Surrogate Mothers Online Q & A: What is the process involved in GS Surrogacy on both the SM and IM's parts? How big a factor is distance? I'm thinking of being a GS Surrogate for my half-sister. She lives in MA and I live in TX. What sort of complications might this cause us? - <A HREF="mailto:Heather.Casey@eds.com">Heather</A> in TX

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Surrogate Mothers Online Q & A

Q & A: Medical Issues - Gestational Surrogacy

Topics may include the risks involved in surrogacy, side effects from meds, questions about protocol, etc.

25. What is the process involved in GS Surrogacy on both the SM and IM's parts? How big a factor is distance? I'm thinking of being a GS Surrogate for my half-sister. She lives in MA and I live in TX. What sort of complications might this cause us? - Heather in TX - Top

For the SM in a GS Surrogacy, there is physical and psychological testing to ensure she is a good candidate to be a surrogate. The physical testing includes tests for:

1. Sexually transmitted diseases (STDs) including AIDS

2. Hysteroscopy (small catheter inserted into the uterus to visualize the interior) and/or HSG (dye is injected into the uterus and fallopian tubes to show the size/shape of the uterus and if the tubes are clear). Possibly a trial transfer where the same catheter used to transfer embryos is inserted into the uterus to measure how deep the cavity is.

3. A mock cycle. The same hormones used to prepare the uterus for embryo transfer are used to determine the SM's reaction to them. Usually a blood test for estrogen and progesterone are done on menstrual cycle day 3 and an ultrasound is taken about cycle day 14 to measure the thickness of the uterine lining.

If the IM has had egg retrievals for prior IVF's, she will most likely have all the testing she needs. Although all the STD tests must be current within 6 months. Usually, the only other test she would need would be the menstrual day 3 LH (Luteinizing Hormone) which tells the doctor whether her ovaries are capable of producing enough eggs for an IVF.

Once all the pre-testing is done, the SM and IM's cycles are matched, usually with birth control pills. The SM and IM both start Lupron toward the end of the BCP cycle. Lupron is an injectible drug (given with a very thin 1/2" needle just under the skin) which shuts down the normal hormone production so the doctors can control your cycle. Both continue Lupron shots daily until the day of egg retrieval.

Once their menstrual cycles arrive:

The SM starts estrogen replacement (in either pills, patches or shots) to build the uterine lining. A couple weeks later an ultrasound will be done to again check the thickness of the lining.

The IM starts daily fertility drug injections for about 10-12 days to stimulate her ovaries to produce many eggs. She will have blood tests and ultrasounds throughout to track her progress (how many eggs, what size, etc.).

Once the doctor feels the IMs eggs are "ripe", they will retrieve the eggs thru an ultrasound guided needle inserted thru the vaginal wall to the ovary. The IM will be under anesthesia and usually can go back to work the next day.

When the eggs are retrieved, they are placed in a petri dish with sperm from the IF to be fertilized and incubated for 2-5 days. The SM also starts progesterone replacement at this time (usually injections, but sometimes suppositories, lozenges, or vaginal gel). Progesterone and estrogen replacement continues until the 12th week of pregnancy or a negative pregnancy test.

The embryos are transferred to the uterus of the SM thru a thin catheter placed through the cervix.

Distance: Many of the relationships I have seen are long distance ones. Most of the testing can be done in your home state. One or both of you would have to travel for the retrieval/transfer. Other than that, the only problem distance poses is the IM's ability to attend doctor appointments, visit with the SM, be able to see the progress being made, etc. Our SM is 1,000 miles away, but we keep in touch with pictures and phone calls 4-5 times a week. I was able to be at the first several ultrasounds, but haven't been able to be at the last two. Our SM had them videotaped for us and FedEx'd the tape to us.

Hope this answers all your questions.

Linda P - Updated: January 17, 2000
Topics may include the risks involved in surrogacy, side effects from meds, questions about protocol, etc.

25. What is the process involved in GS Surrogacy on both the SM and IM's parts? How big a factor is distance? I'm thinking of being a GS Surrogate for my half-sister. She lives in MA and I live in TX. What sort of complications might this cause us? - Heather in TX - Top: For the SM in a GS Surrogacy, there is physical and psychological testing to ensure she is a good candidate to be a surrogate. The physical testing includes tests for:

1. Sexually transmitted diseases (STDs) including AIDS

2. Hysteroscopy (small catheter inserted into the uterus to visualize the interior) and/or HSG (dye is injected into the uterus and fallopian tubes to show the size/shape of the uterus and if the tubes are clear). Possibly a trial transfer where the same catheter used to transfer embryos is inserted into the uterus to measure how deep the cavity is.

3. A mock cycle. The same hormones used to prepare the uterus for embryo transfer are used to determine the SM's reaction to them. Usually a blood test for estrogen and progesterone are done on menstrual cycle day 3 and an ultrasound is taken about cycle day 14 to measure the thickness of the uterine lining.

If the IM has had egg retrievals for prior IVF's, she will most likely have all the testing she needs. Although all the STD tests must be current within 6 months. Usually, the only other test she would need would be the menstrual day 3 LH (Luteinizing Hormone) which tells the doctor whether her ovaries are capable of producing enough eggs for an IVF.

Once all the pre-testing is done, the SM and IM's cycles are matched, usually with birth control pills. The SM and IM both start Lupron toward the end of the BCP cycle. Lupron is an injectible drug (given with a very thin 1/2" needle just under the skin) which shuts down the normal hormone production so the doctors can control your cycle. Both continue Lupron shots daily until the day of egg retrieval.

Once their menstrual cycles arrive:

The SM starts estrogen replacement (in either pills, patches or shots) to build the uterine lining. A couple weeks later an ultrasound will be done to again check the thickness of the lining.

The IM starts daily fertility drug injections for about 10-12 days to stimulate her ovaries to produce many eggs. She will have blood tests and ultrasounds throughout to track her progress (how many eggs, what size, etc.).

Once the doctor feels the IMs eggs are "ripe", they will retrieve the eggs thru an ultrasound guided needle inserted thru the vaginal wall to the ovary. The IM will be under anesthesia and usually can go back to work the next day.

When the eggs are retrieved, they are placed in a petri dish with sperm from the IF to be fertilized and incubated for 2-5 days. The SM also starts progesterone replacement at this time (usually injections, but sometimes suppositories, lozenges, or vaginal gel). Progesterone and estrogen replacement continues until the 12th week of pregnancy or a negative pregnancy test.

The embryos are transferred to the uterus of the SM thru a thin catheter placed through the cervix.

Distance: Many of the relationships I have seen are long distance ones. Most of the testing can be done in your home state. One or both of you would have to travel for the retrieval/transfer. Other than that, the only problem distance poses is the IM's ability to attend doctor appointments, visit with the SM, be able to see the progress being made, etc. Our SM is 1,000 miles away, but we keep in touch with pictures and phone calls 4-5 times a week. I was able to be at the first several ultrasounds, but haven't been able to be at the last two. Our SM had them videotaped for us and FedEx'd the tape to us.

Hope this answers all your questions.

Linda P - Updated: January 17, 2000

Unless stated otherwise, all responses in the SMO Q&A are courtesy of one or more of the following hosts:

Sherry - Experienced gestational surrogate currently working on her 2nd surrogacy arrangement

Linda - New Mommy to twins born via gestational surrogacy and egg donation

Jennifer S. - Experienced AI surrogate

Lynn - New Mommy to a daughter born via traditional surrogacy

Tracie - 5 time egg donor (triplets, 2 sets of twins and 2 singletons) and 3 time surrogate (2-AI, 1-IVF).

Lisa - Experienced egg donor and previous gestational surrogate currently working on her 2nd surrogacy arrangement (Lisa was our former ED host, prior to July 1999.)
Disclaimer: Responses from SMO Q&A Hosts do not necessarily represent the opinions and ideas of SMO. Neither the Q&A hosts nor SMO guarantee the accuracy or completeness of any information contained in the responses given here. As such, neither SMO nor the Q&A hosts are responsible for any errors or omissions or for the results obtained from the use of such information. Neither SMO nor the Q&A hosts shall be liable or responsible to any person or entity for any loss or damage caused, or alleged to have been caused, directly or indirectly by the information or ideas contained, suggested, or referenced in these responses.

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