Understanding the Science: How Surrogacy Works from a Medical Perspective
- Carlos Diaz
- Aug 15, 2024
- 4 min read
Updated: Aug 22, 2024
Surrogacy is an intricate process that blends advanced medical technology with the natural miracle of life. Understanding both the science and nature behind surrogacy can make the journey feel more connected and reassuring. In this article, we explore the key stages, from the rigorous screenings to embryo development and pregnancy, while highlighting the medical details that make this process both scientifically robust and naturally profound.
1. The Initial Medical Screening for Intended Parents (IPs)
For intended parents, the journey begins with comprehensive screenings. These include blood tests, hormone panels, and genetic carrier screening such as the Horizon test. The Horizon test identifies potential carrier diseases in intended parents, and if a risk is detected, the egg donor can also undergo the same test to minimize potential genetic risks for the baby. Additionally, a spermogram (semen analysis) evaluates sperm quality, considering factors like motility, morphology, and concentration. Psychological evaluations are also conducted to assess emotional preparedness for the journey ahead.
2. Egg Donor Testing: Ensuring Quality and Safety
Egg donors undergo exhaustive testing, including genetic carrier screening (if selected), infectious disease testing, hormone assessments, and ultrasounds. The ideal age range for egg donors is typically between 21 and 30, as younger donors tend to produce higher-quality eggs. Donors are thoroughly screened to ensure they meet health and medical requirements that align with best practices, providing intended parents with the best possible chances for success.
3. Human Subfertility and Embryo Grading: Navigating Nature’s Challenges
Humans are naturally sub-fertile as a species, meaning that even under optimal conditions, conception isn’t guaranteed. After eggs are retrieved and fertilized, embryos are cultured for up to seven days and graded based on development, symmetry, and cell quality. Embryos are graded using a system like 5AA or 6AB, where the first number represents the development stage and the letters describe the quality of the inner cell mass and trophectoderm.
Embryos that reach the blastocyst stage on days 6 or 7 are still viable but may have slightly lower success rates compared to day 5 embryos. The preference for day 5 embryos stems from their higher implantation potential, as they have reached the ideal stage of development when transferred. Mosaic embryos, which contain both normal and abnormal cells, can still be viable depending on the degree of mosaicism. Non-invasive PGT-A (Ni-PGT-A) allows for genetic testing of these embryos without invasive biopsies, improving the chances of selecting healthy embryos.
4. The Surrogate Selection and Preparation Process
Selecting the right surrogate is a critical step. Surrogenics requires surrogates to have had at least one successful pregnancy and delivery, ensuring they are physically capable and emotionally ready for the journey. Surrogates undergo extensive medical and psychological evaluations, including a hysteroscopy to examine the uterine lining for any potential issues. Hormonal treatments like estrogen and progesterone prepare the surrogate’s uterus for implantation. Many surrogates must first stop contraceptives and undergo treatments to regulate their cycles. This synchronization with the embryo transfer process is essential for a successful implantation.
5. The Role of Nature in the Process
While surrogacy is grounded in science, it’s also deeply influenced by nature. Even with all the advanced technology, the process still relies on natural factors, such as how a surrogate’s body responds to treatment or how embryos develop. Each stage is a collaboration between science and nature, and although we can control many elements, there’s still an inherent unpredictability that makes this journey unique and personal. This balance is what makes surrogacy both a precise medical process and a profoundly natural experience.
6. Embryo Transfer and Gender Selection
Once the surrogate’s body is ready, the embryo transfer takes place. The transfer is guided by ultrasound and involves placing the most viable embryo into the surrogate’s uterus, as determined by the embryologists. In cases where PGT-A (Preimplantation Genetic Testing for Aneuploidies) has been performed, some intended parents may express a preference for gender selection. While this preference can be considered, the priority is always to transfer the healthiest embryo first. It’s important to note that while gender selection is possible, it cannot be guaranteed as it depends on the availability and quality of embryos. Following the transfer, progesterone support continues, and a beta hCG test is conducted 10-14 days later to confirm pregnancy.
7. Pregnancy Monitoring and Staying Connected
After pregnancy is confirmed, the journey continues with regular ultrasounds and hormone monitoring. Intended parents can stay involved through virtual appointments, shared reports, and even sending personalized audio recordings to the surrogate. These recordings, whether of lullabies or stories, can help the baby recognize the parents’ voices even before birth. The relationship between the surrogate and intended parents often deepens during this time, as they share the excitement of each milestone.
8. The Birth Plan and Delivery: Bringing It All Together
As the pregnancy progresses, detailed birth plans are developed to ensure that everything runs smoothly when the big day arrives. The intended parents are usually present at the birth, ready for immediate skin-to-skin bonding. Surrogenics’ legal and medical teams work closely to manage all necessary documentation, ensuring that the intended parents are fully recognized as the baby’s legal guardians from the moment of birth.
9. Post-Birth Legal Procedures and Documentation
After the birth, the process moves into the final legal steps, including securing the birth certificate and, for international parents, applying for the Consular Report of Birth Abroad (CRBA) and passport. DNA testing may be conducted to confirm the genetic link between the baby and the intended parents, ensuring compliance with legal requirements. Surrogenics’ partners handle these procedures efficiently so that families can focus on welcoming their new child.
Final Thoughts: The Harmony of Science and Nature
Surrogacy is where cutting-edge science meets the natural miracle of life. From genetic testing and embryo grading to the natural processes that guide pregnancy, every step is a delicate balance between control and nature. By understanding both the scientific and natural elements of surrogacy, intended parents can feel confident in the process while appreciating the unique journey that leads to the birth of their child. At Surrogenics, we are committed to guiding you every step of the way, with compassion, expertise, and a deep respect for the process that brings families together.
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