Is Amniocentesis Required for Surrogacy?

For surrogacy, the surrogate mother does not need to undergo amniocentesis. After the surrogate mother has undergone the implantation of embryos that have passed PGS (now known as PGT-A) genetic screening, a Non-Invasive Prenatal Test (NIPT) is conducted between weeks 9 to 13 of pregnancy. NIPT checks for abnormal chromosome numbers in the baby and can detect conditions such as Down syndrome, Edwards syndrome, Patau syndrome, and others, with an accuracy of 97% to 99%. NIPT is performed by extracting blood from the surrogate mother and does not carry the risk of miscarriage or preterm labor associated with amniocentesis.

However, in the context of in vitro fertilization (IVF), the age and health condition of the pregnant individual need to be considered. If the individual is older or has other conditions that may hinder pregnancy, the risk of complications during pregnancy might be higher. Therefore, when choosing a surrogate mother for the IVF process, it is advisable to select a woman of suitable age, good health, and with a history of successful pregnancies.

At RSMC (Reproductive Sciences Medical Center), surrogate mothers undergo rigorous screening and are aged between 21 and 37 years old, having previously given birth to at least one child. They also undergo multiple tests. Before embryo implantation, PGT-A is conducted to screen for chromosomal abnormalities in embryos and to reduce the risk of miscarriage. If there are concerns about embryo health, RSMC offers comprehensive prenatal testing to minimize all possible risks, including early pregnancy blood tests, NIPT, NT ultrasound, quadruple marker screening, and fetal echocardiograms. RSMC has a professional legal team to assist in matching surrogate mothers and is the only physician-managed surrogacy agency in the United States. The surrogate mother database is thorough and complete, and candidates undergo strict medical tests, criminal background checks, financial background checks, and psychological assessments, passing through seven rounds of stringent screening. The acceptance rate is only 7.5%, ensuring a rigorous safeguarding of the child's future.

Further reading: Introduction to the Precise Examinations Required for Surrogate Maternity Check-ups

Amniocentesis: Appropriate Candidates and Populations

Amniocentesis is a procedure that can help pregnant women determine if their fetus has chromosomal abnormalities or other congenital conditions, particularly Down syndrome. Amniocentesis is typically performed between weeks 16 and 20 of pregnancy. It involves extracting amniotic fluid from the pregnant woman's abdomen and analyzing fetal cells within the fluid. This procedure provides information about the fetus's chromosomes, genes, and metabolites, allowing for the assessment of chromosomal abnormalities or other congenital conditions with high accuracy. Additionally, amniocentesis can be used to detect neural tube defects, blood disorders, and the fetus's blood type.

Appropriate Candidates for Amniocentesis:

1、Advanced maternal age (35 years or older): Older age increases the risk of fetal chromosomal abnormalities. Statistics show that the probability of giving birth to a child with Down syndrome is 1 in 200 for mothers aged 35 and above, compared to 1 in 1500 for mothers aged 20.

2、Pregnant individuals or their partners with a family history or genetic disorder: If either the pregnant individual or their partner has a history of chromosomal abnormalities or other congenital conditions, there is a risk of passing these conditions to the fetus. For instance, carriers of conditions like thalassemia or hemophilia might transmit these disorders to their offspring.

3、Abnormal prenatal screening results: If prenatal screening results from ultrasound or blood tests indicate a high-risk or uncertain condition, further diagnostic confirmation through amniocentesis is recommended to accurately assess the risk of chromosomal abnormalities or other congenital conditions.

4、Individuals who have experienced multiple miscarriages or have had embryos with chromosomal abnormalities.

If you meet the criteria mentioned above, such as advanced maternal age, recurrent miscarriages, a history of embryos with chromosomal abnormalities, or medical conditions that may not be suitable for pregnancy, you might consider undergoing a surrogacy IVF treatment at the RSMC (Reproductive Sciences Medical Center) in the United States. By using embryos that have undergone PGT-A genetic screening, the risk of chromosomal abnormalities due to genetics or advanced maternal age can be minimized, leading to increased pregnancy success rates and reduced miscarriage rates. This approach is suitable for women who have experienced repeated IVF failures or multiple miscarriages. Through PGS genetic screening, pregnancy success rates can exceed 80%. Therefore, if considering surrogacy, we would advise clients to first collect embryos that have undergone PGS before proceeding with implantation.

If either the pregnant individual or their partner has a family history or genetic disorder, such as carrying genes for conditions like thalassemia or hemophilia, PGD (Preimplantation Genetic Diagnosis) may be necessary. PGD allows for targeted screening and diagnosis of embryos that carry specific genetic mutations. This enables the selection and implantation of embryos without the genetic mutations, thereby preventing the transmission of inherited genetic disorders to the baby.

Further reading: What is PGS Testing? How does it increase the success rate of IVF?

Amniocentesis Risks and Potential Effects on the Fetus

Before deciding whether to undergo amniocentesis, pregnant women should have a detailed discussion with their doctor about its necessity and risks, and make a decision based on their own circumstances and preferences. Although amniocentesis is a prenatal test carried out with the future health of the child in mind, it is still an invasive procedure. Despite its low risk, it can potentially lead to the following adverse outcomes:

1. Amniotic fluid leakage or infection: Since the needle penetrates the amniotic sac, it may cause amniotic fluid leakage or introduce bacteria. This could result in reduced amniotic fluid levels or fever. If this occurs, prompt medical attention and treatment are necessary.

2. Fetal injury or bleeding: The needle may come into contact with the fetus's body parts such as the umbilical cord, limbs, or organs, potentially causing injury or bleeding. This could impact the fetus's development or survival. In such cases, close monitoring of fetal movements and heartbeat is required.

3. Miscarriage or preterm labor: Amniocentesis could trigger uterine contractions or premature rupture of membranes, leading to miscarriage or preterm labor. This is the most serious and concerning outcome. Immediate medical intervention is necessary if this occurs.

4. Placental abruption or abnormal implantation: Amniocentesis may affect placental function, potentially causing placental abruption or abnormal implantation. This could lead to bleeding, oxygen deprivation, stillbirth, and other complications. Timely medical care is essential in such situations.

According to statistics, the miscarriage rate associated with amniocentesis is approximately 0.5% to 1%, meaning that out of every 100 pregnant women undergoing amniocentesis, 0.5 to 1 may experience a miscarriage as a result. The occurrence rates of other adverse effects are even lower. Therefore, prior to undergoing amniocentesis, it is advisable for pregnant women to carefully weigh the pros and cons and choose an experienced and skilled doctor to perform the procedure, in order to minimize the risks and potential adverse outcomes.

What to Pay Attention to After Amniocentesis Procedure? Here are Common Recommendations:

• Rest as much as possible within the first 24 hours after the procedure, avoiding strenuous exercise or lifting heavy objects.

• Avoid taking baths or swimming within the first 48 hours after the procedure to prevent infection.

•  Refrain from engaging in sexual activity or using tampons within the first week after the procedure to prevent bleeding or infection.

• Avoid flying or embarking on long journeys within the first month after the procedure to prevent altitude sickness or blood clot formation.

Following amniocentesis, it is important to monitor your body's condition closely. Seek immediate medical attention if you experience the following symptoms:

• Fever or chills

• Abdominal pain or abdominal swelling

• Leakage of amniotic fluid or vaginal bleeding

•  Reduced or absent fetal movements

• Uterine contractions or rupture of membranes

Remember, these recommendations are general guidelines, and it's crucial to follow any specific instructions given by your healthcare provider. If you have any concerns or experience any unusual symptoms after the procedure, it's always best to seek medical advice promptly.

How Does RSMC Ensure the Health of the Baby?

Whether you are considering surrogacy or undergoing amniocentesis during your pregnancy, careful consideration and decision-making are essential. Prior to undergoing amniocentesis, it is recommended that pregnant individuals engage in thorough communication and consultation with their doctors. After the amniocentesis procedure, it's important to follow the doctor's instructions and advice, rest and care appropriately, to facilitate recovery and prevent complications.

RSMC ensures the health of the baby through various stages, from the implantation of embryos screened through PGT-A genetic testing to five prenatal check-ups for surrogate mothers once pregnancy is established. Additionally, weekly updates from client managers provide prospective parents with the surrogate mother's prenatal reports, closely monitoring the condition of both the baby and the surrogate mother.

RSMC boasts an advisory committee of medical experts including neonatologists, maternal-fetal medicine specialists, and obstetricians-gynecologists. This committee, consisting of eight doctors with doctoral degrees and years of experience, is unique in being the only physician-managed surrogacy agency in the United States. Leveraging their collective experience and expertise, our advisory committee supports prospective parents and surrogate mothers in receiving state-of-the-art medical care. This collaboration serves to mitigate all potential risks throughout the pregnancy and childbirth process, ensuring the safety of both the surrogate mother and the baby.

For further reading: RSMC Offers Its Own Egg and Surrogate Mother Database, Immediate Matching Without Waiting!