Surrogacy Treatment Program
Provisional selection of Surrogate
Once your treatment plan has been decided , the first step is to select a surrogate mother. In compliance with ICMR guidelines we recruit surrogate from Surrogacy Agencies.
The surrogates are provisionally screened based on basic eligibility criteria (see surrogate selection criteria). At this stage the surrogate's documents are also verified and the results of the verification are also conveyed to the Intended parent(s). We will also be handling all the legal agreements between the Surrogate, Caretaker, Intended parents , IHR and SURRO SERVICES. If the intended parent(s) so desire, we will arrange a meeting with the surrogate. We will go ahead with the surrogate's pre-treatment evaluation only after obtaining the formal consent from the Intended Parent(s).
Surrogate evaluation and selection
The surrogate's complete medical and family history is taken and the surrogate and her husband are investigated as per the surrogate selection and evaluation guidelines provided by the Indian Council of Medical Research. (See Surrogate selection criteria)
If after evaluation the surrogate is found to be medically fit then the surrogate is selected for further treatment. The surrogate is also psychologically counseled and informed about the risks associated with surrogacy. The surrogate and her husband's consent is obtained before her treatment can be initiated.
Donor selection and investigations
If an egg donor is required then prospective egg donors are screened and evaluated as per ICMR selection criteria (see egg donor selection criteria). Most of the egg donors are sourced locally (Eastern India). They have wheatish to dusky complexion. Fair skinned egg donors are less common. We attempt to match the egg donors according to the Intended Parent(s) requirements.
Foreign Donors:
If you insist we can engage the services of Specialized Egg donor agencies.
Donor Confidentiality:
As per Indian norms (ICMR guidelines) the Egg donor information is confidential. We therefore cannot provide any picture or disclose the identity. We can however provide the donor's medical reports that will prove the donor is in good health and free of sexually transmitted diseases. We can also provide donor profile on paper on request. The donor profile will include Physical profile, Test Results, Basic Background Information like age, marital status, no of children.
Once the Intended parents provide their formal consent to go ahead with the donor, we can start the egg donor's ovarian induction cycle.
Ovarian Induction, Pick up & IVF.
The Intended mother (Self Surrogacy) or the Egg donor ( Egg Donor Surrogacy) undergo ovarian stimulation , eggs are harvested and fertilized to obtain embryos. The whole process takes 15-20 days and involves the following stages:
Hormonal injection on day 2 of the menstrual cycle: Marks the start of Ovarian Stimulation.
Follicular monitoring till the date of ovulation:A series of USG Trans Vaginal scans are done over a span of 7-12 days from the date of commencement of Ovarain Induction, to monitor the growth of the follicles. This is called follicular study. From this data the date and time of ovulation can be determined.
Ovum Pick-Up:The eggs are collected on the day of ovulation and taken to laboratory for further processing.
IVF / ICSI :Invitro fertilization is initiated about 2-3 hours after the Pick-up. Sometimes Intra cytoplasmic Sperm Injection (ICSI) may need to be carried out. The fertilization of the eggs are completed by the end of the same day.
Culturing of Embryos: The embryos are cultured for a few days till they attain the stage which is ideal for Embryo Transfer (Blastocyst stage). During this stage the growth of the embryos are monitored periodically to see if they are dividing normally.
Surrogate Preparation.
The Surrogate's endometrium preparation has to be started in synchronization with ovarian induction so that the surrogate's endometrium achives the desired thickness by the time the embryos are ready for transfer. Therefore the
ovarian stimulation of the egg donor/ intended mother is started first. The surrogate's preparation cycle is therefore timed according to the stimulation cycle. If the embryos are ready before the surrogate is ready then they can be cryopreserved.
Patients who opt for self transfer along with transfer to surrogate mother need to plan their visit and stay well in advance, by consulting with our gynecologists who will advice you about your stay according to your treatment plan.
Endometrium Preparation involves administration of oestrogen hormone (Estradiol Validate 2mg twice/ trice daily) to the Intended mother along with folic acid supplements and Ecosprine till the desired endometrium thickness is achieved (usually takes 15-20 days) . Estragel (2.5 gms) needs to be applied on abdominal skin twice or trice daily for the same duration. Simultaneously Endometrium Thickness study is done which involves regular measurement the Endometrium Thickness using Ultrasonography. It takes 15-20 days to usually attain the proper thickness which should ideally be at least 7mm and above.
Embryo Transfer
Only maximum of two embryos are transfered in a single attempt. Intended parents reserve the right to cryopreserve the extra embryos. After ET, the surrogate mother is immediately shifted to the surrogate house and will remain there till positive pregnancy test which is conducted two weeks after transfer.
Positive Pregnancy test.
Post ET Care and Management till Delivery and post partum recovery of surrogate mothers is run under the aegis of "SURRO-SERVICES". Surro services has all the facilities to house Surrogate mothers, dedicated caretaker and staff to look after the day to day health and well being of the surrogate mother
The Surrogate mothers are shifted to Surro-Services on the same day after ET procedure. This is done to segregate the surrogate from her husband and therefore reduce the risk of STD. The Surrogate mother will remain at Surro - Services till positive pregnancy test is conducted two weeks after transfer.
If Pregnancy is Negative:If the result is negative, and there are extra embryos under cryopreservation, Intended Parent(s) can opt for another cycle with the same surrogate or a different surrogate
If Pregnancy is positive: If the result of the pregnancy test is positive the surrogate will continue to remain in the surrogate house till 6 weeks post delivery. 6 weeks post partum recovery is medically recommended and the Intended parents are responsible for all the medical, food, lodging expenses of the surrogate that may be incurred during the post partum recovery period.
Once the surrogate mother is positive she will visit IHR every 15 days for follow ups during which the surrogate's general health and fetal growth assessments will be made by routine investigations and Ultrasound Monitoring. The Surrogate's designated Care Taker will accompany the surrogate during these visits.
Apart from the routine tests the surrogate will also undergo some special investigations that are carried out in 3D/4D using the State of the Art Ultrasound technology provided by Voluson S6 USG machine form Wipro G.E health care. These special investigations are as follows:
  • First trimester screening for Downs syndrome at 11-13 weeks of GA
  • Fetal Anamoly Scan at 19-20 weeks GA (Second trimester)
  • Foetal echo at 24 weeks
  • USG Feto-Placental profile in third trimester.