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Surrogacy in Israel

Israel is a country, where Bible formula “be fruitful and multiply” works in the best way. Traditional values, such as creation of family and having children, combined with the modern technologies, which make possible to become parents even in the most difficult cases of infertility, create extremely good legal and medical base for IVF and surrogacy treatment here. Israel will be for a very long time the leading country in infertility treatment with the best specialists and the biggest amount of IVF cycles per year per population. First of all, because of the government policy and support for anybody, who have desire to create a family.

Is surrogacy legal in Israel?

Agreements for the Carriage of Fetuses Law (Approval of Agreement and Status of the New Born), 5756-1996 and Amendment 2 to it made in 2018 are the main legal acts which regulate access to surrogacy in Israel.

According to the Law, surrogacy is considered as an infertility treatment due to strict medical indications for heterosexual married couples or single women, residing in Israel. In both cases there should be a genetic link to at least one of the parents (in case of married couple to the Intended Father, in case of single woman to herself only, it is not possible to use donor’s oocytes for single woman).

Only gestational surrogacy is allowed here. It is mentioned, that the surrogate mother should not receive money as a compensation for her services. However, she has right for full remuneration due to the time, dedicated to surrogacy process, all medical expenses, expenses for closes and lost income during pregnancy. The amount of money she can get according to surrogacy contract, signed with the Intended Parents, should be preliminary confirmed by special state Committee (Approval Board).

What is the Approval Board?

Approval Board is created in Israel as a special body that has different representatives in its structure, such as specialists in gynecology and obstetrician, specialist of general medicine, psychologist, social worker, representative of the religious community of the parties and representative of government (specialist in law).

Legal status of Intended Parents (marriage, residence) is not the only one requirement for surrogacy. Their age should be between 18 and 54 (in some specific cases can be prolonged by the decision of the Approval Board). The Members of the Approval Board will also check their medical and mental status, their psychological readiness to undergo surrogacy process, will check if they are fully informed about the legal details of the process and if they are not prosecuted either in Israel or abroad. Usually the Approval Board gives its conclusion about surrogacy cases which take place on the territory of Israel. Nevertheless, sometimes it can also make a decision about surrogacy abroad if it is needed due to medical reasons.

It is forbidden to undergo surrogacy programs without the preliminary hearing in the Approval Board, as well as to make surrogacy programs in the IVF centers not authorized by the government. It can become a reason of prosecution and even imprisonment of the Intended Parents.

Who is a surrogate mother in Israel?

There are no requirements about her residence status, but there is a requirement about her religion. Surrogate mother should have the same religion (Judaism), as the Intended Mother not to create confessional conflicts after the baby is born. According to Judaism the baby gets his/her religion from the mother, who gave birth to this baby.

Read more about surrogacy and religion in our Blog!

It is recommended that the surrogate mother is single (widowed, divorced), conceived and gave birth to at least one her own healthy child and she is in the age from 22 to 39 years old. She also should not be a relative of the Intended Parents and have not more than 4 deliveries in total with not more than 2 fetus per pregnancy. Besides, it should has already passed at least one year since the last delivery.

In some cases, the Approval Board can give their acceptance to have a married woman as a surrogate, but they need to get an approval from her husband before the signature of the contract.

It can be done not more than 6 embryo-transfers to the same surrogate mother until she is pregnant. Not more than two surrogacy births can be given by the same surrogate mother.

Egg donation and PGD testing

As a rule, egg donors are anonymous in Israel. Their cells can be used by the infertile Intended Mother due to medical reasons only, approved by the doctor. In some cases, egg donor can be known (only after such decision is taken by the Approval Board).

There are two types of egg donors in Israel. First is “a volunteer donor”, who is a woman with good health conditions, 21-35 years old. Second is “a treated donor”, who is a woman undergoing IVF treatment by herself and is willing to give her oocytes to another couple. Both types of egg donors cannot be relatives of the Intended Parents. A volunteer donor should also be single (not married).

Financial compensation for egg donors is plain for everybody and established by the government. One donor cannot make more than three donation cycles (with the time gap at least 180 days between the cycles).

A donor may request that some of the eggs extracted from her body be frozen for future use by her or submitted for research. The number of eggs in such a case will be 20% of the number of eggs extracted from the body or two eggs, whichever is lower.

PGD testing can also be used here, due to the medical indications only.

Who are recognized as legal parents of the baby?

At the end of the fifth month of the surrogate mother’s pregnancy the Intended Parents are obliges to notify the authorities about the approximate date of her delivery. The social worker should be present during the delivery of the surrogate mother and will organize the transfer of the baby to the residency of Intended Parents. In such a way the authorities are checking social and living conditions for baby, protecting his/her best interests.

After that the Intended Parents should fill the documents to get the parental order in the Court that will give them their full parental rights. Once the parental order is obtained, the Intended Parents are recognized as legal parents of the child and transfer to him/her their nationality.

Post-birth support

Israel residents have right to get financial support from the government in the end of surrogacy process regardless the country where the program was performed. Parents are eligible for the hospitalization expenses coverage, even if the baby was born abroad. The difference is that in one case the government pays directly to the Maternity House and in another case Parents should show receipts from the hospital situated abroad to claim some funds back.

Moreover, the Intended Parents are entitled to get grants after the baby’s birth as well as get a birth and parenthood period from their place of work.

 

Surrogacy in Israel is a very interesting topic, however, we cannot recommend this country for our international clients, who are searching for options abroad due to the legal requirements.

At the same time, we are happy to inform you that the experience of Israel’s IVF specialists can be find not only in Israel, but also in Belarussian-Israel clinic we work with.

Contact us today to get more information about our surrogacy programs in Belarus we have for foreigners!

Surrogacy in Europe. Is surrogacy in Portugal legal?

Surrogacy in Portugal is one of the most controversial topics during already almost 15 years. From one side the government voted for quite friendly legislation, from the other side all these initiatives were abolished by the Constitutional Court as contravening the Constitution.

Usage of assisted reproductive technologies as a way of infertility treatment is regulated in Portugal by Law 32/2006 dated 26.07.2006, Law 25/2016 dated 22.08.2016, which has made changes to the Law 32/2006 related to surrogacy provisions, and Regulatory Decree 6/2017 dated 31.07.2017 that regulates procedural issues of surrogacy.

Who is able to use surrogacy in Portugal?

According to provisions of these normative acts, it is possible to use gestational surrogacy in Portugal for both Portuguese and foreign citizens in case they have strict medical indications for it, for example in case of absence of the uterus or any other diseases of this organ, that enables a woman to carry a child (if it is a same-sex couple, both women should be medically unable to carry a baby). Surrogacy services are understood here as a way of treatment and help from woman to woman, so it is possible to use only in altruistic from for heterosexual and homosexual female couples. These services are not available for single parents (both male and female), as well as for homosexual male couples, as they are not able to carry babies a priori.

Any payments to surrogate mother are prohibited here and can cause penalties or even 2 years of imprisonment for Intended Parents. The same situation is with intermediary activity (work of agencies) or performing surrogacy program in any other center that one that was authorized by authorities, all these is forbidden.

What is the procedure?

According to the Regulatory Decree 6/2017, all couples intended to use surrogacy services in Portugal should send their medical and legal documents to the National Council of Medically Assisted Procreation of Portugal according to a specific list and to get their authorization for surrogacy contract conclusion. Moreover, there should be some kind of “draft form” of surrogacy contract with its essential provisions protecting rights of each side of the contract. The procedure of getting such kind of authorization can take from 3 to 6 months.

Unconstitutional provisions

At the same time, ruling no. 225/2018 of the Constitutional Court of 24 April 2018 declared unconstitutional some rules of the Law of PMA regarding surrogacy (Law 25/2016), which led the CNPMA (National Council of Medically Assisted Procreation of Portugal) to declare as extinct all the then underway processes of authorization to conclude surrogacy contracts. So, currently this procedure doesn’t work.

Regarding donor’s oocytes, previously all donors were anonymous, but later the Constitutional Court decided that their personal data should be available due to the right of children to know their identity. Currently all children born from donor’s gametes have the right to request their personal data from breeding centers when they reach the age of 18 years old. This provision makes process of donor’s searching much longer and more expensive, as not all donors are ready to be non-anonymous.

In July 2019, the Assembly of the Republic approved a new legislative initiative which, in the process of preventive inspection of constitutionality, was once again declared unconstitutional in two provisions, which led the President of the Republic to return the Decree to the Assembly of the Republic, without promulgation.

Is surrogacy in Portugal legal or not?

In conclusion, for the moment there is no legal framework that regulates surrogacy in Portugal, so the practice of this technique is not legal.

Portuguese citizens should find options abroad for their infertility treatment, until the surrogacy law is established. We want to encourage you to learn more about our surrogacy programs in Belarus.

Don’t hesitate contacting us if you have any further questions, we will be happy to help!

Surrogacy law by country. How to choose a country for your surrogacy program overseas?

Many infertile couples all around the World are suffering from the impossibility to use surrogacy services and/or egg donation in their own country because of moral or legal ban of this kind of treatment. After a lot of high-profile cases, such huge surrogacy destinations as India and Thailand were closed for foreigners that left a lot of infertile couples confused about their possible surrogacy destination. Today we are going to talk about the most common surrogacy destinations overseas, so you can find the best option for your country specifically.

Surrogacy in United States of America

United States is one of the biggest countries with the most controversial legal practice about surrogacy nowadays, as it varies from state to state from the total ban to very loyal attitude to this issue. Some states are surrogacy friendly, such as Arkansas, California, Delaware, Illinois, Nevada or New Hampshire. In some states there is no legislation about this, for example, law of Alaska, Colorado, Georgia, Iowa, Montana and Massachusetts is silent about surrogacy. Other states have banned this practice totally, such as Louisiana, Michigan or New York.

So, the best option is to perform surrogacy program in the State, where it is legal, and surrogacy contracts are enforceable by law and supported by courts. The other thing is that together with great opportunities and guarantees Intended Parents should be ready to face huge expenditures in case they choose United States option for surrogacy.

First of all, surrogacy agencies in USA are extremely expensive. The same is with attorneys, medical services and delivery process, let alone genetic tests, travel expenses and medical insurance. In total price of surrogacy program in USA will vary from approximately 95,000 to 200,000 USD Dollars that is at least three times more expensive than price for the same programs in Ukraine or Georgia. That’s why some couples who live in USA apply for surrogacy abroad for themselves, especially if they know that according to their health conditions they will most probably need several IVF cycles.

Second thing you need to be aware of, is the birth order. The birth order is a specific document, issued by court, which assigns parentage to a child. There are pre-birth and post-birth orders, depends on the state. The pre-birth order is done before the baby is born, although it is not effective until the birth occurs. However, it gives to the Intended Parents peace in mind, as after obtaining it, the maternity house will indicate the names of the Intended Parents in the original birth certificate and the child will be given directly to the parents from the hospital. Without it, the name of the surrogate mother will appear in medical documentation and further legal steps will be needed to finish the process. Consequently, the post-birth order can be issued only after the baby is born and the hearing in the court is finished. Sometimes, for such cases parents should attend the trial personally.

In most cases, US allow surrogacy for heterosexual married couples only, therefore and in case that you are a member of LGTB community, we strongly recommend you to seek for highly-qualified legal advice when searching for surrogacy in United States.

The good news, is that every baby (including babies born via ART and surrogacy) born on the territory of US is getting US citizenship automatically. So, this can be a very good option for countries where there are difficulties with getting baby’s passport in the Consulate of their country of origin, such as Spain, France or Germany (we remind you that without citizenship and passport of the baby will not be able to come back home after the surrogacy process).

Surrogacy in Russia

Another big destination for surrogacy is Russia.

In Russia surrogacy is allowed by law, where it is specified, that only married heterosexual couples or single women, who are not able to carry a baby, can sign a surrogacy contract. At the same time, there are some cases, when surrogacy was performed there not only for single woman, but for single men. We want to warn you, that in such a way, even if it is possible, it can cause some delays, additional expenditures and legal difficulties at the end of  the surrogacy journey, as to get the baby’s birth certificate in Russia is possible only for married couples. Single parents should undergo the hearing in the court to get the birth certificate of their babies. From the April 2018 all parents who have their babies through surrogacy in Russia cannot take the baby out of the maternity house until they get baby’s birth certificate in the civil registrar office. On the other hand, in case of a married couple it is quite quick process.

Additionally, a surrogate mother in Russia has the right “to change her mind” and to keep the baby for herself after delivery. In practice, however, it can occur very rarely, as in this case the surrogate mother will need to give all the expenditures for her pregnancy care, delivery and monthly payments to the Intended Parents back. 

A general advise: we strongly recommend all our clients to have at least 50% (one parent) genetic link to their surrogacy baby, as it makes the process of obtaining the baby’s nationality and passport in the Embassy of their country of origin possible.

In general, Russia is a good option for married heterosexual couples, who are seeking for Slavic egg donors and surrogates. In general the main legal conditions are very similar to Ukraine, including the difficulty in getting the Russian citizenship for a baby in case of complications in getting the citizenship of your own country (in your Embassy). The price is also approximately the same – from 35,000 to 60,000 USD Dollars.

Surrogacy in Ukraine

Surrogacy in Ukraine is totally legal for heterosexual married couples only. The rights of Intended Parents are protected here, as they will be written as legal parents in the birth certificate, issued by Civil registrar office and surrogate Mother has no right to keep the baby, even if she wishes so (on the contrary to Russia, where she has this right). All other questions that are not specified in the Law are usually specified in the Contract between the Surrogate Mother and the Intended Parents. You can be sure, that lawyers who work in this sphere in Ukraine are highly-qualified and know which issues should be specified in the Contract to protect the rights of all sides.

 As an agency which have a long experience working in the surrogacy field in Ukraine, we can give you the real picture about the process there. Ukraine nowadays is the most attractive destination for foreign couples. Affordable prices for surrogacy programs, big amount of surrogates and huge variety of beautiful fertile egg donors makes this country extremely popular among infertile couples all over the World. In Ukraine you can find very highly-equipped private IVF clinics and very good reproductive specialists, as this field has been developed in Ukraine for very long time.

The price of surrogacy programs varies here from 35,000 to 60,000 USD Dollars, which is more or less the same as in Georgia or Russia and three times less than in USA. On the less bright side we strongly recommend infertile couples from such countries as Spain, France or Germany to think twice about this destination, because the process in the Consulate can be extremely long here in case that any difficulty occurs. For example, in case that you country of origin rejects giving the passport to your baby, you will need to spend in Ukraine approximately 3 months before the Ukrainian government will issue Ukrainian citizenship to your baby and the travel passport. Such procedure does not exist in Ukrainian law and is performed with the assistance of the professional lawyers in exceptional cases.

Update: Unfortunately, we have heard recent news about horrible mistakes of some Ukrainian clinics and agencies, which leads to the impossibility to go out of the country with the baby, specifically there are many reports of lack of genetic link between babies and their parents because of mistakes, and Intended Parents that have been prosecuted for child traffic or who suffered the shock of being taken the babies away. On the web-sites of Consulates there are warnings about Ukraine, as some countries believe that if you are going to this surrogacy destination, you need to be aware about the possible risks that it involves. Moreover, according to our own experience, Ukraine has suffered a sharp deterioration of the sanitary and epidemiological conditions during the last 2 years, as reflected in official statistics of high incidence of such dangerous diseases as Measles, Tuberculosis and HIV infections because of poor vaccination, extreme poverty and widespread drug addiction.

Finally there are current considerations in the Ukrainian Parliament to prohibit surrogacy for foreign couples in the near future. We believe that if the situation in Ukraine does not improve, it can repeat the destiny of India – another very popular surrogacy destination which is now closed for foreign couples for a number of reasons.

Surrogacy in Georgia

Georgia is a relatively new and not so popular destination for surrogacy. European and American clients are typically not very familiar with this country andd know very little about specialists, laboratory equipment and law regulation about surrogacy process in Georgia. We can assure you, that with more or less the same price than in Ukraine (the prices here varies from 35,000 USD to 55,000 USD) in Georgia you can get the same or ever better quality of services.

First of all, during last few years IVF and surrogacy in Georgia has developed enormously and new opportunities for international couples have arisen. Lastly, the country has seen the opening of several new IVF clinics equipped with the most advanced technology, which gives more possibilities for treatment not only for local or middle-east patients, but for patients all around the World.

Comparable with Ukraine or Russia, here you can request infertility treatment and surrogacy, even if you are not married. According to Georgian legislation, it is possible for heterosexual couples, although still not possible for single parents. Egg-donors here are not anonymous, so you can personally meet them and even sign a contract in Notary together with your surrogate mother.

Neither surrogates nor egg-donors have parental rights of babies born through surrogacy in Georgia. Intended Parents are written as legal parents in the birth certificate of a baby.

Another extremely important advantage here is that in case that your country of origin rejects giving the citizenship to your baby you can obtain Georgian citizenship and travel passport in less than a month. The procedure for such cases is strictly regulated and simplified and takes not more than 3 weeks and a 100 Euros legal fee. This is much quicker and cheaper than in Ukraine or Russia, where such procedure for babies born via surrogacy is not established and decisions are taken by the government exceptionally.

Many couples hesitate when deciding if to come to this country, just because it doesn’t have so many Embassies of foreign countries inside it. It is true that many Embassies and Consulates, which are responsible for Georgian territory are situated either in Turkey or in Armenia but still the country counts with Embassies of such important countries as Germany, China, US, France and United Kingdom. In any case, we strongly recommend this surrogacy destination for all couples, without exceptions. According to our experience, it takes much less time to come to the Embassy in Turkey and back, that to wait for decision of Ukrainian or Russian authorities regarding the issuance of nationality for the newborn surrogacy baby.

Surrogacy in Belarus

Surrogacy in Belarus is strictly regulated. Even though this destination for IVF tourism is not popular yet, we believe that in the future the situation will change and this country will become more open for the international tourists. According to the Belarusian law, surrogacy is possible here for married heterosexual couples and single women, but on practice most clinics work with the married couples only. Eggs from a donor undergo here a 6-month long quarantine, to avoid any possibility to infect the future child, as the incubation period of some diseases is exactly 6 months. So, you can be sure that your donor is double-checked.

Intended Parents will be written as legal parents in both medical and civil certificate of birth without any mentioning about the surrogacy program, because the medical confidentiality is highly respected in Belarus. The level of the medical treatments here is very high, as the qualification of Belarusian medical staff is extremely high, they are very good professionals, who will treat you in the best way. Besides, the cost of prematurity care is nearly zero.

We think that the price/quality ratio in the biggest in Europe here, as the average cost of surrogacy program in Belarus varies from 35,000 to 45,000 USD.

Surrogacy in Canada

Surrogacy in Canada is possible on altruistic basis only, since it is possible to pay for the medical treatment of the surrogate mother and reasonable expenses only. So, if you are going to perform your surrogacy program here, be ready to wait for a long process and many requirements. Another risk is that Canada has no pre-birth orders that can guarantee your rights after the baby’s birth, so be ready, that the surrogate mother in Canada has the right to keep the baby, as in Russia.

The good part of surrogacy in Canada is that you will probably not pay anything for the agencies, as you can manage the process by yourself, what reduces the price of surrogacy program enormously comparable with USA (the total cost of surrogacy program in Canada is around 70,000 USD). In the same way as in US, the baby born through surrogacy in Canada has the right to get Canadian citizenship and passport, what is a big advantage in some cases.

Surrogacy in Greece

The situation with surrogacy in Greece is more or less the same as in Canada. It is allowed, but restricted. Greece is a very attractive destination for EU citizens, as it gives them ability to travel home with their baby immediately after the baby’s birth. Nowadays, surrogacy is allowed in Greece for heterosexual couples (either married or unmarried) and single women on altruistic basis only with or without egg-donor. The main difference from Canada is that here the Intended Parents need to undergo the trial even before the surrogacy contract is signed. In Greece court gives to the Intended Parents some kind of permission for the surrogacy program according to their age, marital status and medical reasons.

Another thing, is that in Greece (after the court decision) Intended Parents automatically become legal parents from the moment of conception, so the surrogate mother will not appear in any medical documentation. This fact can be very helpful for some Embassies during the process of obtaining the baby’s citizenship and passport. Take into the consideration, that the surrogacy baby is not entitled for the Greek citizenship and passport.

Surrogacy in Cyprus

Surrogacy in Cyprus is not regulated by law, what creates some kind of legal vacuum that is widely used nowadays by some agencies and legal companies working in this field. We strongly recommend you to be very careful with the provisions of the surrogacy contract if you are going to perform your surrogacy program in Cyprus, as this is the only one document that will regulate your relationships with the surrogate mother. In any case, it is not possible to give any assurance that this contract will be enforceable by a Cypriot Court. Regardless of the provisions of the surrogacy contract, the surrogate mother will be considered as a legal mother of a baby, born out of wedlock. The genetic connection to the Intended Father can be established via DNA test or medical documentation from the IVF clinic. So the baby can be registered on the name of surrogate mother and the genetic father by his voluntary acknowledgement or by Court.

The next step for the Intended Parents is to adopt the child via the hearing in the Court.

The cost of the surrogacy program in Cyprus will be around 60,000 USD and is mainly used by gay couples, the surrogate mothers are mainly from Ukraine as Cyprus is a very small country with small population.

Surrogacy in India, Thailand and Mexico

Surrogacy in India, Thailand and Mexico is not legal for international couples any more.

Conclusion

We didn’t talk in our article about such surrogacy destinations as Cambodia and Kenya, as we believe that the high risks and high rates of the baby’s mortality will keep you away of these destinations.

To know more about childhood and protection of children in the following countries we recommend you to read the “End of childhood report 2018” from “Save the Children” organization with the latest rates of all countries over the World.

We wish you good luck in your surrogacy journey in the destination of your choice. We, at Pons Medical believe that anyone who is opened to new horizons, the impossible will be become possible. We wish you happiness for you and your family!

Don’t hesitate to contact us if any questions appear.

Author: Sukhanova Anna, legal adviser of Pons Medical Group

Monitoring of Surrogate Mothers

The monitoring of the surrogate mother during pregnancy is an essential part of a surrogacy program. The monitoring is explicitly mentioned in our contract.

How is the Monitoring performed?

The monitoring involves three levels of intervention:

First line monitoring

First level involves a phone call every three days to the surrogate mother to check her health and psychological status, nutrition and overall living situation. This level, called “first line monitoring” also implies that the surrogate mother will contact the coordinator immediately if something unusual occurs. In case of some complication, the surrogate mother is taken to the hospital in the shortest time and a treatment is implemented to address any possible complication.

Second line monitoring

The second level or “second line monitoring” involve a plan of medical visits during the pregnancy period. Every month the surrogate will visit the gynecologist to monitor the development of pregnancy. Photos and video recordings will be taped in order to create a comprehensive medical report for the intended parents. Blood tests are also performed routinely as well as a brief visit to the psychologist to evaluate the mental health of the surrogate. In case that some complication is detected, the protocol of the “first line monitoring” is activated and the surrogate is taken to the hospital for further evaluation or treatment. If the complications are not serious, as for example, a vitamin deficiency, the gynecologist will prescribe the necessary supplements or medications.

The “second level monitoring” lasts for the whole pregnancy period. From the nutritional point of view, the second level of monitoring involves monthly sessions with a nutritionist to evaluate the food intake of the surrogate mother so that it corresponds with the standards of nutrition under pregnancy, implying enough intake of vitamins, minerals, proteins, healthy fats, etc. as well as negligible intake of harmful food, like trans-fats, sugar, and industrial caned products. We also discourage the consumption of industrial poultry and other meats with high level of hormones or antibiotics and a high level intake of vegetables, eggs, white fresh fish, healthy whole grains and fresh fruits.

Third line monitoring

Finally the third level or “third line monitoring” involves random visits to the surrogate mother to evaluate her living conditions in-situ. It also involves the indications of random blood tests to detect the use of toxic substances, drugs, etc. These tests are done every three months. The surrogate mother is not warned beforehand and it can happen at anytime.

With the implementation of our three levels of monitoring we assure optimal living and health conditions for the surrogate mother during pregnancy. We also assure that any health complication is addressed in a timely manner. Constant monitoring also contributes to the psychological stability of the surrogate mothers, as they will feel guided and protected during this difficult period.

Human life is the most precious treasure, that’s why, we at Pons Medical Group, perform exhaustive testing and monitoring during pregnancy to guarantee successful deliveries and happy and healthy children.

Please, don’t hesitate to contact us if any questions appear.

Author: Edel Pons, General Director of Pons Medical Group

 

Read more about recruitment of surrogate mothers in our blog!

The Harmony Test

During pregnancy our surrogate mothers will make a lot of tests and screenings that can be tiring and irritating. That is why we want you to know about the importance and necessity of one of the most important tests that you can make during this precious period.

We think that for every parent and also for our future parents it will be helpful and significant to have an idea about what the Harmony Test is and why it is performed.

So let’s talk about it.

What is the Harmony Test?

The Harmony test is one of the most necessary tests, which needs to be done during your pregnancy in order to be ensured that there is nothing dangerous for your child.

It is a non –invasive prenatal testing, which can be made after 10 weeks of pregnancy. It’s a blood test, that analyses and measures the DNA from the fetus that circulates in the mother’s blood, in order to predict the risk of certain chromosome conditions , like Down syndrome (trisomy 21), Edward’s syndrome ( trisomy 18) or Patau syndrome ( trisomy 13).

Unfortunately, chromosomal condition can occur in every pregnancy. All these syndromes result in numerous defects and they can be fatal for your child. Also this test determines whether the baby is a boy or girl and poses no risk to the fetus. The test has not any risk to you baby and is almost 100% accurate.

Three Trisomies

Down Syndrome

Trisomy 21 also known as Down Syndrome is the most common trisomy at the time of birth. It is associated with moderate to severe intellectual disabilities and may also lead to digestive disease, congenital heart defects and other malformations.

Edwards and Patau Syndromes

Trisomy 18, known as Edwards syndrome and Trisomy 13 known as Patau syndrome are associated with a high rate of miscarriage. These babies are born with severe brain abnormalities and often have congenital heart defects as well as other birth defects. Most affected individuals die before or soon after birth, and very few survive beyond the first year of life.

Sex chromosome conditions

The sex chromosomes (X and Y) determine whether we are male or female. X and Y chromosome conditions occur when there is a missing, extra, or incomplete copy of one of the sex chromosomes. This test may not be applicable to everyone, so you need to discuss it with you doctor.

Who is the Harmony test suitable for?

The Harmony test is specially recommended in case of pregnancy by surrogacy though the test is also suitable for a wide range of pregnancies. In surrogacy, as a specific type of IVF treatment, a prenatal test that offers near 100% accuracy in the diagnosis of congenital conditions can provide great reassurance.

 The Harmony test is suitable for:

  • All twin and singleton pregnancies including IVF pregnancies
  • Surrogacy pregnancies

The Harmony test can also be used to know the sex your baby, this feature of the test is suitable for:

  • Singleton pregnancies only (not twins)
  • In case of twin pregnancies if the fetuses are both female. If there is one female and one male, it will appear as male pregnancy only.

Pons Medical Group is a leading surrogacy agency in Georgia providing IVF services, donor services, surrogacy, pregnancy care and delivery.

Don’t hesitate to contact us if any questions appear!

Author: Knarik Margaryan, Coordinator of Tbilisi unit

Egg Puncturing

In vitro fertilization (IVF) is a complex series of procedures used to treat infertility or genetic problems and assist with the conception of a child. It is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner’s sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.

What is egg puncturing?

If you are using your own eggs during IVF, at the start of a cycle you will begin treatment with synthetic hormones to stimulate your ovaries to produce multiple eggs – rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs will not fertilize or develop normally after fertilization.

Egg puncturing is also known as the oocyte pick-up, or OPU, egg retrieval is the process by which eggs or oocytes are removed from the ovary after stimulation during IVF. After you take fertility injections to grow multiple ovarian follicles, which house the eggs and once they reach the target size, ovulation is triggered and the egg are removed through the vagina during “mini-surgery”. Using an ultrasound doctors remove the eggs using a needle guide that is attached to ultrasound probe.

After being  removed, the eggs go to the laboratory to be prepared for freezing or for fertilization with sperm to create embryos. When the embryos are created, they will be transferred to Intended mother’s uterus or it will be used with surrogate mother.

Medications for stimulation. 

To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or a combination of both. These medications stimulate more than one egg to develop at a time. When the follicles are ready for egg retrieval — generally after eight to 14 days — you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature. Typically, you will need one to two weeks of ovarian stimulation before your eggs are ready for retrieval.

 About 34 to 36 hours after you receive the hCG shot, the egg retrieval will take place. It is normal to be nervous about the procedure, but most women go through it without much trouble or pain.

Is egg puncturing painful?

Before the egg puncturing, an anesthesiologist will give you some medication intravenously to help you feel relaxed and pain-free. Usually, a light sedative is used, which will make you “sleep” through the procedure. This is not the same as general anesthesia, which is used during surgery. Side effects and complications are less common. Overall egg retrieval is a safe procedure. Some fertility clinics prefer to use conscious sedation, which uses a sedative to help you relax and an anesthetic to numb and block pain.

Duration of operation


The egg puncturing process takes about 20 minutes. One benefit to conscious sedation is that recovery time is faster than general anesthetic, which allows you to head home and rest more quickly following the procedure. Another perk is that conscious sedation allows you to be awake and a part of the procedure without the anxiety and pain related to egg retrieval.

Many women who had experienced this process, found it fairly easy and without much pain after. Their advice is to be relaxed, because as they say there is no need to be nervous. After the process, you can have a rest for one or two hours and then leave the clinic.  Most likely you will go home and sleep the rest of the day. The next day of egg retrieval you will be able to do everything, you have been doing before it.

For you this is the only way to get a baby genetically related to parents and this process often gives good results and it definitely worth to try.

Author: Knarik Margaryan, Coordinator of Pons Medical Group

What services do the Surrogacy Agencies offer?

What services do the Surrogacy Agencies offer?

The choice of a surrogate pregnancy agency is a very important decision, and we will give you some tips to take into account for a better decision.
The Agencies are companies or organizations specialized in surrogating that, generally, provide two very important services:

-Organize the process of surrogating, including advice on procedures, contact with specialized lawyers who will make legal presentations and fund trusts, contact with the reproduction center that will carry out the embryo transfer, contact with translators when the parents they do not speak the language of the country and more. Normally they are not in charge of organizing trips or stays, for the future parents.

-To obtain a suitable pregnant woman and donor of ovules for the process, and to be in charge of carrying out the medical analysis of health, verifying the non-existence of pending issues with the justice, carrying out interviews about her lifestyle, etc. When contracting with an agency, the agency will provide us with a database of profiles of women who have applied to act as pregnant women, in order to choose the most appropriate one.

How to choose which agency to hire?



1) Website.

It is very important to carefully analyze the agency’s website and get all the information about it. It is good to take the time and carefully read each of the articles, publications, and history of the agency.

Observe if they have experience, who is responsible, where exactly is located, if they serve heterosexual couples only, if they have databases of pregnant women, and all the necessary information (see below).

An untidy website, with spelling errors, with links that do not work, etc. may be a sign of carelessness.

2) Skype interview.

It is a must, contact the agencies and request a Skype interview or similar, to be able to answer questions and queries, and learn more about the company we are analyzing.

In this step, we can ask everything we want to know and verify if they have translators, what the payments are like, what guarantees they offer, what happens if medical treatment fails, etc.

3) Recommendations.

If we receive recommendations from someone who has already done the surrogacy process in one or another agency, or who knows them and knows they are good in their work, it will be very good, since we can confirm the seriousness of it and that will give us more peace of mind.

4) Making the decision.

After having obtained all the information we need about the different agencies, we will be able to decide which is the most appropriate for us.


Important information to ask


Whether researching the website, in the Skype interview, through references or via email, we recommend consulting the following information and asking the following questions:

-Experience in surrogacy.

What experience do they possess in surrogating? How many years have you been engaged in it? How many cases work per year?

-Responsible for the agency.

Who is the responsible or owner of the agency? Why is he dedicated to surrogating? Do you have training on the subject?

-Travel and stay.

Do the budgeted costs include the tickets or the stay? Are they responsible for making our stay or hotel or should we reserve it? How many times should we travel there, and how long should we stay on each trip?


-Different programs and guarantees.

Do they have different surrogating programs? What does each one include? What is the difference between them?

-Cost, values, and forms of payment.

What values should we pay to the agency? What is the total cost of the entire process? Is it a closed value or can it have modifications? What are the differences in money that may exist? Do the costs include medical fees and expenses? Do the costs include legal fees and expenses? Do the costs include compensation payments to the pregnant woman? What forms of payment do they have? Should everything be paid at the beginning or paid as the process progresses?

-Election of the medical center.

Does the medical center choose the agency, or do we choose it? Do they have their own medical equipment?

– Selection of the law firm.

Does the law firm choose the agency, or do we choose it? Do they have their own lawyers?

-Election of the pregnant woman (and donor of ovules)

How do we choose the pregnant woman? Do you provide us with a database? Can we communicate with them before choosing it? Can we communicate with them during pregnancy? What procedure do they do if the pregnant woman does not become pregnant? How are the studies performed on the pregnant woman to determine if she is suitable for the process?

-Laws of the country and documentation.

What do the laws in that country say about surrogating? What procedure should be carried out before the birth? What procedure should be carried out after birth? Will the baby’s documents go to our name or the pregnant woman’s name? Will the baby have the nationality of his country? Should we carry out an adoption process towards the baby?

Yes, you are trying to get some genuine help to form or grow a family. Therefore, you must make sure you are working with a reputable agency or an in vitro fertilization clinic that supports and will help you protect your family and your future baby.

Well, after all these questions you will ask the agency, depending on the answers, you will have a lot of useful information to determine which is the most appropriate agency for you and your family.  However, remember there are no correct answers, only answers that make you feel supported and strengthened.

Author: Edel Pons, General Director of Pons Medical Group

Euploidy and aneuploidy

Euploidy and aneuploidy

 

It is very important to receive good quality embryos during the artificial reproductive technologies, as it is the key to a successful treatment. But what does actually “good quality” mean? Is this about the microscopical evaluation of embryos by an embryologist? Let’s go to the fundamentals of this question.

 

During the fertilization process, two cells from both of parents will fuse, a spermatozoon of a father and an oocyte from a mother. Each of this cells stores a half of the usual number of chromosomes, and chromosomes are the carriers of the genetic material in all cells of the human body. But when the fertilization occurs, their genomes, each from 23 chromosomes (22 autosomes and one sex chromosome), will form the genome of a future embryo.

 

In normal conditions, under this process the embryo will be formed with 46 chromosomes: 44 autosomes, which are equal in both genders, and two sex chromosomes: XX for girls XY for boys. This state is called “euploidy” and it means the normal amount of chromosomes.

 

Sometimes, according to the individual situations in parents, their gametes can contain the wrong amount of chromosomes. The cause can be both age-related and associated with medical conditions such as inherited problems, harmful environment (ionizing radiation, some medications).

 

This will result in the formation of the embryo which will have the wrong number of chromosomes (less than 46 or more than 46). This called “aneuploidy” and it may lead to health problems in a child. Also, such embryos can be morphologically normal, so, during the microscopy, the embryologist will not see any abnormalities. The genetic status of embryos will not necessarily lead to some changes of their appearance.

 

How to estimate the genetic status of embryos?

If a doctor will decide that the parents are in the risk group, they will be proposed with the preimplantation genetic testing. It means that their embryos will be biopsied, a little part of them (5-10 cells) will be taken to the genetic laboratory and, after the investigation, the doctor will receive: which embryos are aneuploid and which are public, so could be recommended for a transfer. For the best chances for pregnancy, the most qualitative morphologically and, at the same time, the euploid embryo will be picked for a transfer.

 

Will the aneuploidy definitely lead to diseases in a child?

Well, with it these problems are not guaranteed. According to the Preimplantation Genetic Diagnosis International Society recommendations, there is a ‘priority’ list of transferring aneuploid embryos in case if there are no euploid options. This priority starts from specific aneuploidies which will less probably lead to the health problems, however, more detailed pregnancy investigation will be required to estimate all health risks with ultrasounds and biochemical screenings. Nonetheless, it will be estimated by your doctor and Pons Medical Research will find you appropriate specialists for consultation in case of such a need.

How to select your surrogacy agency

How to select your surrogacy agency

There is no need to spend years of heartaches and many sufferings longing for a family. This is because with the help of a surrogacy agency you can create your own family. Surrogacy is never every woman’s dream of starting their own family, but to other due unavoidable circumstances or personal decisions, it remains to be the only choice or one that will serve their purpose. These agencies will help each individual get a professional education, support, and advice who are about to experience surrogacy.

Some of the services that you can expect include providing parents who want a child with one, gestational carriers and egg donors. Each of these people deserves care and respect that will see them go through with the journey and have a great experience with it. It is possible to find professional agencies that will offer you a personal touch in their services, plus quality cares a support from the start of the process to the end.

To achieve the family that you want is often a personal and somewhat unique journey. With the surrogacy agency, you need to get all the information and support as you make your decision. A good agency is one that acts as a source of knowledge to anyone in need of their services. Furthermore, they should provide the confidence and care that each decision requires.

Not everyone can qualify for surrogacy

Not everyone can qualify for surrogacy. That is why in each of these agencies you will be accessed and provided with the right education and information.

It is wise to choose that agency that knows how to match a couple with the right surrogate mother. In addition, they need to ensure that every individual involved shares in the same goal and expectations. Surrogacy is a legal issue, which is why the right paper has to be processed for all the parties involved get no problems in the future. 

Surrogacy is an arrangement in which a woman carries and delivers a child to another couple. When you find yourself thinking about surrogacy, it is crucial that you are aware that it can be an emotionally-charged experience.

How to choose a surrogacy agency

  • Screening Process

Good surrogacy agencies carry out screening to learn about the personal and medical backgrounds of both parties. Medical screening involves ascertaining the presence of sexually transmitted diseases that can be transferred from the surrogate to the child and other health issues that can reduce the likelihood of a healthy pregnancy. Screening entails both medical as well as psychological screening. They also conduct criminal history and financial background investigations.

  • History and Reputation

Many surrogacy agencies come and go, so it is important that you find one that is reputable. You do not want to trust just anyone for a process like this one. Ensure that your agency has been around for a significant amount of time and is capable of offering successful surrogacy arrangements.

  • Legal knowledge

They are kept abreast with surrogacy laws and medical standards, a great deal of which change from time to time and differ from one state to another. Legal counsel from a resident or referred lawyer is also readily available when you make surrogacy arrangements through a good agency.

  • Provides Support

Surrogacy is associated with a number of medical, financial, emotional and legal concerns. At a good surrogacy agency, you are sure that you are going to have a team of professionals that will guide and support you at every stage of the surrogacy agreement.  

  • Total Cost and Fees

Request them for a full estimate of the total cost associated with the surrogacy process. It is important to compare them with other agencies. In addition, compare the level of service they offer within a particular price range.

How surrogacy works

Most couples use an agency to manage a surrogacy. These institutions basically serve as go-betweens, assisting intended parents to look for a suitable surrogate, make required arrangements, and collect fees, particularly compensation for medical expenses, for the surrogate. These agencies also conduct screening on possible surrogates.

Questions to ask your surrogacy agency

If you decide to choose surrogacy as a path to having a baby it is important the relationship between both parties be protected. This is accomplished by selecting an agency that is not strictly a matching service. 

It is critical to ask these following questions to the surrogacy agency:

    • How long the agency has been in surrogacy business
    • Their screening process for surrogacy
    • The cost of the services
    • The fertility specialists and clinics they team up with
    • If they have any legal advisors

Surrogacy provides a viable solution for couples who wish to have a child of their own. You may be wondering where to find a good surrogacy agency. Pons Medical is a leading surrogacy agency in Georgia.

Folic acid for pregnant women

 Folic acid for pregnant women

Folic acid helps prevent defects of neural tube, which affect the brain (anencephaly) and spinal cord (spina bifida), also it affect the baby’s heart. Neutral tube defects can develop at the first 28 days after conception. Most of the time, the woman doesn’t even know that she is pregnant. More than half of all pregnancies in the world are unplanned, the World Health Organization recommends to take 400 mcg (0,4 mg) of folic acid daily, starting before conception (if you are planning the pregnancy – 1 month before is better) and until the first 12 weeks of pregnancy. If the woman has already a child with neural tube defects, she should ask her doctor for a larger dose. Taking folic acid may even lower your risk of preeclampsia. Also, our body needs this nutrient to make normal red blood cells and prevent types of anemia.

Where to get folic acid from?

The best way is to get the Folic Acid from the supplement with the right amount. Also, you can find it in green leafy vegetables, nuts, beans, citrus fruits and other.  But! Your organism absorbs the synthetic version of folic acid better than the natural one from food. So even if you eat a balanced diet, a supplement is very important and recommended in 100% cases.

Iron components

Iron helps blood in both the mother and the baby to carry oxygen. It is the important component of hemoglobin (a protein that helps to transfer the oxygen to tissues), myoglobin (a protein that helps supply oxygen to your muscles), collagen (a protein of bones, cartilages and other connective tissue) and many other proteins. Also, it helps maintain a healthy immune system. If there is a deficit of this nutrient the iron-deficiency anemia can take place. Preventing iron-deficiency anemia can cut your risk of preterm delivery, low birth weight, and infant mortality.

Why do you need more iron during a pregnancy?

The amount of blood in your body increases by 20-50%. You need extra iron for more hemoglobin. Your baby needs extra iron for growth, especially in the second and third trimesters. Also, many women start their pregnancy with insufficient stores of iron in their body.The pregnant woman needs 27 mg of iron daily. Red meat, poultry, seafood, liver, grains, legumes – add good content of animal iron and plant iron in our food.

How do you can get as much iron as possible from your diet?

Always cook in a cast iron pan. Include a source of Vitamin C (orange juice, strawberries, broccoli, onion, lemon) with every meal, especially with plant iron it will increase absorbing of Iron to 6 times more. Try not to eat iron contain products with coffee and tea, soy foods and dairy products (this food contains iron inhibitors, that can decrease the absorption of iron). Also, try to eat the iron contained products on empty stomach for increased absorption. Make a space during the day between eating food with iron and with calcium.

Should you take an iron supplement?

It depends on your diet (how much iron consist food you have), season (you get less iron at cold seasons) and your medical test of blood (can show if you have the iron deficit anemia). Also, it is always good to take Multivitamin Complex with daily need amount of iron. If your analysis of food and diet is not good (you may have the low amount of hemoglobin or erythrocytes, etc), in such situations your doctor can give you extra iron.

What side effects you are prone to?

You may have constipation; it is a common problem of many pregnant women, drinking prune juice or taking other natural laxatives can help you deal with this problem. But if you have over constipation or diarrhea, nausea or other stomach problems, please consult your doctor, he will help you. And don’t worry if your stools look darker, this is because you are taking iron in your food this is a harmless side effect.

In conclusion

Pons Medical Research is a leading provider of surrogacy programs in Ukraine with expertise in ICSI fertility treatment through ICSI IVF / PICSI and using ICSI Procedure, suggests for a good prenatal dietary and nutrition plan for its clients.

You should start to take prenatal vitamins before you begin trying to get pregnant, if possible. Folic acid is one of the main prenatal vitamins for your baby. Iron will help you to have a good health during the pregnancy. Don’t forget to take your vitamins daily and have a healthy good and balanced diet. Pons Medical Research wishes you a healthy pregnancy, full of great emotions and good useful vitamins!

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