At beginning, surrogacy has been accepted as an answer to certain forms of childlessness for centuries ago in the Old Testament of the Bible
Sarai, at the age of 80 told to Abram that he ‘go in unto my maid (Hager); it may be that I may obtain children by her’ and he was done. It will be later when
Sarai was herself 90, the Lord God allowed her to have her own child by Abram, who by then was 100 years old. But first surrogacy was started. It was ‘natural surrogacy’.
Today it is actually different thanks for modern assisted conception techniques.
Thanks God IVF are available, and its allows this not simple but natural step to use the eggs of the woman wanting the baby and, with the sperm of her husband, to create their own embryos in lab and transfer these to a hosts uterus. So, this is IVF surrogacy.
In some times this is just alone unique way to have their own genetic children.
IVF surrogacy is now accepted in Ukraine and in many countries around the world. So surrogacy gives you possibility to have your own babies to fill your family.
When we talk about IVF surrogacy we have to understand few simple terms.
First-one term to understanding is ‘the genetic couple’; they have also been named as ‘the commissioning couple’ or ‘intended parents’.
Second one is the woman receiving the embryos created from the gametes of the genetic couple. She is known as the ‘surrogate host’ or simply ‘host’, in a life we could talk “host mather“. In Ukraine language “host“ understanding like something between “auxiliary”, “supporting”or “servise” mathers.
The principal indications for IVF surrogacy are clear.
(1) Women without a uterus due to congenital anomalies of the uterus who have had a hysterectomy for carcinoma or for severe obstetrical or gynecology hemorrhage or ruptured uterus.
(2) Women who have a lot of repeated miscarriages.
(3) Women who have repeatedly failed to achieve a pregnancy after IVF treatment.
(4) Women who have good long-term prospects for health but they have certain medical conditions, which may make pregnancy life-threatening
(5) Women with “no medical“ indications - career or social reasons
In our practice, all genetic couples are referred by their local consultant who have experience in infertility problems and in IVF practice in our local branches in some countries in Europe. First step on this way to make preselecting for this treatment. Usually the genetic couple are seen alone in looking for the first instance for IVF surrogacy, and usually they have a lt of difficulties on this way firstly to understanding of all the medical aspects of the treatment.
Second step is to select surrogate host. It is could takes few weeks or months.
When the genetic couple have found someone they believe will be a suitable host Thereafter partners are interviewed at length and a full explanation of the all next steps on a way for dreamed baby.
The role of counseling in our branches or in our clinic in surrogacy is to help to understanding all parties and prepare all parties contemplating this last-resort treatment with IVF surrogacy.
Our counsultants gives you also all ensures that all parties to the arrangement are confident and comfortable with their decisions because there are very many issues that must be discussed with both the genetic couple and the proposed host surrogate. This is small list of questions: finding their own host in Ukraine; discuss practical difficulties and cost of treatment by gestational surrogacy in view of medical and psychological risks of surrogacy and of course of potential psychological risk to the child; ways of collaboration with multiple pregnancy; what handicaps could have possibility during pregnancy and after delivery; of course, we discuss possibility that the host may wish to retain the child after birth and we explain that the risk of retaintion of children in Ukraine in cases like this still are the least around the world.
And we not tired to tell about all legality of IVF surrogacy in Ukraine.
Counseling of couples about surrogacy in Ukraine in our own practice invariably has taken place in the homes of the genetic couples or in the office in the countries where we have branches and by an independent fertility counselor to the Materi clinic. Counselingt often could takes several hours and frequently several visits.
We discuss questions if treatment fails.
Due to situation with treatment of infertility in the Europe not rare we talk about egg donation.
Treatment of the genetic mothers
Treatment of genetic mothers could carry out distantly or in site in Ukraine in the clinic.
We are understandinf the fact that most women requesting surrogacy are normal, apart from not having a uterus or have difficulties with carrying out the pregnancy, the management of their treatment cycles is usually straightforward and could be supervised even distantly. All needed test before treatment you could find in the site.
These patients will usually be treated with a period of long down-regulation with the gonadotropin releasing hormone analogs. After achieving baseline levels, then follicular stimulation with gonadotropins can begin as described ubiquitously.
Usually patients come to the clinic few days before hCG administration with escort of our partners from the branches.
Vaginal ultrasound oocyte retrieval, fertilization of all oocytes, cultivation in lab and embryos transfer we make us usually, as described ubiquitously.
Test for pregnancy you make at home.
Treatment of the host mother
The host mothers may be treated in one of the two following ways.
Embryo transfer in a natural cycle
This method is considered most suitable for women who have not penetrative unprotected sex or who have been sterilized, or whose husbands have had a vasectomy and who have been confirmed azoospermic. The main factor to decide this type of protocol is guarantee of no risk to themselves of conceiving in the IVF surrogacy cycle. Actually only well-motivated hosts have been treated in natural cycles.
Embryo transfer in a hormone-controlled cycle the most frequent with precycle down regulation.
Control of the host’s replacement cycle by down- regulation with a gonadotropin releasing hormone analog and replacement estrogen therapy, as described ubiquitously. This type of cycles may be recommended for at least few main reasons:
(1) If the menstrual cycles of the host are irregular,
(2) If their menstrual cycles are found not to be ovulating regularly
(3 ) If luteal phase insufficiency is suspected;
(4) If the host is fertile and we have to be sure in “no conceiving“ during the cycle.
(5) If the treatment carrying out distantly, like in all our cases.
The preparation and treatment of couples for treatment by IVF surrogacy is very similar to that practiced by other centers as described ubiquitously.
All the procedures are as for rutine IVF cycles, but with transfer of the embryos to another woman, who has been suitably prepared in a hormone-controlled cycle the most frequent with pre-cycle down regulation.
Treatment by IVF surrogacy could satisfy with achieving the highst ‘delivered baby rates’ both per genetic couple and per surrogate host. We could tack about more then 60% of live birth rate per genetic couple and more then 70% per surrogate host what we could achieve, in a mean of 1.3 cycles with two embryos transferred but no more then three.
All of the IVF surrogacy arrangements require the active participation of professionals during all parties of treatment that could prevent the most of complications.
In the Ukraine the IVF surrogacy treatment regulated the orders of the Ministry of Health and the orders of the Ukrainian Society of Reproductive Medicine and the fact of legality of the IVF Surrogacy treatment are well known.
The most important requirement about IVF surrogacy around the world is the welfare of any child born as a result of IVF surrogacy treatment and the welfare of any existing children must at all times be taken into account when considering licensed treatment.
This tenet guides the decisions for all licensed clinics and of all couples undertaking treatment by surrogacy.
Surrogacy is not forbidden just in the Jewish religion, which is very much family-oriented
Other religions have different views on the surrogacy.
The Christian Churchs are frequently strongly against all forms of assisted conception, particularly those associated with gamete donation and surrogacy but the Anglican Church is less rigid in its views and has not condemned the practice of surrogacy. So discussion is go on.
The Islamic view appears to be discussed for egg donation and surrogacy that would not be allowed, except, perhaps, that it might be permissible between wives with the same husband, but debate continues.
The IVF surrogacy is now an accepted form of medical treatment in the world.
But this type of treatment is still suitable for a small group of infertile women with unique causes of their infertility.
Although IVF surrogacy remains controversial and is not practiced in many European countries.
The indications for treatment are limited but remain strong enough to a small group.
The treatment process is in itself straightforward.
In a normal stimulated IVF cycle, any embryos fertilized cultivate and transferred to the host uterus. Possibly any (all) embryos are frozen and later transferred to a selected surrogate host.
Actually if we use fresh embryos in IVF surrogacy cycle we get mach more better outcome of treatment.
Embryos could be created from freshly collected oocytes fertilized with beforehand frozen sperm of husbents.
The biggest substantial disadvantage is that some families are unable to find appropriate hosts at all, and are therefore denied the opportunity to treatment.
During the past 25 years of IVF surrogacies have no serious clinical, ethical or legal problems have been encountered.
A minor problem encountered because the most of them caused by the arrangement frequently have had unreasonably high expectations of success.
C being provided to them.
Afterword, actually the host is fit, young and known to be fertile.
Thay and the genetic parents expect success more than all other outcomes and feel badly let down if this is not achieved.