Selecting a surrogate mother is a complex process and consists of several steps.
First of all, choosing an appropriate candidate is a huge job and a great responsibility for an IVF doctor. Numerous factors have to be checked and double checked before admitting a surrogate mother to a program : medical history, current state of physical as well as mental health, endometrium lining, checking if she will satisfy and pass all of the mandatory tests, infections have to be studied carefully too.
Yes, a healthy pregnancy has a lot of effort to put in it and being able to choose the candidate that completely fulfills the medical requirements is definitely not a simple task.
It is possible that a surrogate mother does not achieve pregnancy despite being proven to be medically a perfect candidate. Some processes during surrogacy happen independent from our efforts and expectations. Fresh embryo transfer may need to be cancelled due to the unexpected start of surrogate’s period or vice versa, a long delay in cycle may cause uncertainty and the need to plan a new sequence of procedures.
Anyway, doctor will perform the additional and repeated examinations and will replace the surrogate mother only in case he has a solid medical reason, such as the identification of ovary cysts, uterine myomas, risks of bleeding and so on.
IVF is a treatment that requires careful observations before the embryo transfer. As for the intended parents, we would like to mention that you should not insist to change the surrogate mother unless the doctor provides serious medical reasoning. What is always worth remembering is that there are other factors that can influence IVF outcomes and the chances of a successful pregnancy. First of all, under the factors, we of course mean embryo quality and its ability to implant successfully.
Before implantation, embryos go through the grading process where embryologists check their quality and choose the best ones for the transfer. However, sometimes, not all of the transferred embryos manage to implant successfully and continue their development in the female body.
After studying the situation or even several further attempts, sometimes using an egg donor can be even more recommended rather than replacing the surrogate mother.
Remember that before being admitted to the program surrogates perform all of the possible tests that are pregnancy related and the reason of replacing them have to be very solid and reasonable.
The idea is not that if IVF attempts are unsuccessful this can not be due to the surrogate mother’s health and happens because of the embryos — the point is that yes, surrogate mothers will sometimes need to be replaced but there needs to be a strong reasoning behind that action. Additionally, of course the professional surrogacy agencies and clinics have already thought of the worse case scenarios and are prepared for them in advance. In our case, we will always have a plan B for our beloved patients, however, this does not mean that we should make any of the decisions in a rush.