The gestational surrogacy transfer is the long-awaited event in surrogate motherhood that leads to surrogate pregnancy.
Details of IVF procedures are recorded here, so that you can be prepared for what is going to happen when you get to your clinic.
Though each clinic is slightly different in methods and protocol, this page will walk you thorough what commonly occurs at transfer.
Please note: This site is not intended to give medical advice.
It is for informational purposes only. Please understand that the author of this site is not a medical provider, and has a basic understanding of the IVF process due to personal experience.
Consult with your doctor for further information.
Gestational surrogate motherhood requires going through part of IVF, in vitro fertilization, in order to become pregnant with the intended parents’ child or children.
Through an egg retrieval process, eggs are harvested from either the intended mother or an egg donor, and fertilized with the sperm of the intended father. They are then transferred via gestational surrogacy transfer into the womb of the surrogate. The surrogate mother has no biological link to the child.
Details of IVF Procedures: Types of Transfers
There are two different type of embryo transfers.
Fresh Embryo Transfer
A fresh transfer is where eggs retrieved from an egg retrieval are fertilized with sperm and then transferred into the surrogate mother 3-5 days later. This type of transfer requires the surrogate mother to have her menstrual cycle synced with the intended mother or egg donor, in order that the embryos are transferred at the optimal time.
Frozen Embryo Transfer
The other form of embryo transfer is a frozen transfer. Following an egg retrieval, additional embryos that were not chosen for immediate transfer may be frozen for future use. These embryos will then be thawed for a frozen embryo transfer when needed. The transfer may follow the surrogate mother’s natural cycle, or alternately, the clinic may change her cycle to coordinate her for their own reasons (such as scheduling).
The chances of pregnancy resulting from a gestational surrogacy transfer are greater with a fresh transfer, though frozen transfers do work. Personally, I have gone through frozen transfers three times; each embryo that was transferred resulted in a live, full term birth (I was lucky; this isn’t typical.)
It is important to note that eggs themselves are rarely frozen. They contain a great amount of water that when freezing can damage the egg. Though some clinics do freeze eggs, it is usually to preserve them for cancer patients or others who do not have a partner to create an embryo with at the time of retrieval.
It is rare that a surrogate mother would experience frozen eggs (though it does occasionally happen).
Details of IVF Procedures: Starting Medication for Transfer
As soon as a surrogate mother is approved by a clinic and matched with intended parents, the clinic will most likely start her on birth control pills, to be able to regulate her cycles.
Depending on if this is to be a fresh or frozen transfer, additionally, this may be to sync her cycle with the intended mother or egg donor.
In the month prior to the gestational surrogacy transfer, she may then be placed on Lupron in order to suppress her cycle, and again, to sync her with an egg donor or intended mother.
This is nearly always done with a fresh transfer, and may or may not be done with a frozen transfer.
She will also start estradiol medications to build the lining of her uterus to make it the optimal thickness for the transfer. This coincides with the egg donor or intended mother’s start of stimming medications in preparation for the egg retrieval, if a fresh cycle is intended.
To monitor the lining, she will undergo ultrasounds as well as multiple blood tests to check her hormone levels. If there is a problem, and any of the testing comes back less than perfect, adjustments will be made to the doses or the cycle will be stopped to be continued the following month.
The week of the gestational surrogacy transfer, 3-5 days before the day of the transfer, the surrogate will start progesterone via injections, vaginal suppository, or both. This coincides with the day the egg donor or intended mother is stimmed. The progesterone is intended to release hormones to cause the embryos to implant for surrogate pregnancy. She may also be given antibiotics.
Details of IVF Procedures: The Gestational Surrogacy Transfer
The day of the gestational surrogacy transfer the surrogate mother and intended parents will usually be waiting in limbo, eagerly awaiting a phone call coming from the clinic letting them know when the transfer will be. The surrogate mother may be required to consume a large amount of water before the transfer, so that the doctor will have an easier time seeing her uterus on an ultrasound machine.
Not all clinics require the bladder to be full.
It is usually the day of the gestational surrogacy transfer that the reproductive endocrinologist will tell the intended parents how many embryos are viable for the transfer.
The doctor will usually not have this conversation with the surrogate mother at all, but will go through the intended parents only.
The surrogate mother may be given a Valium to relax her prior to the transfer.
She will then lay in a typical gynecological exam chair, with an ultrasound machine.
Via vaginal ultrasound, the doctor will cleanse the cervix with a saline solution.
Then, using the ultrasound as a guide, he will insert the embryos through the cervix into the uterus via a small, thin catheter. Each embryo will have its own catheter. This catheter is like a small, thin straw with a bulb at the end. The entire gestational surrogacy transfer takes just a few moments.
Most surrogates do not feel as though the gestational surrogacy transfer is painful. They equate it with a pap-smear for the most part. Some do experience pinching or menstrual type cramping at the time or following.
Details of IVF Procedures: Following a Gestational Surrogacy Transfer
After the transfer is completed, the surrogate mother will be required to lay prone on the table/chair for a period of time.
This varies by clinic, but could be anywhere from a few moments to upwards of an hour.
She is then free to return home or to a hotel room, where she will most likely undergo a modified bedrest.
This is where the doctor requires her to lay abed getting up only to do routine things like going to the restroom, getting a drink of water, answering the door, etc. This bedrest, if required, is generally from one to three days.
Surrogate pregnancy tests are routinely done via blood test two weeks after the embryo transfer. They are repeated every two days until pregnancy is confirmed or it is clear that a surrogate pregnancy was not achieved.
The surrogate mother will continue with estradiol and progesterone injections until the pregnancy test. If the transfer has failed, she will discontinue medications. If it was successful, she will continue through the first trimester of surrogate motherhood.
Details of IVF Procedures: Typical Restrictions
Typically, a surrogate mother will be required to abstain from sexual relations through the first trimester. She may also be restricted from exercise as an added precaution.
In addition, a surrogate mother will most likely be asked not to lift more than 5-10 lbs throughout the first trimester, and more than 15 lbs throughout the pregnancy. The biggest hurdle surrogate mothers face with this restriction is being able to pick up their own child.
Details of IVF Procedures: Chaotic Clinics
As you begin to go through the IVF process, whether as an intended parent or as a gestational carrier, you will find that clinics seem, well, chaotic at times.
This is normal, and is not indicative of a bad clinic.
For lack of better words, many surrogates have felt as though the clinic acts like a “chicken with its head cut off” during the weeks leading to transfer.
You can expect an attitude of “this-needs-to-be-done-now” with various testing and procedures, leaving you little time to prepare.
It may seem frustrating as had you known that such procedures were necessary, you could easily have planned for them in advance. You may be treated as though you are familiar with various procedures and medication whereas it is all quite new to you.
As a surrogate mother, you may feel as though you are being left out of the loop. Clinics and doctors generally treat the intended mother as the patient, even when using an egg donor. They do not consult with the surrogate except as needed. It can feel as though a surrogate is nothing more than an incubator.
This chaos is all worthwhile when it is over, and a surrogate pregnancy is achieved. After the pregnancy is verified, the IVF clinic will most likely turn the surrogate mother over to her regular OB/GYN.
- Getting Started Guide
- Surrogacy Requirements: Health
- Surrogacy Requirements: Family
- Truth About Compensation
- Gestational Surrogacy Compensation
- Surrogacy Compensation
- Gestational Surrogacy Medications
- How to Give an Injection
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