Creating a Relationship with your Surrogate

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It’s important during this phase of your process to establish the foundation of your relationship with your surrogate.  Here’s what I hear from surrogates about what they are looking for.

Surrogates are not looking for a new best friend. Their goal is to help you create your family and the pay-off for them is seeing you gazing at your newborn for the first time. During the process, however there are things that can help make your relationship smooth and pleasant. I always tell surrogates and intended parents that there are four things that make a surrogacy relationship work. They are trust, communication, appropriate boundaries and flexibility.

The most important ingredient in any surrogacy relationship is trust. Trust is the foundation of surrogacy and should be at the core of your relationship with your surrogate. This is not total, unconditional, blind trust, but trust as a mutual gift that you give one another. Surrogates want to feel that you trust them and that you know that your baby is in good hands. They don’t want or need to be managed by you (although of course it’s understandable that you want lots of details). If you have a solid foundation of trust in your surrogate and she in you, you will be able to relax and enjoy your surrogacy journey.

The next important ingredient in your surrogacy relationship is communication. While you and your surrogate will have a team of professionals that you can talk to throughout your journey being able to communicate with each other about your relationship and about the pregnancy will help you feel that you are really participating and it will help your surrogate feel that you really care. At the core of good communication is having clear and articulated expectations. It is totally appropriate to ask your surrogate how much and what kind of communication she wants. It is also important for you to be clear about how much communication you want. The best way to keep open lines of communication with your surrogate is to be interested in her and her life, but you can keep it light and let the relationship develop naturally.

Boundaries are an essential part of any relationship and the surrogacy relationship is no different. You can always open a boundary as the process progresses, but once you open a boundary up it is very hard to close it again. Be careful not to make promises that you can’t keep–remember your surrogacy relationship exists for one goal: to help you create your family. Intended parents sometimes make the mistake of “falling in love at first sight” with their surrogate when they meet her and realize that she is the woman who will help them fulfill their dream of parenthood. In that honeymoon phase they may reveal things or promise things that they later regret. The rule of thumb is: take it slow, be warm and authentic and have good boundaries.

The final ingredient in the surrogacy relationship is flexibility. Surrogacy is not a linear process and there are many points in the journey where flexibility will be essential. Remember that your surrogate probably has a very full life outside of the surrogacy and although your journey to parenthood may be first and foremost on your mind, she also has to think about her kids, her partner, and her job, and the surrogacy may not always be first in line for her attention. So, be flexible in your expectations of her. She doesn’t need to return your call instantly to be taking good care of her body and your baby!

Overall, your surrogate’s primary goal is to succeed at having your baby–the relationship that you have along the way is the backdrop for that unfolding story and the beginning chapter in your child’s life. When you trust each other, have good, open communication, live inside of appropriate and fluid boundaries and bring flexibility to all of your expectations you set the stage for a wonderful journey together!

BENEFITS OF SURROGACY

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Surrogacy means something different to each person it touches. For intended parents, it is the chance to finally complete their family and realize their dreams of parenthood. For surrogates, it is the chance of a lifetime to give selflessly to another family who needs them.

For both parties, surrogacy is an extraordinary journey and a deeply rewarding experience unlike any other.

Surrogacy Benefits for Intended Parents

Intended parents come from all different backgrounds — many are same-sex couples or hopeful single parents who are ready to start a family, while others have struggled for years with infertility and have exhausted their fertility treatment options. However, all of these intended parents have one thing in common: a strong desire to add to their families. For these couples and individuals, surrogacy makes this dream possible.

The advantages of surrogacy are clear to the hundreds of families who have been created in this special way. Here are just a few surrogacy benefits that intended parents enjoy:

  • Surrogacy allows infertile couples to become parents when they may not be able to have children otherwise.
  • In most cases, gestational surrogacy allows one or both parents to be biologically related to their child.
  • Surrogacy gives hopeful parents the opportunity to raise a child from birth.
  • Intended parents are involved throughout the pregnancy experience and are generally able to be present for many key milestones, from the embryo transfer to their baby’s birth.
  • Surrogacy gives intended parents the opportunity to know and form a special bond with their surrogate and her family.
  • Intended parents may face fewer restrictions with surrogacy than with adoption; those who cannot adopt due to agency restrictions on factors like age can still pursue surrogacy.
  • Surrogates have already carried other pregnancies and have a proven uterus, increasing their chances of successfully carrying a surrogate pregnancy. This may make surrogacy more likely to be successful than fertility treatments for intended parents.
  • Surrogacy gives intended parents more control and peace of mind throughout the pregnancy than they usually have with fertility treatments or adoption.

While surrogacy is not without its challenges for intended parents, it is often the answer to years of hard work and frustration for hopeful couples and individuals who have tried unsuccessfully to add to their families.

IVF babies do not have lower cognitive skills than naturally conceived children

Researchers analysed data of hundreds of UK children who had been born through IVF or ICSI (when the man has a low sperm count), testing the same groups of children every few years up to the age of 11. They found a positive association between artificial conception and cognitive development when a child was between the ages of three and five.

The study published in the journal, Human Reproduction, also shows that parents who undergo such treatments are generally older, more educated and have a higher socio-economic status than parents who had naturally conceived children. Artificially conceived babies are more likely to be part of a multiple birth or have low birth weight, however, this study finds their family backgrounds ‘override’ the possible negative effects to health that could lessen cognitive ability. The findings are significant given previous studies show a mixed picture, with some research suggesting assisted reproductive treatments can harm a child’s cognitive abilities.

Researchers Professor Melinda Mills and doctoral student Anna Barbuscia, from the University of Oxford’s Department of Sociology and Nuffield College, used data from the UK Millennium Cohort Study, a nationally representative group of 18,552 families. They analysed a sample of babies born in 2000-1 who were resident in the UK at nine months, using data from the Department of Social Security Child Benefit Registers.

Out of 15,281 artificially conceived children born in 2000-1, 8,298 were followed up for cognitive ability tests in 2003, 2005, 2007 and 2012. Out of 15,218 children born in 2000-2001, who were followed up for cognitive ability tests in 2003, 2005, 2007 and 2012, 214 were conceived artificially through IVF or ICSI. Standardised tests (British Ability Scales) were used at each stage to assess the children’s vocabulary skills (at three and five); reading at seven, and use of verbs at 11. The scores were compared with those of children who had been naturally conceived.

Analyses show that mothers and fathers are on average four to five years older, respectively, than parents of naturally conceived children. This group of parents is also likely to have a higher income and belong to a higher social class, with the mothers more likely to be highly educated and employed than mothers of naturally conceived babies. The study notes that these factors are ‘consistent and statistically significant’ and highlights that they are widely accepted as being linked with children with higher cognitive abilities in the early years.

Researcher Professor Melinda Mills, from the Department of Sociology, said: ‘The findings suggest that the positive effect of the family background of children conceived through artificial reproduction techniques “overrides” the risks of related poor health impairing their cognitive ability. Although artificially conceived babies have a higher risk of being born prematurely or as a multiple birth, we have found they also have parents who are older, better educated and from a higher income bracket.

‘These are all factors linked with better outcomes for children. What is significant is that this positive effect is over the long term up to the age of 11. The findings support other studies showing that on balance such fertility treatments do not impair a child’s higher thinking skills.’

Lead author Anna Barbuscia said: ‘The strong desire and considerable psychological and financial effort involved in having a child through artificial conception treatments undoubtedly contributes to more attentive parenting.

‘Parents may perceive their children as more fragile but once past the period of greatest risk, their parenting style may change to become more like other parents. This might account for the fact that the gap in higher cognitive ability has closed by the time both groups of children had reached the age of 11 with only slightly better scores for artificially conceived children at this later stage .’

The paper explains that since the first IVF baby was born in 1978, there has been a rapid increase in the use of artificial reproductive technology, with more than 5 million children conceived this way (up to 2012). To date, results on the long-term effects on children have been mixed. Some studies reported an increased risk of damage to their behavioural, social, emotional and cognitive development, as well as mental disorders or physical problems such as low birthweight and premature delivery.

By contrast, a series of systematic reviews concluded, however, that there were no developmental differences once the baby was a few weeks old. Other studies draw similar conclusions to the Oxford study, showing not only comparable but higher mental health and social development in IVF children.

Diagnosing miscarriage

If you see your GP or midwife because of vaginal bleeding or other symptoms of miscarriage, you may be referred to an early pregnancy unit at a hospital for tests. 

If you’re more than 18 weeks pregnant, you’ll usually be referred to the maternity unit at the hospital.

Tests

The hospital can carry out tests to confirm whether you’re having a miscarriage. The tests can also confirm whether there’s still some pregnancy tissue left in your womb (an incomplete or delayed miscarriage) or if all the pregnancy tissue has been passed out of your womb (a complete miscarriage).

The first test used is usually an ultrasond scan to check the development of your baby and look for a heartbeat. In most cases, this is usually carried out using a small probe inserted into the vagina (transvaginal ultrasound). This can feel a little uncomfortable but isn’t painful.

You may be able to have an external scan through your tummy if you prefer, although this method reduces the accuracy of the scan. Neither type of scan is dangerous to the baby and they don’t increase your risk of miscarriage.

You may also be offered blood tests to measure hormones associated with pregnancy, such as beta-human chorionic gonadotropin (hCG) and progesterone. These may be repeated after 48 hours if:

  • the levels are borderline
  • the scan isn’t conclusive
  • it’s very early in your pregnancy

Sometimes a miscarriage can’t be confirmed immediately using ultrasound or blood testing. For example, a heartbeat may not be noticeable if your baby is at a very early stage of development (less than six weeks). If this is the case, you may be advised to have a further ultrasound or pregnancy test, or both, again in a week or two.

Recurrent miscarriages

If you’ve had three or more miscarriages in a row (recurrent miscarriages), further tests are often used to check for any underlying cause. However, no cause is found in about half of cases. These further tests are outlined below.

If you become pregnant, most units offer an early ultrasound scan and follow-up in the early stages to reassure and support parents.

Karyotyping

If you’ve had a third miscarriage, it’s recommended that the foetus is tested for abnormalities in the chromosomes (blocks of DNA).

If a genetic abnormality is found, you and your partner can also be tested for abnormalities with your chromosomes that could be causing the problem, which is the rarest of known causes. This type of testing is known as karyotyping.

If karyotyping detects problems with your or your partner’s chromosomes, you can be referred to a clinical geneticist (gene expert).

They’ll be able to explain your chances of a successful pregnancy in the future and whether there are any fertility treatments, such as IVF that you could try. This type of advice is known as genetic counselling.

Ultrasound scans

A transvaginal ultrasound can be used to check the structure of your womb for any abnormalities. A second procedure may be used with a 3D ultrasound scanner to study your lower abdomen and pelvis to provide a more accurate diagnosis.

The scan can also check if you have a weakened cervix. This test can usually only be carried out when you become pregnant again, in which case you’ll usually be asked to come for a scan when you are between 10 and 12 weeks pregnant.

Blood testing

Your blood can be checked for high levels of the antiphospholipid (aPL) antibody and lupus anticoagulant. This test should be done twice, six weeks apart, when you’re not pregnant.

Antiphospholipid (aPL) antibodies are known to increase the chance of blood clots and alter the way the placenta attaches. These blood clots and changes can reduce the blood supply to the foetus, which can cause a miscarriage.

Missed or delayed miscarriage

Sometimes a miscarriage is diagnosed during a routine scan carried out as part of your antenatal care. A scan may reveal your baby has no heartbeat, or that your baby is too small for the date of your pregnancy. This is called a missed or delayed miscarriage.

Can You Be Infertile and Still Have a Period?

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You may be wondering what the answer is to the question “can you be infertile and still have a period.” Please continue reading to find out more about this topic.
Menstruation as a Sign of Fertility
Having a regular menstrual cycle is considered a sign of normal reproductive health. For this reason, a woman getting a checkup or seeking help if she is having trouble conceiving can expect to be asked some questions about her menstrual cycle and what is normal for her. In some cases, changes to a woman’s menstrual cycle may indicate a problem that can interfere with her ability to conceive.
Can You Be Infertile and Still Have a Period: The Answer
You can have a period and be infertile. The fact that a woman is menstruating doesn’t necessarily mean that she can conceive and carry a baby to term. For example, if a woman isn’t ovulating regularly, she will have a harder time getting pregnant. Some women continue to have periods but don’t ovulate at all. This medical condition is known as anovulation.
Oligomenorrhea
Some women have irregular menstrual cycles where they may have periods that are quite close together at certain times and then skip some months entirely. Teenage girls who have just started to menstruate may not have regular periods for the first couple of years. Once their hormone levels start to regulate themselves better, their periods should start to develop a regular pattern. When oligomenorrhea occurs in adult women, it may be caused by problems with hormone production, which throws off the normal menstrual cycle.
This condition may also be caused by problems with ovulation. The lack of a regular menstrual cycle can indicate a fertility problem that means it will be more difficult for the woman to conceive. In a situation where a woman only ovulates a few times per year, her chances of being able to get pregnant are greatly reduced.
Amenorrhea
When a woman stops menstruating completely, this condition is known as amenorrhea. There are a number of reasons why a woman may stop menstruating and the doctor will need to rule out pregnancy as a cause first. If the pregnancy test is negative, then other possibilities for the lack of menstruation can be considered. Excessive stress and extreme athletic activity can cause a woman to miss periods. Losing a lot of weight rapidly may also interfere with the monthly cycle. Finally, taking some types of medications (narcotics and some drugs used to treat psychiatric conditions) may cause amenorrhea.
Trying to Get Pregnant
Some women don’t think much about their menstrual cycle until they are considering starting or adding to their family. Having an irregular cycle is something that they have simply lived with. Skipping periods sometimes or stopping menstruating entirely may well have been something they considered to be a positive outcome.
Even women who have always had cycles that ran like clockwork and who found it hard to become pregnant may have wondered “can you be infertile and still have a period?” Since the two are not related, menstruating regularly doesn’t necessarily mean that conception will occur quickly or at all.
The fact that a woman does have regular periods can help to rule out some types of fertility issues if she and her partner decide to see an infertility specialist. Keeping track of the menstrual cycle for several months can give the doctor much-needed information to work with. The specialist will want to know about any changes in the length of the cycle that have occurred and if the woman’s periods themselves have changed.

How Do I Know if I Am Infertile?

If you are wondering about your fertility and thinking to yourself, “How do I know if I am infertile,” you are not alone. Knowing when to seek out additional help can make the conception journey a lot smoother than being left alone with your fears of infertility.
Suspecting Infertility
Women who do not get pregnant quickly often wonder if they are infertile. Although friends and family members may have tale upon tale of unplanned pregnancies or know lots of people who got pregnant on their first try, the reality is that it often takes time to reach the goal of conceiving a baby.
Questions to Ask Yourself
The average time to conceive varies for every couple. Generally, specialists do not consider a couple to be infertile until they have been trying for at least six months if they are over 35 and at least a year if they are under 35. Yet, length of time is not the only indicator you might be infertile.

Ask yourself the following questions:
Do I ovulate on a regular basis?
Have I taken any drugs in the past, legal or illegal, that may be affecting my fertility today?
Was I ever tested for sexually transmitted diseases? If so, was the test positive and did I receive proper treatment?
Have I been diagnosed with a reproductive health problem like PCOS or endometriosis?
What is my general health? For example, are you severely underweight or are you being treated for cancer?

If the answer was ‘no’ to the first question or ‘yes’ to any of the other questions, you may be infertile. It would be in your best interest to have fertility tests run sooner than later.
Answers on Your Own
Undergoing fertility testing can be expensive, time consuming, and stressful. Before putting yourself and your partner through the pressure of clinical tests, try doing a little research on your own.
One way for women to do this is by using a fertility monitor. It helps keep track of hormonal changes in your body, letting you know when a woman is most fertile. If you never get a peak reading, it may indicate you have fertility problems.
Both partners can test themselves at home using the Fertell Fertility Test, which boasts a 95 percent accuracy. This test measures:
Males: Motile sperm concentration
Females: Ovarian reserve via follicle stimulating hormone (FSH)
Even if the test comes back negative, you could still be infertile due to other reasons that are not tested for in this kit.
Women: How Do I Know If I Am Infertile
Finding the answer to the hard question of infertility can sometimes prove to be a difficult journey. In fact, some couples do not end up with a definite answer and are diagnosed with unexplained infertility. But, before they get to that point, a barrage of testing is done to answer the question ‘how do I know if I am infertile’.
Reasons for infertility involve a myriad of factors, so be prepared to take a lot of tests. Often, you will get a recommendation for a fertility clinic and doctor from your general practitioner. Infertility can be caused by things like previous chlamydia and steroid use, so be up front with your reproductive specialists when they ask you screening questions.
Women can be expected to go through a number of tests that might include:
Ovulation and hormone testing: Testing is done through various methods to determine whether hormonal imbalances or ovulation issues are leading to infertility.
Ultrasounds: An ultrasound may be performed to check the uterine lining or for cysts and fibroids that could be leading to fertility problems.
Hysterosalpingography: This is an X-ray with fluids that are used to look at your reproductive organs, especially your fallopian tubes.
Laparoscopic surgery: An outpatient surgical procedure where doctors manually look for blockages, ruptures, cysts, or other medical problems that could be causing infertility.
Hysteroscopy: The uterus is expanded using gas or water and the doctor looks for irregularities using the hysteroscope.
Endometrial biopsy: A small sample of tissue from the endometrium is taken and tested for abnormal hormone levels.

Infertility Testing and Men

Testing that men may encounter is usually in the form of semen analysis. Men will be asked to give one or two samples of semen, which is then tested for several factors. Not only does the count matter, but so does the amount of motile sperm and their shape.
Men’s hormonal levels can also be tested via blood work. Further testing, like genetic, may be indicated after the semen analysis to check for male fertility problems. Your physician will let you know if additional testing is necessary.
Questioning your fertility is not uncommon if it has been several months and you do not have that positive pregnancy test in hand. If you have reasons to believe infertility might be a problem, schedule an appointment with your doctor to discuss testing. The sooner a potential problem is diagnosed, the sooner it can be treated.

Diseases that Make You Infertile

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Diseases that make you infertile demonstrate the interconnected relationships of different systems within your body. Pregnancy is an enormously stressful event for a woman’s body. Anything that compromises a woman’s health can potentially harm her baby. In some cases, infertility shows there is a condition occurring within a woman’s body that will prevent a successful pregnancy.
Causes of Infertility
Both men and women can be infertile. It is not strictly a “woman’s problem.” Underlying causes have several sources. Both men and woman share the cause of infertility, with other cases involving unknown or a combination of factors.

Female Reproductive Disorders
Hormone Disorders
Hormone levels exist in a delicate balance within the body. Disorders that interfere with your body’s state of equilibrium can cause infertility. Both male and female hormones occur within a woman’s body. Polycystic ovary syndrome (PCOS) describes a disease where there is an overproduction of male hormones and underproduction of ollicle stimulating hormone. Rather than maturing, eggs become cysts due to damaged follicles within the ovary. The decrease in ovulating eggs results in female infertility.
Other conditions affecting the pituitary gland are among the diseases that can make you infertile. You may not readily associate the pituitary gland as a factor in pregnancy; however, it plays an important role in your ovulation cycle. Hormones released stimulate ovulation. Any condition that affects their production can cause irregular or absent periods. Without ovulation, you cannot become pregnant. Tumors are a common cause of pituitary gland hormonal imbalances.

Cancer of Reproductive Organs
Male infertility can have complex causes, ranging from congenital disorders to childhood diseases to hormonal causes. Many of these conditions cause infertility by lowering a man’s sperm count and thus the chances that fertilization will occur. In the same way, diseases that interfere with a woman’s ability to ovulate also cause infertility.
Testicular Cancer
Testicular cancer is a treatable disease that attacks young men most often between the ages of 15 to 34. Infertility results when immature sperm cells mutate and become cancerous. Treatment options include surgery and chemotherapy, both of which can cause infertility.
Ovarian Cancer
As with testicular cancer, your chances of recovery from ovarian cancer are best if the disease is detected and treated early, before it has spread to other organs. This cancer attacks the ovaries, the site of egg production in women. Most often, doctors opt for surgery and removal of the female productive organs as the best treatment option. Chemotherapy and radiation may also cause infertility. Ironically, infertile woman may be at increased risk of developing ovarian cancer.

Other Unrelated Conditions
Conditions that may seem to have nothing to do with pregnancy can also cause infertility. Diabetes is one example. One complication resulting from diabetes is retrograde ejaculation. In this case, sperm is not ejaculated from the penis but rather goes into the bladder.
Celiac disease, an allergic condition to wheat, is another example of a seemingly unrelated condition that can hamper sperm production and fertility. Recent studies have shown links between spontaneous abortion in women and testicular dysfunction in men.
Diseases That Make You Infertile
Childhood Diseases
Childhood diseases are another cause of infertility. It can be difficult to accept sometimes that having the mumps can affect your ability to have children later in life. It’s because these diseases occur during the developing years where potential exists for them to affect your adult life. In men, complications from the mumps can cause orchitis, an inflammation of the testicles. In some cases, orchitis infects the testicles so severely that one or both may cease to function, resulting in male infertility.
Sexually Transmitted Diseases
Sexually transmitted diseases or STDs, represent another cause of infertility in both men and women. Chlamydia is a bacterial disease that affects either sex. Like other conditions, it may or may not have obvious symptoms, increasing its potential for further complications. Untreated chlamydia can spread to a woman’s uterus and fallopian tubes. Left untreated, chlamydia can cause pelvic inflammatory disease, which can lead to permanent damage of the uterus, ovaries, and other reproductive structure, resulting in infertility.
For men, the fertility risks are equally as great. The potential exists for chlamydia to spread to the epididymis or the tube that delivers sperm from the testes. It is also the site of sperm maturation. Damage to the epididymis can impair sperm growth and interfere with sperm leaving the man’s body during ejaculation. Severe cases can cause infertility in men.