Multifetal Pregnancy Reduction

Multifetal pregnancy reduction (MFPR) is the medical procedure that reduces the number of fetuses carried during the multiple pregnancy.  It might be a very depressing subject for the intended parents to discuss, however, in long term perspective, MFPR can lead to a healthier pregnancy.

It is a fact that multiple pregnancy is a common occurrence during the In vitro fertilization treatment. The reason is that in order to increase the chances of a successful transfer, 2 or 3 embryos are often transferred at a time. When all of them implant successfully, intended parents are often surprised with twins of triplets. MFPR is not performed when a female carries twins, but may be done to decrease the number of fetuses from 3 or more to 2.

In most of the cases, the aim of the multifetal pregnancy reduction is to increase the chances of a healthy pregnancy. More fetuses are unfortunately  linked to higher chances of miscarriage, stillbirth and lifelong disabilities.



The procedure itself is performed early in the pregnancy (9-12 weeks), when the size of the fetus is very small. Widely used method includes injecting potassium chloride in the fetus via a needle, which is inserted in woman’s abdomen.

As already mentioned, multifetal pregnancy reduction is not performed during the twin pregnancy. The risk of this medical procedure is to unintentionally harm other than selected fetus(es). In order to avoid termination of the pregnancy, most of the fertility doctors and surrogacy agencies will strictly refuse to perform MFPR in case of twins.


How to feel about multifetal pregnancy reduction?

The procedure is undoubtedly mentally traumatizing and has a heavy emotional load. However, as strange as it may sound, intended parents should realize that it is done in  sake of a more successful and healthy pregnancy.


Surrogate Mother Selection Criteria

In reality, it is not that simple to formulate the golden standards for the surrogate mother selection. Criteria can sometimes  be different across the countries and agencies. However, it is important that intended parents have the general understanding and have an idea of what should they expect and how their surrogate mother is controlled before being finally  chosen for the program.

Intended parents need to be ensured that the agency will do it’s best, double check medical condition of the surrogate mother and choose the most appropriate candidate with the highest likelihood of success.

Does not matter whether baby is genetically connected to the surrogate mother or not. There exist a number of medical complications and conditions  which may occur or transmit  while the baby is being carried by the surrogate.

Most of the surrogacy agencies will require that surrogate mother does or provides the results of routine medical tests, such as : complete blood count, HIV test, hepatitis C,  measurement of hormone levels, pap smear test  and more.

The list of tests and requirements may vary across countries and agencies.  In some cases, apart from the ordinary tests, the surrogate should provide additional reports:


  • Chest X-ray and the conclusion that surrogate does not have tuberculosis.
  • Conclusion from the breast physician.
  • It is often required that the surrogate mother has her own children. It is important to check the report from the pediatrician and make sure that surrogate’s biological children are healthy and do  not have any medical problems.
  • Conclusion from the narcologist.
  • Report from the psychologist – yes, it is important to know that a surrogate mother is mentally healthy and completely ready to get started with the program and such a responsible journey.
  • The reports should of course include the final conclusion that the surrogate mother is healthy and does not have any pregnancy related issues.


During the introduction to the agency and the preliminary discussion, intended parents can require the list of surrogate mother selection criteria and double check that their candidate is satisfying them.

Huge amount of tests does not necessarily mean more qualitative check up and service. It is crucial that all of the tests have their purpose and are connected to the pregnancy. Intended parents should not hesitate to ask as many questions as needed and desired.


Ectopic Pregnancy

Ectopic or tubal pregnancy  is a noteworthy pregnancy complication. Fortunately it is not common but should be identified and treated as soon as possible.

After fertilization, egg implants to the inside of the uterus. Ectopic pregnancy occurs when egg attaches itself outside of the uterus, most commonly in the fallopian tube(that’s where the term tubal pregnancy comes from). Embryo can not continue proper development outside of the uterus and if left untreated, can be life threatening or cause serious damage to the mother.



As ectopic pregnancy occurs in the beginning of the pregnancy it may happen that a female does not yet know about her condition. Therefore, it is also possible that there are no present symptoms. When the pregnancy test is positive and there are other early pregnancy signs too (sore breasts, nausea..), it is important to watch out for following symptoms:

  • Vaginal spotting or bleeding – bleeding might vary from light to heavy. After getting a positive pregnancy test, beginning of red/brown bleeding or spotting should not be left inattentively. Ectopic pregnancy may also cause the fallopian tube rupture which may lead to severe bleeding. In this case doctor should be contacted immediately.
  • Pelvic pain
  • Abdominal pain  – pelvic or abdominal pain might be of different intensity(mild, sharp,severe) and appear irregularly. Pain may be on the one side of the body.
  • Shoulder or neck pain – ectopic pregnancy might cause internal bleeding. Blood will then gather under the diaphragm and irritate the nerves that go in the area.
  • Weakness, dizziness
  • Fainting


Causes and risk factors

In reality, it might be complicated to find out the cause of ectopic pregnancy. However, commonly, the problem is caused by the damaged fallopian tube that prevents egg from getting into the uterus, leaving it no other way but to implant outside of it. Common causes of blocked tube include:


  • Pelvic infection and inflammation
  • Scar tissue from previous surgery
  • Abnormal growth that changes tube’s shape


Ectopic pregnancy might happen to anyone, however,there are several risk factors that might increase the chances. They include :

  • Maternal age above 35
  • Having experienced ectopic pregnancy before
  • Pelvic inflammatory disease
  • Previous pelvic surgeries
  • Endometriosis
  • Smoking
  • Fertility drugs


Diagnosis and treatment

Ectopic pregnancy can be diagnosed through several methods :


  • Pregnancy test to confirm the pregnancy
  • Ultrasound – is used to check the location of the embryo, whether it is in the uterus or fallopian tube. Because an embryo can not continue proper development anywhere other than uterus, mother might have already miscarried before the exam. It is also possible than a female is on such an early stage of pregnancy that an embryo cannot yet be seen. Swollen fallopian tube or tissues left from the embryo will help to clarify the situation.
  • HCG levels – HCG is is a hormone that is produced during pregnancy. Provided that the pregnancy is confirmed, HCG levels should not be lower than expected.
  • Pelvic exam – will help to locate pain and check for tenderness in the abdomen.


If ectopic pregnancy is diagnosed, the treatment will vary according to the condition. Unfortunately, there is no way to transplant embryo in the uterus, so removing pregnancy tissues is the only way to support mother’s recovery. Remember that if the fallopian tube ruptures, it will cause severe bleeding and can lead to fatal consequences.


Treatment with Methotrexate

If ectopic pregnancy is identified on the early stage of pregnancy and there has been no damage to fallopian tube, the injection of methotrexate can be performed. It will stop cells from developing and allow the body to absorb remaining tissues instead.


Surgical Treatment

On later stages, medication might not be helpful and a small surgery will need to be performed. Laparoscope, a relatively thin instrument will be inserted through a very small incision in the abdomen. Remaining pregnancy tissues will be removed with the instrument. Surgery itself is called laparoscopy. According to the situation, fallopian tube might need to be removed during the laparoscopy.

When fallopian tube is already ruptured and a woman is experiencing heavy bleeding, emergency surgery will need to be done. It is called laparotomy and is performed through a larger incision.


Future Perspectives

Thinking about future pregnancy can be hard after a painful experience. Doctors may suggest to wait for 6 months approximately until the next try, however the duration may vary according to the treatment and the actual reason that caused the problem. If the fallopian tube was not removed, HCG levels should be checked regularly to see if the ectopic tissue was removed completely. If the results are 0, the recovery is progressing well and there is a good chance to have a successful pregnancy.

When the tubes are very damaged and a woman can not conceive naturally, remember that IVF treatment is a way to successful pregnancy and parenthood.


Golf Ball Syndrome

On about 20th week of pregnancy, it is common to have a mid-pregnancy scan. During this procedure, ultrasound will reveal how baby’s organs(including heart), are developing. During the examination process, sonographer, (doctor performing the scan) may notice small bright spots on the baby’s heart. Because of their visual appearance, these white spots are referred to as gold balls and we would normally say that baby has a gold ball syndrome. Medical term for the spots is echogenic foci/focus.


Golf balls are found in up to 5% of fetuses. Their amount could vary from one to higher and are commonly located in the left ventricle of the heart. Usually their presence is not considered to be threatening : normally, they indicate neither fetal  heart defect nor a heart dysfunction. Medically the process is explained as the mineralisation within a papillary muscle.  


However, in some rare cases golf ball syndrome could be related to heart defect too. Additionally there has been identified a bond between golf balls and chromosomal abnormality, trisomy, causing the down syndrome. The suspicion about golf ball syndrome resulting in trisomy usually raises when mother has other medical problems and further fetal problems have been identified during the ultrasound.


Absence of other risk factors such as no medical issues and young maternal age, decrease the chance of a down syndrome significantly.


It is usually advised to perform an additional scan in about 3 weeks. First of all, because the golf ball syndrome has the tendency to disappear itself. If not, the detailed scan will reveal if there are any additional defects or whether the amniocentesis needs to be performed.  When there is an uncertainty about harmlessness of golf balls, followed by certain pregnancy complications and risks, amniocentesis is a definite way to figure everything out.


During pregnancy, baby is surrounded by the sac of fluid, which is called amniotic fluid. Baby’s skin cells are shedded in the fluid and examination of this cells gives the opportunity to identify whether the baby has correct number of chromosomes. This medical procedure is called amniocentesis or chorionic villus sampling and is performed via passing a relatively thin needle through mother’s abdomen into the amniotic fluid. Amniocentesis is a very accurate representation of baby’s chromosome number and accordingly, gives a trustful impression whether baby could have a down syndrome.


Amniocentesis is not always recommended to perform and healthcare providers will only advise making the procedure when they have a reasonable suspicion about chromosomal abnormality.


Complications following the procedure could include bleeding, leakage of amniotic fluid, miscarriage or severe cramping. The complications are not common, however are worth to be taken into consideration.
In case of a surrogacy pregnancy, agency and clinics should simultaneously organize further scans in coordination with intended parents.  Parents, on other hand, may like to be informed in advance about how much is the agency prepared for such occurrences and which procedures do they use to identify baby’s condition as clearly as possible.


Surrogacy and Preeclampsia

Preeclampsia is a medical condition that appears only during pregnancy. It’s characteristics may be quite distinct. However, if the condition is mild, it is important to be familiar with all common symptoms and contact the doctor in a timely manner. There is also a connection between surrogacy and preeclampsia. Further we will additionally discuss what can intended parents do to make their parenthood journey less complicated.


What is preeclampsia?

Preeclampsia is a complication that may appear only during pregnancy. It will usually start after 20 weeks of gestation. It is important to diagnose preeclampsia and treat it on time. Otherwise, the condition can lead to fatal consequences for baby and a mother.

The most common symptoms of preeclampsia are high blood pressure (more than 140/90 mmHg) and protein in the urine (proteinuria).

High blood pressure solely does not necessarily indicate preeclampsia. For example, gestational hypertension is a condition of having high blood pressure during pregnancy, but without extra protein in urine  or problems with  any other organs. However, there are cases when gestational hypertension ultimately develops to preeclampsia.

When the condition is more severe, symptoms can be accompanied with:


  • severe headaches
  • abdominal pains
  • blurred vision or sensitivity to light
  • shortness of breath
  • seldom urination


Swollen hands and legs can sometimes characterize preeclampsia.

Fatigue, dizziness and nausea may also be signs of preeclampsia and in order not to confuse them with the symptoms of pregnancy, it is essential that pregnant females attend prenatal checkups regularly.

On the appointment, doctor will check blood pressure, make urine and blood tests. Usually doctors will check kidneys, because preeclampsia can affect them too.  Ultrasound may be needed to make sure that baby is growing as supposed.

We already know that during pregnancy, baby gets oxygen and food through placenta. Preeclampsia can prevent placenta from getting enough blood. Insufficient blood flow to placenta means that baby will get less nutrients and oxygen finally resulting in premature birth. Preeclampsia can also be the reason of placental abruption(placenta separating from the uterus) finally resulting in a stillbirth. Preterm labour is also a common occurrence when having preeclampsia.


Risk factors

There are no known causes of preeclampsia. However, several factors have been identified to be potentially risky:

  • Having experienced preeclampsia during previous pregnancies
  • Chronic hypertension (high blood pressure)
  • Being pregnant with multiple babies (ex: twins, triplets…)
  • Being pregnant for the first time
  • Babies from different partner on second or further pregnancies
  • Having body mass index (BMI) 30 or higher, referred to as obesity
  • History of chronic high blood pressure, kidney diseases , blood clotting before pregnancy.
  • Age (younger than 20 or older than 40)
  • Genetic factors (sister or mother had preeclampsia)



Preeclampsia is not only a threat to a baby. In future moms, it can cause complications including :

  • stroke
  • seizure
  • fluid in the lungs
  • heart failure of cardiovascular disease
  • problems in kidneys, liver or even eyes. If severe, preeclampsia can seriously affect other organs.


Complications may also include:

Hemolysis (HELLP) which is a more complicated and severe form of preeclampsia and can cause fatal consequences for mother and a baby. HELLP causes the disruption of red blood cells, erythrocytes. Hemolysis is a threat for other organ systems.

If preeclampsia is accompanied by seizure, then the condition develops to eclampsia. Because of its severnes, independant from the stage of pregnancy, the delivery becomes unavoidable.


Treatment and consequences

If the symptoms are mild and the baby is not yet developed sufficiently, doctor may advise  a bed rest, consumption of plenty of water as well as  food rich in proteins. Medicines to lower  blood pressure may be prescribed. Regular prenatal checkups are required to control the course of pregnancy. With the help of ultrasounds, doctor will have to check the heartbeat of a baby. Steroid injections are sometimes used to accelerate the development of baby’s lungs.

Actually, the only cure to preeclampsia is the delivery. Doctor may have to induce the labour, even if mother is not close to term. When preeclampsia is severe and fetus is on the early stage of development, parents and doctor might have to discuss fatal consequences that could be caused by keeping the fetus.

Of course, it is better to be as close to due date as possible. For example after 37 weeks of gestation, when the baby is usually developed enough, delivery is the only option to keep preeclampsia from getting worse. In this case, usually both, mother and baby do just fine.


Surrogacy and Preeclampsia

Professional surrogacy agencies control the health of a surrogate mother regularly. Basically one of the main things intended parents should ensure is that their agency is going to screen the surrogate frequently. It is important that parents are always updated with the information about health of a surrogate and their baby.

Experienced agencies and clinics are already familiar and have experienced patients with most of the pregnancy complications. While some of the conditions are easier to control and manipulate than preeclampsia, the agency will not hesitate to explain their approach to this health condition and share best practices from their experience.

Remember, that the desired results are not always achieved on the first try. In fact, a lot of good things come after times of struggle and failure. There is certainly quite a high possibility to make everything work out just fine, however, it’s important to have a solid, stable and well thought backup plan(s). Same applies for surrogacy agencies and at some point, this is what intended parents should care about in the beginning too.


Tuberculosis and Pregnancy

Back in the previous centuries, tuberculosis was one of the leading infections responsible for death of thousands and thousands of people. Nowadays, recovery can take a long time and the infection is usually cured with the help of antibiotics. It is possible to get infected during pregnancy and pregnant females who have discovered they have tuberculosis, should consider getting treatment as soon as possible. Further we will discuss the relationship between tuberculosis and pregnancy, symptoms, consequences and action plan in different situations.


About Tuberculosis

Tuberculosis (TB) is a contagious infection that is caused by the bacteria called “mycobacterium tuberculosis”. Mostly, TB  attacks lungs, but can also affect other parts of the body, for example : bones, brain, spine and kidneys.

Infected person may have tuberculosis in two forms, active or latent.

Latent tuberculosis means that the immune system is able to block the germs(microbes) from spreading. Latent TB is not infectious and does not cause any symptoms. However, the bacteria is present and the infection may once get activated. Medicines can diminish the probability of activation.

Active tuberculosis, on the other hand, is contagious. The microbes are multiplying, spreading and causing symptoms.

As latent TB doesn’t cause symptoms, it is only possible to identify the infection through medical tests. Active TB , however, has somewhat distinctive symptoms including :


  • A long-lasting cough (21 days or more)
  • Cough that brings up phlegm, sometimes bloody.
  • Pains in the chest
  • Loss of appetite and weight
  • Constant fatigue
  • Fever and night sweats
  • Nausea


Tuberculosis can be transmitted like flu or cold. Microbes can be spread when an infected person speaks, sneezes, coughs, laughs and so on. However, the infection is not easy to catch. A healthy immune system has the ability to fight and even kill the bacteria. It’s also not likely to get infected after having a brief contact with the infected person. The microbes grow relatively slowly and a frequent/long contact is required to catch the TB.

Smoking is proved to greatly increase the risk of getting Tuberculosis.


Tuberculosis and Pregnancy

After introduction to common symptoms of tuberculosis, it is not hard to notice a coincidence with the ones of pregnancy(change in appetite, nausea, fatigue). For that reason , sometimes the only noticeable symptom of TB during pregnancy can be coughing accompanied by the phlegm.

After noticing any of the symptoms, doctors will usually advice to do the phlegm, blood or skin tests. Chest x-ray may also be needed. Mendel-mantoux test, also known as tuberculin sensitivity test is another way to screen for the TB bacteria. A small injection in the skin followed by a swelling in the area is a sign of existence of TB bacteria. The swelling may appear throughout 2-3 days after the injection and it’s presence, doesn’t necessarily indicate the active form of tuberculosis.

Parents should not fear of the tests, as if not identified on time, tuberculosis has the potential to be very harmful for a baby. The consequences may include:


  • Miscarriage
  • Premature birth
  • Preterm labour
  • Baby getting infected with TB (If TB is active and mother has not started treatment yet, there is a chance that baby gets infected during labor. Doctors will make the test after the baby is born.)


The treatment includes antibiotics and can kill the infection if are taken regularly, according to doctor’s prescription. Majority of medicines are safe for both, mother and baby. The treatment may last up to 9 months, until the bacteria is finally killed. However, unfortunately, there are cases when tuberculosis is resistant to medicines(drug-resistant TB) and treating it can be more difficult.

Pregnant females should combine doctor’s treatment with the lifestyle that will make their immune system stronger. Eating healthy food and getting as much fresh air as possible, play an important role in the recovery.


Tuberculosis and Surrogacy

Of course the surrogacy agency and clinic will screen a surrogate mother on tuberculosis. However, it is possible that surrogate mother catches the infection during pregnancy – just like any other pregnant female. It is important that the surrogacy agency is not only monitoring the pregnancy, but has the ability to act operatively in similar situations. If surrogate gets infected, the agency should act accordingly and promptly to perform the steps that are needed to eliminate the issue. Surrogate mother should receive immediate treatment, get checked regularly and be controlled to lead the lifestyle that will increase the chance of a successful pregnancy to maximum.

Intended parents may want to get informed about surrogacy agency’s action plan in similar situations before the beginning of the program.

Parents have to stay positive. Despite the fact that tuberculosis is not a desired condition, especially while expecting a baby, it is better to be aware of it  and receive  treatment in a timely manner. There is always a way to make the situation better, especially with the disease that is proven to be treatable.


Pregnancy Complications

Pregnancy is a very special period that needs a lot of attention. A female body undergoes a number of changes during the gestation. It is a common experience to have mild headaches, nausea, dizziness and other minor discomforts. However if symptoms get even a bit disturbing, females should contact their doctors immediately. Lack of control and care may lead to serious pregnancy complications that may affect a baby as well.


Future parents should be informed about all common types of pregnancy complications and in case of noticing any of the symptoms, should be able to act accordingly.


Some of the common pregnancy complications include :


Nausea and vomiting

Nausea and vomiting are very frequent symptoms during pregnancy. While it is a common knowledge, females should also know that if nausea gets severe, it may be serious. Pregnant women suffering from heavy nausea may not be able to drink or eat. Malnutrition and dehydration can do harm to baby’s development.



Bleeding during pregnancy is a serious issue and needs an immediate attention.

It may indicate several things throughout the pregnancy. Heavy bleeding accompanied by abdominal pain could be a sign of ectopic pregnancy. Depending on the period of gestation when the bleeding occurs, it may mean miscarriage or placenta separating from the uterine lining (“placental abruption”).


Flu symptoms

Immune system weakens during pregnancy and makes females less resistant to flu. Doctors usually recommend pregnant women to get the flu vaccine. During gestation, females are more likely to experience flu complications that may become harmful for a baby too (in some cases even causing miscarriage). Flu vaccination is safe for mother and has benefits for a baby. When  pregnant female gets vaccinated, antibodies are delivered to baby via placenta and protects child up to several months after delivery. Additionally, mother’s strengthened immune system can have a positive influence on unborn baby’s development.

Healthy meal plan, good rest and sleep, exercise and hygiene are the best things to follow in order to avoid getting sick during pregnancy.



Extreme sadness is a surprisingly common issue during pregnancy. Changes in body during and after pregnancy are usually responsible for symptoms similar to depression – anxiety, being moody and restless.Females may also feel irritation and swings in appetite. Mother’s extreme sadness has a negative influence on a baby. Sometimes if depression is severe,  women may even think about harming themselves or babies. Therapy and medicines are essential to regulate mother’s mental condition.


Preterm labour

If female has regular contractions before the 37th week of gestation, it can be due to preterm labour. Before 37 weeks baby is considered to be premature and the preterm labour may cause health problems to him/her. If labour starts too early, it can be even fatal for a child. Medicines are used to delay the labour and a bed rest is usually advised. In sake of survival and satisfactory health, it is better for baby to be as mature as possible at the time of delivery.



Preeclampsia is a serious condition and is diagnosed if a pregnant female has high blood pressure, too much protein in urine or problem with kidneys. Symptoms may also include blurred vision, headaches and dizziness. Preeclampsia starts after 20 weeks of pregnancy. Many females develop mild symptoms near to the due date. Doctors will need to induce the labour as delivery is the best option during the condition. These females will usually do just fine and give a birth to healthy children.

However situation may be risky if the symptoms are severe and it is too early to deliver. Doctor will have to watch mother and a child very closely, give them appropriate care, recommend bed rest and prescribe medicines to lower the blood pressure.


High blood pressure

If mother begins to have high blood pressure after 20 weeks of pregnancy and has no other symptoms, both mother and baby should be watched closely in order to exclude preeclampsia.


Gestational diabetes

Gestational diabetes or glucose intolerance means high blood sugar levels during pregnancy. Body doesn’t produce appropriate amounts of insulin, hormone that regulates sugar. In most cases, condition is temporary and mothers are able to control their blood sugar levels. They need to exercise and follow diet from their doctors.

Poorly monitored and controlled diabetes can cause serious consequences for a baby (early delivery, breathing problems). It may also increase the risk of preeclampsia.

Later in life, females who have experienced gestational diabetes, have a higher chance to develop type 2 diabetes. It is essential for them to control their weight and lead healthy lifestyles.


Ectopic pregnancy

Ectopic pregnancy is a condition when fertilized egg attaches itself outside of the uterus(instead of the inside). This kind of pregnancies are also referred to as tubal, because majority of them  occur in the fallopian tube. Symptoms may include abdominal  pain, dizziness, fainting and bleeding. Unfortunately ectopic pregnancy is a serious complication and needs to be spotted timely. It can be fatal because internal bleeding will begin if embryo tears the fallopian tube. There is no way to place tissue inside the uterus, so ending pregnancy is the only option during this condition.


Baby’s (fetal) problems

Unborn baby’s health should be monitored regularly.Sometimes females may feel them moving less than before. Doctor may also discover that  baby is smaller than normal on the certain stage of pregnancy (gestational age). In order to detect baby’s health issues, such as problematic organs or problems with growth, doctors will need several tests. Treatments may vary. Sometimes it is advised to deliver early. On the other hand, baby might not be in trouble at all and mother may only need a special care(bed rest) before the delivery.


In order to prevent serious pregnancy complications, health of a mother and a child should be monitored regularly. Additionally, parents as well as other family members, should do their best to provide healthy and caring atmosphere for the yet unborn member of their family.


How to Choose your Surrogate Mother

Should we choose surrogate mothers ourselves or should we give the freedom of choice to our surrogacy agencies?  For the sake of transparency and reliability there is a tendency in many parents to gather information and choose the surrogate mother themselves. However, we would recommend that you give the flexibility to your trusted agency and let them help you with the choice.  Reasons behind that decision are several and vary from possible complications to the need of changing the surrogate.


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. Lining of the uterus, also known as endometrium, might not reach the essential thickness for pregnancy or even more, surrogate may need to withdraw from the program due to personal reasons.  This kind of disturbances are not always the case and are not large in number but why should parents experience inconveniences?  If there is even a slight chance of complication and delay, we should always have the plan B. Professional agencies have a pretty logical solution to these problems – they have backup surrogates. Experiences show that agencies that have thought about backup choices of surrogates in advance, have much higher success rate in comparison to ones that stick to only one and the same surrogate mother. They have the ability and resources to fix unforeseen obstacles on time.


On the other hand, some unpleasant surprises may emerge if we do not have enough information about the surrogate mother. Agencies and partnered clinics should already have collected  and revised the following data but parents should also show interest in them :


Surrogate mother MUST NOT :

  • Have miscarriages and stillbirths in her medical history
  • Be a smoker or alcohol consumer


Surrogate mother MUST :

  • Be healthy, medically and mentally


Surrogate mother is recommended :

  • To already be a biological mother to a child


Opinions about the surrogate already being a biological mother are controversial. It is considered that once a mother, she will have higher chances to conceive the second time. Moreover,  already being familiar with the process of pregnancy and the labour itself, it is less likely that the surrogate experiences any kind of attachment towards the child.


Opposite to the above mentioned beliefs, we can bring the examples of Cambodia, Nepal  and Thailand. When law didn’t use to regulate surrogacy in these countries, the main requirement from the agencies was that surrogate mothers were single. For that reason, most of those women didn’t have families and accordingly, neither did they have biological children. However, this fact has not caused any kind of complications neither from medical , nor from mental point of view.


To sum up, assuring that surrogate has already experienced parenthood is not a must. Moreover, having one child doesn’t guarantee the 100% chance of getting pregnant twice(take the example of secondary infertility pathology) and court cases in USA and UK prove, that neither does it guarantee that surrogate is not going to get attached to a newborn.  


What parents should learn from examples and experiences of others, is that if they trust the agency, they should trust it completely and do it for the sake of making right choices and avoiding irreparable situations. Also parents should read our blog to know what to expect and which information to request from their  agencies. 🙂