By Sola Ogundipe
Would you as a woman get pregnant and bear a stranger’s baby? If not, would you at least do it for your sister or your other relatives? Whether you do or not, surrogacy is fast becoming an attractive assisted reproductive technique all over the world.
Dozens of Nigerian couples have embraced surrogacy and are still embracing surrogates to complete their families, even though they are not talking about it as much as they ought to.
Nevertheless, surrogacy remains one of the least talked about tools in the fight against infertility. Why do surrogates do what they do? What do they get out of it? How hard is it to give a child to its parents after having it in your womb for nine months? These are among plethora of issues that couples thinking of exploring the world of surrogacy desire to be educated and informed about.
Surrogacy is the involvement of a third party in the infertility treatment process; a couple asks another woman to carry and give birth to a baby for them, because the female partner is unable to have a normal pregnancy.
If you are a woman that is unable to carry a child, due to problems with conception or potential problems with pregnancy, labour or delivery, then a surrogate mother can carry your child on your behalf.
Surrogacy has also been used by older couples unable to conceive naturally, and by homosexual male partners who want to have a child that has been conceived with one partner’s sperm and the surrogate’s own eggs, or donor eggs.
For those who want to start a family but face a variety of challenges in the process: surrogacy is a great way achieve this goal. To the process is a situation in which a third party (woman) agrees to carry a pregnancy to term on behalf of an infertile couple.
There are basically two types of surrogacy — natural (traditional surrogates) or IVF surrogate mother (gestational surrogate). Both require a surrogate mother to carry the baby for the intended parent(s).
Traditional surrogacy uses the biological father’s sperm to artificially inseminate the surrogate mother who then carries the baby for the intended parents. A traditional surrogate shares a genetic connection with the baby she carries.
On the other hand, gestational surrogacy uses IVF to create an embryo that is then carried by the surrogate. In gestational surrogacy, the surrogate has no genetic ties with the baby since her eggs are not used.
Gestational surrogacy allows many heterosexual intended parents to be the biological parents, contributing embryos created from their own egg and sperm. If an egg donor is needed, intended parents would need to find a suitable egg donor that would provide an egg to be fertilized by the intended father’s sperm through IVF.
A natural surrogate mother is genetically related to the child, apart from carrying the child she has also gone through the procedure of insemination, with the use or her own eggs.
On the other hand however, an IVF surrogate is not genetically related to the child. She carries a pregnancy, created by the egg and sperm of the commissioning couple.
Ideally, the surrogate should be under the age of 38 years, married or in a stable relationship. She should also preferably at least have had previous live birth without complications.
Once eggs are retrieved, they are fertilized in a laboratory to create embryos, which grow for 3-5 days before being transferred to the surrogate or frozen for later use. Typically 1-3 embryos are then implanted into the surrogate’s uterus.
Six weeks later, upon heartbeat confirmation, the gestational mother is officially considered pregnant. Throughout her pregnancy, the intended parents, the surrogate, and their programme coordinator try to stay in touch, discussing parenting tests and any other matters that may arise. This consistent communication allows for an honest and fluid process.
How can a surrogate be found? A friend or relative could be engaged as a surrogate, however there are surrogacy agencies which help find surrogates and make all necessary arrangements and also collect fees such as medical expenses.
There are a few Nigerian fertility clinics such as Nordica Fertility Centre, Lagos, that offer such services with high level of success.
A prospective surrogate is thoroughly screened and counseled. Such person should not have medical disorders, such as diabetes or blood group incompatibilities and shouldn’t smoke, drink or abuse drugs. He said couples requiring IVF surrogacy is usually those in which the woman’s ovaries are producing good quality eggs, but her womb has been has been damaged or surgically removed. This can occur instances whereby a woman had uterine cancer, severe hemorrhage for some reasons, or a ruptured womb from previous pregnancy.
Sometimes women who suffer from medical problems such as severe diabetes, heart and kidney diseases put themselves at risk if they were to carry a pregnancy to term. But for others, surrogacy may be indicated because there is history of repeated miscarriage, due to some immunological incompatibilities i.e. Rhesus blood group incompatibility between mother and foetus.
Success rates for traditional surrogacy are approximately 10-20 per cent per cycle if intrauterine insemination is done but with IVF, the chances depend on the age of the surrogate. For IVF surrogacy, live birth rates are in the range of 35-40 per cent per cycle.
One of the biggest surrogacy issues is whether it is fair to the surrogate mother. It is generally assumed that she will become attached to the child she is carrying, even if it is not genetically her own, and that it is in some way cruel to take it from her, even if that is the established agreement.
However, studies have shown that surrogate mothers rarely change their minds and want to keep the child. Surrogate mothers adopt a range of techniques to maintain an appropriate relationship with the baby they are carrying, including bonding with the commissioning couple, and this helps to prevent attachment. Most surrogate mothers are proud of the job they are doing and feel positive about being able to help a childless couple to start the family they want so much.
There are many complex issues surrounding surrogacy, and these are discussed in depth in our related article. It is vitally important that you understand both the laws of the country that you travel to for treatment, and the laws of your home country regarding surrogacy contracts, before you begin the surrogacy process.
Expert legal advice is highly recommended to ensure that any contract you enter into overseas is enforceable, and that it will be recognised on your return home. Even though such advice is not cheap, it is a small price to pay to ensure everything runs smoothly and that you become the legal parents of your surrogate child.
Surrogacy is usually a treatment of last resort and proper legal and medical precautions need to be taken at every step of the process.
Not only does surrogacy allow people to overcome obstacles on their journey to creating a family, but also it allows surrogates the incredibly rewarding experience of playing an integral role on the journey to parenthood. Surrogacy is an enriching experience for everyone involved.