Whether you are an egg donor or altruistic surrogate, the process requires engagement with a Victorian fertility clinic, health and legal checks, counselling and various medical procedures.
A note on language: altruistic surrogacy and egg donation might be needed by a lesbian couple or single woman, as well as by a gay male couple or single man. The latter is much more likely, therefore our language reflects this scenario, but the process is similar regardless of who the commissioning parent/s may be. If they are a lesbian couple or single woman, however, or if the gay male couple or single man has compromised fertility themselves, they might also require a sperm donor. Fertility clinics have clinic-recruited sperm donors available, or the prospective parent/s might ask someone they know.
Using a fertility service
Conceiving a child through altruistic surrogacy and egg donation requires the services of a fertility clinic. Victorian law requires everyone involved in the arrangement (including partners) to have sought legal advice, and to go through a number of procedures (the clinic will assist you with these):
- a police check, to ensure neither of you has ever been convicted of a violent offence or charges have been proven against either party in relation to a sexual offence
- a child protection order check, to ensure neither of you has had a child removed from your care, and
- clinic counselling, to ensure you both understand the implications of donor conception and consent to the procedures involved.
An overseas police check is required if either party has resided overseas for a consecutive 12 month period in the past 10 years. There is a presumption against treatment for anyone who does not pass the police and child protection checks and treatment must not be provided. If barred, you can appeal to the Patient Review Panel, and subsequently to the Victorian Civil and Administrative Tribunal (VCAT).
Egg donors must undergo a number of health screens, see a medical specialist and fill in a questionnaire about their medical and family history. If there is an indication of a family genetic condition, the clinic will discuss the implications of this with you and the prospective father/s for your role as a donor. The prospective surrogate and biological father will also undergo standard health checks, including for HIV.
What is actually involved
The medical procedures for the egg donor are lengthy and invasive. They are essentially the first half of an IVF procedure, usually beginning with ‘down-regulation’ (taking the birth control pill for some weeks) and hormonal hyperstimulation of your ovaries to produce the maximum safe number of eggs. There are some risks involved with hyperstimulation which the clinic will inform you about. Blood tests and vaginal ultrasounds will determine when eggs should be collected from your ovaries. This involves a day hospital procedure, using a light sedation or general anaesthetic. The procedure takes 20 minutes, but you might need to rest for the following 24 to 48 hours.
While the eggs are developing in the donor’s ovaries, the surrogate’s menstrual cycle will usually be medically managed to synchronise with the egg collection process. If you are the surrogate, you will take oestrogen and progesterone to prepare the lining of your uterus for a possible embryo transfer.
When the donor’s eggs are collected, they are fertilised with frozen, screened sperm from the prospective biological father. One or more eggs may be successfully fertilised, and go on to develop into an embryo that can be transferred into the surrogate’s uterus. This is a short procedure, akin to a pap test, that does not usually require any anaesthetic. Any additional embryos can be frozen for subsequent transfers, if needed.
Awaiting the results of the pregnancy test two weeks later can be nerve-wracking for everyone, and if no eggs from the first donation lead to a successful pregnancy and birth, you might all need to go through this multiple times.
If conception is successful
The processes of attempting conception, pregnancy and birth are amazing for everyone involved, but also potentially exhausting and stressful. The relationships between the prospective father/s, the egg donor (and her partner if she has one) and surrogate (and her partner if she has one) will determine the extent to which you all have contact and give support to each other during these processes.
The prospective parent/s and surrogate (and the egg donor, if she is to have any ongoing contact with the family) will need to talk openly, perhaps many times, about their hopes for the birth and early infancy. What sort of birth does the surrogate want to have? What professional and other supports will she need at this time? Is she willing for you to play a role, and if so what? Would she be willing to breastfeed, at least during the period when her body is producing colostrum? Is this what the parent/s would want? When and how will the parent’s take home the baby, and what sort of contact might the surrogate or egg donor have with the new family in the early days?