QuestionHi Dr. Ramirez
I am writing from NY.
I am 41 never been married but still have hope for that to happen someday. Growing up I never really wanted to be pregnant, having kids were ok but I just didn't want to go through pregnancy. Considering I'm getting older and knowing the body doesn't bounce back the way it does when your younger I am thinking about surrogacy for when I do marry. I have no desire at all to be pregnant ever. The only medical reason I would have for using a surrogate would be that my specialist told me that he didn't recommend me getting pregnant as the extra weight would cause my scoliosis to worsen or at anyrate make it a hard pregnancy for me. How intense this is I do not really know I didn't bother to go into it with him since I never wanted to be pregnant anyway.
My questions are these.
Would my scoliosis be a legitimate reason for surrogacy and therefore be partially covered by insurance in regards to the egg harvesting part?
How many of my eggs would be harvested and fertilized for the procedure and how many would be implanted into the surrogate? I would want at least two implanted.
If more than two eggs are harvested do they all have to be fertilized and if so what happens to the eggs that are not implanted into the surrogate? I would not want any of my eggs that were fertilized and healthy to be terminated. If more than two eggs are fertilized to increase the chances of a viable eggs has there ever been anyone who had more than one surrogate at the same time so as to not terminate any of the healthy viable eggs?
Would the eggs harvested from me and the sperm used to fertilize the eggs be tested for genetic defects before the fertilization process?
Would I be able to choose the sex of the child before the fertilization process?
I know this is a very expensive procedure around $70,000 unless we have a family member to be the surrogate so any additional information you may have that would help me in my decision to use a surrogate would be appreciated.
Thank you
Rae
AnswerHello Rae,
Here are the answers to your questions:
1. I can't answer this one because insurance companies make their own decisions regardless of what we put as the indication for treatments. However, I don't think that they would accept scoliosis as an indication for surrogacy or IVF.
2. I can't answer this question because the results can vary widely. It all depends on how well your ovary stimulates, how many mature eggs are harvested (retrieved), how many fertilize and how many develop into viable embryos. In your age group, the chances are very low for getting an adequate number of viable embryos. For that reason, after the age of 37 we usually put back everything we have in order to get one.
3. All eggs are fertilized because we don't know, and have no way of knowing, which are the good ones, which are the bad ones, and which ones will fertilize and grow into good embryos. Embryos that are not used can be frozen for use at a later time. As mentioned earlier, you probably would not have any extra embryos to freeze, since I would recommend putting them all back.
4. Embryos can be tested for genetic abnormalities using a procedure called PGD (preimplantation genetic diagnosis). We also do chromosomal tesing on our patients prior to an IVF cycle.
5. If you do PGD on the embryos.
6. Your biggest hurdle is your age. There is a reduction in fertility and pregnancy rates with increasing age. You know this as the "biologic clock". Eggs have a finite lifetime (around 40) and deteriorate with time. Therefore, that is your biggest hurdle. Nationally, the chances of pregnancy in your age group with IVF is about 20% per attempt.
I hope this answers your questions.
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
