- it would be a fresh transfer.
We will synchronise all the cycles together and then take you through the treatment.
The overall processes can take from the very first step to actually having an embryo transfer into the surrogate can take from to three to six months. Sometimes it may take longer. The important points during this course you also need to consider taking the advice of a family solicitor to ensure that you would be eligible for the parental order application, that would give you the right to be the legal parent of a child.
These are briefly some of the considerations that you need to consider in mind before going for a surrogacy arrangement. Obviously, many of these can be discussed in detail at your consultation.