Author Name: Dr. Prashant S Joshi Mentor Name: Dr. Pooja Singh on April 07, 2020
SURROGACY- AN OVERVIEW
Being a mother is a dream for every woman though nowadays increasing number of women are finding it difficult to become pregnant naturally. The inability to become pregnant naturally even after one year of regular unprotected sex is known as infertility and worldwide around 50 million couples experience this. They need to resort to some kind of medical help. Assisted Reproductive Techniques like IVF and Surrogacy help many infertile women to achieve pregnancy.
Let us try to understand both these techniques
IVF also commonly known as test tube baby is a procedure where multiple mature eggs of the women is taken out from her ovaries by a simple procedure and then allowed to be fertilized by prewashed partners sperm in the specialized embryology lab to form embryos. Generally, one or two good embryos are then placed back into the womb after preparing inner lining of the womb by hormone replacement therapy to achieve pregnancy.
Surrogacy in layman terms is also known as borrowing or renting a womb. It is a process which involves a surrogate who carries a baby in her womb throughout the pregnancy for a couple (intended parents) and then agrees to give back the baby to the couple after she gives birth.
There are complex ethical and legal issues involved with surrogacy.
Traditional Surrogacy is a process where the surrogate is also the biological or genetic mother and she becomes pregnant by means of artificial insemination.
Gestational Surrogacy is where a surrogate woman is not related genetically to the baby she carries in her womb. The intended mother’s egg is used along with the husband’s sperm and by the process of IVF, the resulting embryo is transferred in the surrogate mother’s uterus.
Reasons for Surrogacy: It is especially useful in few women who are congenitally born without a uterus or for some reasons had their uterus removed surgically. Also certain conditions affecting the uterus like big fibroid or any medical condition where the lady is unable to carry her baby, surrogacy becomes the option. Social reasons like Gay couple or LGBT or widows or single ladies can have baby through this process.
Pre-requisites to select a Surrogate
1.The surrogate mother should be married with one child
2.Her age should be between 25-35 years
3.She should be voluntarily willing and not for commercial reasons
4.She should be healthy, medically fit and free from infectious diseases
The initial step involves proper counseling regarding the legal, financial and insurance issues involved. Proper consent and legal forms and agreements shall have to be signed by both the parties.
Then treatment of the genetic mother is begun which involves stimulation of the ovaries with hormonal injections and collecting the eggs by oocyte retrieval technique. The eggs collected are then fertilized by the prewashed prepared husband’s sperm. The embryos formed are then observed and cultured for a period of 5 days till the blastocyst stage is reached.
Meanwhile, the surrogate’s hormones are downregulated and endometrial preparation is done with hormone replacement therapy. Finally, the embryos are placed in the surrogate womb through embryo transfer technique.
The surrogate is followed up to receive antenatal care till successful delivery of the baby. After this the birth certificate shall have the name of the genetic parents and the surrogate will have to hand over the baby to the genetic parents and will have no rights over the baby as per the agreed upon terms and conditions.
Going through the process requires lots of emotional, legal and financial issues to be handled well and an informed decision by both parties is very necessary.
During hormonal stimulation and egg pick up procedure of the genetic mother, she may experience bloating, headache, mood swings, painful ovaries and sometimes infection. Some women also are more anxious and suffer some depression at times.
The surrogate might have emotional turmoil as she knows that she is only carrying someone else’s baby in her womb and she has to undergo all the pain such as nausea, heart burn, weight gain, swelling, backache and also complications associated with any pregnancy.
She has the risk of multiple pregnancy, gestational diabetes and hypertension, Cesarean section and postpartum depression
In February 2020, the union cabinet approved the surrogacy bill, having following salient features:
IVF and Surrogacy: IVF is much cheaper and less complicated whereas Surrogacy involves emotional, financial, insurance and legal issues which have to be dealt.
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