For further information about surrogacy, contact our Roseville practice, near Sacramento, to schedule a consultation.
Northern California Fertility Medical Center
1130 Conroy Lane, Suite #100
Roseville, CA 95661
Phone: (866) 714-2492
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Although the majority of infertility causes can be remedied through either conventional medical and surgical treatments or In Vitro fertilization (IVF), there are some conditions that prevent a woman from being able to carry a pregnancy. In years past, classical surrogacy has offered these women a chance to raise children. This procedure, which involves the insemination of a surrogate with the sperm of the infertile woman’s partner, raises a number of complicated ethical and legal issues because the baby is the genetic child of the surrogate. IVF surrogacy, provided at our Roseville practice, near Sacramento, allows us to create embryos from the eggs and sperm of the infertile couple and transfer them to the uterus of a gestational surrogate, who has no genetic connection to the child.
In order to undergo in vitro fertilization with a surrogate, a woman must have an adequate ovarian reserve but be medically unable to carry a pregnancy. Absence or congenital deformity of the uterus, as well as any medical condition that makes pregnancy potentially life threatening, are conditions that can be overcome through IVF surrogacy.
Couples who fulfill the necessary criteria to undergo IVF surrogacy at our Roseville practice in the Sacramento area must find someone willing to carry a child for them. Surrogates can be close friends or family members, or strangers who have been located through media advertising or a surrogate agency. Because the surrogate carries the pregnancy to term and gives birth to the child, it is unrealistic and virtually impossible for her to be anonymous. Couples should give careful thought to choosing a surrogate with whom they can be comfortable working with over a period of several months.
Prior to beginning treatment, surrogates must be fully screened to ensure that there are no conditions present that could trigger complication during pregnancy. The range of tests she must undergo includes:
The intended parents may also be required to undergo tests if it has not already been confirmed that the woman has an adequate ovarian reserve and that there are no unidentified problems with sperm quality that could hinder success.
Due to the legal complexities of a surrogate pregnancy, it is absolutely imperative to draft a contract that both parties can agree on before beginning the IVF process. The contract should be specific and thorough, addressing all aspects of the surrogacy process in detail, especially the matter of who the intended parents of the child are to be. It is necessary for the couple and the surrogate to be represented by separate attorneys, as their interests are inherently different.
Like IVF with egg donation, the process for IVF surrogacy at our Roseville practice, near Sacramento, involves the same basic steps as an ordinary course of in vitro fertilization, with a few slight differences. While the prospective mother is undergoing ovulation induction, the surrogate will be receiving medications to synchronize her cycle with that of the mother.
Once the eggs are ready, they will be collected from the mother through ultrasound-guided transvaginal aspiration and then fertilized with the prospective father’s sperm. Once embryonic development has been confirmed, between three and five days after retrieval, a few healthy embryos will be transferred to the uterus of the surrogate. Remaining embryos can be cryopreserved for later transfer, in the event that the first cycle is unsuccessful.
It is generally expected that the intended parents will stay in touch with the surrogate throughout the pregnancy, offering support. The degree and manner of their involvement in the pregnancy should be discussed before the procedure begins and agreed upon by all parties. The following are some real-life examples of conflicts that can arise during a surrogate pregnancy (all names have been changed).
Carla: Dr. Thompson delivered my three children. He even delivered me! I trust him completely and consider him a part of my family. Dr. Thompson is a family practice physician and has delivered thousands of babies over the years. I never had a problem with my previous pregnancies and I don't need a specialist for this one. I couldn't imagine going through a pregnancy without him. Why can't Laurie and Mike trust me to know what is best?
Laurie and Mike: After months of research, we have identified an experienced high risk OB/GYN with an office twenty minutes from Carla. We have spent nine years trying to have a baby on our own and will spend over $50,000 on this surrogacy. This baby is so precious to us and we're so worried something will go wrong. We've heard horror stories of tragedies that could have been prevented. We want Carla, and our baby, to have the best care possible. After all we've been through, this doesn't seem like too much to ask.
Solution: After much discussion, the parties agreed that Dr. Thompson will continue as Carla's primary physician. Her care will be overseen by the high risk OB/GYN who will review records and make periodic examinations.
Jan: I lift free weights regularly to relieve stress and keep in shape. In the summer my family and I love to water ski with our new jet boat. During my last pregnancy I was skiing through my eighth month. You should have seen the stares! I think exercise helps maintain a healthy pregnancy and builds endurance for the labor process. I would never do anything to hurt the baby. I agreed to have a baby for Steve and Sara, but I didn't agree to give up my whole life.
Steve and Sara: Sara stayed in bed for ten weeks trying to hold on to her last pregnancy. We think Jan should not take any unnecessary risks. Walking and swimming in moderation is OK, but what if she falls while skiing, or drops a weight? This is only a temporary restriction. Jan can get back to all her activities after the delivery. Taking care of the pregnancy should be the number one priority.
Solution: It is certainly in everyone's best interests for Jan to maintain good health and a positive attitude throughout the pregnancy. Jan agreed to consult with the IVF physician as well as her OB/GYN and to follow medical advice regarding activity restriction. Steve and Sara will let the physician set these parameters.
Katie: I'm a very shy person. Only my husband has been there at the births of our children. Can't Margaret and James understand it's nothing personal? The next thing they'll want is for me to have the baby on live television! The birthing process is a very private one to me. Sometimes I lose control and say things I regret. Last time I really screamed at my husband for rubbing my back the wrong way. I also am pretty shy about my body. I would be embarrassed for Margaret and James to see me this way.
Margaret and James: We want to be there with our baby from the very beginning. We want to be able to tell him or her about the birth. To not share in this time would be such a loss. This is our baby and we think we are entitled to be part of the birth. We promise to be very respectful of Katie. We have a right to be there. It feels very selfish of her to exclude us.
Solution: The parties looked for a way to honor Jan's need for privacy. It was agreed that Margaret and James will stay outside the delivery room during labor, but will be called in just before the baby is born. They agreed to stand at Katie's head and to not interfere in any way. They will be the first ones to hold the baby.
Stephanie: When I agreed to be a surrogate, I had no idea of the time it would require — doctor's appointments, meetings with the lawyer, support group meetings. I already had a busy life. I work full time, take care of my two children, and volunteer for the crisis hotline. On top of all this, Patricia calls me every other day wanting to know how I'm feeling. Then she tells me all about her life! I don't want to be rude, but I don't have time for this! The relationship is beginning to feel intrusive. Sometimes I don't answer the phone just to avoid her.
Patricia: How do you think it feels to have my baby growing in someone else's uterus over 2000 miles away? I get so worried when I don't hear from Stephanie. Hearing her voice makes me feel more secure. Even though I'd like to, I don't call every day. I want to experience this pregnancy as much as possible. I don't think it's asking too much to stay in touch with each other.
Solution: Stephanie and Patricia agreed to communicate largely by email, which feels less intrusive to Stephanie. The doctor's office has agreed to fax summaries of OB/GYN visits directly to the intended parents. Stephanie promised to notify Patricia of any change in her condition. The parties acknowledged that they had different needs and that they would try to be sensitive to each other.
It is likely that the previously described conflicts could have been avoided if, before proceeding with a surrogate pregnancy, the parties had thoroughly discussed relevant issues and set forth all verbal understandings in the written surrogacy contract. A counselor can be quite helpful in facilitating this dialogue. With sufficient commitment to the process of communication, an agreement that supports the needs of all parties can usually be reached.
Although it can be a relief and a blessing to have someone who is already close to you offer to be your surrogate, it is important to realize that navigating this journey with a family member or close friend can actually complicate matters unless the proper steps are taken to ensure the best interests of everyone involved are met.
First and foremost, it is absolutely necessary to perform all of the same pre-treatment steps as if you were undergoing IVF surrogacy with a stranger. While many people may be tempted to keep things informal while dealing with a family member, setting up the proper legal arrangements and conducting the necessary medical and psychological evaluations ahead of time will ultimately prove worthwhile.
Although the surrogate may see her participation as an "act of love," it must be recognized that the financial, physical, and emotional burdens of pregnancy are significant and that the responsibilities of both parties should be realistically and clearly addressed prior to the IVF process.
Finally, without the help of a surrogate agency to mediate between parties, the conflicts that can and do arise during this process may be extremely difficult to resolve. At Northern California Fertility Medical Center, we recommend the both parties participate in a counseling program before and during the surrogacy to help prevent or resolve any issues that may threaten the relationship.
If you are interested in learning more about the IVF surrogacy program at our Roseville practice, serving the Sacramento area, please contact Northern California Fertility Medical Center today. Our professional staff can answer all of your questions or schedule a consultation for you with one of our infertility specialists.