When it comes to a gestational carrier, the woman carrying a child is not at all related to it genetically or biologically. The woman just provides a nurturing environment in her uterus for the child during the gestational period, which is usually about 40 weeks. A gestational carrier is different from a traditional surrogate. A traditional surrogate donates her egg and then subsequently carries the child, whereas a gestational carrier carries the eggs from the intended mother or an egg donor in her uterus.
Who needs gestational carrier?
A gestational carrier is needed by couple in which, the woman cannot carry the pregnancy. This is because the woman's uterus cannot carry the child which may be due to different reasons. One reason may be that the woman's uterus may not be able to carry the pregnancy to its full term. Another reason could be that her uterus is surgically removed. Certain medical conditions such as severe diabetes too may be a reason for taking help of a gestational carrier.
Gestational carrier - Autologous
In this case, the intended mother uses her own eggs. The recipient couple undergoes screening via the usual infertility diagnosis. Mathrutva then treats the intended mother as a traditional in vitro fertilization (IVF) patient, and collects the eggs at the end of her cycle. Her egg and the intended father's sperm is then fertilized in the lab. A physician eventually transfers the embryo to the gestational carrier.
Gestational carrier with donor egg
This type of treatment is done, if the intended mother is unable to conceive using her own eggs. Here, the treatment makes use of donor eggs. A physician then transfers the embryo to the gestational carrier.
The intended mother undergoes an IVF cycle if she uses her own eggs. In case she is using a donor's eggs, the donor will undergo an IVF cycle. The intended mother will be next monitored at our centre with transvaginal ultrasound frequently in order to measure the size of the developing follicles until they reach a size of 18 to 20 mm. She will also undergo a blood test to check for estradiol levels. Once the lead follicles reach the required size of 18 to 20 mm, she will be given an intramuscular injection to "trigger" egg maturity. In 36 hours, our physician will retrieve her eggs transvaginally.
Her eggs will be then brought into the lab. We will unfreeze the frozen intended father's sperm. Our embryologist will inject a normal appearing sperm into each mature egg. This procedure is called intracytoplasmic sperm injection (ICSI). The resulting embryos will be then allowed to grow in the lab. Our physician will transfer a specific number of embryos into the gestational carrier. The number of embryos transferred depends on their quality and age of the intended parent or egg donor.
While the intended mother is undergoing the IVF cycle, the gestational carrier will be given estrogen as well as progesterone in sequential fashion through intramuscular injections. This is done in order to prepare the carrier's uterine lining for implantation. Before we begin this preparatory step, the carrier will come in to be sure that her uterine lining is thin and her ovaries have no cysts. Once this is confirmed, the carrier will start the estrogen. About two weeks later, the carrier will be called for another transvaginal ultrasound and blood test to make sure that the lining is developing adequately. Once this is confirmed, the carrier will start the progesterone as instructed by our nurse.
In order to be sure that the gestational carrier responds adequately and develop a lining that is ready to support a developing embryo, the carrier will undergo a practice cycle first. This cycle involves injections of estrogen, and then a mid-cycle uterine evaluation to make sure that the endometrial thickness is appropriate. If the lining is unfavourable, adjustments are made for the fresh cycle. Once the test cycle is complete, and all of the pre-screening blood tests and psychological screening are complete, we begin the real cycle.
The time taken between the first consultation of the intended parent and the gestational carrier, and the completion of pre-screening and fresh cycle is approximately 4 to 8 months.