The confirmation of a failed embryo transfer can feel devastating. After weeks, sometimes months, of contracts, medications, and monitoring, a negative pregnancy test result often leaves both intended parents and surrogates feeling confused, angry and even a bit hopeless. The good news is that a negative pregnancy test now does NOT mean there won’t be a positive test in your future. While we often won’t have an exact reason as to why your transfer failed, here’s a look at a few common culprits.

Egg and Embryo Quality
Sometimes eggs and embryos that look great on transfer day fail to divide and multiply properly once inside the surrogate’s uterus. Most IVF doctors use an Embryo grading system based on factors such as symmetrical cell structure, large inner cell mass, and evidence of as few fractions as possible in the cells to determine the quality of the embryo. However, even embryos with a high grading may fail to result in a positive pregnancy test. Occasionally genetic defects in the developing embryo are also believed to play a part in a failed transfer.

Sperm Quality
Occasionally a sperm head can contain abnormal DNA. If the sperm used to fertilize the egg does not have competent DNA, the embryo may fail to divide properly leading to a negative pregnancy result. Factors known to have an impact on sperm quality include exposure to chemicals and tobacco use.

The Uterine Lining
A thin endometrium (uterine) lining is a leading cause for failed transfer in all IVF transfers. The surrogate will be monitored closely in the weeks preceding transfer in order to ensure that her lining is thickening nicely. In most cases medication protocol can be altered to try and thicken the lining. If an optimum lining cannot be reached the transfer may be cancelled, or potentially unsuccessful if completed.

In most cases the exact cause for a failed transfer will remain unclear. However, the success rates of second transfers are generally much higher than those of first transfers. Your doctor will work with you and your surrogate to make the changes that are most likely to result in a positive pregnancy on your next cycle. Call us here at Shared Conception, we are adept in handling this phase in the pursuit of building your family.

While some parents will openly seek and try to achieve a multiple pregnancy, the news that your surrogate has been confirmed with more than one fetus can come as a surprise. In the rare instance that your surrogate becomes pregnant with triplets or other high order multiples the news can be immensely overwhelming. Whether achieved intentionally or not, the news of a multiple pregnancy can be equal parts exciting and terrifying.

Typically when a multiple pregnancy is confirmed, Shared Conception will reach out to both you and your surrogate to offer educational and emotional support. Keep in mind that she is likely dealing with many emotions of her own centering around the realization that her body is carrying multiple fetuses and how that will impact her life and that of her family.

From time to time it may be important to schedule a consultation with a high risk pregnancy physician. Our surrogacy agency is happy to refer you to someone for this consultation. This person will be able to help you sort through the potential risks of continuing a multiple pregnancy and whether or not a reduction is something you should consider.

In the event that a reduction is needed or desired, Shared Conception will walk you through what will happen and when. Our agencywill also be responsible for speaking with your surrogate about the procedure and ensuring that she has everything she needs in order to navigate the weeks ahead.

Shared Conception understands the wide range of emotions that come with that first ultrasound and are always ready to help you. Our surrogacy agency  has a wealth of information and support is available to you at all times.

The options of starting a family through surrogacy are peaking. Demand and competition are driving the clinical costs down, and it’s more affordable for couples who want their own biological child or who want to raise a newborn through the gift of surrogacy and egg donation.

The giver of the gift of surrogacy and the people who are accepting it have needs and expectations of how the relationship should develop. If a comprehensive plan hasn’t been made, then complications can arise.

Let’s start by giving a hypothetical situation.  Mr. and Mrs. Smith need the help of a surrogate.  They accept the offer from a friend, Mary.   They feel comfortable with this friendship and trust that this woman will take care of herself during the pregnancy.  Mary asks for a certain amount of money to cover costs during pregnancy, and the Smiths agree.  In the back of their mind, Mary is being “paid” to carry their baby.

Mary gets pregnant via in vitro fertilization (IVF) and is now carrying twins for the Smiths.  The Smiths call her every day to see how she is. They ask if they can do anything. They want to attend all the appointments.  They ask the OB if Mary’s working, eating, sleeping and sexual activities are OK for their babies.

Mary feels overwhelmed and micromanaged.  After all, she has given birth before, and she knows what she is doing.  Resentment sets in. Soon she is avoiding phone calls and gritting her teeth through appointments, and her husband is wondering what in the world they got themselves into!  The Smiths feel her pulling away and become worried and start to mistrust her actions.  They have a right to ask these questions.  After all, they are “paying” her, and she is carrying their children.  The rest of the pregnancy is filled with stress on both sides, as Mary now can’t wait to give birth and get these people off her back.

The babies are born healthy and strong, and the Smiths take them home.  Now Mary hardly EVER hears from them. It may be months before she even sees them, and they used to be close friends.  She feels used and left behind, forgetting how she felt during the pregnancy.  Regret sets in.

As for the Smiths, they are coping with two new lives!  They are not getting the sleep they used to and bills from the surrogacy and new babies are piling up.  Their lives have been turned upside down, and they can barely get time alone with each other let alone make calls to Mary.

Discussing Expectations Can you see what happened?  No one really discussed expectations. The before, during and after pregnancy relationship needs were not met, and therefore, a bad taste has been left behind where the beauty of families working together to bring a much-wanted child into the world should have been.

Before anyone makes the choice of surrogacy, certain aspects need to be thoroughly thought out and discussed. Here is a short list:

*     Should a family member be asked to be a surrogate?
*     Would a friend be a good choice? (If the answer is yes in either of these categories, then there is a separate         list of concerns to think about.)
*     What race, religion and marital status would you like a surrogate to be?
*    What is the working status preference of a surrogate?
*     What do you envision your role in the pregnancy?
*     What are your expectations as to the amount of contact with the surrogate during and after the pregnancy?
*     What are the financial expectations, and how will that be handled?

These questions are just the tip of the iceberg, but they open up a dialog and can make a huge difference in a surrogate relationship.

Having someone to mediate is also helpful.  A successful surrogate arrangement can be done independently, but having a third party assist you with relationship management can be invaluable.  Having a third party to handle the escrow account can be a great relief on both the intended parents and surrogate.  Mixing the topics of money and babies is a sticky situation at best and should be avoided – if possible – in order to concentrate on the pregnancy and the surrogacy relationship.  A well-managed escrow account can also make all the difference.

Contact Shared Conception for information on having someone assist you in the surrogacy process. We are happy to help.

If you are a woman who wants to be a gestational carrier or traditional surrogate independently, without the help of an agency, then you need to really consider what you are getting yourself into.

Surrogacy is a life changing endeavor and as great as it sounds in theory, in practice it’s a huge undertaking. Looking into ‘independent’ surrogacy situations is most common among those who are finding it difficult to raise the full amount of funds needed and therefore will consider cutting corners. Women who are compelled to help couples and individuals sometimes find themselves compromising their beliefs out of the goodness of their hearts. Below are 14 common mistakes to avoid. Its so important to be true to own ideals…that is one of the best gifts you can give to your Intended Parent(s) and to yourself!

Giving out personal information, especially before a contract is signed, such as social security numbers and release of medical information to anyone but the attorney, psychologist or clinic.

Not having a face to face meeting before any contracts are signed.

Not having your own legal representation when reviewing your surrogacy contract.

Being ‘talked into’ agreeing to issues that are fundamentally against your personal ethics/religion or life style i.e. abortion, selective reduction, working with IP’s that you don’t feel comfortable with, etc.

Not insisting that all compensation, per the contract, be deposited into an escrow account before the first transfer.

Agreeing to at home inseminations (IUI)

Going without term Life Insurance of at least $250,000 (or any insurance policy for that matter).

Cutting out benefits such as lost wages, maternity clothing allowance, c-section reimbursements and child care, etc. because you don’t think you will ever need them.

Thinking that it’s OK to use federal or state funded medical insurance for a surrogate pregnancy.

Thinking that the surrogacy process will be fast and easy.

Excerpts from Sharon Lamothe

Nausea, or morning sickness, in pregnancy is incredibly common, and is generally a good sign that the pregnancy is healthy. However, this fact does little to help ease the discomfort throughout the day, or when you, the surrogate, is bent over the toilet! With surrogacy, there are certain factors that can increase the intensity and duration of the nausea, such as:

Medications – While the exact reason behind nausea during pregnancy is not known, many believe it has to do with increasing hormone levels. Since surrogates use hormones, such as estrogen and progesterone, to help create an environment ideal for a pregnancy to occur, this can also increase the chances they’ll have nausea. Since surrogates generally take these medication at least until 10-12 weeks (average) of pregnancy, this means they might have nausea earlier, and longer, than during one of their own pregnancies.

Multiples – Anytime a woman undergoes IVF procedures, there is a higher chance for multiples to occur. Twin, triplet, and higher order multiple pregnancies usually cause women to experience higher levels of nausea, and for a longer period of time. Of course, the usual (potential) causes for nausea also apply during a surrogate pregnancy, and can include: low blood sugar, emotional stress and/or fatigue, traveling, and some foods. While there is no sure-fire way to prevent nausea during pregnancy, there are a few ways to naturally mitigate the effects. What may work for one woman may not work for another, so a bit of trial and error is sometimes needed to find what will help.

Here are a few of our tried and true all natural nausea remedies:

Ginger Products – These have proven effective against morning sickness, and generally include: ginger ale, ginger candy, ginger tea, or even simply inhaling the scent of fresh ginger.

Protein and Complex Carbs – Peanut butter on apple slices, or celery sticks; nuts (unsalted); cheese; crackers; milk; cottage cheese; and yogurt.

Snack – Eat every 1-2 hours throughout the day, small portions, and drink plenty of fluids between meals. Also, have a small snack at bedtime, and if you get up to go to the bathroom in

Plain, and/or dry foods – Eat some soda crackers before you get out of bed, and allow some time for digestion. Also, try eating white rice, dry toast, broth, saltines, or a plain baked potato inlieu of adding anything richer or creamier to your meal.

Hard Candy – Suck on hard candy, such as Preggie Pops (or a similar brand), ginger candy, ormints. Some people respond better to “hot” items, like the sensation provided by ginger, while others respond better to the “cold”, like with mints.

Vitamin B6 – If you’d rather take a B6 supplement, consult your doctor or midwife beforehand to make sure it’s right for you. However, there are foods rich in B6 that may help ease nausea, and a few are: poultry, sweet potatoes & potatoes (with skin), sunflower seeds, spinach, bananas, avocado, and garbanzo beans/chickpeas.

Acupressure – There are acupressure wristbands that are generally used for motion sickness, but have also been found to help with morning sickness.

Ventilation – Keep rooms well ventilated, or have a small fan nearby for easier breathing. This

can also help reduce common smells in your home or work that contribute to your nausea.

Aromatherapy – Some have found that fresh, citrus scents help, such lemon, lime, or orange,

as well as peppermint, spearmint, or ginger. Essential oils in a diffuser are a great resource

Acupuncture – If you would like to try acupuncture as a method of reducing your nausea,

consult your doctor or midwife beforehand, and look for an acupuncturist who is trained to work

Prenatal Vitamins – Try taking your prenatal vitamins at night, and check with your doctor or midwife about the iron levels in the vitamins you are currently taking. Switching to a vitamin that is lower in iron may help reduce nausea.

Rest – Listen to your body, and get plenty of rest. Some women have the reaction of becoming nauseous if they do not get enough sleep.

Things you can avoid to potentially help with reducing nausea

• Avoid the foods or smells that make you nauseous. At times this is easier said than done, but it can help if you take a route through the mall to avoid the food court, refrain from cooking certain meals, or asking your spouse/partner to avoid a particular cologne or perfume until

• Avoid secondhand smoke. This is good advice for pregnancy in general, and can also help

• Avoid taking medications for morning sickness, unless specifically instructed by your doctor Nothing is working! What should I do? For some, nothing you can change or do, will help with the nausea, and you may want to consult your doctor or midwife if absolutely nothing is yielding results. That being said, sometimes there truly is nothing that can be done, but to remember that for most women. While nausea is certainly not an enjoyable part of pregnancy, for most it will pass with the first trimester, or early into the second. Hopefully something on the list above will help you through these weeks, and congratulations to you and the intend parents on the pregnancy!

Placenta Encapsulation Specialists encapsulate women’s placentas for them so they can consume it after giving birth. When carefully and properly prepared for consumption, the placenta can nourish the postpartum mother just as it did for the baby in your womb. Through training, these specialists prepare and dehydrate the placenta, grind it up and put it in little vitamin like capsules so that mom can then take the capsules and get all the wonderful postpartum benefits.

This method is known as Placentophagy. Encapsulation is a great “middle ground” for those that want to have the healing benefits of consuming their placenta without actually having to eat it outright. You can hire a trained professional to come to your home to do the encapsulation process there or, depending on what state you live in, some will provide the services in their own personal sterile kitchens. When the encapsulation specialist hands you the capsules two days after the birth, you would have no idea there was placenta inside.

Some of the benefits of placenta encapsulation include:
• Faster postpartum recovery
• Less likely to have “baby blues” and can help ease symptoms of postpartum depression
• Increase to your breast milk supply (if you plan pump for your intended parents or donate it)
• Gives you a boost of energy
• Lessens the feeling of fatigue
• Hormonal balancing

Placenta encapsulation and surrogacy
How can you benefit from placenta encapsulation as a surrogate? All of the hormones that are in the placenta are your very own hormones even if the DNA of the baby you are carrying does not match your own. Giving birth is still giving birth, so as a surrogate you still have to go through these natural hormonal fluctuations. Typically, as a surrogate you get to rest more than a woman that also has to care for a newborn baby immediately after giving birth and that certainly does help with your recovery. However, placenta encapsulation can help you bounce back even quicker with a smoother transition back into your pre-pregnancy life.

All of the oxytocin in the encapsulated placenta will help ease any sad feelings and make the emotional transition a bit smoother for her. In addition, many surrogates provide breast milk to the intended parents for a certain amount of time after the birth. In some cases, the surrogate will provide breast milk for a long and extended period of time. When exclusively using a breast pump to express breast milk, it can be difficult to stimulate the breast enough to produce an adequate amount of milk both in a timely manner initially after the birth, as well as, for an extended period of time after that. This is because the breast pump isn’t as effective at stimulating and expressing milk as baby suckling at the breast is.

Typically, when taking the placenta capsules within two days of giving birth your milk supply will not only come in sooner but you will also have a larger supply one your milk comes in. This can make your breast milk pumping relationship with your pump much easier on you. You might even be willing to supply breast milk for a longer period of time because you will be expressing a larger milk quantity for each pumping session.

Accessibility to a Placenta Encapsulation Specialist and the rates for encapsulation services will vary based on where you live.

DISCLAIMER: The information on this page has not been evaluated by the Food and Drug Administration. The services offered by any Placenta Encapsulation Specialists are not clinical, pharmaceutical, or intended to diagnose or treat any condition. Families who choose to utilize the services on this page take full responsibility of their own health and for researching and using the remedies discussed above.