Monthly Archives: February, 2023

Surrogacy is a reproductive method where one woman carries a pregnancy for another and, after the birth of the child, hands it over to its biological parents.

It represents a suitable alternative for couples where assisted reproductive techniques have not led to the desired pregnancy, or pregnancy could be life-threatening or in the case of a homosexual couple.

INDICATIONS FOR SURROGACY

From a medical perspective, conditions in which surrogacy would be appropriate include:

1. Absence of a uterus or severe defects of the reproductive system
2. Multiple failed IVF attempts
3. Severe form of antiphospholipid syndrome, lupus or thrombophilia
4. Advanced stage of chronic kidney disease
5. Need for life-saving treatment, which is contraindicated during pregnancy – for example chemotherapy.

TYPES:

Depending on the genetic relationship between the surrogate mother and the child, there are 2 types of surrogacy:

1. Traditional – in this case, the oocyte that will be fertilized belongs to the surrogate mother and, accordingly, the child will carry her genes.
2. Gestational – gametes from future parents or donor eggs/sperm are used. In the second option, the child will be genetically related to only one of the future parents.

In addition, it also can be:

1. Altruistic – the surrogate does not receive payment for the service. Only medical costs are covered.
2. Commercial – the surrogate receives a commission outside of medical costs.

SURROGACY AROUND THE WORLD

Surrogacy laws vary widely from country to country. Additionally, the conditions for hiring a surrogate are also not the same around the world.

In most European countries such as France, Austria, Germany, Italy, etc. surrogacy is prohibited by law. In some countries, such as Belgium, The United Kingdom and the Netherlands, it is allowed, but only when it is done altruistically, i.e. without additional payment.

Ukraine, Russia and Georgia are among the countries with the most liberal surrogacy laws. Even commercial surrogacy is allowed there and there are numerous agencies that offer it. This is also the reason for the so-called “reproductive tourism” to these countries.

SURROGATE MOTHERHOOD IN BULGARIA

At the moment, surrogacy in Bulgaria is not allowed and is not applied as a possible alternative for couples with reproductive problems. The woman who gave birth to the child is considered its mother. In 2010, an attempt was made for a draft law aimed to legitimize surrogacy in our country. According to that, only altruistic surrogacy would be allowed, and only for married couples. For now, however, this option remains impossible in Bulgaria, and couples wishing to become parents in this way have to travel abroad.

КАКВО ПРИЧИНЯВА ИНФЕРТИЛИТЕТ ПРИ ЖЕНИТЕ?

ПОВТАРЯЩА СЕ НЕУСПЕШНА ИМПЛАНТАЦИЯ И ИН ВИТРО: КАКВО ТРЯБВА ДА ЗНАЕМ?

IMPLANTATION FAILURE – WHAT ARE THE GENERAL REASONS?

The success rate of in vitro fertilization is determined by various factors. This means that several cycles often have to be carried out until the desired pregnancy is achieved. It is no secret that the process is often long and associated with many emotions.

Although there is no official definition of recurrent implantation failure (RIF), it is generally accepted that it is when pregnancy has not occurred after at least 3 transfers of healthy embryos.

The reasons for this serious problem can be both on the part of the woman and on the part of the embryo. In this article, we will present some of the most common factors contributing to RIF.

MOTHER’S AGE

  Studies show that IVF is most successful in women up to the age of 35. With increasing age, cases of aneuploidy (abnormal number of chromosomes) in the resulting embryos increase, leading to a higher number of failed implantations. Interestingly, such a difference in in vitro success was observed to a much lesser extent when donor eggs were used, supporting the idea that maternal age affects egg quality.

UTERINE ANATOMY ABNORMALITIES

Various conditions such as fibroids, hydrosalpinx or congenital abnormalities of the uterus can prevent implantation. They are usually diagnosed before the in vitro cycle has started. At the discretion of your obstetrician-gynecologist, you may be offered surgical treatment.

IMMUNOLOGICAL PROBLEMS

When RIF cannot be explained by another reason, the next step is looking for an immune system abnormality. Among the most common immunological causes of implantation failure are:

1. Elevated levels of some antibodies – antiphospholipid, anticardiolipin, anti-β2 glycoprotein-I antibodies, as well as lupus anticoagulant, typically seen in women with antiphospholipid syndrome, are associated with recurrent implantation failure.
2. Some features of the woman’s immune system – imbalance between Th1 and Th2 cells, as well as abnormally increased activity of uterine NK cells.

A RECEPTIVE ENDOMETRIUM

The endometrium (uterine lining) undergoes significant changes in its morphology during the menstrual cycle, without which pregnancy could not occur. Under the influence of estrogens and progesterone, the thickness of the endometrium increases to about 8mm. In addition, there is a period called the “implantation window”, around 19-21 days, when the uterus is receptive to the embryo and implantation can occur. In a certain percentage of women, this period of uterine receptivity is shifted from the normal time, resulting in infertility.

Recurrent IVF implantation failure is a complex problem. The various reasons that can lead to it determine the availability of different methods of treatment.

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In the following lines, we will pay attention to the main tests that pregnant women will have to undergo in the next 9 months.

For expectant new mothers, pregnancy and childbirth can be full of uncertainty and worry. Between being overwhelmed with new information and adjusting to the changes your body is going through, pregnancy can be quite a challenge. Yes, fears and anxieties are normal, but it’s important not to let these feelings completely overwhelm you.

We prepare in many ways for the arrival of the little baby, from designing the perfect nursery to the right diets and exercises. But, it is important not to forget to tune our consciousness to the truly amazing experience that comes with the appearance of new life in the world.

Any pregnancy is established with a urine or blood pregnancy test (testing the levels of ß-hCG- pregnancy hormone). It is recommended that the first examination with an obstetrician-gynecologist be done about 10 days after the delay of the menstrual cycle.

The main tests during pregnancy in the different periods are the following:

Regular examination of PCC, urine and blood sugar

Examination of the pregnant woman’s blood group and Rh (Rhesus factor).

Early biochemical screening – 11-13 weeks – early fetal morphology

Sexually transmitted infections

Microbiological examination of vaginal discharge and smear test

Late fetal morphology

You will likely have many thoughts and questions during your pregnancy. Coping with symptoms and making lifestyle and daily routine changes can be overwhelming at times.

Here are some tips to help you relax during this time:

Take time for yourself – every day

Do something that you like and that is just for you.

Talk to your loved ones, friends, and family – about everything that bothers you.

Be active every day (if this is not prohibited for medical reasons)

Exercise releases endorphins that will improve your mood. You don’t have to do strength training or go to the gym. Just try to incorporate different activities into your daily routine, be it a walk outside.

Be realistic about how much you can do (whether at work, at home, or in your social life)

 Balance your diet

Do not hesitate to ask your gynecologist about anything that interests you.

If you are concerned, talk to your supervising OB/GYN or midwife.

Source: Аптеки Запад – Онлайн аптека с грижа за Вас! | APTEKIZAPAD.BG

FACTORS FOR A HIGH RISK PREGNANCY