MEDICAL PROCESS

With gestational surrogacy, intended parents can use the mother’s egg or a donor egg as well as the father’s sperm or donor sperm. With gestational surrogacy, the carrier has no biological tie to the embryo that is transferred to her during the in vitro fertilization cycle.

When using an egg donor and the intended father’s sperm, the medical process is as follows:

FDA Testing of the Egg Donor and Intended Father: The FDA requires the egg donor and sperm provider to undergo the following tests for the egg provider 30 days prior to retrieval and 7 days from sperm production for the sperm provider:

1. HIV-1 antibody and NAT (or MPX)
2. HIV-2 antibody
3. HIV group O antibody
4. Hepatitis C antibody and NAT (or MPX)
5. Hepatitis B surface antigen
6. Hepatitis B core antibody (IgG and IgM)
7. Serologic test for syphilis (TP or RPR)
8. Both the egg provider and sperm provider must also have:
   1. Neisseria gonorrhea and Chlamydia trachomatis NAT on urine or a swab
9. Additional testing for the sperm provider must include:
   1. HTLV-1 and HTLV-2
   2. Cytomegalovirus (CMV) (IgG and IgM)

In the case of an anonymous egg donor, the FDA testing that is required is done by the egg bank from which the anonymous donor egg was obtained.  The egg bank will provide a Summary of Records and indicate the anonymous donor egg is FDA eligible for use.

ASRM recommends testing the egg donor’s and sperm provider’s blood types and Rh factor along with gestational carrier’s blood type and Rh.  If there is the potential for Rh incompatibility, all parties should be informed about the obstetric significance of this condition.

Ovarian Stimulation: On day 2 or 3 of the menstrual cycle, medication is prescribed to the egg donor to stimulate the growth of multiple follicles in her ovaries. During this time, follicular growth is monitored through ultrasound as they develop into eggs, and hormone levels are tracked through blood tests. Medication protocols are changed as needed. 36 hours before the scheduled egg retrieval, a trigger shot(s) is given to induce maturation of the eggs within a scheduled timeframe.

Egg Retrieval (OPU): Eggs are retrieved using a thin ultrasound-guided needle during a short procedure under sedation. The number of eggs retrieved from the egg donor depends on her body’s response to the medication.

Sperm Collection and Embryo Creation: On the day of egg retrieval (or egg thawing in case of frozen donor eggs), a sample is collected from the intended father to fertilize the donated eggs.

Testing of Gestational Carrier: At Gift of Life Surrogacy, we require that gestational carriers and their partners (if applicable) undergo the following tests within 90 days of embryo transfer:

1. HIV-1 antibody as well as NAT (or MPX)
2. HIV-2 antibody
3. HIV group O antibody
4. Hepatitis C antibody and NAT (or MPX)
5. Hepatitis B surface antigen 1304
6. Hepatitis B core antibody (IgG and IgM)
7. Serologic test for syphilis (TP or RPR)
8. CMV (IgG and IgM)
9. Additional testing for the gestational carrier’s male partner (if applicable):

1. 1. HTLV-1 and HTLV-2
   2. Cytomegalovirus (CMV) (IgG and IgM)

Embryo Transfer: Embryo transfer is a minor procedure. Following the procedure, the gestational carrier’s hormone levels are tracked through blood test to confirm pregnancy. Any fresh embryos that are not transferred to the gestational carrier may be frozen and used in a future cycle.