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At least 19 recordsLinked to original sources
PubMed1992

Characteristics of participants in a gestational carrier program.

Genetic parents and gestational carriers in our gestational carrier program were evaluated by psychodiagnostic interview and by the Minnesota Multiphasic Personality Interview-2 (MMPI-2), a widely used objective psychological test, to identify psychopathology and describe personality characteristics. Overall, participants exhibited no overt psychopathology. Personality differences were found between gestational carriers and genetic mothers and genetic fathers and mothers. Clinical interviews revealed that gestational carriers tended to be the dominant partner in the relationship, were motivated by a wish to help an infertile couple, enjoyed being pregnant, showed narcissistic needs, and expressed a wish for secondary financial gain. The majority of gestational carriers stated that they had considered becoming a traditional surrogate but felt they could not surrender a child that was genetically theirs. These results indicate that there is not any predisposing psychopathology which attracts participants to the gestational carrier program.

Adult↗
PubMed1998

Gestational carrier pregnancy.

OBJECTIVE: To evaluate the results of a gestational carrier program in terms of pregnancy rates in fresh and cryopreserved cycles. DESIGN: Retrospective analysis. SETTING: Private IVF program. PATIENT(S): Women with uterine or medical reasons for unsuccessful gestation. INTERVENTION(S): In vitro fertilization of oocytes with fresh or cryopreserved ET to gestational carriers. MAIN OUTCOME MEASURE(S): Pregnancy rates and deliveries. RESULT(S): A PR of 56.3% and a cycle rate of 30.8% was achieved in each patient <40 years of age in 117 cycles of fresh or cryopreserved ET. There were no pregnancies for nine patients >40 years of age in 27 cycles. CONCLUSION(S): Carrier gestation offers a satisfactory solution to childlessness caused by uterine or major medical factors.

Adult↗
PubMed2005

Obstetrical complications in gestational carrier pregnancies.

OBJECTIVE: To report two cases of severe obstetrical complications in gestational carrier pregnancies and to review our clinical experience and compare our results with those reported in the literature. DESIGN: Retrospective analysis. SETTING: A university IVF program. PATIENT(S): Women without a functioning uterus or those whose pregnancy would exacerbate a medical condition were enrolled in the gestational carrier pregnancy program. INTERVENTION(S): IVF cycles using oocytes from genetic mothers (or oocyte donors) were performed, with ET to gestational carriers. MAIN OUTCOME MEASURE(S): Clinical pregnancy rates, obstetrical complications, and neonatal outcomes. RESULT(S): Ten couples underwent a total of 13 cycles using gestational carriers. A clinical pregnancy rate of 69% (9/13) was achieved. An intrapartum hysterectomy and a late puerperal hysterectomy were required because of severe obstetrical complications. The late puerperal hysterectomy was performed for placenta accreta in a triplet gestation. This carrier sustained multiple cerebral infarcts and blindness. One triplet infant died secondary to a hypoplastic left ventricle and complications of prematurity. A second gestational carrier with a singleton gestation underwent a hysterectomy for a uterine rupture, and the infant has cerebral palsy. CONCLUSION(S): The past medical and obstetrical histories of potential gestational carriers must be closely scrutinized, and candidates must be thoroughly counseled about the potential risks involved in the procedure.

Female↗
PubMedDate not supplied

Gestational carrier is an optimal method for pregnancy in patients with vaginal agenesis (Rokitansky syndrome).

OBJECTIVE: To evaluate the results of successful pregnancy for patients with Mayer-Rokitansky-Kuster-Hauser syndrome using a gestational carrier. METHODS: All gestational carrier patients who attended our infertility clinic between 1995 and 2002 were reviewed for this study. Of the patients, 6 women with MRKH syndrome had 12 ovarian stimulation cycles, which resulted in 12 fresh and 5 frozen embryo transfers into six gestational carriers. RESULTS: The mean number (+/-SD) of embryos obtained per cycle was 4.8 (+/-2.9). Either two (n = 15) or three (n = 2) embryos were transferred to the gestational carrier. Three pregnancies were achieved following fresh embryo transfer, which included one clinical pregnancy that ended in spontaneous abortion, a singleton, and a set of twins. The pregnancy rate for fresh embryo transfer was 25% per retrieval and 50% per patient. No pregnancy was achieved following frozen embryo transfer. CONCLUSION: Gestational carrier is shown to be an effective treatment for patients with Mayer-Rokitansky-Kuster-Hauser syndrome.

Adult↗
PubMed2006

Use of a gestational carrier for a patient with recurrent adverse pregnancy outcomes from early onset severe pre-eclampsia.

OBJECTIVE: To describe the first reported case of gestational carrier treatment to prevent severe early onset pre-eclampsia. DESIGN: Case report. SETTING: A university-based reproductive endocrinology and infertility clinic and a tertiary care hospital. PATIENT(S): A 29-year-old woman and her husband with three consecutive pregnancies complicated by early onset severe pre-eclampsia causing fetal demises at 22 and 24 weeks gestation; a neonatal death at 25 weeks gestation; and life-threatening maternal hemolysis, elevated liver enzymes, and low platelets. INTERVENTION(S): An IVF procedure in the patient using her husband's sperm with the transfer of two embryos to a friend who offered to be a gestational carrier. MAIN OUTCOME MEASURE(S): Successful IVF cycle in the patient and uncomplicated pregnancy and delivery in the gestational carrier. RESULT(S): The gestational carrier achieved a pregnancy and progressed without complications to delivery of a healthy, 3.2-kg infant at 39 weeks gestation. CONCLUSION(S): The use of a gestational carrier deserves consideration as a treatment option in patients with poor reproductive histories because of early onset severe pre-eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. This experience also suggests that development of pre-eclampsia may be in large part maternally rather than embryologically or paternally driven.

Abortion, Habitual↗
PubMed1995

High success with gestational carriers and oocyte donors using synchronized cycles.

PURPOSE: Our purpose was to determine if exogenous hormone stimulation of the endometrium improves the implantation and pregnancy rate with a host uterus or gestational carrier. RESULTS: Nine couples underwent 14 embryo transfer cycles with a gestational carrier. The median age was 31.3 years for the infertile women donating the oocytes and 36.6 years for the gestational carriers. Eight pregnancies were achieved documented by ultrasound confirmation of cardiac activity. The pregnancy rate was 64.3%, with 1.6 cycles per patient. CONCLUSION: We show that synchronized exogenous hormone stimulation of the gestational carrier improves the success rate of embryo transfer. When the success rate is compared to a timed embryo transfer with the gestational carrier's natural cycle, from previous reported studies, exogenous hormonal stimulation appears to enhance endometrial receptivity and improve the implantation rate.

Adult↗
PubMed2006

Family members serving the gestational carrier needs of women lacking a uterus: a report of two cases.

CASE REPORT: In two instances, a designated relative served as a gestational carrier for a woman who no longer had a uterus. In the first case, a 38-year-old woman underwent an emergency cesarean hysterectomy due to worsening fatty degeneration of the liver in the third trimester, culminating in massive hemorrhage, consumptive coagulopathy and the loss of twins at 28 weeks gestation following successful in vitro fertilization. In the second case, a 28-year-old had congenital absence of the uterus and vagina. Both surrogates volunteered for service and were carefully screened medically, reproductively, and psychosocially prior to proceeding. All parties were required to execute informed consent and contracts with private attorneys before entry. Both gestational carriers conceived following the initial embryo transfer; one as the result of previously cryopreserved embryos, the other from embryos obtained following the synchronized in vitro fertilization of newly aspirated oocytes. Gestational carriers were prescribed oral estradiol and vaginal progesterone to prepare the uterus for implantation, and maintained this regimen throughout the first trimester of pregnancy. The pregnancies proceeded uneventfully and resulted in the delivery of singleton births at term. Both infants were formally adopted after delivery by the genetic parents in compliance with the advice of counsel under New York State law. CONCLUSION: Family members serving as gestational carriers provide women with functional ovaries but no uterus, the opportunity to have genetic offspring, while avoiding much of the high cost and social uncertainty of commercial surrogates.

Adult↗
PubMed2005

Gestational carrier pregnancy with oocytes obtained during surgery for stage IIIc ovarian cancer after controlled ovarian stimulation.

OBJECTIVE: To report a case of gestational carrier pregnancy with oocytes from a stage IIIc ovarian cancer patient. DESIGN: Case report. SETTING: University hospital. PATIENT: A 38-year-old woman with stage IIIc ovarian cancer. INTERVENTION(S): Controlled ovarian stimulation, cancer surgery, and IVF-ET to a gestational carrier. MAIN OUTCOME MEASURE(S): Oocyte fertilization and pregnancy. RESULT(S): Singleton term delivery occurred after transfer of three frozen-thawed embryos. CONCLUSION(S): Cryopreservation of embryos derived from IVF of oocytes obtained from ovarian cancer patients should be an option for their future fertility.

Adenocarcinoma↗
PubMed2005

Embryo cryopreservation after diagnosis of stage IIB endometrial cancer and subsequent pregnancy in a gestational carrier.

OBJECTIVE: To describe a case of embryo cryopreservation before hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer. DESIGN: Case report. SETTING: University and community service. PATIENT(S): An infertile woman with endometrial biopsy demonstrating grade II/III moderately differentiated endometrial adenocarcinoma. INTERVENTION(S): A Progestasert intrauterine device (IUD) was inserted into the uterine cavity to potentially reduce tumor proliferation during the stimulation cycle followed by oocyte retrieval and cryopreservation of 14 embryos. MAIN OUTCOME MEASURE(S): Pregnancy. RESULT(S): Successful pregnancy in a gestational carrier. CONCLUSION(S): Embryo cryopreservation and use of a gestational carrier may offer a fertility option for patients with endometrial malignancies without substantially delaying treatment.

Adenocarcinoma↗
PubMed2004

Normal infant by a gestational carrier for a phenylketonuria mother: alternative therapy.

The consequences of pregnancies in untreated phenylketonuria (PKU) mothers are a high incidence of spontaneous abortion, intrauterine growth retardation with microcephaly, congenital malformations, and abnormal intellectual development. PKU fathers, on the other hand, produce normal children. Obviously children of PKU women and men are at least heterozygous, proving that the abnormalities produced by the PKU mothers are not genetic but "intrauterinely environmental." Exposure to the mother's metabolic abnormalities affects the fetus during the entire pregnancy. A PKU mother can produce a healthy infant if she maintains a very restricted and controlled diet before and during pregnancy. However, even the most recent reports describe a very high incidence of congenitally abnormal children of PKU mothers, hence dietary compliance is not working in all cases. A 26-year-old PKU patient with proven fertility underwent standard ovarian stimulation in preparation for oocyte retrieval. Following conventional co-incubation of the oocytes and her husband's sperm, two embryos were transferred to the gestational carrier's uterine cavity, resulting in a single intrauterine pregnancy. Birth was induced at 39 weeks of gestation. The male infant weighed 3486 g. Head circumference was 36 cm and length 50.5 cm; there was no evidence of any abnormality and/or malformation. At 1 year of age, the child's growth measurements and development assessments were normal. This describes the first reported successful term pregnancy of an untreated PKU mother with the help of a gestational carrier (GC), producing a normal infant. This is an alternative method that should be offered to PKU women who are unable and/or unwilling to maintain a well controlled diet before and during pregnancy.

Complementary Therapies↗
PubMed1993

The use of surrogate gestational carriers for assisted reproductive technologies.

OBJECTIVES: We determined the effect of embryo transfer, zygote intrafallopian transfer, and frozen embryo transfer on clinical outcomes after surrogate gestational transfers. STUDY DESIGN: Prospective randomization was carried out. RESULTS: Forty-five infertile couples were matched with a gestational surrogate carrier and underwent 81 cycles of embryo transfer with various assisted reproductive technologic procedures. Nineteen cycles produced a clinical pregnancy, with delivery in 15 of 81 cycles (18.5% live-birth rate). Fifteen of the 45 couples (33%) had a child from the surrogate gestational carrier program. CONCLUSION: No significant differences in clinical outcome were observed on the basis of the type of procedure performed or the age of the patient.

Adult↗
PubMed1993

Gestational carrier--a reproductive haven for offspring of mothers with phenylketonuria (PKU): an alternative therapy for maternal PKU.

Maternal phenylketonuria, PKU, has a detrimental effect on embryogenesis. Infant pathology is independent of fetal genotype, but is directly correlated with excessive phenylalaninaemia throughout pregnancy. Although normal children have been delivered by affected mothers who either had benign hyperphenylalaninaemia or in whom strict diet has apparently maintained maternal phenylalaninaemia in the low normal range from before conception, more abnormal than normal births have been reported. In addition, attempts at dietary management are often unsuccessful; most reported cases documented various severe pathological consequences of maternal PKU. Currently available methods provide viable alternative treatment. In vitro fertilization using the parental gametes, followed by implantation of the pre-embryo in a surrogate mother, would avoid a metabolic environment impairing normal development, and therefore should be recommended as alternative therapy for potential mothers with PKU.

Female↗
PubMed1992

Genetic offspring in patients with vaginal agenesis: specific medical and legal issues.

OBJECTIVE: There are new options for genetic offspring in patients with vaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome). The reported world experience to date with genetic offspring of patients with vaginal agenesis consists of five pregnancies (including two reported here and two frozen embryos). The specifics of these cases are presented for discussion. STUDY DESIGN: We present a retrospective description of two women with vaginal agenesis and their matched gestational carriers with positive outcome of two live births. Care was delivered in a private in vitro fertilization and gamete intrafallopian transfer program. RESULTS: In vitro fertilization of oocytes gathered from the genetic mother with vaginal agenesis and sperm from the genetic father were transferred to a gestational carrier. Two live births and one blighted ovum pregnancy resulted. CONCLUSION: Until recently, treatment for patients with vaginal agenesis (Mayer-Rokitansky-Küster-Hauser syndrome) has centered on the creation of a functional vagina. The technology of in vitro fertilization and embryo transfer, allowing for collection of oocytes from the genetic mother, fertilization by the genetic father, and placement into a gestational carrier, enables a woman without a uterus to have her own genetic children. The specific medical and legal issues involved in facilitating genetic offspring in these instances must be considered; these include the initial matching of the genetic parents with the gestational carrier, cycle synchronization for in vitro fertilization and embryo transfer, anatomic difficulties of oocyte retrieval, birth certificate documentation, and the current legal status of a gestational carrier.

Adult↗
PubMed2004

Use of assisted reproductive technologies and anesthesia in a patient with primary pulmonary hypertension.

OBJECTIVE: To report the use of assisted reproductive technologies (ART) in a patient with primary pulmonary hypertension. DESIGN: Case report. SETTING: University medical center. PATIENT(S): A 28-year-old nulliparous woman with primary pulmonary hypertension (PPH) treated with continuous intravenous epoprostenol. INTERVENTION(S): Ovarian stimulation, egg retrieval, general anesthesia, and pregnancy by surrogate carrier. MAIN OUTCOME MEASURE(S): Successful ART cycle(s) in patient with PPH and successful gestational carrier pregnancy. RESULT(S): Successful pregnancy by surrogate gestational carrier. CONCLUSION(S): Assisted reproductive technologies and a surrogate gestational carrier were a successful reproductive option for a patient with primary pulmonary hypertension. Ovarian stimulation, oocyte retrieval, and general anesthesia are not without risk but were well tolerated in this case. Multidisciplinary involvement in the planning and administration of such procedures is necessary for optimal outcomes in these patients.

Adult↗
PubMed2002

Transabdominal-transperitoneal ultrasound-guided oocyte retrieval in a patient with müllerian agenesis.

OBJECTIVE: To describe the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval undertaken in a patient with müllerian agenesis and ovarian malposition who underwent a successful gestational carrier treatment cycle. DESIGN: Case report. SETTING: A tertiary-referral reproductive medicine unit. PATIENT(S): A 26-year-old patient with müllerian agenesis. Her 44-year-old mother served as the gestational carrier. INTERVENTION(S): Controlled ovarian hyperstimulation, transabdominal-transperitoneal ultrasound-guided oocyte retrieval, embryo transfer. MAIN OUTCOME MEASURE(S): Oocyte recovery rate, fertilization rate, pregnancy test. RESULT(S): Six oocytes were retrieved using a percutaneous transperitoneal needle puncture under ultrasound guidance. Two cleavage-stage embryos were transferred to the gestational carrier, resulting in a twin pregnancy. CONCLUSION(S): For various reasons, patients with müllerian agenesis may not be candidates for standard transvaginal ultrasound-guided oocyte retrieval. Although laparoscopic oocyte retrieval has been frequently used in this setting, the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval may offer further advantages in select cases.

Abdomen↗