by Dr Gavin Sacks | Apr 9, 2019 | Blog
In January 2019, there was an excellent randomised trial published on endometrial scratching prior to IVF.
This procedure goes back many decades when women had a curette and many seemed to be more fertile afterwards. The idea of a scratch as a more refined procedure was taken up enthusiastically but this latest excellent study suggests that it should not be used so widely. However, we must also remember that the uterus is an essential place for the pregnancy to develop and we must always be thinking about its suitability for embryo implantation.
This requires some kind of examination and the benefit to IVF may be more complex than simply scratching the lining. For example, the passing of a catheter or tube through the cervix to dilate the cervical canal can make embryo transfers easier or can help the Clinician in determining whether there is a problem in the cervix. Many scratch biopsies are done in the context of a hysteroscopy when other important problems such as polyps or adhesions or uterine congenital abnormalities can be discovered and treated.
Furthermore, an embryo scratch biopsy can also be used for tissue diagnosis for critical factors such as hyperplasia, endometritis and immune studies.
Clearly, the routine undertaking of the scratching went too far and it would be wrong to think scratches should be done prior to every cycle as this data shows. Equally though, especially in those with repeated IVF failure, further exploration of the uterus is essential. It should be done on a limited number of occasions and the Clinician should try to obtain as much information as possible from such an invasive procedure.
In summary, a scratch should be reserved for those that repeat IVF failure and then as part of a wider assessment.
Original article by medical reporter Sophie Scott
IVF scratching: Are women putting themselves through a painful procedure for nothing?
Key points:
- A global study found endometrial scratching is not effective in boosting fertility in IVF
- Patients are charged up to $700 for the add-on treatment
- The IVF peak body says doctors should stop recommending it to couples
Michelle Ross would have done anything to have a second child.
After enduring years of heartbreak and disappointment, the 33-year-old finally turned to IVF for help.
“I lost eight babies in 12 years. We had tried for so long. We were happy to do anything we could to get pregnant,” she said.
She said doctors told her it was unlikely she would have another baby because she had severe endometriosis.
When she was told a painful procedure called endometrial scratching might boost her chances of conceiving, she did not hesitate.
“They told me the scratching made the uterus more sticky during IVF,” she said.
A doctor inserted a catheter into Ms Ross’s uterus and used it to superficially wound the lining.
The theory is that the scarring causes inflammation, which makes it easier for embryos to implant in the uterus.
Ms Ross described endometrial scratching as eight out of 10 on the pain scale.
“I was in pain for a week,” she said.
She got pregnant a month after the procedure, and went on to have a healthy baby girl she named Jessica.
But a new global study has cast doubt on whether the procedure played any role in Ms Ross’s successful pregnancy.
Experts find no evidence that endometrial scratching works
A group of fertility researchers from around the world compared the number of live births from women who underwent endometrial scratching to those who didn’t.
Of the 1,364 women studied, 180 women had babies in the group that had endometrial scratching, while there were 176 births in the control group.
Researchers concluded that the procedure, which is widely offered by clinics across Australia, did nothing to boost a woman’s chances of getting pregnant through IVF, describing it as “painful and pointless”.
Study lead Professor Cindy Farquhar from the University of Auckland said it was clear the procedure did not boost a woman’s chance of giving birth.
“On the basis of this study — which is the biggest and most robust to date — we would encourage IVF clinics to stop offering it,” she said.
The research has been published in the prestigious medical journal, the New England Journal of Medicine.
More than 80 per cent of Australian fertility clinics offer endometrial scratching, usually to couples who have failed to get pregnant after several rounds of IVF.
The procedure can cost up to $700.
“This study provides the opportunity to tell patients that the evidence doesn’t stack up,” said Louise Johnson, head of the Victorian Assisted Reproductive Treatment Authority (VARTA).
VARTA offers support and information to couples struggling with fertility.
Ms Johnson believes many would-be parents are desperate for success, and may put themselves through dubious procedures in a bid to get pregnant.
“Couples going through IVF are extremely vulnerable, and clinics have an obligation to inform patients about treatments that can cause pain and won’t increase the chance of conception,” she said.
Obstetrician Professor Ben Mol from Monash University said doctors had been offering couples the scratching procedure for many years, despite a real lack of strong scientific evidence that it worked.
“It is great news that we now know that this technique does not help,” he said.
“Luckily, we didn’t find it caused any harm, apart from bleeding and pain.”
He said other add-on IVF treatments such as steroids and treatments to reduce immune cells in the uterus should also undergo better evaluation.
“The concern is that there are more of these add-on therapies offered without a sound scientific base, and many will turn out not to be effective once properly evaluated,” he said.
IVF peak body says it should no longer recommend the scratch
Professor Luk Rombauts from the Fertility Society of Australia, which represents medical staff working in fertility clinics, said the study findings will change what advice is given to IVF patients.
“I would no longer recommend [endometrial scratching] for patients who come through the door for IVF,” he said.
However Professor Rombauts said some patients who had already had the scratching before becoming pregnant through IVF may still want it.
“I would like to think doctors would tell patients about the risks and benefits and the best available evidence,” he said.
“Patients often read a lot online about possible IVF treatments and we will need to educate our patients about this new evidence.”
Ms Ross said she would never know for sure what impact the scratching procedure had on her body, but believed it helped her conceive.
“I really don’t know if it helped, but I would ask for it again if I ever had IVF again,” she said.
by Dr Gavin Sacks | Sep 12, 2016 | Blog
This article is an important part of an ongoing debate about immune therapy. See my previous article on this (“Enough! Stop the arguments and get on with the science of natural killer cell testing”). It is definitely clear and accepted by most specialists that prednisolone does not improve outcomes for everyone. One reason could be that that while some benefit, some (as described in this article) are harmed (or their chances are decreased). Hence the need for highly specialised immune testing to try to target this therapy to those who are most likely to benefit. Tests such as NK cell testing are technically far more difficult than is often realised, and considerable effort needs too be done by the lab to produce a reliable result with a meaningful reference range. Very few labs in the world are currently able to offer that.
– Dr Gavin Sacks
Researchers at the University of Adelaide are urging doctors and patients to refrain from using a specific steroid treatment to treat infertility in women unless clinically indicated, because of its links to miscarriage, preterm birth and birth defects.
Writing in the journal Human Reproduction, researchers from the University’s Robinson Research Institute, led by Professor Sarah Robertson, say widespread use of the drug is not warranted, given there is a high degree of suspicion that corticosteroid drugs – such as prednisolone – can interfere with embryo implantation, and may have harmful effects on pregnancy and the child.
Corticosteroids are increasingly used to treat infertility in women with repeated IVF failure and recurrent miscarriage. Many women receive the drug in the belief that reducing immune cells called “natural killer” cells will facilitate a pregnancy. However, this belief is mistaken, as despite their alarming name these cells are actually required for healthy pregnancy.
Professor Robertson says there is a great deal of medical and consumer misunderstanding about the role of the immune system in fertility and healthy pregnancy.
“Steroid drugs such as prednisolone act as immune suppressants, preventing the body’s immune system from responding to pregnancy. But by suppressing the natural immune response, these drugs may lead to further complications,” Professor Robertson says.
“The immune system plays a critical role in reproduction and fertility. Natural killer cells and other immune cells help to build a robust placenta to support healthy fetal growth. But if we suppress or bypass the body’s natural biology, there can be dire consequences that don’t appear until later,” she says.
“For example, suppression of the immune system through inappropriate use of these drugs is linked to impaired placental development, which in turn elevates the risk of miscarriage, preterm birth and birth defects.”
Research shows that women taking corticosteroids over the first trimester of pregnancy have a 64% increase in miscarriage; the risk of preterm birth is more than doubled; and their children have an elevated risk of birth defects, including a 3-4 times greater risk of cleft palate.
“Our main message to clinicians and to women hoping to achieve pregnancy is that they should be focused on achieving good-quality pregnancy and the life-time health of the child, not just getting pregnant,” Professor Robertson says.
“Corticosteroids such as prednisolone may impair healthy pregnancy, which may lead to poorer long-term outcomes for the baby.
“We believe IVF doctors should not be offering this treatment to most patients, and should discuss concerns with women who request it.
“The exception would be in specific cases where the patient has a diagnosed autoimmune condition, but those cases are rare,” she says.
Explore further: Study finds variation of the interval between first and second pregnancy
More information: Sarah A. Robertson et al. Corticosteroid therapy in assisted reproduction – immune suppression is a faulty premise, Human Reproduction (2016). DOI: 10.1093/humrep/dew186
by Dr Gavin Sacks | Sep 10, 2016 | Blog
This exciting concept involves harnessing mitochondria from a woman’s ovary (from a biopsy at laparoscopy) and then injecting them into an egg during the ICSI procedure. Mitochondria are the main energy drivers in all cells, and it is believed that such a boost may improve egg quality. It is so new that fewer than a hundred cases have been reported so far, but Dr Sacks is collaborating with the company involved and they are hoping to bring this technology as a trial to Australia soon.
– Dr Gavin Sacks
Groundbreaking research presented in Perth could pave the way for older women to have babies by “freshening up” their ageing eggs.
Canadian reproductive endocrinologist Robert Casper yesterday revealed progress into so-called ovarian rejuvenation, where doctors use healthy young cells from the ovaries to re-energise a woman’s eggs.
The main obstacle for women in their 40s to become pregnant is that they are born with all their eggs, which deteriorate over time.
But doctors believe they can turn back the clock by using egg precursor cells harvested from tiny pieces of tissue removed surgically from the outer edge of the woman’s own ovaries.
The tissue can be quickly frozen and then thawed to isolate active mitochondria, which are the powerhouse of cells.
Professor Casper told a Fertility Society of Australia conference that a woman’s eggs fell in number and quality in a way that could be likened to a torch being left on a shelf for 40 years.
“That’s about the time it takes for a woman to expire the number of eggs with which she was born,” he said.
“Using the flashlight analogy, the torch itself is OK but the batteries are running flat.
“The focus of our research is on energising old cells, by adding younger and more powerful mitochondria collected from precursor cells lining adult ovaries.”
Professor Casper said the technique would allow a woman with poor egg quality to use her own energised eggs for in-vitro fertilisation.
Researchers initially used the technique on mice to prove it worked, before adapting it for women on IVF programs in Toronto who had failed to conceive because of poor embryo development.
Using the women’s own egg precursor cells, they were able to help many of the women conceive and have healthy babies.
Professor Casper said he hoped the new technique would help more older women and those with premature ovarian ageing to have children.
Article originally posted on The Western Australian on September 8, 2016. Written by Cathy O’Leary.
by Dr Gavin Sacks | Sep 9, 2016 | Blog
The problem with endometriosis is that it often produces no symptoms, or its main symptom is infertility. And it has been shown that treating even mild disease (no symptoms) can double subsequent pregnancy rates. In the current climate of IVF access and success, many choose to go straight to IVF and potentially avoid surgery. But if IVF is not successful, laparoscopy for endometriosis is certainly a reasonable option.
– Dr Gavin Sacks
Endometriosis: You may have heard the word, but do you really know what it is? Many women don’t until they find out they have it … which would make sense if it weren’t so common. One in 10 girls and women suffer from the disease, according to the Endometriosis Foundation of America – Lena Dunham, Padma Lakshmi, and Daisy Ridley among them.
Normally, hormones spur the uterus lining to build up, then shed (that’s your period). In a woman with endo, cells that are uterus lining-esque but live outside it grow in response to these hormones too. The cells “get thicker and thicker, but there’s nowhere for them to go,” explains Iris Kerin Orbuch, MD, the director of the Advanced Gynecologic Laparoscopy Center in NYC. The result: intense pain, caused by both inflammation and because cells can distort anatomy and pull on organs.
This pain can go untreated for years, an issue highlighted in a new documentary Endo What? Symptoms are all over the map – cramps, fatigue, painful sex, infertility, even trouble breathing. That, plus the fact that endo cells aren’t picked up by medical imaging “makes it very difficult to diagnose,” says Dr. Orbuch. Women go a median of 8 1/2 years between symptom onset and diagnosis, per the American Society for Reproductive Medicine. These women were told they had digestive or mental issues and more … but actually, they had endometriosis.
“They said I had a ruptured cyst…”
Cassidy Haney, 20
Panama City Beach, Florida
“I went on the pill for irregular periods when I was in seventh grade. My period could be really frequent or super heavy, but it was always painful. Tampons hurt. One day junior year, I passed out from the pain. A gynecologist told me ‘a cyst ruptured’ and gave me pain meds. Things didn’t get better. I was confused and angry. The ob-gyn just changed my birth-control prescription. I thought, She’s a doctor. She knows what she’s talking about.
During my freshman year at NYU, I was having trouble walking – I needed a cane! It felt like after an abs workout, when you’re so sore, you can’t straighten out. That semester, I filtered through my friends, weeding out the ones who rolled their eyes and said, ‘We all cramp during our period.’
Eventually, I went to the health center. Not for anything period-related, but because acidic foods made me vomit. The doctor thought it was odd that I could eat provolone cheese but not pepper jack and sent me to an internist. He said, ‘This sounds like interstitial cystitis [IC],’ which is a bladder issue, and asked about my health background.
I got so lucky: He sent me to his sister-in-law, who happens to be an endometriosis specialist. Often they run hand in hand, IC and endo. She did surgery and took 14 specimens from my bladder and removed my appendix. It was completely covered.
There’s still a spot of endo on one ovary that she left behind to preserve my fertility, but I’m at, like, 5 to 15 percent of the pain I had before. I haven’t had to miss school or use a cane. My periods are two days long. It’s a 180.”
Article originally posted on Cosmopolitan, September 8, 2016. Written by Danielle McNally.
by Dr Gavin Sacks | Sep 8, 2016 | Blog
As entertaining as this may be, it is of course important to always remember that getting pregnant in your mid 40s is much more difficult than in your mid 30s. In terms of reproduction, there is no time to lose – attempts to improve outcomes with older eggs have generally been very disappointing so far.
– Dr Gavin Sacks
Like all great comic creations, Bridget Jones is timeless, though she is not ageless.
In the new film, Bridget Jones’s Baby, Helen Fielding’s 43-year-old heroine is no longer knocking back the Chardonnay or counting calories, although she does face some weight-gain issues in the shape of a puzzling pregnancy bump. But who is the daddy, darling? Bridget can’t decide.
Along with millions of other women, I will be racing to my local cinema with a tin of slimline G&T, a straw and several similarly equipped girlfriends. We can rely on Bridget to make us laugh like drains. Who cares whether that perpetual adolescent is capable of graduating to the self-free combat zone of motherhood? It’s only fiction, isn’t it?
Well, yes and no. Bridget Jones was real enough to a generation of neurotic singletons. She deplored Smug Marrieds while exuding a bewildered sense of loss as a woman’s traditional role was altered beyond recognition. She had a career, but she wasn’t much good at it. Her heart was in romance.
In any previous generation, Bridget would have been a nice county gel settling down with a Rufus, an Aga and three daughters with names ending in “a”, not living in fear that she would die alone with cats.
We all cheered when she finally bagged her own Mr Darcy. Little did Jane Austen suspect that, 200 years later, her maxim would be adapted to read, “It is a truth universally acknowledged, that a single woman in possession of big pants must be in want of a husband, but she will be too ashamed to say so and he will be too fickle to commit.”
Bridget Jones undoubtedly has a huge influence beyond the covers of a paperback. The problem I have with the new movie is that adorable Bridget becomes party to the big Fertility Lie.
Put it this way, how many 43-year-olds do you know who fall accidentally pregnant? All the fortysomething women I know who don’t have children are trapped inside what one gynaecologist calls “the brutal cycle of IVF, adoption and regret”.
If you haven’t had a baby by the time you’re 43, the chances of you getting up the duff from a one-night stand are about the same as you finding a childless fortysomething male who isn’t a practising homosexual or a priest.
Young women are told today that “40 is the new 30”. Unfortunately, their bodies didn’t get the memo. Alex Jones, presenter of The One Show, is not stupid, far from it. But the 39-year-old admitted earlier this year that it hadn’t really occurred to her she might have trouble starting a family until she got married last December. Yet her fertility window was closing fast. As Alex said, girls spend so much of their youth practising safe sex that you forget you need to start the unsafe kind in plenty of time to have kids.
“This is a dangerous trend, and women quite often have unrealistic expectations about fertility,” according to Mark Perloe, an American specialist in reproductive endocrinology. According to Dr Perloe, at the age of 43 Bridget Jones is more likely to have a miscarriage than a baby.
A study published in the British Medical Journal, of more than 600,000 women in Denmark who had a pregnancy between 1978 and 1992, bears out that bleak prognosis. It showed a steady, age-related rise in rates of miscarriage – from 9 per cent among women in their early to mid-20s to a staggering 75 per cent among women aged 45 and older. The increase was already considerable among those in their 30s.
Yet, the trend is for women to ignore science and start their families later and later. According to recent figures, women over 40 are now having more babies than women under 20. This is almost entirely due to career pressures and house prices. Older motherhood has its advantages, sure, but the dangers are too often ignored.
Look at Nicola Sturgeon. Scotland’s First Minister just made public her own miscarriage at the age of 40. The SNP leader said that she hoped that the revelation would help to break a “taboo”. She wants to challenge “assumptions and judgments” made about political leaders who do not have children. Ms Sturgeon was upset by a New Statesman cover showing her and other childless female political leaders, including Theresa May and Angela Merkel, standing round a cradle that contained only a ballot box.
Look, any woman who has gone through the trauma of miscarriage has my deepest sympathy. I will remember my own till my dying day. The baby that nearly was can be every bit as real as the ones that are. But I can’t help feeling that Nicola Sturgeon is being slightly disingenuous.
Did she get pregnant so late in the day because a political career made any other option difficult? No one would judge her for that, but there is still far too little openness about why so many of our most powerful women don’t have kids.
The fact is women are only truly on a level career playing field with men when they are not held back by parental responsibilities. Women still do the lioness’s share of childcare and housework, and only the lucky (or wealthy) few can afford to pay a nanny, or are blessed with a househusband. This painful, intractable inequality is the real taboo that needs to be broken.
Why can’t we just be honest and say that most mothers would be hard-pushed to have the single-minded focus on politics that makes a Sturgeon or a Theresa May? I feel glad that two such capable women are holding the reins of power and, if not giving birth helped them to get there, so be it.
Let’s also be frank about the vast resources and backstage support team a successful woman needs to pass for a man. We are only going to change that on the day someone asks a young guy: “So, Josh, how are you planning on combining a career with fatherhood?”
Until then, women will continue to postpone having a family to fit round a workplace designed by men for the convenience of men, and too many will suffer the misery of miscarriage and infertility.
Alex Jones has just announced that she is pregnant. Like her namesake, Bridget, the BBC presenter is one of the lucky ones who got pregnant late. Alex believes young women need to be taught about fertility every bit as much as about contraception. I couldn’t agree more.
Girls, please don’t trust Bridget Jones. She’s a hoot – but a baby at 43 is pure fiction.
Article originally published on the Telegraph.co.uk on September 6 2016. Written by ALLISON PEARSON
by Dr Gavin Sacks | Sep 5, 2014 | Blog
This week’s SBS Insight program demonstrates the highly emotional and complex nature of surrogacy.
From my perspective as an IVF specialist, surrogacy represents one of the great advances in fertility treatment in recent years. And as an Obstetrician, I also see the incredible effort made by women to carry, nurture and give birth to a baby they are prepared to give away to the recipient couple. Thus there are two sides to what actually happens, as well as the many diverse social and legal views.
When I see couples in my fertility clinic, the idea of ‘surrogacy’ is often not very far from their thoughts. Most of those couples go through years of frustrating attempts to conceive a child. Many have multiple early miscarriages. They start reading anything and everything on Dr Google, and can all too easily go down a route where they try increasingly expensive and sometimes ineffective interventions. All this because the desire to have a family “just like everyone else” is overwhelming.
Medical tests may or may not find a particular cause for their infertility, and many go on to have IVF treatment. Over 5 million IVF babies have been born since the first successful IVF treatment in 1978. Currently about 3% of Australian babies are from IVF treatment. It has clearly been a great success – nothing short of a revolution in fertility treatment.
But in fact, IVF success rates are limited to about 40% per cycle in even the best of circumstances. So the pressure mounts on couples who are not initially successful. There is a natural tendency for them to start to think that maybe they can’t carry a pregnancy, that the problem is in their womb, and how easy it might be to fix if they could get someone else to carry their embryos. That’s a surrogate: a woman who will carry another couple’s embryo and baby. Many women have close friends who, seeing their struggles, volunteer with the obvious offer to help. And often they think the best they can do is to be a surrogate.
How common is surrogacy?
In reality though, very few couples actually need surrogacy. As frustrating as a diagnosis of ‘unexplained infertility’ or ‘unexplained repeated miscarriage’ can be, most women do succeed eventually. Lots of ongoing research has led to treatment advances assessing all aspects of the problem including the uterine environment, sperm quality, the woman’s immune system, and the genetic quality of the embryos created in IVF. An IVF specialist would be the best person to explore all these aspects with the couple, and in most cases is likely to succeed.
When they have not been successful, the problem most commonly is with the woman’s eggs (rather than her uterus). Women are trying to have babies at a far older age than they did in the past. In 1971 the average age of first pregnancy was 21 years, and now it is over 30. But women are born with a fixed number of eggs, and those eggs deteriorate in number and quality with time.
Thus on average once a woman reaches 35 years old, egg quality can become the main reason for failure, manifesting as either infertility or repeated miscarriage. It is not their womb but their eggs that are the problem. In fact, egg donors [insert link to https://drgavinsacks.com.au/service/egg-donors/ ] are far more commonly the best treatment in these couples. And egg donors (usually aged less than 35) have eggs with a great chance of success in any situation, even in a woman who may be significantly older (in her 40s or more) who has had many unsuccessful attempts to have a baby with her own eggs. We should be very clear in this sadly common situation – an older woman will not succeed using her own eggs and a younger (or different) surrogate womb. Currently we are unable to make ‘new’ eggs in that situation, and so her best chance will be to look for an egg donor.
Whose baby is it anyway?
I find that women and couples facing the prospect of needing an egg donor sometimes find it too difficult to contemplate. Of course we all want our own genetic children. But genetics are far more complicated than a ‘tape with instructions’ in the form of DNA. What ultimately makes us who we are is a complex interplay of many factors. For example, which genes we inherit from each parent will affect the expression of each gene, and the environment of a cell will influence gene expression. We have only recently started to understand this in a whole new branch of science called epigenetics. And of course we would all acknowledge that the environment we grow up in will alter the sort of people we are. While we still have much to learn in this area, we also know that the uterine environment will have profound consequences on that child’s health, often well into adult life (such as heart disease).
So, a woman who carries a pregnancy, whether from her own embryo or someone else’s, does have an enormous impact on the long-term development of the child. If a woman or couple need an egg donor, she will of course not contribute the exact genes given by the female, but she will grow that embryo from a microscopic few cells to a full size baby. It is more than ‘carrying’. The mother-baby relationship in a pregnancy is far closer than that. Interactions between baby and mother cells occur from the earliest stages. Maternal hormones enter the fetal circulation, and fetal hormones, DNA and whole cells enter the maternal circulation. The mothers’ immune system is fundamentally and uniquely altered to accommodate this. A mother is not merely a ‘carrier’, but a ‘nurturer’.
Who is surrogacy for?
This brings us back to the concept of surrogacy. Who is it for? It is clearly essential for women who don’t have a uterus (by birth or following a hysterectomy). It is essential for gay men who wish to have a child. It is sometimes necessary when pregnancy may be considered to have major life-threatening risks for the mother (such as when there is heart or kidney disease). And there are indeed a few women who, often for no explicable reason, simply can’t succeed with everything modern fertility treatment can give. They may have had multiple miscarriages with genetically normal pregnancies, or multiple IVF cycles with genetically normal embryos. Altruistic surrogacy in Australia currently involves very small numbers of cases overall. In my clinic (IVFAustralia in Sydney) [link to http://ivf.com.au/ , one of the largest IVF clinics in the country, we do about 7-10 cases a year. It is believed that many more than that go overseas for commercial surrogacy, although since there is currently no national regulation there is no formal data collection on that.
How does surrogacy work?
As discussed above, the age of the egg is a key factor. So if a couple need to go down the surrogacy route, it’ll be far more likely to work if eggs are collected (from IVF) as soon as possible. This can be done even before a surrogate is actually identified. Eggs can now be frozen and stored indefinitely with excellent survival and success rates. Most couples would fertilise eggs and freeze embryos for which success rates are even better. Placing an embryo back in the womb (of a surrogate) is a simple procedure like having a Pap smear. But the significance of that procedure means considerable effort needs to be done by all sides in preparation. Extensive counselling of all parties (recipient and surrogacy families), opinions from obstetricians, psychologists and lawyers takes time and money. Ultimate success (never guaranteed of course) will be much more likely when the process is open, formal, and regulated.
What does it feel like to have a surrogate baby or to be a surrogate mother?
In the couple I was involved with in the SBS Insight program, there were no doubt varying emotions and feelings throughout the process – as you might expect. But the preparation meant that it continued smoothly, even when events worked out slightly differently to planned. None of us was expecting the recipient couple to be in the delivery room during labour and delivery. But our extensive preparation meant that it just seemed right. And ultimately, it was a truly wonderful event for the recipient to see labour and birth first hand, and really appreciate what her surrogate was doing for her.
Altruistic surrogacy created an intense emotional experience in which all appreciated that the newborn baby was very special indeed. Created and stored as a frozen embryo 2 years previously, carried in the womb of the surrogate to America (where she lived) and back, and being born with 2 mothers, a father and the surrogate’s partner watching over lovingly. It has been a privilege for me to be part of such a process, and I hope that the SBS program will help bring this – often misunderstood – treatment into mainstream cultural acceptance.
Dr Gavin Sacks is one of the very few senior IVF specialists in Australia who is also a practising obstetrician. Gavin writes regularly about the latest technological advances in fertility treatment and practice.
For further information about Gavin click here.
