||In most cases, women who choose Surrogacy have already exhausted all other methods of having a baby. If you still have viable eggs, but are unable to carry a pregnancy, your eggs can be retrieved and IVF used to fertilize them with your partner's sperm. They are then transferred to your Surrogate.
If you have no viable eggs of your own you can choose to use donor eggs obtained from an Egg Donor, which are then fertilized by your partner's sperm. The embryos are then cultured in the Fertility Center's embryology laboratory and transferred to your Surrogate.
Gender Selection is also an option that many couples choose if they have a preference for a boy or girl.
In cases where the female partner does not have viable eggs and the male partner does not have viable sperm, Sperm and Egg Donors can be used. However, it is vital that you check the legal situation in your country of residence regarding this type of Surrogacy as it is normally considered adoption.
Selecting your Surrogate
The Fertility Center's Surrogacy program has a very high success rate thanks to a careful assessment of potential Surrogates. the Center has an excellent reputation for providing quality medical care and support to Surrogates. All potential Surrogates undergo an intensive screening process which commences with a very detailed questionnaire, the initial screening phase of the application. They are then interviewed by a member of the Doctor’s medical team. This is followed by medical testing including testing for infectious diseases such as AIDS and Hepatitis C, and evidence of drug abuse. Only once a candidate has cleared all of these steps is she considered a potential Surrogate.
All Surrogates are aged under 38, with the average age being 30 years, and have had a previous successful pregnancy.
You will be provided with important details of your Surrogate’s medical, genetic and family history, her social and educational background, her motivations to become a Surrogate and details of her appearance. Surrogates and recipients are required to sign standard consent forms which guarantee the respective rights of both parties.
Using your own eggs
The process for Surrogacy using your own eggs is very easy and straight forward and is the same as normal IVF only your cycle will be coordinated with your surrogate.
To control the timing of egg ripening and to increase the chance of collecting substantial number of eggs, fertility drugs are prescribed according to each individual case. Before determining the egg retrieval schedule, the Doctor performs an ultrasound of the ovaries to check the development of eggs and a blood/urine test to measure hormone levels.
The Egg Retrieval Process
The retrieval procedure to obtain the eggs is performed trans-vaginally using a hollow needle guided by the ultrasound image (this is completely comfortable under sedation and local anesthesia). Eggs are gently removed from the ovaries using the needle. This is called "follicular aspiration." Its timing is crucial because the egg will not develop properly if it is collected too early; if too late, the egg also may develop poorly or may have already been released from the ovary and lost.
With IVF fertilization the eggs are placed with the sperm in incubators to allow fertilization to take place. With ICSI a single sperm is inserted into an egg. The eggs are examined carefully at intervals to ensure that fertilization and cell division have taken place; the fertilized eggs are now called embryos.
PGD on embryos to identify chromosomal abnormalities and gender selection will be completed on day 3 when 6 cells are present.
Embryos are placed in the surrogate’s uterus 5 to 6 days after egg retrieval after preparation of her endometrium and hormone levels. A speculum is inserted into the vagina to expose the neck of the womb (cervix). The embryos are suspended in a tiny drop of fluid and then very gently introduced through a catheter into the womb under ultrasound guidance. The transfer is followed by a resting period of two hours.
Using Donor Eggs
Once you have selected your Surrogate your next step is to select an Egg Donor from the Fertility Center's donor pool. The Center's medical staff then coordinates your Surrogate's cycle with that of your donor to obtain a fresh embryo transfer. Synchronization of cycles includes using medication to create a hospitable uterine environment for transfer of the embryos.
All viable eggs produced in a single donor cycle are fertilized with your partner's sperm, and all embryos belong to you. If there are more embryos than required for the transfer to your Surrogate you can store your extra embryos using Cryopreservation. Cryopreserved embryos can be used for subsequent attempts at Surrogacy whether or not your fresh transfer is successful.
If a male problem also exists, Donor Eggs can be used with Donor Sperm using ICSI (intracytoplasmic sperm injection into the eggs). However, you must check the law in your country of residence as this procedure will probably be considered as Adoption.
The Doctor offers you a large selection of screened donors. They are primarily young Thai women with an average age of 26, including many with high level education such as university. He is fully aware that choosing an egg donor can be an intense and emotional process especially when you are also using a Surrogate. You can be assured that:
All donors are rigorously screened
The Doctor and his staff are available to review your family history, your Surrogate's history and the donor's history and answer any questions you may have.
Extensive information is provided on all Donors and Surrogates, and you get to make all the final decisions on the donor to be used for your family.
For many patients, the time from their initial contact with the Doctor to commencement of their Egg Donation and Surrogate program can be a little as 6-weeks. In most cases, Patients only need to stay in Thailand for 5-10 days for a full Egg Donor/Surrogacy cycle.
Donor and Surrogate selection can be accomplished over the internet before you come to Thailand- in fact, I recommend this to make sure you secure the Donor and Surrogate of your choice.
The Doctor's experience means you have the best possible chance of success for Donor and Surrogate cycles, including both fresh and subsequent frozen embryo cycles (if pregnancy is not immediately achieved).
Egg Donor and Surrogate services may also be combined with PGD Gender Selection.
The Medical Procedure
If you are using a Donor the cycle begins once you have selected your Egg Donor and Surrogate.
At this time the Doctor will also be starting your Egg Donor on medication to suppress her ovaries. Once she and your Surrogate have both had menses, their cycles are coordinated. This can be done while you are still your home country. Your Surrogate will start using estrogen to establish a healthy endometrium lining and the donor will begin the stimulation of her ovaries with gonadotropins. When the follicles on her ovaries have reached a mature size (generally 10 -15 days) The Doctor, or a member of his medical team, will notify you that she is ready for the next step. At this time the Surrogate visits the Doctor for an ultrasound to measure the thickness of her endometrium lining. She then begins using either oral or vaginal progesterone supplementation to increase her progesterone levels so that it mirrors the natural process of pregnancy. It is also necessary to schedule sperm collection for the day of egg retrieval so you and your partner will need to be in Thailand at this time.
The day after egg retrieval and sperm collection the Doctor, or a member of his medical team, will contact you with the results of the retrieval (how many mature eggs have been retrieved) and the results of fertilization (how many viable embryos you have). You will then decide how many embryos you wish to transfer to your Surrogate and how many you wish to store for later use using Cryopreservation. Embryo transfer is performed 5 days after retrieval.
On the day of embryo transfer, the Doctor will confirm with you the number of embryos that you would like transferred. His advice is generally not to transfer more than 2 embryos due to the possibility of a multiple pregnancy. The transfer is performed at the hospital and requires no special preparation on your part. Transfers are done under ultrasound guidance and the discomfort for your Surrogate is minimal and no anesthetic is required. The transfer is usually quick and your Surrogate is able to go home after two hours of rest in the hospital’s recovery room.
10 days after the embryo transfer a serum (blood) pregnancy test is performed at the Fertility Center. Your Surrogate will continue with both oral and vaginal progesterone and oral estrogen until the pregnancy test. If the pregnancy test is negative she will discontinue all medications and will probably begin a period within the next week. If the pregnancy test is positive the Doctor will recheck her estrogen and progesterone levels. She will continue the estrogen and progesterone for another 10 weeks (until 12 weeks gestation when the placenta will be supporting the pregnancy).
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