What if we don’t get pregnant during my surrogacy procedure?
If your surrogate mother does not get pregnant during your initial embryo transfer, you can try again with frozen embryos remaining from your IVF procedure.
The success rate generally with frozen embryos is 45%, but that is very generalized. The actual likelihood of success depends on the quality of the embryos and their stage of development. The doctor will review your remaining embryos and make a recommendation. Then adding an extra embryo can improve the probability of the next FET attempt.
It is not unusual for a surrogacy procedure to require two or three transfer attempts. Unusual cases have needed six or more attempts before the parents achieved a pregnancy. Often this is just a question of luck, but if the surrogacy procedure has failed more than three times, we often recommend the parents consider the possible causes of the failures before continuing.
Repeated failures are most often the result of a chromosomal defect in the embryos. PGD can detect for damaged or incomplete chromosomes, but only before they are frozen. Once frozen the embryos cannot be tested.
The parents can also consider the source of the chromosomes – either the donated eggs or sperm. If your egg donor has successfully donated previously for successful pregnancies, then you can be confident that the eggs are in good condition and carry healthy chromosomes. The sperm can be tested through a Sperm Fragmentation Test, which will examine the individual cells at a chromosomal level for damage and completeness. 9Note this is much different test than the standard semen analysis sperm donors will have had prior to their initial donation.) The Fragmentation Test will give an indication of the health of the sperm (and the resulting embryos) and provide important insights into how to move forward with the surrogacy procedure.
The first step in the repeat FET procedure will be to look for an excellent surrogate. It will probably not be the same woman — the clinic will choose the most fertile surrogate candidate available at the time of your transfer. As you’ve had two failed attempts, the clinic will wait for an especially fertile candidate — someone who is relatively young, recent successful pregnancies, and an endometrial scan well over 8.00 mm. The right surrogate will significantly improve our chances.
The doctor will also review the existing embryos to see what is their development stage and quality level. If they are high quality he may want to transfer two — but it’s also likely that he will want to transfer three. You may make a special request that he transfer up to four remaining embryos. He will consider the options and make a decision that balances the likelihood of success with the possibility of multiple births (triplets or more). Because an embryo reduction is not legal in some countries, the doctor will be careful to limit the possibility of triplets.
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