We at Ankoor Fertility Clinic are willing to help you, you just have to help us by participating. We are here to bridge the gap. As today we live in a society that is more aware, is more accepting, is more willing to change for the better, why then deny a childless couple the right to parenthood? Let us give you insights into helping you bust your myths about surrogacy in Mumbai.
What is surrogacy treatment?
Surrogacy is when a woman due to any medical condition or otherwise is unable to carry a child in her own womb (uterus) and has to take the help of another woman to carry her child in her womb and deliver it.
What are the types of surrogacy procedure?
The different types of surrogacy are – Traditional surrogacy and Gestational surrogacy.
In traditional surrogacy, a surrogate mother is artificially inseminated, either by the intended father or an anonymous donor and carries the baby to term. The child is thereby genetically related to both the surrogate mother, who provides the egg and the intended father or anonymous donor. This is BANNED in India.
In gestational surrogacy, an egg is removed from the intended mother or an anonymous donor and fertilized with the sperm of the intended father or anonymous donor. The fertilized egg, or embryo, is then transferred to a surrogate who carries the baby to term. The child is thereby genetically related to the intended mother or woman who donated the egg and the intended father or sperm donor, but not the surrogate.
Gestational surrogacy can be Altruistic or Commercial. Read More
Altruistic surrogacy refers to those surrogacy agreements where the surrogate does not receive monetary compensation. In most altruistic surrogacy agreements, the surrogate is a close relation to the intended parents (family member/close friend).
A commercial gestational surrogacy agreement includes a predetermined monetary compensation to the surrogate, in addition to covering medical costs, etc.
Who is a commissioning couple / intended parents?
A couple who will raise the child once it is handed over to them by the surrogate is known as a commissioning couple or intended parent. The commissioning couple may both be the genetic parents, or just one or neither of them may be genetically related to the child.
To whom surrogacy in Mumbai is advised?
The above are a few listed medical conditions wherein it may be difficult or sometimes impossible to bear a child in your own wombRead More
- Absence of her uterus since birth which is a congenital abnormality. Such women will never have menses/periods.
- Conditions like cancer, severe bleeding in the previous childbearing which could not be controlled or Rupture (tear) uterus leading to obstetric hysterectomy (removal of the uterus ) in order to save the mother’s life.
- Damaged uterine lining esp in INDIA
Eg: A) Tuberculosis (these women may not have cough or fever but may experience very less bleeding during menses) OR
- Women who have repeated miscarriages
- Women who have repeated failed IVF cycles
- Any medical condition that would endanger the life of the mother.
- A severe case of Rh isoimmunisation.
B) Repeated cleaning of the uterus (D&C)Read More
- The inner lining of the uterus is damaged because of which the embryo would not be able to implant in it.
What is the success rate of surrogacy centres in Mumbai?
- The success rate of surrogacy centres in Mumbai is very good with a carry home baby rate of around 60%.
Can a woman of any age be a surrogate mother?
Surrogates are selected only in the early reproductive years (up to 35 years) of her life and she should have already proven her fertility by giving birth to her own child.
What are the different routes of conceiving at Ankoor Fertility Clinic – in case we as a couple is desirous of conception?
Can a surrogate ever conceive with donor eggs?
Yes, in fact, the chances of conception with donor eggs are much better as the donor is a young healthy woman eg 50-60 % (donor egg) vs 20-30% (self egg).
Surrogacy in Mumbai with donor eggs – when does one need it?
In the following situations, you may need a donor egg for your surrogate
- Due to aging the number and quality of eggs have reduced drastically.
- If you have no functioning ovaries due to premature ovarian failure
- If you have streak ovaries due to some congenital anomalies.
- Sometimes the ovaries may have been removed due to cancer or severe endometriosis etc
- A woman who is at risk of passing a genetic disease to her offspring.
- If in the previous failed IVF cycles bad oocytes quality was observed.
Is Surrogacy in Mumbai right for you?
Opting for surrogacy is an emotional roller coaster ride for the couple, the families, and friends. It is a decision where the ‘right’ and the ‘wrong’ are very individual things.
We as infertility specialists can help the couple see things in the correct perspective.
We also have a psychological counselor in our clinic – who takes care of all your emotional rides through this journey.
What are the screening criteria for a surrogate? How is a surrogate chosen?
The surrogate and her partner are screened for the following
A detailed history of the surrogate and her husband is taken.Read More
- Age/ Marital status/ EDUCATION/ OCCUPATION
- Menstrual & Obstetric history (how many pregnancies she has had, when was the last pregnancy, any history of recurrent abortions, etc. to determine fertility potential)
- Family history (history of any genetic/congenital abnormalities in any family member)
- Personal history(habits like using tobacco, smoking, drinking, what is the contraceptive being used)
- Any history of blood transfusion
- A drug intravenously administered into her through a shared syringe
- Last coital date
- The couples extramarital relationship status in the last six months
We at Ankoor Fertility Clinic, also carry out blood tests and screen for any hormonal abnormality in the surrogate, any major blood disorder, and infections that can be transmitted to the baby. Detailed pelvic sonography is done to ensure maximum chances of success. We also do blood tests of the donor’s husband to screen for any infectious diseases that may be transmitted to the baby if not screened early.Read More
What is the surrogacy procedure involved?
A detailed financial and legal agreement is then made between the surrogate and the commissioning couple
Protocol for getting the eggs:
Protocol to prepare the surrogate mother:
For IVF surrogacy in Mumbai matching of the menstrual cycles of the genetic mother and the surrogate is done by adjusting their menstruation dates by oral contraceptive pills.
When the cycle starts, the surrogate is put on estrogen tablets to prime the uterus.
- THE PROTOCOL USED FOR THE GENETIC MOTHER is day 2 protocol or day 21 protocol depending on the age of the genetic mother and other test results.
For the day 2 protocol called the ‘Antagonist protocol’, oral contraceptive pills are given in the previous month. On the 2nd day of the periods, gonadotropin injections are started and doses adjusted according to ultrasound findings. When the size of the follicle reaches 14 mm the genetic mother is given an antagonist injection to prevent a surge of endogenous hormones.
For the day 21 protocol called the ‘Long protocol’, GnRH analogs are started on day 21 of the previous cycle. Once the genetic mother gets her periods, gonadotropin injections are started.
In both the protocols, when the follicle reaches a 17-18 mm size hCG trigger is given and eggs are retrieved from the genetic mother 36 hours after the trigger injection. On the same day, the genetic father gives his semen sample. The eggs of the genetic mother are fertilized with sperms of the genetic father in the laboratory by IVF / ICSI procedure.
- THE PROTOCOL USED FOR THE GENETIC MOTHER
When her menses start, the surrogate is put on estrogen tablets to prime the uterus, and serially her ultrasound is done. Once her endometrial lining is ready for implantation, the surrogate is started on progesterone tablets on the day of oocyte retrieval of the genetic mother.
The embryo which has resulted from the above-mentioned procedure is transferred into the womb of the surrogate under ultrasound guidance. The surrogate is then put on luteal support using progesterone tablets/ injections and pregnancy is confirmed using a simple blood test done 15 days later.
How is the nine months journey like for the surrogate?
The surrogate is treated as a high-risk pregnancy
Appointments are scheduled with the consultants every two weeks for the first 6 months, then every week for the next 2 months, and then weekly / biweekly in the last month.
Her health and hygiene are of utmost importance and adequate care is given for the same. She is provided with a nutritious diet and clean water. The surrogate and her husband are explained about not having intercourse or any physical relations for one month prior to her enrollment till 3 months post-delivery. This is explained to them during their counseling session with the psychologist and later on by the doctors also. This is emphasized in every ANC visit also.
Blood tests required in any antenatal care are done and special tests to pick up any obstetric or medical complications like hypertension, diabetes, etc. at the earliest may also have to be done.
Two doses of Inj. Tetanus toxoid is given during pregnancy. The baby’s growth is monitored stringently.
Ultrasound is done at 6 weeks to confirm pregnancy and the viability of the baby, then at 12 weeks to assess growth and certain parameters like nuchal thickness.
At 18 -20 weeks, a detailed level III ultrasound is done to detect any abnormalities in the baby.
At 28 weeks and 34 weeks, Color Doppler is performed to assess the growth of the baby and rule out intrauterine growth retardation.
We also give an injection in the 7th month to help in fetal lung maturity to minimize neonatal distress if the surrogate goes in preterm labor.
Fetal well-being tests like non-stress tests are done as and when required.
Thus it is taken care that adequate nutrition reaches the baby and baby’s growth is maintained.
We keep the couple posted on the progress of the baby and send them ultrasound pictures and blood reports as and when they are done.
A surrogate mother registers as a patient in her own name. While registering she mentions that she is a surrogate mother and provides all the necessary information about the genetic parents such as names, addresses, etc. She must not register in the name of the person for whom she is carrying the child, as this would pose legal issues, particularly in the untoward event of maternal death (in whose names will the hospital certify this death?)
We have an LDRP (Labour Delivery Recovery Puerperium) room for delivery which is equipped to handle any obstetric emergency.
Is it possible for me to feed my baby after surrogacy?
YES …It is very much possible that the intending parent can feed her baby in spite of not carrying her in your womb.
What are the different ways by which children born through surrogacy may receive breast milk?
Just because the baby is born through surrogacy does not mean he or she cannot receive breast milk and the many health benefits it provides.Read More
Benefits of Breastfeeding:
- Breastfed babies have been found to have higher IQs, more protected from leukemia, and less likely to have problems with obesity.
- Breast milk protects babies from getting diarrhea, ear infections, and respiratory problems such as asthma.
- Premature babies who receive breast milk are more protected from infections and high blood pressure later in life. Breast milk contains the protein CD14 which works to develop B cells which are immune cells that are needed in the production of antibodies in an infant to build the baby’s immunity system.
- The babies may drink breast milk acquired through a milk bank, breast milk donor may be located or the intended mother may induce lactation before the birth of the baby.
Also, it can receive benefits through induced lactation.
Induced lactation has been embraced by the nursing community as a welcome method to enhance the bonding relationship between a new mother and baby born through surrogacy.
Lactation involves two hormones: Prolactin is considered the milk-making hormone while oxytocin is the hormone responsible for releasing breast milk. Both of these hormones are controlled by the pituitary gland and are therefore not ovarian hormones. This means that even in a woman who has undergone a hysterectomy lactation can be induced.
The hormones involved in inducing lactation both respond to nipple stimulation and thus respond to manual stimulation such as:
- breast massage
- nipple manipulation
- sucking by baby
- sucking by a hospital-grade electric breast pump
While manual stimulation alone should be sufficient in inducing lactation, hormonal therapy to induce lactation is also available. This typically involves administering high levels of estrogen hormones in order to simulate pregnancy. This is followed by the abrupt withdrawal of estrogen to mimic the hormonal environment in a woman’s body after birth.
Medication to enhance prolactin levels will then be administered and sucking – whether by a baby or a pump – will begin at this point.
Inducing lactation can take anywhere from 5 days to 4 months, so expecting mothers often begin to induce lactation during the third trimester of a surrogate pregnancy. Inducing lactation should only be attempted with the guidance of a pediatrician, lactation consultant and/or doctor.
How will I know that the surrogate will give me my baby after birth?
As per guidelines by the Indian council of medical research (ICMR), surrogates are selected from ICMR accredited Assisted Reproductive Technology (ART) banks . Following this a legal agreement is made between the commissioning couple and the surrogate couple which is notarized. It has all the clauses as mentioned by the ICMR which includes handling over of the baby, compensation to be given to the surrogate mother, whom to hand over the baby in case of death or separation of either of the intending parents.
Further, post delivery of the surrogate , the birth certificate is made in the name of the intending parents.