IVF Using a Gestational Carrier or Gestational Surrogate
There are many requirements that have been set by the Food and Drug Administration that regulate the use of donor human cells such as eggs, sperm and embryos. Couples who intend to use a gestational carrier are therefore required to have specific donor screening tests.
In particular, the male partner of the couple planning to use a gestational carrier is required to have initial donor testing performed at the same appointment he will be scheduled to collect and freeze a semen sample that will be used in the future IVF cycle. This semen sample will be cryopreserved and quarantined for 6 months (as recommended by the American Society for Reproductive Medicine guidelines). He will need to have the donor testing repeated before the semen sample can be released from quarantine and used in the IVF gestational carrier cycle.
Informational psychological counseling is required for the intended parents and the gestational carrier and her partner. Additionally, the carrier is required to undergo psychological testing to determine whether or not she is a suitable candidate to be a gestational carrier.
Use of a gestational carrier in an IVF cycle is an involved and lengthy process. Therefore, we would like to provide a basic step by step guide for you in an effort to streamline this process. Your individual progress may vary!
Step 1: The intended parents will meet with one of our Nashville Fertility Center physicians for consultation and to determine treatment options. The physician will then request that the IVF coordinator perform a chart review, and an informational IVF packet with financial estimates will be mailed to them.
Step 2: The intended parents will set up an appointment and then meet with a psychiatric clinical specialist, to review the psychological implications of gestational surrogacy.
Step 3: Once the couple is certain that they want to use a gestational carrier, they will need to begin their search for a suitable carrier. If they already have a candidate in mind, they may set up an appointment with the psychiatric clinical specialist for the carrier’s psychological evaluation. Please be aware that Nashville Fertility Center does not have a gestational carrier recruiting program, but our physicians will medically screen potential carrier candidates for you once you have found one.
Step 4: The potential gestational carrier will need to schedule the psychological evaluation and testing with a psychiatric clinical specialist. Subsequently, the carrier, her partner and the intended parents all meet with the same psychiatric clinical specialist in a group appointment. If for any reason the candidate is determined to be unsuitable, our physicians will not allow the potential carrier to go any further in this process.
Step 5: The intended parents may complete their IVF donor testing prerequisites once they have had their informational counseling with the psychiatric clinical specialist. The male will need to freeze a semen sample and do the male FDA donor testing at the same appointment. This is the sample that will be quarantined for 6 months before it may be used in the IVF cycle. (Sperm freezing may be scheduled earlier in the process as desired by the intended parents)
Step 6: The gestational carrier will need to schedule a medical evaluation by one of the NFC physicians. Once the physician has evaluated the carrier and determined that she is suitable, she may complete the IVF prerequisite testing. This will include a uterine evaluation such as a sonohysterogram (SIS) or hysterosalpingogram (HSG), as well as screening blood work.
Step 7: Once the intended parents and the gestational carrier have completed the psychological counseling, medical evaluation and prerequisite testing for the IVF cycle, they may all schedule to attend IVF class. This class will review the specifics of the IVF cycle including consents, calendars and medication use, including injection teaching for certain medications used in the IVF cycle.
Step 8: The intended parents may begin working with an attorney to develop a legal contract between the couple and the gestational carrier. They may use attorney Lisa Collins who practices in the Nashville area and specializes in gestational carrier/donor and adoption law or another attorney of their choosing. We must have a letter from their lawyer that a contract is final or a copy of the contract in order to begin the IVF cycle.
Step 9: Once all parties have completed psychological counseling/clearance, medical evaluation/clearance, normal prerequisite/donor testing, a semen sample frozen in quarantine, attendance at IVF class, signed IVF consents, and signed legal contract, then the intended parents and the gestational carrier may contact the IVF coordinator to develop their specific IVF cycle plans and proceed with the IVF cycle.
Each of these steps is essential to ensuring that the cycle will proceed smoothly and that the intended family are legally and medically safeguarded. The use of a gestational carrier can be complicated at times, but at NFC we strive to streamline this process as much as we can to make all parties involved feel comfortable and to execute the cycle as efficiently and transparently as possible.