The age of the genetic mother is of great importance in surrogacy. Depending on the age of the mother, the protocol for surrogacy is maintained. Surrogate pregnancy is to be continuously monitored as it is considered a high risk pregnancy. Read on.
The age of the genetic mother and the outcome of the medical tests determine whether the physician would choose a two day protocol or a twenty-one day protocol. The former one is medically termed as Antagon protocol, where the oral contraceptive pills are administered on the previous month. Gonadotropin injection is prescribed on the said days of the periods. This is followed by a regular USG monitoring. Antagon injection is administered when the size of the follicle becomes 14mm. This stops the gush of the endogenous hormones.
The twenty-one day protocol is called the Long Protocol, where the GnRH analogue commences from the twenty-first day of the previous menstrual cycle of the genetic mother. Then when the periods start, gonadotropin injections are administered simultaneously. hCG trigger is injected when the follicles reaches 18mm. Progesterone tablets are prescribed to the surrogate on the day the hCG is injected to the genetic mother. The oocyte or the egg is retrieved after 36 hours which generally falls on the twelfth or the thirteenth day of the cycle. On the same day, the egg is inseminated with the sperm taken from the genetic father.
Fertilisation and Confirmation of Pregnancy
The fertilisation of the eggs of the genetic mother with the sperm of the genetic father is performed in the clinical laboratory.
- The physician may decide to do it either by the IVF or ICSI method. The embryo is then planted inside the womb of the surrogate mother. This entire process is conducted under the guidance of the ultrasound technique.
- At this stage the luteal support is granted to the surrogate mother to ease out the initial stage of the pregnancy and in order to make it a successful one.
- This is basically done through the administration of progesterone tablets or it can also be given in the form of injections. It is usually after a period of fifteen days, the pregnancy is termed as confirmed.
This Is a High Risk Pregnancy
A surrogate pregnancy is always considered to be a very delicate case. There are usually more than doctors who monitor the progress of the pregnancy. The surrogate has her appointment scheduled at regular periodic intervals. For the first six months, she has to attend for a gynecological checkup. For the following two months the visits are scheduled at a gap of fifteen days and for the final month, the visits can be weekly or twice a week depending on the status of the fetus and the mother.
During the pregnancy a number of blood tests and ultrasounds can be conducted as decided by the physician. Most of the blood tests are routine ones like -
Pregnancy often comes with certain medical complications like diabetes and hypertension. These issues are taken care of through medications. The first two doses of Tetanus are usually given during the pregnancy itself.
- Blood group determination
Monitoring of the Baby's Growth
- The final confirmation of the pregnancy comes after the ultrasound conducted after six weeks of the transplant of the embryo.
- After twelve weeks, the growth of the baby and certain other parameters like the nuchal thickness is assessed.
- A level III ultrasound is performed after the eighteenth week. This assures whether there are abnormalities in the fetus.
- If the genetic mother is over 35 years, amniocentesis is conducted after 16 weeks.
- Color Doppler is performed between 28-34 weeks. It rules out intra-uterine growth retardation if any and assessed the growth of the baby.