Embryos are tiny, delicate things. Following the embryo transfer process, surrogates concerned about how to protect the embryo they're carrying may worry about how secure the embryo is once it's placed in the uterus. Is it possible for the embryo to "fall out" after it has been transferred?

IS IT POSSIBLE FOR AN EMBRYO TO FALL OUT AFTER TRANSFER?

The overwhelming fear is that walking, jumping, or even urinating could cause the embryo to simply slip out of the uterus. Doctors often prescribe bed rest following the transfer to allow the embryo time to “get settled” and implant, so it makes sense that undue movement could cause the embryo to become dislodged and slip out, right? Rest assured that this is highly unlikely. The idea has merit, in theory, but it is not plausible in reality. The uterus is a muscular organ. This means that it stays contracted and tight in its natural state. While the area inside of the uterus is called a “cavity,” it is not a literal empty space. The transferred embryo does not have open space in which to move freely or roll around. 

WHY EMBRYOS DON'T FALL OUT

Your body is prepared well for the embryo transfer with IVF medications. Nearly all IVF doctors will require your uterine lining to be thick enough for the walls to touch in the middle before proceeding with a transfer. This creates an environment in which the thick, sticky endometrial lining leaves no empty space. When the embryo is placed between the uterine walls and the muscle contracts, it will create a secure place for the embryo to bury itself deep within that thick lining and begin to grow. Visualize placing a poppy seed in the crease of your elbow and then folding your arm shut tightly by using your muscle. Now wiggle that arm as hard as you can. No matter how hard you try, that poppy seed will not fly out. 

An implanted embryo inside of a flexed uterus is much the same. No reasonable external physical activity—be it jumping, rolling over in bed, walking, or running—can cause a healthy receptive embryo to become dislodged once it has implanted into the endometrial lining. The bed rest period is meant to help you relax and encourage the embryo to implant and bury itself within the endometrial lining. 

While you should always follow doctor’s orders regarding bed rest, do not be afraid to get out of bed to use the restroom or stretch your legs. If you have questions about what activities are approved, both during bed rest and once you’re cleared to return to daily life, do not be afraid to ask your nurse or doctor.

READY TO LEARN MORE?

Please contact Growing Generations for more information about being a surrogate in our program.  

Often surrogates are curious which IVF doctor they’ll be paired with for their journey. Ultimately, the surrogacy doctor you will work with is chosen long before you receive the profile of the intended parents that you will be helping.

HOW IS A PHYSICIAN CHOSEN FOR MY SURROGACY JOURNEY?

When intended parents retain Growing Generations for surrogacy, they will have the option to either continue working with one of their own private practice IVF physicians or select one of our partner doctors.

Many couples do not have pre-established relationships with doctors when they retain us and will select one of our partner doctors. Growing Generations is very proud to work with doctors we believe to be some of the best IVF physicians in the US. Many of these doctors are industry leaders boasting some of the best success rates in their fields.

These doctors include:

• Brad Kolb, HRC Fertility

• Shahin Ghadir, Southern California Reproductive Center

Occasionally, we will encounter intended mothers who have tried to attain pregnancy on their own before turning to surrogacy and have developed a trusting relationship with their personal IVF doctor. We will allow them to continue working with their own IVF doctor in these cases.

WILL THE IVF DOCTORS BE NEAR ME?

That depends on a variety of factors, but most surrogates can expect to travel for some of their medical procedures. Often, the doctor you meet with during your medical screening process will be the one you wind up working with during your medical cycle and embryo transfer. However, sometimes your doctor will change depending on the doctor your intended parents have previously chosen. This is a normal part of the process and not a cause for concern.

Know that whichever doctor you’re working with, it’s one that Growing Generations has great faith in. You should always feel comfortable and informed when it comes to your health and the doctor that you’re working with. Each doctor has their own staff of third-party reproduction nurses who will be in regular communication with you during your medical phase. You should always feel comfortable reaching out to your nurse with any questions or concerns that you may have.

To learn more about the surrogacy and IVF process, contact Growing Generations.

Revised 5/15/18

Many surrogates find themselves wondering why their intended mother needs their help. One potential cause stems from prolonged or advanced polycystic ovary syndrome, PCOS for short. PCOS is often associated with pregnancy difficulties and infertility, leading many women to turn to surrogacy to build their families. 

WHO GETS PCOS AND WHY?

PCOS is actually quite common. Doctors estimate that as many as 8% to 13% of all women in childbearing years suffer from PCOS, and suggest that as many as half of those women may not even know they have it. 

Women suffering with PCOS produce too much of a typically male hormone called androgen. When it is too abundant, androgen prohibits the body from allowing a healthy egg to be released from the ovary into the fallopian tubes, sometimes leaving the woman unable to conceive a child.  Instead, the immature eggs turn into small cysts and are retained inside of the ovaries. These retained cysts will continue to contribute to steadily elevated levels of androgen in the body, serving only to fuel the cycle of PCOS further. 

PCOS Symptoms

PCOS is often characterized by missed or irregular periods, excess body hair, weight gain, and acne. Given that these are symptoms that are incredibly common for most women, many don’t mention them to their doctors for many years. The diagnosis itself can often take quite a while to attain, given that PCOS is only diagnosed as an “exclusionary diagnosis,” meaning it is only diagnosed after every other possible diagnosis has been ruled out. 

PCOS: PREGNANCY, MISCARRIAGE & SOLUTIONS

For women living with a PCOS diagnosis, the answers to their fertility can run the line from very hopeful to very grim. While some women may need minor hormone therapy to regulate their cycles and work to correct the abundance of androgen, others may experience infertility or miscarriage. Often, this latter group of women is left considering reproductive technologies and even surrogacy as the best way to create their families.

Helping these women build their families through surrogacy is deeply rewarding. (You can learn about other reasons to become a surrogate in our related blog post.)  Reach out to us online to learn more.

Yeast infections are common and impact millions of women every year. Even so, many women will experience their first yeast infection, or potentially her first outbreak of several yeast infections, in her surrogate pregnancy.

WHY ARE YEAST INFECTIONS MORE COMMON IN SURROGATE PREGNANCY?

According to the American Pregnancy Association, the second trimester of pregnancy represents the time in a woman’s life where she is most likely to experience a yeast infection. So why is there an increased likelihood of a yeast infection in surrogacy if you never experienced one during your own pregnancies? The link could be because several potential causes of a yeast infection occur all at once as a woman prepares to become a surrogate.

For example, some common causes of yeast infections include: 

• Hormonal changes related to pregnancy

• Starting hormone therapy treatments (including birth control pills, estrogen, or progesterone treatments)

• Taking antibiotics or steroids (a common component of your pre-transfer medical protocol)

• An increase of sugar in the diet (sweets are a common craving for pregnant women)

• An influx of vaginal intercourse (potentially before or after doctor ordered pelvic rest)

• Blood or semen in the vagina

Often characterized by an increase and change in appearance of your normal vaginal discharge and a persistent, insatiable itch, yeast infections are caused when the levels of yeast and acid in the vagina are out of balance. Both elements are present in your body normally, so the presence of bacteria is not the problem; it is the unbalance that presents the issue.

YEAST INFECTION TREATMENT DURING SURROGATE PREGNANCY

While yeast infections have no major risks or implications to the pregnancy, they can still be uncomfortable and problematic for you, especially if left untreated. Yeast infections during pregnancy can be difficult to control, so it’s best to get early treatment. 

Additionally, and unlike traditional pregnancies, yeast infections in IVF pregnancies and surrogacy may require a different form of treatment than your standard over the counter creams. This is because many IVF doctors do not want the creams or their plastic applicators introduced to your vagina in the early stages of your pregnancy. While some doctors may be OK with the creams with hand application only, other doctors may choose to call in a prescription to treat the infection orally.

We understand that it can feel embarrassing and invasive to tell your nurse about a potential yeast infection before simply self-treating with over the counter medications, but in the case of surrogacy, you should absolutely mention symptoms to your nurse, even if this is a multi-occurrence infection. 

Treatment is key, because if it is left untreated, the yeast infection can be transferred to the child you are carrying during birth, leading to a condition of the mouth called thrush.

Once you begin treatment you can expect to experience relief from the symptoms within 10 to 14 days, although most treatments will begin to offer relief from many of the symptoms within 48 hours. 

STEPS TO PREVENTING YEAST INFECTIONS DURING PREGNANCY

If you find that you are experiencing repeated yeast infections during your journey, you may opt to introduce the following natural prevention measures in order to try and stave off any future infections. 

• Wear loose clothing

• Wear cotton underwear

• Always wipe from front to back after using the restroom

• Limit sugar intake, as vaginal yeast feeds on sugar

If you have additional questions or concerns, try to focus on feeling comfortable mentioning this to your nurse or case specialist. Sending an email to approach the subject may offer you a bit more comfort than mentioning it in a call, but understand that both your case specialist and your nurse manage these sorts of issues every day, and they’re nothing to be embarrassed by.

Growing Generations is a premier surrogacy agency that provides intended parents, surrogates, and egg donors with exceptionaly attentive service. If you are interested in becoming a surrogate, contact us online or complete our surrogate application.

The time following a miscarriage or D&C (dilation and curettage) can be both physically and emotionally challenging, and many surrogates wonder when their menstrual cycle will return following either a miscarriage or D&C. Attuning yourself to your body’s health and response over the next several weeks helps you understand how you are recovering and what your next steps in surrogacy will be. 

HOW LONG DOES INITIAL BLEEDING LAST AFTER A MISCARRIAGE?

You will typically experience a slow bleed for up to a week following the miscarriage or procedure. Typically, bleeding stops once your human chorionic gonadotropin (hCG) levels have returned to zero. Doctors will generally monitor your blood hormone levels to ensure that your hCG levels return to zero on their own.

HOW SOON AFTER MISCARRIAGE OR D&C DO YOU GET YOUR PERIOD?

Your first period will generally return within four weeks of your hCG levels returning to zero. However, it is not uncommon for some women to experience prolonged return to ovulation and menses, which can last up to eight weeks. 

WHEN WILL OVULATION RESUME?

In many cases, ovulation will not occur during your first cycle, as your body is still recovering. In most cases, your IVF doctor will wait for you to experience one or two cycles before starting medications for a repeat medical cycle and transfer. During this time, your cervix will remain soft and open, which may make intercourse painful.

WHEN TO BE CONCERNED ABOUT EXTENDED BLEEDING AFTER A MISCARRIAGE

In the cases of a natural miscarriage especially, you’ll want to pay special attention to how long your initial bleed lasts and how frequently you experience a recurrence of bleeding. In these cases, it is possible that some tissue may have been retained in the uterus and is preventing your body from healing. If you continue to experience light spotting over an extended time, it could be possible that your body is having trouble returning to regular hormone levels. You will want to speak with your doctor if you experience any case of extended bleeding.

PROLONGED ABSENCE OF MENSES (NO PERIOD AFTER MISCARRIAGE)

A prolonged return of menstruation is not normal. While it can take up to eight weeks for your body to properly recover and return to having regular cycles, some women will experience an even longer delay. This is typically experienced after a D&C as opposed to a natural miscarriage and may indicate the presence of new scar tissue or fibroids inside of the uterus. If you have not experienced a menstrual bleed by 10 weeks following the miscarriage or procedure, it is important that you notify your doctor.

At Growing Generations, we are here for you every step of the way. Contact Growing Generations to learn more.

All pregnant women are tested for gestational diabetes during their pregnancy, and it is no cause for alarm. Even if they’ve had no prior issues with blood sugar levels in their day-to-day life or in previous pregnancies, they will still have a glucose test during pregnancy as a surrogate.

While being a surrogate does not raise the odds of developing gestational diabetes, factors such as excessive weight, age, and carrying multiples may contribute to a more significant insulin resistance and the development of this condition.

GESTATIONAL DIABETES TEST

Glucose tolerance tests monitor the body’s ability to turn sugar into energy. During pregnancy, the additional hormones can confuse the pancreas, rendering it unable to break down glucose properly. When this happens, blood glucose rises and, on occasion, the woman will develop gestational diabetes. Unlike type 2 diabetes, gestational diabetes is purely hormonal. If a diagnosis of gestational diabetes is given, it is not the result of your surrogate’s food and exercise choices. This is not a diagnosis that could have been avoided with different behaviors.

GLUCOSE TOLERANCE TEST RESULTS

Learning that your surrogate’s initial glucose tolerance test came back elevated is a conversation that no intended parent hopes to have during their journey. Your initial reaction will likely be surprise, which then ignites questions and concerns: “She’s never had THAT in her history! What does this mean for the pregnancy? What did she do to ‘fail’ this test when she’s never failed it before?”

Let’s start by establishing a baseline. Having an elevated one-hour glucose test result is not a “failure.” If the test result is elevated (a “fail”), then there is nothing that could have been done differently by your surrogate to “pass.”. Also, many women will have elevated levels in a one-hour standard test and go on to pass a three-hour screening and have no problems. However, an elevated result on a one-hour glucose screening can also be the first indicator that your surrogate has developed gestational diabetes. In either event, it’s important to note that this test result is not the result of any action or inaction on the part of your surrogate.

Understand that your surrogate is likely having an emotional reaction to these results as well. Despite not being able to control the results, she likely feels guilty and perhaps even a bit scared. The kindest thing that you can do for her is to reassure her that she hasn’t lost your trust and that you’re in this together.

WHAT DOES IT MEAN FOR THE BABY?

If left unidentified or untreated, gestational diabetes can affect the baby. Here's how: With a buildup of sugar in the bloodstream, a pancreas will work harder than it should, often to no avail. This means that the glucose buildup can, and often will, cross the placenta and work its way into the developing baby’s blood. That will cause the newborn’s pancreas to work overtime and create more energy than it needs. As a result, that fetus will store the extra energy as fat. This can lead to a variety of complications, including high birth weight, damage to the shoulders as they exit the birth canal, and an increased risk of obesity or type 2 diabetes later in life.

GESTATIONAL DIABETES TREATMENT

In most cases, gestational diabetes can be managed by closely monitoring diet and adding a bit of additional exercise. Your surrogate will be asked to monitor her glucose levels with a home testing kit and keep a strict log of her food intake and sugar levels, but she may not need to change much about her lifestyle.

Women who are unable to control their blood sugar levels, even with strict adherence to diet and exercise, may be asked to begin taking oral medication or injected insulin. For most women, gestational diabetes will go away once the child is born. The American Diabetes Association advises women who develop gestational diabetes to have a 2-hour glucose tolerance test at 6 weeks postpartum in order to ensure that the diabetes has cleared up.

UNDERSTANDING GESTATIONAL DIABETES DURING SURROGACY

It’s important to understand what gestational diabetes is (a hormone-driven resistance to insulin) and what it is not (poor dietary choices or the inability to follow a diet). Your surrogate will likely feel some level of guilt in the case of a gestational diabetes diagnosis, even though it was induced by pregnancy. This is a great time to show her that you support her and will stand by her side moving forward.

Growing Generations is always here to answer your questions as intended parents and support you throughout your family-building journey.