So, you’ve matched as a gestational carrier and are getting ready for the medical screening. What should you expect?
As a gestational carrier, you can feel like you’re just jumping over one hurdle after the next! Your partner is supportive, the agency accepts you, your own OB-GYN says you’re a good candidate for a subsequent pregnancy, the parents-to-be and you hit it off and are ready to get started…..the next step is the medical screening tests. These are ordered by the IVF clinic and can be done local to your home, if the IVF clinic allows, or they are done at the IVF clinic.
What are they looking for?
Clinic staff will want to understand your physical and mental health status before they transfer an embryo. If there are any items that can be modified, then they want to know that up front. There are also some deal-breaker items that could exclude you from
What will they have me do?
You will complete a health history exam, have a physical exam, give blood and urine for testing, and have a uterine cavity evaluation. This includes a vaginal ultrasound and either a sonohysterogram or a hysteroscopy. These are procedures that can cause some cramping. They allow the health care provider to evaluate the inside of your uterus to confirm there are not any concerning findings that could cause issues with implantation.
How soon will I know the results?
The results of the evaluation of your uterus will be known at that appointment. The lab results usually take 7-10 days to return and the IVF clinic should contact you to review the results with you. The parents-to-be will also get a summary of the test results.
Minor adjustments – sometimes the labs need follow up
Thyroid level: The normal TSH (thyroid stimulating hormone) level is around 0.5-5.0. When you are trying to conceive, most IVF clinics like this value to be 0.5 to 2.0. If your value is above 2.0, they will likely have you start a medication called levothyroxine. It’s very well tolerated with few side effects. You will have your TSH checked again to confirm it has come down to the right range and likely will have it checked each trimester of the pregnancy.
Rubella/Varicella: Are you still immune to these viruses? A blood test can tell if you are. Since both of these would be dangerous to get while pregnant, most IVF clinics will check to confirm if you’re immune. If you are not immune, then you would go to your primary care provider to get a booster vaccine. This can cause a delay of a few weeks, but that is usually ok, since you’d be spending that time working on the legal agreement anyway.
Vitamin D: Many people are Vitamin D deficient. In fact, if you’re considering being a gestational carrier or are currently matched, consider taking a supplement! If your test comes back low, then you’ll be advised to start a supplement and the IVF clinic will retest you a few weeks later.
More information needed
While incredibly stressful to get, a positive HIV or Hepatitis test clearly needs follow up. These are situations where you would be referred to your primary care provider or a specialist so a confirmatory test and a full workup can be done to confirm you don’t truly have a serious health issue. Keep in mind, no test is perfect and sometimes a test can be ‘abnormal’, but it is not accurate. Taking the time to make sure you are healthy before carrying someone’s baby is critical!
Unfortunately, sometimes testing reveals something that means you cannot be a gestational carrier. This is unlikely, since your medical records have been reviewed and you’ve had a ‘clearance’ exam from your own OB-GYN, but it’s possible.
To reassure you, since 2013, Forward Fertility has only had one carrier applicant who was not able to proceed due to a finding at the medical screening appointment. So, odds are in your favor.
Examples of deal breakers include: abnormal finding with the uterus (a uterine septum, a huge fibroid, multiple polyps, scar tissue from a c-section or procedure), a positive drug screen for the carrier or her partner, or a sexually transmitted infection such as chlamydia, gonorrhea, HIV, hepatitis, or syphilis.
Once the IVF clinic gives medical clearance, you and the parents-to-be will be able to begin the legal contract process.