The pregnancy

The pregnancy is an exciting time.  You'll find out whether the surrogate is pregnant about 2 weeks after the transfer.

Getting Updates

Keeping updated on your surrogates pregnancy may be difficult, especially when your surrogate may be illiterate, may not speak English, and in a different time zone.  Your main conduits will potentially be:

It's likely that the clinic's doctor will be your main point of contact.  When you are in India, discuss with the clinic how you'll get updates.  And then follow-up appropriately checking on planned appointments and request scans and faxes of hospital results.

To address this communication issue, Rotunda has recently launched a "Pregnancy Tracker Program" through a third party facilitation company called OGI.  For an (additional) fee of Rs. 100,000 (about US$2,300), OGI will provide regular health updates after every clinical examination, representing the intended parents during scans and tests.

Tests

The pregnancy will include normal checkups.  These include screening tests (like the double marker and triple marker tests) and diagnostic tests (like amniocentesis or CVS).  These tests check for common birth defects including Down syndrome, trisomy 18 and open neural tube defects.

Screening tests are designed to check whether there are any defects and they:

Women with “high risk” screening results are offered diagnostic testing. Women with a “low risk” result usually choose not to have diagnostic testing

Diagnostic tests are more accurate than screening tests, but also more invasive, and are performed on samples obtained by amniocentesis or chorionic villi sampling (CVS).  These tests:

The diagnostic and screening tests are not perfect; there is still a 3% chance of abnormalities even if the tests show negative results.

Routine Checkups

Check with your clinic on how often the gestational surrogate will have routine checkups.  These may be every month or every two weeks.  If anything is detected, additional medication or tests may be required. 

Additional Treatments

During check-ups, various medical issues that require treatment may be identified.  The doctor will identify and treat these as appropriate.  Typically, because of time zone differences, routine treatments will often be implemented without consulting the intended parents.  It may be worth discussing with the clinic which treatments will be completed with the intended parents consent and which ones will require consent.   

For peace of mind, you may want to brush up on the Food and Drug Administration (FDAs) system to rate the safety of drugs during pregnancy.  Many other countries have their own pregnancy categories for pharmaceutical agents.  The fact is that most medicines have not been studied in pregnant women to see if they cause damage to the growing fetus, but you can research any medication given to the surrogate to determine how it is classified.  The FDA's classifications include:

Note that the FDA requires more data than other agencies, so pharmaceuticals defined as pregnancy category A in other countries may be in the FDA's pregnancy category C .