Assessment of the Surrogate Mother
There are a lot of requirements to a woman, who wants to become a surrogate mother, however, a woman, who is either married or in a stable relationship, relatively young (usually before 35 years old), and who has at least one child of her own, which was carried and delivered without any serious complications will be considered the best candidate. In addition, this woman is not to be either drug or alcohol addicted, she is not to smoke, and her health history should be without any serious medical disorders, like diabetes, or Rhesus antibodies, which can jeopardize the health of the fetus.
In order to make sure that a woman, who wants to become a surrogate mother meets all the criteria, mentioned above, her medical history is looked through, different physical and internal examinations are performed, and the uterus of a potential surrogate mother is evaluated either with the help of an ultrasound or hysteroscopy. Moreover, a psychological evaluation is also needed to be carried out.
Ultrasound scan
During the ultrasound investigation conducting, high frequency ultrasound waves help to examine the cervix, uterus, ovaries as well as the Fallopian tubes. These waves’ reflection produces an image on a screen, which is similar to an X – ray procedure, however, there is one advantage of the ultrasound investigation over the X – ray – it is completely harmless. As a rule this investigation does not take more than 15 minutes. Moreover, it is routinely performed as an outpatient procedure. It is applied as a kind of a diagnostic procedure to access practically all organs, which are situated in the pelvic area and it helps to detect any kind of abnormality in the womb, like a polyp, malformation, a forgotten coil, which was used as the method of contraception, etc.; such abnormalities in the Fallopian tubes, as hydrosalpinx, which means the presence of water in the tubes, and different kinds of abnormal ovarian development, like polycystic ovaries, etc.
Ultrasound is also applied with the aim to monitor treatments, like insemination and In Vitro Fertilization, as with the help of ultrasound, it is possible to evaluate the development of the follicles and measure the thickness of the endometrium.
In addition, ultrasound is also applied as the method of choice to diagnose pregnancy and to detect multiple pregnancy on the earliest terms.
The pelvic organs can be examined in two ways: it is either possible by passing the probe over the abdomen (this procedure is called the abdominal scan), by inserting the probe into the vagina in a gentle way (this kind of ultlrasound procedure is called the vaginal scan). In order the best results would be obtained, the abdominal scan procedure requires a full bladder, which provides the bowels to be pushed away from the ovaries, and at the same time it is a good transmitter for the ultrasound waves. However, the vaginal ultrasound scan is considered to give more accurate picture of the organs, situated in the pelvic area than the abdominal scan, because of the shorter distance for the sound waves to travel. There is one more advantage of the vaginal ultrasound – the full bladder is not the necessary condition for the vaginal ultrasound analysis, this way the woman feels more comfortable.
Hysteroscopy
There exist two types of hysteroscopy procedure: a diagnostic hysteroscopy and an operative hysteroscopy. In both kinds a hysteroscope (an optic device, made of fibre, which looks like telescope) is applied. Any kind of a hysteroscopy is conducted with the aim to observe the interior of the uterus.
Diagnostic hysteroscopy
Diagnostic hysteroscopy is considered to be quite a simple procedure, which is applied with the aim to look into the inside of the uterus and detect any possible abnormality in it, such as: a polyp, adhesions, fibroids as well as uterine septum (a piece of tissue, which divides the cavity of the uterus). This kind of analysis can be performed as an outpatient procedure. As a rule no anesthetic is used, however, sometimes it is possible to make an injection of a local anesthetic into the neck of the womb. The very procedure consists of an insertion of a speculum into the vagina in order to see the cervix, then a fine (it is of about the same thickness as a pencil) optic telescope, which is made of a fibre, is inserted into the uterus through the cervix. In order to have a good and clear view of the uterine cavity, either carbon dioxide gas or fluid is applied in order to distend it.
Operative hysteroscopy
The procedure of operative hysteroscopy is quite alike the one of the diagnostic hysteroscopy, except that there is some kind of an operating instrument, like a pair of fine scissors or biopsy forceps is placed into the uterine cavity through a special channel in the operative hysteroscope.
In case if any kind of abnormality, such as septum or adhesions, etc was found during the diagnostic hysteroscopy procedure, it can be removed with the help of an operate hysteroscopy. However, it should be previously discussed and agreed with the patient. This kind of an operation may either be conducted after some while (usually in case if a woman was not aware of her diagnosis), or at the same time (if he diagnosis needed confirmation). However, operative hysteroscopy is a procedure, which is only conducted under a general anesthetic
Most women undergo either type of hysteroscopy procedure without any complications; however, to some possible complications belong the following ones: infection, making a hole through the uterus, some internal organs injury, bleeding. It is quite possible, that a patient experiences some kind of discomfort after the hysteroscopy procedure was conducted; sometimes cramps and vaginal staining for several days are possible.
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