SURROGATE MOTHER
Presenter :
Kiran Shahnaz
Rubab Batool
INTRODUCTION
The word “surrogate” is originated from latin word
“subrogare”, which means “appointed to act in the place
of”.
A surrogate/surrogate mother is a women who carries a
child for someone else, and the process is called surrogacy.
The fertility clinic offers surrogate mothers between the age
group of 23 to 40 yrs, preferably a married women with kids
to carry the baby for another women who are unable to
carry the pregnancy in their womb due to some medical
conditions.
METHODS OF SURROGACY
Gestational surrogacy:
In this method, the child is genetically unrelated to
surrogate. The embryo is created via in vitro fertilization
(IVF), using the eggs and sperm of the intended parents
or donors, and then transferred to the surrogate who is
often referred to as a gestational carrier.
The embryo is created using the intended father’s
sperm and the intended mother’s eggs.
CONTINUED….
Gestational surrogacy:
The embryo is created using the intended father’s
sperm and a donor egg.
The embryo is created using the intended mother’s egg
and donor sperm.
A donor embryo is transferred to a surrogate.
CNTD…
A traditional surrogacy (partial, natural, or straight
surrogacy) :
In traditional surrogacy, surrogate’s egg is fertilized in vivo by
the intended father’s or a donor’s sperm.
Insemination of the surrogate can be either through natural or
artificial insemination.
Using the sperm of the donor results in a child who is not
genetically related to the intended parents.
INDICATION
Absence of uterus; which may be innate or due to
hysterectomy.
Significant uterine anomaly. Eg: irreparable Asherman
syndrome, Unicornuate uterus associated with recurrent
pregnancy loss.
Absolute or serious medical contraindication to pregnancy.
Eg: pulmonary hypertension.
Biological inability to conceive. Eg: single male, homosexual
male couple.
CNTD…
Unidentified endometrial factor. Eg: multiple unexplained
previous IVF failures despite the transfer of good-quality
embryos, recurrent miscarriages and implantation failure.
COUNSELING
For the genetic couples:
A review of all alternative treatment options.
The need for counseling.
They need to find their host.
The practical difficulty and cost of treatment.
The medical and psychological risks of surrogacy.
Potential psychological risk to the child.
The chances of having multiple pregnancies.
Possibility of child born with abnormality..
For the genetic couples:
Possibility of smoking and drinking during pregnancy.
The possibility that the host may wish to retain the child after birth.
The importance of obtaining legal advice associated with surrogacy.
CONTINUED…
For the host:
The full implications of undergoing treatment by IVF and
surrogacy.
The possibility of multiple pregnancies.
Social implication associated with surrogacy practice.
Abstinence from unsafe sex during and just before the
treatment.
The medical risks associated with pregnancy and possibility of
caesarian section.
Psychological risks associated with surrogacy.
CNTD…
For the host:
The possibility of sense of bereavement while giving baby to
the genetic parents.
The possibility that the child may be born with abnormality.
PROCESS OF SURROGACY
Find a surrogate and create a legal contract and have it
reviewed.
The embryo transfer could be fresh or cryopreserved.
For a fresh surrogate transfer, medications (eg: oral
contraceptive pills or progesterone) are used to synchronize
the menstrual cycles of both the gestational surrogate and
intended mother.
The intended mother uses fertility medication to stimulate
the development of eggs.
The gestational surrogate takes medications to prepare her
CNTD…
At the appropriate time, the eggs are removed from
the intended mother(or independent egg donor) and
fertilized in vitro with her partner’s sperm( or with
donor sperm).
The cultured embryos are then transferred into the
uterus of gestational surrogate.
Once a pregnancy is confirmed, a surrogate either stays
in surrogate house or her home and obstetric care is
provided.
CNTD…
Once a pregnancy is confirmed, a surrogate either stays
in surrogate house or her home and obstetric care is
provided.
As the child is born, the intended parents obtain full
legal custody as outlined in the legal contract.
The process may differ according to the type of
surrogacy and country
COMPLICATIONS
Multiple pregnancy and obstetric complications.
Emotional trauma to surrogate after having to relinquish
the child.
The host may wish to keep the child.
An abnormal child may be rejected by both genetic and
host parents.
The question of whether it is ethical to pay hosts and if so
how much.
COMPLICATIONS
The long term effects on children born as a result of
gestational surrogacy are not known.
The long term psychological effect on both the genetic
couple and host surrogates is not known.
A few genetic woman have responded poorly to
follicular stimulation.
