Gestational Carrier / Surrogacy Program
We greatly enjoy being able to help make families a reality for people who cannot carry a pregnancy successfully and require the use of a gestational carrier/surrogate. We have completed successful pregnancies for women with conditions such as Asherman’s syndrome, blood clotting disorders, adenomyosis, hyperemesis gravidarum, and same sex couples.
A gestational carrier (GC, aka gestational surrogate) is a woman who carries a pregnancy for someone else. The GC is not biologically or genetically related to the child she is carrying. She is providing her uterus for the fetus to grow for the gestational period, and after she delivers the baby, it will go to the biological parents. A gestational carrier is not a traditional “surrogate”, as a surrogate is someone who donates her egg and then subsequently carries the child. Instead, a GC has embryos placed into her uterus that were formed from eggs and sperm from the “intended parents”. Through the process of In Vitro Fertilization (IVF), the eggs were fertilized in the laboratory before they were placed into the uterus.
A gestational carrier is required for any couple in which the female partner cannot carry the pregnancy herself. This may result from conditions in which the female partner has had her uterus surgically removed, such as in the case of cervical or uterine cancer or fibroids, or the uterus may no longer be functional, such as in the case of uterine adhesions/scarring (Asherman’s syndrome). Some patients have medical problems that will make carrying a pregnancy very complicated, such as someone with a blood clotting disorder. As long as the ovaries from the female partner are intact and functional, there is a good possibility that eggs may be harvested, fertilized in the lab with the male partner’s sperm to create embryos, and the embryos may then be placed into the uterus of the GC for her to carry.
If you and your partner are considering using a Gestational Carrier to build your family, please read the blog article Psychological Considerations When Choosing A Gestational Carrier by clinical psychologist, Dr. Ryan Blazei. This quick read has some excellent points for intended parents to think about before embarking on this process.
Prepare for the first appointment
If you are interested in our gestational carrier program, here’s how to prepare for your first visit with one of our physicians:
Primary Care Physician Evaluation – intended parents should both have a visit with their primary care specialist to screen for hypertension, heart disease and general medical risks. Routine health screening assessments, such as a mammogram and Pap smear, should be performed with your primary care physician and the medical records sent to Carolina Conceptions for your appointment.
All intended parents and gestational carriers must undergo psychological evaluation prior to starting a cycle. This is to ensure that all parties involved are emotionally stable, and recognize that the carrier has no “claim” to a baby born as a result of the treatment cycle.
The gestational carrier must be free of infectious diseases. This is essential so that we minimize the risk of transmitting disease to the fetus. The carrier must be seen for a history and physical exam. Records from previous pregnancies, deliveries, and any OB/GYN treatments are required. The carrier is also required to complete an application which includes a medical history form.
The gestational carrier will undergo a uterine evaluation with a sonohysterogram, along with a mock transfer and a HSG, if indicated. She must also have a current pap smear and mammogram/breast exam report.
A GC must be in excellent physical health, so she can not use tobacco or illegal drugs. A GC should have had a normal pregnancy in the past and must also have a current normal pap smear. A GC should have a BMI of less than 30 and be under the age of 38. The partner of the GC, if applicable, must also consent to infectious disease screening and psychological screening.
Intended Parent Testing
The intended parents will also undergo medical and psychological screening. Since the embryos from the intended parents will be placed into the uterus of the GC, the FDA regulations for tissue donation apply. The intended parents must be screened and tested for communicable diseases. The male intended parent will need testing within 7 days of producing the sperm sample used for fertilization. The female intended parent will need to undergo testing within 30 days of egg retrieval. They will also undergo psychological evaluation alone and with the GC, and her partner if applicable.
Infectious disease screening
All parties involved in the gestational carrier cycle, including the intended parents, gestational carrier, and the partner of the prospective carrier must go through infectious disease screening. The intended parents must also complete a medical history questionnaire and undergo a physical exam by their primary care doctor or a physician at Carolina Conceptions.
The prospective carrier and intended parents will meet on their own in order to determine compatibility and if they decide to work together, a legal and binding contract will need to be drawn up by an attorney. All GC’s and Intended Parents must seek legal counsel and have a contract, even when they are using a family member or friend as the GC.
A legal consultation for advice on the current legal status of Gestational Carrier is required for every intended parent. In this consultation, we recommend that you discuss the protections and responsibilities that you and the carrier have under North Carolina law. We must have a copy of a signed contract between the intended parents and the gestational carrier and husband (if applicable) before treatment can begin.
We recommend local attorneys who specializes in family law and are familiar with gestational carrier contracts:
E. Parker Herring, Esq (919) 821-1860.
Jennifer Tharrington, Esq (919) 525-2854. Watch Jennifer’s videos to Learn about the Legal Aspects of using a GC and about What Goes into a Legal Gestational Carrier Agreement.
Insurance for gestational carrier
Iif you are using a private carrier you are required to arrange for medical insurance for her cycle and pregnancy.
Intended Parent: The female intended parent will undergo an In Vitro Fertilization (IVF) cycle if using her own eggs. If using an egg donor, the donor will be placed through an IVF cycle. An IVF cycle begins with ovarian stimulation. Over a period of approximately 10 days, fertility medications are used to stimulate the ovaries to produce many eggs at one time (usually 10-20). These hormones (follicle stimulating hormone and luteinizing hormone) are given via injections just beneath the skin using very small needles. She will be monitored in the office with frequent ultrasounds to measure the number and size of the developing follicles (the fluid filled sacs that contain the eggs) until they reach a size of 16 mm -18 mm. She will also have her blood drawn to measure estrogen levels. Once the follicles reach a size of 16 mm – 18 mm, she will come to the office to have the eggs retrieved from the ovaries.
Once the eggs are retrieved, the male intended parent’s sperm will be used to fertilize each mature egg. The embryos will then be allowed to develop in the lab and a certain number of embryos will be transferred into the GC. The number transferred depends on several factors, such as embryo quality, age of the intended parent or egg donor, and patient preference to reduce the chance of multiples. Usually 1-3 embryos are transferred. This is agreed upon by all parties involved.
Gestational Carrier/Surrogate: While the intended parents are undergoing the IVF cycle, the GC will be given estrogen and progesterone to prepare her uterus for embryo implantation. Before the GC starts the estrogen, she will have an ultrasound to be sure the uterine lining is thin and the ovaries have no cysts. If everything looks normal, she will start the estrogen. She will later have another ultrasound to be sure the lining is developing adequately, then add progesterone when instructed. Shortly after starting the progesterone, the GC will need to come to Carolina Conceptions for the embryo transfer. She will continue estrogen and progesterone for the first 10 weeks of pregnancy. An ultrasound will be done at 6 weeks to verify a healthy pregnancy.
See the checklist for Patients interested in the Gestational Carrier/Surrogacy program.
If you are interested in using a gestational carrier/surrogate, please contact our front desk staff in order to make a consultation with one of our physicians.
Once your deposit has been made and you have decided to participate in our gestational carrier program, you can follow this link to view profiles on prospective gestational carriers.
For further questions, please contact Carolina Conceptions today to learn more about our Gestational Carrier Program. Our Gestational Carrier Coordinator is also available to answer any questions that you may have. You can contact Shannon Lloyd at [email protected]