Surrogacy Risks: IVF Hormones and Pregnancy
Surrogacy involves a woman carrying a pregnancy on behalf of Intended Parents. While it might seem intuitive to assume that surrogacy risks and complications would be significantly different from regular pregnancies, the fundamental biological processes and factors at play are very similar. Both surrogacy and natural pregnancies share common risks because they both involve the intricate interplay of a woman’s body, fetal development, and external factors.
A surrogate undergoes the same physiological changes and hormonal fluctuations as any pregnant woman. These changes can lead to potential risks such as gestational diabetes, preeclampsia, and preterm labor. The surrogate’s body still has to adapt to the demands of carrying a developing fetus, regardless of whether she is genetically related to the child or not. The development and health of the fetus remain crucial in both surrogacy and natural pregnancies. Factors like genetics, maternal health, and environmental influences can affect fetal development in either case. Genetic disorders and other complications are not exclusive to one type of pregnancy arrangement.
The psychological aspects of pregnancy risks are consistent across surrogacy and traditional pregnancies. Surrogates can experience challenges, including hormonal shifts and potential postpartum mood disorders.
Here are some of the most common surrogacy and pregnancy-related health risks:
Gestational Diabetes:
This type of diabetes develops during pregnancy when the body cannot produce enough insulin to meet increased needs. Women who are overweight, have a family history of diabetes, or are older (above 25-30 years) are at a higher risk. Women with polycystic ovary syndrome (PCOS) also have an increased risk.
Preeclampsia:
Preeclampsia is characterized by high blood pressure and damage to organs like the liver and kidneys. Women with a history of high blood pressure, obesity, diabetes, kidney disease, or those carrying multiple fetuses (twins, triplets) are at a higher risk. First-time mothers and women under 20 or over 40 years old are also more susceptible.
Preterm Labor and Birth:
Preterm birth occurs when a baby is born before 37 weeks of pregnancy. Women who have had a previous preterm birth, multiple pregnancies, certain uterine or cervical abnormalities, infections, or chronic conditions like diabetes are at an increased risk.
Miscarriage:
A miscarriage is the loss of a pregnancy before 20 weeks. Advanced maternal age (35 and older), previous miscarriages, certain medical conditions (thyroid disorders, autoimmune diseases), and lifestyle factors such as smoking or drug use can increase the risk.
Gestational Hypertension:
This is high blood pressure that develops during pregnancy without the presence of protein in the urine (which would make it preeclampsia). Women with a family history of hypertension, obesity, or those carrying multiple fetuses are at a higher risk.
Anemia:
Anemia, characterized by a deficiency of red blood cells, can result from insufficient iron intake during pregnancy. Women with a history of anemia, heavy menstrual bleeding, poor nutrition, or certain chronic conditions are at a higher risk.
Placental Problems:
Conditions like placenta previa (placenta covers the cervix) and placental abruption (premature separation of the placenta from the uterine wall) are associated with an increased risk of bleeding and potential complications. Women with a history of these conditions, multiple pregnancies, or uterine abnormalities are more susceptible.
Infections:
Infections during pregnancy, such as urinary tract infections or sexually transmitted infections, can pose risks to both the mother and the fetus. Women with weakened immune systems, poor hygiene, or certain medical conditions are more prone to infections.
Surrogates undergo rigorous medical screening by fertility clinics to ensure their physical and reproductive health aligns with the demands of the surrogacy process. The screening process typically involves a comprehensive assessment of the surrogate’s medical history, physical health, and reproductive capabilities. This begins with an initial consultation where the surrogate’s medical records and history are reviewed, including any previous pregnancies and medical conditions. Blood tests are often conducted to assess hormone levels, infectious diseases, and general health markers.
Medical examinations delve into the surrogate’s reproductive health, involving pelvic ultrasounds to examine the uterus and ovaries. An assessment of the uterine lining and structure is crucial to determine the feasibility of a successful pregnancy.
The Risks of IVF Hormones in Surrogacy
While IVF hormones are generally safe and have decades of research behind them, they can cause specific rare complications. Gestational surrogates who undergo in vitro fertilization (IVF) to prepare for the surrogacy process can experience a range of complications and side effects due to the hormonal treatments. Additionally, Intended Parents or donors using IVF to collect eggs may experience a risk of Ovarian Hyperstimulation Syndrome (OHSS). Mild cases of OHSS may cause discomfort, bloating, and nausea, while severe cases can lead to abdominal pain, fluid accumulation in the abdomen or chest, and breathing difficulties. OHSS requires careful monitoring by medical professionals and, in severe cases, may necessitate hospitalization.
Here are the common risks associated with IVF hormones and surrogacy:
Multiples Pregnancy:
While not necessarily a complication, IVF hormone treatments are thought to lead to a higher likelihood of twins, triplets, or more even in Single Embryo Transfers (SET). Multiple pregnancies carry increased risks such as preterm labor, low birth weight, and other pregnancy-related complications.
Emotional and Psychological Effects:
IVF hormone treatments can cause mood swings, irritability, and emotional sensitivity due to hormonal fluctuations.
Ectopic Pregnancy:
Although rare, there is a slightly increased risk of ectopic pregnancy (where the fertilized egg implants outside the uterus) in IVF-conceived pregnancies. This risk is not unique to surrogates but applies to any woman undergoing IVF.
Blood Clots:
Hormone treatments can increase the risk of blood clot formation. This is a potential concern for anyone undergoing hormone therapy, including surrogates.
Ovarian Response Variability:
The way a woman’s body responds to IVF hormones can vary between cycles. While one cycle may result in a successful pregnancy, subsequent cycles may yield different outcomes due to changes in ovarian function, egg quality, or other factors. The use of IVF hormones in multiple cycles can potentially affect the overall ovarian health and function, leading to difficulties in conceiving naturally or through subsequent IVF attempts.
Uterine Health:
IVF hormone treatments can alter the uterine environment due to hormonal fluctuations and other factors. This could potentially affect implantation and the ability to sustain a pregnancy, leading to difficulties in achieving a successful pregnancy after having had a previous child.
Secondary Infertility:
The use of IVF hormones, especially in multiple cycles, can sometimes be associated with a phenomenon known as secondary infertility. Secondary infertility refers to the inability to conceive or carry a pregnancy to term after previously having a successful pregnancy. It can arise even when a person or couple has previously given birth without any fertility assistance. Here’s how IVF hormones can relate to secondary infertility:
Because secondary infertility is a risk in surrogacy, all potential surrogates should be done with their own family-building before exploring surrogacy.
Fertility clinics and medical professionals closely monitor surrogates throughout the surrogacy process to minimize the risk of complications and address any emerging issues promptly. Careful dosing and monitoring of the hormone medications are essential to ensure a safe and successful outcome. Surrogates should have a thorough understanding of the potential risks and side effects before embarking on the surrogacy process and should maintain open communication with their healthcare team throughout their journey.
While surrogacy involves unique legal and medical considerations, the underlying biological processes and health risks remain akin to those of traditional pregnancies. It’s important for all parties involved to be aware of these shared risks and work collaboratively to ensure the health and well-being of both the surrogate and the developing child.
FAQ: Surrogacy Risks and Complications, IVF Hormones, and Secondary Infertility
Do surrogacy risks resemble those of regular pregnancies?
Surrogacy involves a woman carrying a pregnancy on behalf of Intended Parents. Despite differences in genetic relationship, surrogacy and natural pregnancies share common risks due to the similar biological processes and factors at play. Both scenarios involve the interplay of a woman’s body, fetal development, and external influences.
What are the common risks shared by surrogacy and natural pregnancies?
Surrogates experience the same physiological changes and hormonal fluctuations as pregnant women. Risks like gestational diabetes, preeclampsia, and preterm labor can occur. Fetal development, genetics, maternal health, and environmental influences impact both surrogacy and natural pregnancies. Additionally, psychological challenges like hormonal shifts and postpartum mood disorders are consistent in both situations.
What are some of the most common pregnancy-related health risks?
Common risks include gestational diabetes, preeclampsia, preterm labor and birth, miscarriage, birth defects, gestational hypertension, anemia, placental problems, and infections. Risk factors vary based on maternal age, medical history, and lifestyle choices.
How are surrogates medically screened by fertility clinics?
Surrogates undergo thorough medical screening involving a comprehensive assessment of medical history, physical health, and reproductive capabilities. This includes initial consultations, medical record reviews, blood tests, and pelvic ultrasounds to evaluate uterine health.
What are some of the risks associated with IVF hormones in surrogacy?
IVF hormone treatments can lead to complications such as multiples pregnancy (twins, triplets), psychological effects, ectopic pregnancies, blood clot formation, and secondary infertility.
What is secondary infertility, and how does it relate to IVF hormones?
Secondary infertility refers to the inability to conceive after previously having a successful pregnancy. IVF hormone use, especially in multiple cycles, can impact ovarian function, egg quality, and uterine health, contributing to secondary infertility.
How can surrogates and Intended Parents mitigate risks associated with IVF hormones?
Fertility clinics closely monitor surrogates during the surrogacy process. Effective communication with medical professionals, thorough understanding of potential risks, and adherence to medical guidelines can help minimize complications and ensure a safe outcome.
What is the key takeaway for those considering surrogacy?
While surrogacy has unique legal and medical considerations, it’s important to recognize that the shared biological processes and health risks between surrogacy and natural pregnancies highlight the need for informed decision-making, thorough medical screenings, and ongoing communication with healthcare professionals. All parties involved should prioritize the well-being of the surrogate and the developing child throughout the surrogacy journey.
