Surrogacy provides hope to couples who cannot carry a pregnancy to term and deliver a child. At Park Avenue Fertility, Dr. Levi and his team are here to help you every step of the way. A surrogate is a female who carries the baby for the couple. There are two types of surrogacy. In traditional surrogacy, the surrogate becomes pregnant using her eggs either through insemination with the father’s sperm or through in vitro fertilization (IVF) using the father’s sperm. The surrogate must undergo stimulation with follicle stimulating hormone to develop multiple eggs for use in the in vitro process.
In gestational surrogacy, the couple undergoes in vitro fertilization to produce viable embryos. The couple may be using the intended mother’s eggs or a donor’s eggs. The cycles of the surrogate and the intended mother or donor are synchronized so that the embryos can be transferred to the surrogate at the appropriate time. These embryos can carry the genetic material of both of the parents or one parent. The embryo implants, develops, and is delivered at term.
A surrogate can be a friend or family member, or another volunteer. Many private agencies offer surrogates and can be contacted directly. Park Avenue Fertility’s program can also assist you in finding a surrogate. Surrogates undergo physical and psychological screening to insure their suitability. Compensation is sometimes provided by the couple to the surrogate but is rarely the surrogate’s motivating factor.
Couples considering an IVF cycle with surrogacy must set up an initial consultation with Dr. Levi. A couple’s medical history is taken and a screening for infectious and sexually transmitted diseases is also performed. It is strongly recommended that couples consult with a clinical social worker or licensed psychologist to understand the ramifications associated with surrogacy.
The surrogate is also required to have a consultation with Dr. Levi. The surrogate must be in good health and meet age requirements. The surrogate herself also undergoes comprehensive testing to confirm that she is a good candidate for surrogacy.
Park Avenue Fertility assists the couple in acquiring an attorney that specializes in reproductive law. The attorney will address important, legal issues and draft legal agreements that will set forth the legal rights and obligations of the parties as well as, compensation and expenses for the surrogate and other variable considerations.
Listed below are Park Avenue Fertility’s services associated with a traditional or gestational surrogacy cycle. If you will be using a donor’s eggs, please click on our Donor Egg Program page on this web site.
A monetary amount is sometimes paid by the couple to the surrogate as compensation for her time, efforts and inconvenience. This subject is addressed legally by the attorney.
During this process an insurance policy is provided for the Surrogate. This subject is addressed legally by the attorney.
Cycle Management with Surrogate
The administrative and clinical coordination through the luteal phase follow up.
Psychological Evaluation and Testing
Park Avenue Fertility may require that a clinical social worker or licensed psychologist interview and assess the surrogate’s understanding of the physical, emotional and legal ramifications along with her psychological preparedness and suitability. A standardized psychological test called the MMPI may be performed and scored by a licensed psychologist.
Physical, Pelvic Exam and Medication Protocol Class
The surrogate undergoes a complete history and physical, including a pelvic exam with Pap smear and cultures. The surrogate is instructed regarding the administration, dosages, timing and safety of each medication including Lupron by injection, gonadotropin by injection and HCG. Arrangements for the ordering and delivery of medications will also be made.
Initial Blood Screening
The surrogate undergoes testing for any infectious diseases including but not limited to HIV, Hepatitis, Syphilis, Rubella, etc.
Required Blood Screening
The surrogate undergoes testing for any communicable diseases including but not limited to HIV, HCV, Syphilis, Chlamydia, Gonorrhea.
Fertility drugs can be expensive and prices can range dramatically. A protocol is designed and closely monitored based on the individual’s age, diagnosis, ovarian stimulation history and other relevant factors. Dosage and response to medications varies widely from person to person.
Monitoring for Egg Retrieval
The donor or intended mother or surrogate depending on whose oocytes are being retrieved, is monitored carefully with periodic blood tests and multiple ultrasounds to determine hormone levels, regulate medications and track follicular development.
Monitoring for Embryo Transfer
The surrogate is monitored carefully with periodic blood tests to determine hormone levels, regulate medications and track development of the uterine lining to determine the readiness for embryo transfer. Office visits will include ultrasounds, phlebotomy, injection teaching session for the medications Lupron and Progesterone, and a uterine sounding/mock embryo transfer is performed.
Anesthesia for Egg Retrieval
Anesthesiology services are provided by Integrated Anesthesiology for the oocyte retrieval.
Egg Retrieval Procedure
Oocytes are retrieved transvaginally. Using ultrasound guidance, a specialized needle is carefully inserted through the vaginal wall and into the ovaries. Gentle suction is applied and the fluid from each ovarian follicle is removed as is the egg itself. The oocytes are transferred immediately to the embryology laboratory.
Embryology and Andrology Lab
Procedures that are performed by the embryologist and andrologist include sperm preparation, sperm wash, oocyte identification from follicular fluid, insemination of oocyte, cultures, preparation of embryo, etc.
Intracytoplasmic Sperm Injection
In cases where the sperm may have problems penetrating the outer shell of the egg, fertilization is aided by a micromanipulation technique (ICSI) performed by the embryologist.
Assisted Zona Hatching
This laboratory procedure performed by the embryologist involves thinning or making a small hole in the zona pellucida that surrounds the embryo (a protective layer). Before an embryo implants into the uterus, it must “hatch” from the zona pellucida. There is some evidence that in some women, the zona may be thickened or hard, restricting the embryo from hatching. Thus, by making a small hole in the zona pellucida, the hatching can occur without issue. The hatched embryos are then transferred into the uterine cavity.
Embryo Transfer with Ultrasound Guidance
The highest quality embryo(s) are transferred to the surrogate’s uterus with ultrasound guidance using a thin, soft catheter which is passed through the cervix and into the uterus. This is performed by speculum exam.
- Genetic Screening and Chromosomal Screening
- Preimplantation Genetic Screening and Diagnosis (PGS/PGD)
- Cryopreservation and Storage of Embryo(s)
- Cryopreservation and Storage of Sperm
Our Patient Care Coordinator will contact the couple’s insurance company to check for any services that are covered by their insurance plan. Covered services will be submitted to insurance.