When it comes to fertility treatments, statistics reveal that surrogacy (where a surrogate carries a biological child to term), has around a 60% success rate when the surrogate is under 35 years old. As infertility rates continue to soar, the number of couples opting to use a surrogate is also on the rise. According to the South African Surrogacy Group (SAG), surrogacy provides hope for those who have problems becoming pregnant or carrying to term. The organisation believes that, “If it were not for women who are willing to perform this ultimate act of human kindness, there would be so many men and women out there who would be forced to face a future of broken hearts and empty arms.”
Egg quality is key
If you’ve been trying to conceive naturally for a while, and you’re thinking about using a surrogate, remember that the quality of a woman’s eggs is one of the most important factors to consider when trying to conceive. “In the majority of cases, what is required is an egg donor, not a surrogate,” says SAG. “Many couples believe that a surrogate is the final answer to all infertility problems; and that surrogacy has a 100% pregnancy rate. Sadly, this isn’t the case. The success rate of surrogacy, like “normal” pregnancy, depends largely on the quality and age of the eggs, among other issues like sperm quality, a healthy womb etc.
If you haven’t investigated the quality of your eggs yet, consider seeing a fertility specialist who will run a series of tests to help you determine if your eggs are still viable for a healthy pregnancy. Some of these tests include; a follicle stimulating hormone (FSH) and estradiol test.
FSH is a hormone that helps to control your ovaries’ production of eggs and estradiol is a form of oestrogen that could influence your body’s production of FSH. Your doctor might also want to check your anti-Müllerian Hormone (AMH) levels and antral follicle count.
A very low AMH level could also indicate that you’re producing very few eggs. Although it only takes a single, good-quality egg and sperm to make a baby, the less eggs you release with each cycle, the less chance you have of successful conception.
The legal side
If, after having your eggs tested, you and your partner decide that surrogacy is the way to go, here are a few important facts to take note of:
- It’s illegal in South Africa for a surrogate to be paid or for anyone to profit from surrogacy.
- As the parents of your future biological child, you’re legally obligated to cover all medical costs of the surrogate. This is usually done by taking over the surrogate’s medical aid payments.
- Fertility treatments aren’t generally covered by medical aid.
- If you use a non-profit organisation such as SAG and its volunteers, they can’t guarantee that any potential surrogate is, in fact, suitable mentally, or medically fit to proceed with the process. The respective doctors and psychologists will make these assessments separately at your cost.
- Depending on the situation and what has been agreed upon, you may have to cover out-of -pocket expenses and compensate your chosen surrogate for time away from work in line with her income. This will all need to be discussed and agreed upon beforehand.
According to South African experts on medical law, Adele Van der Walt Inc., “South Africa currently has a law protecting both parties, where surrogacies need to be passed in the High Court. Before the court date, all paperwork needs to be in place, which includes psychological and physical evaluations, and a contract detailing everything from medical expenses to how many IVF attempts you and the surrogate will agree to, and expectations of the surrogate with regards to lifestyle, etc. for the duration of the pregnancy. If you go ahead with the surrogacy without having this contract, approved by the High Court, your baby will legally belong to the birth mother (the surrogate).”
Can anyone be a surrogate?
Melanie Novitzkas, curator of SAG, explains that there’s a rigorous screening process to qualify to become a surrogate. So, if you’re considering becoming one, take note of these prerequisites:
- You must be a mother and have given birth to a baby of your own. “We need to know that you can become pregnant, carry and give birth to a baby. We also need to know you fully understand what it’s like to be pregnant and to give the baby over to the parents,” Melanie explains.
- Your pregnancies and births must have been uncomplicated.
- You have to be in good general health and have a BMI (body mass index) of minimum 18 and maximum 30.
- You must be older than 21, but younger than 43.
- You may not have had more than two previous C-sections.
- You must be a South African citizen.
How many times can you be a surrogate?
Although there’s no set number of times you’re allowed to be a surrogate, Melanie says they recommend an absolute maximum of three surrogate pregnancies, as your body might only be able to cope both physically and psychologically with this number.
Do you want to become a surrogate? Keep these tips in mind:
- Have the right mindset – you’re not giving a baby away, but rather returning the baby to his parents.
- Be aware that not everyone thinks surrogacy is a great idea, and that you may be faced with people passing negative comments.
- Once you’re comfortable with the first two points, consider if you’d like to be a traditional surrogate (using your eggs) or a gestational surrogate (using the eggs of the intended mother or a donor).
- Ensure that you know all the ins and outs of being a surrogate. This includes all the physical, mental and emotional factors, as well as the laws in the country and the tests and paperwork you’ll need to complete.
- Consider the biographical details of the couple you’d like to be a surrogate for (sexual orientation, religious beliefs, race, culture, etc.).
- Decide on the reasons you’re comfortable with in terms of a possible termination of the pregnancy.
- Think of what your expectations of the intended parents will be during the pregnancy and after the birth.
- Just because you’ve never had any problems in falling pregnant, IVF won’t necessarily work and you may not carry to term. Miscarriages and preterm labour are a real possibility, so you’ll need to be prepared for those.
- As with any fertility treatment, surrogacy can be a “hurry up and wait” process. Be prepared to be patient.
- Chat to other surrogates about their experiences.
Lastly, it’s important to be prepared for the unexpected, walk the road with integrity, and never lose sight of the goalpost.