IVF Procedure

In the case that the Intended Mother is the parent-donor, she  receives fertility treatments in her country or in Kazakhstan or  Kyrgyzstan to stimulate the production of ovocytes. If she is not  fertile, donated ovocytes are used for this procedure in which case, it  is the Surrogate Mother who undergoes the fertility treatments to  prepare her body to be impregnated with the embryos. Drug induced  ovarian stimulation will begin during your menstruation (usually within  the first three days of the period). The drugs are administered via  injections into the abdomen using a very short and fine needle. Once the  first dose is administered and the injection procedure is explained,  some patients may inject the remaining doses themselves, or if they  request, can attend the clinic on a daily basis for the specialist nurse  to do so. Although some variations occur from person to person, the  stimulation treatment generally lasts 8 to 12 days. On certain days  during the ovary stimulation procedure, scans are required in order to  monitor the follicular development. The examination involves an  ultrasound screening to evaluate the quantity and size of the developing  follicles. If an adequate size and quantity of follicles (at least  three,18 mm in size) are detected on the ultrasound and blood hormone  levels are suitable, then, in the final stage, an injection to cause  ovulation (generally containing human chorionic gonadotropin- HCG) will  be administered to ensure control the ovulation time. The timing of this  injection is very important because egg collection will begin 35-36  hours after.

When the eggs are stimulated for a pregnancy, they become mature at  which stage they are called ovocytes. The ovocytes are retrieved from  either the mother or the donor. This procedure is done with the help of a  thin needle and a vaginal ultrasound. Afterward, the Embryologist  removes the fluid from the follicles, the ovocytes are then removed from  the follicular fluid.
Egg collection is performed under anesthesia, the patient is sedated  with a very mild anesthesia, and follicle fluids around the ovaries  will be aspirated with the help of an ultrasound to guide. The  embryologist will then separate the eggs inside the follicles under a  microscope, providing an oocyte count for the doctor and patient.

Once the surrogate and intended mother or egg donor all have  their cycles coordinated together, the injectable medication will be  administered for endometrial stimulation. Some surrogates have  complaints of hot flushes, moodiness and headaches.
Estradiol / Estrogen is a medication that is used to thicken  the endometrial lining to prepare for the implantation process. This  medication begins approximately two weeks prior to embryo transfer and  is continued for approximately 10 weeks after embryo transfer depending  on the clinic’s protocol. This hormone can be taken in a number of  forms: oral tablets; injection, or; adhesive patch; but most IVF clinics  use the injection form. Side effects may include, but are not limited  to, weight gain and headaches. Each surrogate will receive further  instructions on how to administer these injections by the clinic.
During the endometrial stimulation phase surrogates will be  required to have a blood test and ultrasound performed on day seven or  as directed by the clinic. Some clinics will require the surrogate to  have their day seven ultrasound at their clinic only. Other clinics  allow the surrogate to remain in their home area until the day of embryo  transfer. Until a clinic is chosen, the surrogate will not know the  exact protocols she will be asked to follow, but she will be informed as  quickly as possible.
The blood tests and ultrasounds will help the clinic determine  the thickness of the surrogate’s endometrial lining. Once the  endometrial lining is at the appropriate thickness and the intended  parent or egg donor are ready to have the egg retrieval, the surrogate  will be required to start some form of Progesterone to assist with and  sustain implantation and pregnancy.
Progesterone is a hormone women normally produce in our  ovaries, but in a surrogacy the addition of supplemental Progesterone is  essential to “warm up” the uterus until the body produces this hormone  on its own. The form of Progesterone may be in an oil-based,  intramuscular injection form or vaginal suppository per the clinic’s  orders.
This medication begins approximately one week prior to the  embryo transfer and is continued for approximately ten weeks after  embryo transfer. Side effects may include, but are not limited to,  fatigue, breast tenderness and mild uterine cramping, like being “super pregnant”.
All these medications are extremely important and MUST be taken  as instructed by the clinic, or otherwise there is a risk of comprising  the IVF cycle, having a miscarriage and being in breach of contract.  Please remember, each clinic varies slightly in their protocol.

PLEASE NOTE THAT THERE ARE POTENTIAL RISKS INHERENT WITH ALL  ASPECTS OF THE SURROGACY MEDICAL PROCESS AND PROCEDURES, INCLUDING  TAKING ANY MEDICATION. IT IS THE SOLE RESPONSIBILITY OF THE SURROGATE TO  INVESTIGATE ALL SUCH RISKS AND TO DISCUSS ALL MEDICAL ISSUES WITH THE  PRIMARY PHYSICIAN

For the fertilization of the ovocytes, a secured sperm is used. This  sperm can be from your partner or a donor. The sperm is directly  injected into the ovocytes using the ICSI method that is perform by an  embryologist by using a special needle to inject only a single sperm  into each egg. The fertilized egg is put into a special culture  environment and will be examined about 16-18 hours later to see if  fertilization has been achieved. The procedure increases the chances of  fertilization and therefore conception. After the Embryologist will  place the fertilized eggs in the incubator monitoring the development of  the embryos between 3-5 days.

The last step of the IVF treatment is the embryo transfer. After  monitoring the developed embryo for 5 days, the healthiest ones are  selected to be implanted in the Surrogate Mother, the other Blastocysts could be frozen in the case another attempt is needed. After the  successful transfer and the implantation, the Surrogate Mother stays at  the Fertility for 24 hours in order to make sure the impregnation is  successful. In the case that the impregnation did not work, a new  Surrogate Mother is chosen to go through the entire process. In the case  that the parent-donor genetic material is defective, ISC will discuss  other options with the Intended Parents in order to still help with  their desire to have a child.