Preparations for the Surrogate Mother
A month in advance to the embryo transfer, the preparation of the Surrogate Mother begins.
Birth control Pills
The Surrogate Mother (SM) is started on BCP on day 1 or 2 of her menses and the pills are given such that she withdraws them 4-5 days prior to the Intended Mother stopping her pills for planning the fresh cycle.
In case of FET (Frozen Cycles), the pills are withdrawn 20-25 days prior to the scheduled date of FET.
To suppress the follicle (egg) formation in the Surrogate Mother in the upcoming cycle, she is given Lupride as a depot preparation on the 18th day of BCP.
Lupride in small dosage can be combined with Estradiol and started on the first day of her cycle. This can be continued till the transfer of embryo is complete.
Folic acid prevents neural tube defects and hence Folic acid alongwith other multivitamins and calcium are started at least a month prior to the transfer of the embryo.
The following schedule is followed once the SM gets her menses in the month scheduled for the Embryo Transfer as mentioned below :
Day 1 : To rule out the presence of any Follicular cyst in the ovaries and to determine the quality of endometrial lining a Pelvic scan is conducted.
Day 2 : Estradiol Valerate is given on a daily basis for the first 7 days and then the Pelvic scan is repeated to determine whether the endometrial lining has started forming or not. Daily micro dosage of Lupride is added to this regimen.
Day 7 : Another Pelvic scan is conducted on Day 7 to evaluate the flow of the blood, the endometrial thickness and the status of the Ovaries. Usually it takes about 12-16 days for the endometrial lining to be ready for the transfer but in some cases it may take longer as well. This scan is again repeated on Day 9 and Day 11 to evaluate the progress.
In some cases there may be 2 to 3 more scans required to accurately determine the endometrial growth depending on previous scan reports.
Embryo Transfer (ET)
Inj. Lupride is withdrawn and Injectable Progesterone alongwith other supportive medication is added to the protocol once the endometrial lining is ready. Post egg retrieval, ET is schedules on day 2 or day 3 in a fresh cycle or 3 to 4 days prior to n FET.