In course of the surrogacy program implementation, a genetic mother is prescribed stimulating medications (tablets, injections) to help her develop more than one follicle where oocytes mature.
If needed, a surrogate is also prescribed medications to synchronize her cycle with the menstrual cycle of a recipient (genetic mother) to ensure preparation of the uterine lining for embryo implantation.
The genetic mother’s cycle is under special observation. She undergoes ultrasound examinations and estradiol tests. When efficient growth of follicles is achieved, the patient is prescribed medications to foster oocyte maturing. Then, follicular puncture is conducted.
The puncture is conducted in outpatient conditions, in a specialized aseptic procedure room or small operating theatre with intravenous anesthesia, ultrasound control and use of special equipment. As a result, eggs are retrieved from the genetic mother’s follicles for further fertilization with her husband’s sperm. The procedure is conducted in a day patient facility. After puncture, the patient stays in the clinic for 1 to 2 hours.
The ovums are fertilized by the husband’s sperm outside the mother’s body. Apart from traditional in vitro fertilization, the ICSI (Intra Сytoplasmic Sperm Injection) method is also used. The latter is used even if there are minor modifications in sperm. There are also additional indications for this procedure, e.g. obtaining few ovums (5 or less). This method provides for the selection of the most viable sperm and its injection in the egg using special tools.
Fertilized eggs are cultivated and transferred into the surrogate’s uterine cavity. The embryo transfer is made within a period starting from the 2nd to the 5th day. Selection of the preferred day of transfer depends on multiple factors. The day of embryo transfer is determined by an attending doctor on a case by case basis. It is recommended that no more than 1 to 2 embryos are transferred into the uterine cavity. However, in case of predicted low probability of implantation, it is possible to transfer more embryos (on the patient’s consent). Embryos are transferred with special elastic catheter inserted in the uterine cavity via cervical canal. The rest of embryos are cryopreserved (frozen in liquid nitrogen) for their storage and further use (during further cycles, if any).
In case of the IVF attempt failure, the repeated cycle is conducted with the use of the cryopreserved embryos.
This does not require genetic parents to undergo the program again. The only thing to do is to prepare the surrogate’s endometrium (highly vascular mucous layer of the uterus into which an embryo is implanted) and transfer embryos.
The cryocycle (artificial fertilization cycle with the use of previously frozen embryos) provides genetic parents with an additional opportunity to achieve long awaited pregnancy. During this period, the genetic parents may stay outside the country of the surrogacy program if necessary arrangements have been made and documents required for the program implementation have been signed.