Monthly Archives: July 2017

Surrogate Breastfeeding

Breastfeeding has proven health benefits for a baby. A number of mothers do not manage or do not have the ability to breastfeed their babies. While they grow perfectly healthy and strong, breastfeeding still has it’s advantages and is sometimes of a high priority for the intended parents.

When surrogate mother gives birth to a child, it is possible to ask her to breastfeed the baby on the next day after the delivery. However, surrogate breastfeeding is not always guaranteed and there are a number of factors to take into consideration.

 

Can intended parents ask surrogate mother to breastfeed their baby after the delivery?

The issue of the surrogate breastfeeding is not the matter of the legal regulation. Surrogacy agencies too, do not mention it in the contracts. Surrogate mothers are not contractually obliged to breastfeed the baby but are neither restricted from doing so.

Intended parents might have the desire that the newborn receives health benefits from the breast milk on the first day after the delivery. While this is a reasonable request to have, it should be discussed with the surrogate mother long before the delivery.

There are a number of reasons why surrogate mother may not be willing to breastfeed a baby. First of all, she will likely want to avoid establishing an emotional bond, which can be a consequence of the breastfeeding. Giving a birth includes emotional and physical load. Sometimes, exhausted after the delivery, surrogate may not always be in the condition to breastfeed a child. Surrogate mother may also plan to dry up her breast milk and she may be planning her personal routine accordingly.

In order to protect surrogate’s feelings and satisfy the needs of the intended parents, surrogacy agency will have to act as an intermediary and participate in the preliminary agreement about the breastfeeding.

When intended parents have a strong desire that the surrogate breastfeeds baby even one time after the delivery, it is always recommended to discuss the issue in advance and check whether they have the consent from the surrogate mother.

 

Fresh and Frozen Embryo Transfer

It is a common perception that fresh embryo transfers are more successful than frozen embryo transfers. The thinking behind this attitude could be that highest quality embryos are transferred during the fresh cycles, while the rest, less viable ones are saved for the future attempts. Another possible issue is  that people do not fully understand what freezing actually means and think that it may affect the embryo quality. As the matter of fact, this way of thinking is not correct.

The belief that fresh embryo transfer has definitely higher success chances than the frozen, is far from accurate.

 

Fresh embryo transfer

Before the cycle, female body should be prepared for the egg retrieval. Ovaries get stimulated in order to produce extra eggs. The medications used for the procedure are not light for the body as they are interfering with the hormones. If the first cycle is not successful or intended parents want more children,  with no frozen embryos in storage, it will be necessary to go through the stimulation and egg retrieval processes once again. Definitely not the best practice.

While the hormone levels are being manipulated with every new retrieval procedure, it is important to also consider that each fresh cycle can cost even up to 10 000 USD, depending on the location and clinic.

 

Frozen embryo transfer

Frozen egg transfer requires preparation too –  the uterine lining has to thicken in order to be ready for receiving the embryo. The medications used for the process are less expensive than the ones used while the retrieval and fresh cycle. Additionally, they are much less demanding of the body.

When the embryo transfer occurs a while after the stimulation and retrieval, female body gets the chance to normalize hormone levels and get back to natural state, which is more suitable for the conception. A lot of researchers argue that this can have a positive effect on baby and reduce the chances of low birth weight and preterm labour.

A lot of intended parents find it very comfortable, not having to worry about the egg production and the repetition of the retrieval procedure. With the frozen eggs in storage, intended parents have the ability to plan the date of their cycle months in advance and prepare for it appropriately.

 

Egg freezing

As medical technologies have advanced a lot, freezing techniques have altered and advanced too. Ultra rapid freezing method results in higher success rates than the slow freezing method that was used back in the days.

Important notice for the intended parents is that freezing does not change or affect an embryo. In fact, embryos are kept from aging and are conserved the way they were before freezing. This is also the hint that the chances of success can not be lower in comparison to fresh embryo transfer.

In terms of success, there are no clear evidences in advantage of fresh or frozen egg cycles, however, the same applies to the disadvantages too.

 

The best practice

In order for the embryo transfer to be most practical, both medically and financially, it would be reasonable to stick to the following route : after the egg retrieval, perform fresh embryo transfer and in case of further cycles, use the frozen ones. Repeated cycles should be planned with the storage of frozen embryos.

Before planning the retrieval and transfer procedures, intended parents should  discuss the action plan with the surrogacy agencies and the donation clinics. It is important to know how they plan the cycles, whether or not they give the opportunity to freeze embryos, which methods they use and how they come in accordance to the best practices of the embryo transfer .

 

Meeting With the Anonymous Egg Donor

Egg donation regulations vary across the countries. According to law, egg donation can be known or anonymous. It may happen during a fertility journey that parents request meeting with the anonymous egg donor. Further, we will discuss whether is it possible and what other alternatives do intended parents have.

It is not hard to understand why intended parents want to meet their egg donor in person. However it is important to take several factors into consideration :

When intended parents request meeting with the anonymous egg donor, the personality of a donor has to be revealed. This step completely opposes the regulation and the idea of an anonymous egg donation, during which the anonymity and privacy of a donor are absolutely untouched. While parents might promise and claim that they respect their donor’s privacy and will not disclose any details from the meeting, it will still come in conflict with the initial agreement and country’s regulation.  

More importantly, in some countries egg donation is possible and allowed only when it is anonymous. The best of surrogacy and egg donation agencies operate accordingly, within the framework of country’s regulation. They do not allow revealing donor’s personal information.  At the same time, agencies will have a database of egg donors which contains all of the essential information for the donation procedure – such as donor’s medical history, medical records, proof of her mental health, information about her appearance – eye color, hair color and etc.

 

When can intended parents meet with the egg donor?

Meeting with an egg donor in person may be of high-priority for some intended parents.  If this is the case, it is essential to consider it before planning the program and choosing the destination. Intended parents will have to choose the country where surrogacy is regulated by the law, is legal and egg donation does not have to be anonymous. When anonymity is not a requirement in the country and donor can be known, intended parents can then get acquainted with her through the personal meeting.

One more factor to remember is that the possibility of known egg donation does not necessarily guarantee it. Egg donor herself might have privacy issues and  have no  desire to expose her identity. Surrogacy and egg donation agencies will first have to clarify this issue and choose the donors from the database,  who do not mind being introduced  to the patients. Intended parents should always consider contacting surrogacy and egg donation agencies first and discussing their priorities and inquiries before actually planning the program.

 

Surrogacy in Greece

In Europe, there is a lack of countries where surrogacy is allowed. In many cases, European couples have to leave the continent in order to find a suitable surrogacy destination. Greece is one of very few European countries where surrogacy is regulated and legal. Since 2014, surrogacy in Greece has been available for non-EU citizens too and has become an international destination for couples seeking surrogacy services.

 

In Greece, intended parents do not need to be married and single females are eligible for surrogacy services too. As for 2017, same-sex couples and single males are not currently allowed to become parents through a surrogacy program. Intended parents are required to provide medical proof that they are not able to have children without the assistance and fertility treatment such as IVF.

 

Although the law states that surrogacy should be altruistic, it is not completely so. Regulations allow surrogate mother to be paid up to 10,000 Euros. This amount is considered as a compensation for the loss of the regular job. It can be evaluated based on surrogate mother’s skills and qualifications –  how much would she earn as an employee.

 

Embryo transfer cannot occur without the permission of the court. Court has to allow a surrogate mother to participate in a program and intended parents should submit their medical records too. After about 8 weeks, court will notify the decision to the participating parties.

 

Of course surrogacy agencies and clinics will screen surrogate mother closely, however, it can happen that medical preparation of the surrogate does not go  as expected or she has to be replaced due to a private or medical reason. In this case, a new candidate will need to be presented to the court , whose approval will take an additional time. In this case, the total approval time may take up to 6 months.

 

Intended mother will be baby’s legal mother and her male partner – baby’s legal father. According to the Greek Civil Code, surrogate mother has no rights to request custody.

 

Total costs of surrogacy will of course depend on concrete services that intended parents need. Prices of surrogacy services are not very affordable in Greece and may sum up to 60,000 EUR.

 

Whether Greece is an attractive surrogacy destination depends on an individual case.  Intended parents will have to make a decision based on financial and other private matters, as well as after the communication with surrogacy agencies operating in the country. Meanwhile, we have provided several highlights that summarize surrogacy in Greece:  

 

Pros

  • Court approval and involvement prevents legal controversies
  • Intended parents are legal parents
  • Greece is a famous tourist destination with well known resorts

 

Cons

  • Approval process might get delayed
  • Not affordable
  • Surrogacy is not allowed for same-sex couples and single males

 

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