Gestational Carriers

What is a gestational carrier?

A gestational carrier completes a pregnancy with an embryo that is not genetically her own for another family to raise. Her pregnancy is a result of a transfer of a genetically unrelated embryo using in vitro fertilization (IVF) techniques. After birth, the baby is reunited with the intended parents.

The intended parent may be single or married, male or female and may or may not be biologically related to the baby:

• The intended mother may be the genetic parent who is unable to carry the pregnancy herself because of medical conditions which make pregnancy and delivery very risky to the health of the mother and/or the baby. Such conditions include unexplained recurrent miscarriages, heart disease, diabetes or hypertension. In other cases the intended mother may have had a hysterectomy or may have been born without a uterus.
• The intended parent may not be genetically related to the child who is conceived via In Vitro Fertilization and utilizing donor egg or donor sperm.
• The intended parent can be a single male using donor eggs with In Vitro Fertilization techniques.

Who can be a gestational carrier?

The gestational carrier can be a relative or a friend. In some cases, the gestational carrier or host receives no fee, other than medical expenses, for carrying the pregnancy for the intended parents. 

What is the difference between a gestational carrier and surrogate?

A gestational carrier refers to a woman who carries a pregnancy to term for another individual or couple, using embryos that are genetically unrelated to her. The term “surrogate” can encompass both traditional surrogacy (which involves the surrogate’s own genetic material) and gestational surrogacy (which involves a gestational carrier carrying genetically unrelated embryos). 

Types of Surrogates

The term “surrogate” can be used in two ways, leading to some confusion:

• Traditional Surrogate: In traditional surrogacy, the surrogate becomes pregnant using her own eggs, making her the biological mother of the child. This method is less common due to legal and emotional complexities.
• Gestational Surrogate: A gestational carrier, also known as a gestational surrogate, is a woman who carries and gives birth to a child on behalf of another individual or couple. In a gestational carrier arrangement, the intended parents provide their own embryos, which are typically created through in vitro fertilization (IVF) using the eggs and sperm of the intended parents or donors. The gestational carrier’s role is solely to carry and deliver the baby; she is not genetically related to the child.

What treatment is involved in gestational carrying?

The intended mother or egg donor will undergo an in vitro fertilization (IVF) procedure to obtain the eggs. This involves taking daily injections to stimulate the ovaries to produce multiple eggs. The eggs are then fertilized in the laboratory with sperm from the intended father or sperm donor. The gestational carrier will be treated first with estrogen skin patches and then progesterone to prepare her uterine lining to receive the embryos. The surrogate will have several blood tests and ultrasounds to make sure that her uterine lining is developing properly. Typically one good quality embryo is transferred into the gestational carrier’s uterus 3-5 days after fertilization.

The Embryo Transfer

A speculum will be placed in the vagina. The cervix will be cleansed with culture media and the embryo will be gently transferred into a predetermined site within the womb using a very soft catheter. The transfer of the embryos is not painful and takes only a moment to accomplish. We do our transfers with your bladder empty to make it more comfortable for you. For those interested in acupuncture, arrangements can be made ahead of transfer. Following the transfer, the gestational carrier will rest for 15-30 minutes before leaving the office. We recommend that the carrier continue to take it easy at home for the next 24 hours.

After the Embryo Transfer

• The pregnancy test (beta HCG) will be scheduled two weeks after the retrieval and the carrier will be notified of the result within 1-2 hours. A positive result means that an embryo implanted. The carrier will be instructed to continue with progesterone treatment (injections, vaginal tablets or vaginal suppositories) until the 12th week of pregnancy.  
• The HCG level should double every 48 hours or so early in early pregnancy. A less than ideal rise in HCG level may sometimes indicate a possible miscarriage or tubal pregnancy. So, the doctor may order the test every 2-3 days to make sure that the level rises appropriately.
• An ultrasound will be scheduled about 4 weeks after the embryo transfer. 
• At this point, the gestational carrier will be referred to an obstetrician for the remainder of the pregnancy.