You will undergo a cursory physical examination, a hysteroscopy (fluid ultrasound done using a very small camera) to ensure there is nothing in your uterus that could inhibit a pregnancy, blood testing and cervical cultures for infectious diseases (STDs), and drug and nicotine screening. Your spouse/partner (if applicable) as well as the Prospective Parents (or Prospective Father and Egg Donor) will have infectious disease tests run. Within a week of the embryo transfer, the Prospective Parents (or Prospective Father and Egg Donor) will have certain tests repeated, pursuant to FDA regulations.
IVF AND IUI MEDICAL PROCESSES
It is strictly your decision as to whether becoming a Gestational Surrogate or a Traditional Surrogate is right for you. The following are the medical processes associated with both and are typical protocols. Protocols can vary clinic to clinic and the Prospective Parents' clinic may have a different protocol.
You will be put on birth control pills to coordinate your cycle with that of the Prospective Mother. You will take a medication called Lupron, which is used to shut down your ovaries (this is ensure that you have no biological tie to the baby). The Prospective Mother will generally commence the use of Lupron or equivalent medication to manipulate the timing of the release of eggs. At the appropriate time, following an ultrasound to confirm your ovaries are quiet and there are no cysts, you will begin taking supplemental estrogen to build up your endometrial lining and the Prospective Mother will commence administration of ovarian stimulation medications. The clinic will monitor you both via ultrasounds - you to check your uterine lining and the Prospective Mother for follicle development - and blood draws to check hormone levels. You will commence taking supplemental progesterone to nourish the anticipated pregnancy approximately three days prior to the embryo transfer. Approximately 3 to 5 days following the creation of the embryos, a specified number of embryos will be transferred into your uterus (typically 2). After clinical confirmation of pregnancy by blood test (beta hCG) and a second beta two days later to confirm the number is increasing appropriately, you will be scheduled for a pregnancy confirmation ultrasound that will take place approximately one month from the date of the embryo transfer. You will have a couple more ultrasounds and be weaned off the supplemental hormones between 9-12 weeks of pregnancy, when you will "graduate" from the fertility clinic and commence obstetrical care.
You will meet with the physician to monitor your cycle, and will typically have one or more ultrasounds to monitor follicle development and your uterine lining. Medications may be used (although typically for the first few cycles they are not), based upon the physician’s protocol and recommendations as well as the parties’ agreement. An ovulation predictor kit will be used to determine when a LH (luteinizing hormone) surge has occurred. Ovulation will generally occur 25-35 hours after the surge. When the ovulation predictor test is positive, you will return to the fertility clinic for the inseminations. Most often, the clinic will perform an intrauterine insemination (IUI), depositing the semen directly into the uterus, thus bypassing potentially hostile vaginal secretions. Frequently, more than one insemination will be performed. Approximately two weeks later, a blood test or urine test will determine whether you are pregnant. Traditional Surrogates will generally commence obstetrical care around 8-9 weeks of pregnancy.