Historically, multiple pregnancies were not uncommon with an in-vitro (IVF) cycle. The reason for this was straightforward. Due to the technology involved, for IVF to be successful, multiple embryos were often transferred at the same time increasing the chance of at least one embryo implanting in the uterine lining and resulting in a successful pregnancy. To compensate for lower rates of implantation for individual embryos and to achieve acceptable pregnancy rates, multiple embryos were transferred to each IVF patient. Consequently, IVF carried a higher chance of multiple pregnancies.
From the start, however, the goal for IVF was to produce “a” pregnancy, and not necessarily to produce twins (or more). The desired outcome has always been, and remains, healthy pregnancy and delivery, and of course a healthy baby. Over time, though, intended parents building their families through assisted reproductive technology (ART) got used to the notion of having more than one baby at a time and even sought this out. The feeling was that twins could be viewed as “getting two for the price of one,” and saving time and money to grow their family this way. With the advances in technology, this has changed dramatically, particularly in the last few years — especially when it comes to recipients of embryos formed from donated eggs. Today, transferring more than one embryo is not recommended by the Indian Law, unless there is a clear medical reason to transfer two. The primary reason for this? Multiple pregnancies and multiple births create situations that carry both risk and expense.
Facts that intended parents and gestational surrogates who are tempted to “try for twins” should be aware of:
One of the most common risks of carrying twins or triplets is premature birth. If, because of premature birth, babies require a stay in a neonatal ICU (NICU), the costs to the parents will be not only financial but also personal and emotional. Healthcare experts have estimated that medical costs for delivery and newborn care can be as much as four times greater for twins than for single babies. The amount increases to twelve times higher for triplets!
Also, keep in mind, studies show the total cost of raising multiples is likely higher than the cost of raising the same number of singletons. Everyday items needed for a child will need to be purchased all at once in multiples which may be a financial burden (rather than, of course, re-using what you already have for your baby as your family grows).
In addition to premature birth, the risks associated with multiple pregnancies include low birth weight (which can bring problems such as cerebral palsy, neural-tube defects like spina bifida, vision and hearing loss, and other developmental or neurological problems), intrauterine growth restriction, the need for Caesarean sections, pre-eclampsia, and a greater chance of gestational diabetes. While any pregnancy has risks, many risks are dramatically increased with twin births: Singleton deliveries are associated with a 9% risk of low birth weight, a 2% risk of very low birth weight, and a 14% risk of prematurity, while these same risks jump to 57%, 9%, and 65%, respectively, with twin births. The financial and emotional costs of caring for children with lifelong disabilities, if any result, may be high.
When a surrogate finds herself carrying multiple fetuses (greater than twins), often physicians will recommend a selective reduction to reduce the number of fetuses to just one or two to increase the chances of a successful, full-term pregnancy and delivery of a healthy baby. But choosing to undergo a selective reduction may be an emotionally difficult decision for both intended parents and gestational surrogates — one that can be avoided by choosing a single-embryo transfer.
Intended Parents who choose a single-embryo transfer generally get matched faster with a gestational surrogate. The fact is more and more gestational surrogates are requesting a single-embryo transfer; they are well-informed and understand the risks that come with multiples, and are often aware of the medical recommendation of ASRM for single embryo transfer (many mental health providers will discuss this in particular during the mental health evaluation).
Additionally, even if willing to carry twins, not all gestational surrogates are approved by the treating physician to carry more than one. Keep in mind that because a gestational surrogate is by definition healthy and fertile, when two embryos are transferred the result frequently is multiple pregnancies. The good news is that as implantation rates have improved, the practice of transferring multiple embryos has been reassessed, and the emphasis has shifted to a close focus on the quality of embryos, the age of the egg provider, and the recipient’s age. In the end, ART parenting is willing to work with intended parents who are set on having twins —- as long as their fertility clinic is on board, and fully understand the overall risks versus the benefits.
In Georgia (Europe), there is no specific separate law/statute regulating only assisted reproductive technologies (‘ART”) or either of its method including surrogacy. The following normative acts (some article of these acts) refer to the issues of surrogacy and ART in general:
The basic regulations concerning surrogacy and ART, in general, are outlined in Article 141, 143 and 144 of the Law of Georgia (Europe) on Healthcare, specifically:
141. “Fertilization with the donor’s sperm shall be allowed: a) due to infertility, if there is a risk of transmitting a genetic disease from the husband to the child, or for fertilization of a single woman if a written consent of the infertile couple or the single woman has been obtained. If a child is born, the infertile couple or the single woman shall be deemed as parents, with the responsibilities and authorities proceeding from this fact. The donor shall not have the right to be recognized as the father of the born child”.
The terms used in Article 141 are not quite clear, however, the wording of this article can be interpreted as allowing the use of donor sperm in the fertilization procedure (for example, insemination) provided that fertilization does not refer to in vitro fertilization with the surrogacy program. Such procedure shall be allowed both for the infertile couple and for a single woman provided that the patient signs the informed consent about such a procedure.
“143. 1. In vitro fertilization shall be allowed:
a) to treat infertility if there is a risk of transmitting a genetic disease from the wife or the husband to the child, using the gametes or embryo of the couple or a donor, if a written consent of the couple has been obtained;
b) if a woman does not have a uterus, by transferring the embryo obtained as a result of fertilization to the uterus of another woman (‘surrogate mother’) and growing it there; obtaining the written consent of the couple shall be obligatory.
2. If a child is born, the couple shall be deemed as parents, with the responsibilities and authorities proceeding from this fact; the donor or the ‘surrogate mother’ shall not have the right to be recognized as a parent of the born child”.
Article 144 of the Law of Georgia (Europe) on Healthcare refers to the allowance of the usage of frozen gametes and embryos for artificial fertilization and determines the following:
“144. It shall be possible to use male and female gametes or embryos that have been conserved by freezing for artificial fertilization. The time of conservation shall be determined according to the couples will, under the established procedure”.
As a result of the analyses of the regulations provided in the laws of Georgia (Europe), it may be concluded that In Vitro Fertilization may be performed in the following ways: In vitro fertilization with the use of the couples’ or donor’s gametes or embryos, fertilization with
the donor’s sperm, in vitro fertilization with the use of a surrogate mother and the use of frozen gametes or embryos during in vitro fertilization.
Laws of Georgia (Europe) do not determine the term “Surrogacy”. In terms of the procedure referring to surrogacy, the law of Georgia (Europe) on Healthcare (Article 143) is quite laconic and incomplete in the light of legal accuracy and only determines that In Vitro Fertilization shall be allowed if a woman does not have a uterus, by transferring the embryo obtained as a result of fertilization to the uterus of another woman (‘surrogate mother’). According to this the wording for the surrogacy to be performed, apart from obtaining the written consent of the couple (potential parents) the law requires non-existence of the potential mother’s uterus as a pre-condition for the commencement of such a procedure. This is considered as a drawback of the law in practice interpreted as requiring the medically determined health state of the potential mother thus not having the ability to impregnate and bear the child, in other words, medically evidenced need for surrogacy.
Even though the law does not directly refer to the permitted forms of surrogacy, it is interpreted as allowing gestational surrogacy (where the surrogate mother is only a gestational carrier and does not provide her oocyte for fertilization) and prohibiting traditional surrogacy (where the surrogate mother has a genetic link to the child).
As for the forms of gestational surrogacy itself, as mentioned above, the law does not make any reference to it. However, it might be interpreted in the following manner: it is allowed to perform in vitro fertilization and embryo transfer procedure with the use of either the oocyte donor or sperm donor and the gamete of one of the potential parents and to transfer the received embryo to the surrogate mother’s uterus. In this case, the child born as a result of such a procedure will have a genetic connection only with one of the parents. Besides, the law does not directly require that the child born as a result of surrogacy should have a genetic connection with at least one of the parents neither it directly states such availability. However, such a possibility may be indirectly determined under the regulations set forth by the Order of the Minister of Justice on the Establishment of the Rule on Registration of Civil Acts, adopted on January 01, 2012 (Article Article 19) (hereinafter the “Rule of Registration of Civil Acts”). Article 19 of Rule of Registration of Civil Acts determines the rule of birth registration of the child born as a result of surrogacy arrangements and determines the required documents to be submitted to the Civil Registry for the issuance of a birth certificate showing the potential parents as legal parents of the child. Specifically, Article 19 determines that in addition to the document certifying the fact of in vitro fertilization issued by the medical institution upon the embryo implantation, the following shall be submitted to the Civil Registry:
Even though the Order refers to the procedure of the birth registration, in consideration of its provisions it can be concluded that even if both the oocyte and sperm donors have been involved in the procedure of in vitro fertilization and the received the embryo has been transferred to the surrogate mother (gestational carrier), the potential parents not having the genetic link to the child shall be considered the legal parents of the child (provided that all the documents are submitted to the registry in the form and manner as required).
For the potential parents to be recorded as legal parents of the child delivered by the surrogate mother the following requirements should be met:
1. In vitro fertilization and embryo transfer to the surrogate mother’s uterus shall be performed in a clinic and the document issued by the clinic shall certify the performance of such a procedure;
2. In Vitro fertilization may be performed either with the use of:
3. Surrogacy cannot be used by a single potential parent or same-sex couple. Potential parents must be a heterosexual couple. No evidence of registered marriage or another form of relationship between the couple is required;
4. No proof of the DNA test is required; the document issued by the clinic certifying the performance of the procedure is sufficient;
5. There are no requirements established for the surrogate mother or potential parents to be eligible for the application of surrogacy (e.g. age, surrogate mother’s marital status, consent of surrogate mother’s husband, etc). The only requirement established for the use of surrogacy is the medical need for surrogacy for potential mothers. No separate evidence is required to be submitted to the Civil Registry for the registration of the birth of a child. The document issued by the clinic certifying the performance of the procedure is sufficient.
6. Potential parents are required to conclude the agreement concerning surrogacy before in vitro fertilization and certify it with the notary. Significantly, the agreement cannot be certified by the notary after the embryo is transferred to the surrogate mother’s uterus. The violation of this term will lead to the negative decision of the Civil Registry refusing potential parents to be recorded as legal parents of the child delivered by the surrogate mother. Besides, the parties of such agreement should be:
Since the Georgian legislation requires the above-indicated agreement to be notary certified, it means that the identity of every party of the agreement shall be revealed and cannot be maintained confidential. The parties of the agreement have to either appear at the notary and sign the agreement in the presence of the notary or the parties (either of them) may be represented by another person (s) based on valid notary certified power of attorney (if the power of attorney is issued outside Georgia (Europe), it shall be notary certified and apostilled).
7. Besides, the fact that the child is born as a result of surrogacy should be indicated in the medical reference issued by the maternity hospital where the child is born. Such reference is sent electronically by the maternity hospital to the Civil Registry within 5 business days from the birth of the child. The registration of the birth of the child is fulfilled by the Civil Registry upon the documents required by the legislation are filed by potential parents in the Registry but no later than 7 calendar days from the date the medical reference on the birth is submitted. It is noteworthy that if the documents are not submitted to the Registry within this indicated period, or insufficient documents are submitted, the Registry is authorized to refuse registration of potential parents as legal parents of the child. This decision of the Registry may then be either appeared in court or civil lawsuit might be filed in court claiming for the recognition of parental rights.
8. If the Registry refuses to register the potential parents as the legal parents of the child born as a result of surrogacy, Registry provides the relevant information to the Social Service and the latter shall determine the name and surname of the Child. In such a case, the birth certificate of the child is issued without indicating the parents of the child. The full custody of the child legally is granted to the Social Service and Social Service may decide to grant the temporary custody to potential parents while the dispute concerning the recognition of potential parents as legal parents of the child is finally settled. It should be underlined that the Georgian legislation prohibits any indication of a surrogate mother or/and the donor in the birth certificate of the child even in case of refusal to register potential parents as legal parents of the child. Moreover, the law directly determines that the surrogate mother and the donor are not entitled to claim parental rights over the child.
9. There are no references made to the form of surrogacy, in other words, there are no direct regulations whether commercial surrogacy is allowed or whether only altruistic surrogacy is permitted. Accordingly, there are no prohibitions concerning the payments to be made to surrogate mothers or other restrictions regarding the activities of intermediary agencies. As for the requirements of the Medical Institutions concerning the performance of in vitro fertilization, the medical institutions are required to obtain written informed consent from the patients before the commencement of such a procedure.
10. Besides, the child born as a result of the surrogacy arrangement in Georgia (Europe) cannot leave the country, if the birth certificate of the child does not determine both legal parents of the child even if the child has a foreign passport.
Surrogacy is a process involves insemination of the male sperm into the uterus of the surrogate mother who then carries the embryo of a child till its birth for the Intended Parents. here you can find the list of Top 3 Best Surrogacy Centre in Cyprus, the Middle East with Surrogacy packages, Success Rates, Services & working fertility specialist in Cyprus, Middle East:
As the first ISO 9000 qualified clinic in Northern Cyprus, North Cyprus IVF has been leading the way infertility treatments since its establishment. Our clinic cooperates and collaborates with many prestigious hospitals, scientists and agencies all over the world in order to provide you with the highest quality of treatments available. This collaboration has brought the cutting edge MicroSort technologies to Cyprus in late 2011. The MicroSort technology that allows for highest precision sperm sorting for gender selection treatment is only offered in Mexico and now at our clinic for family balancing reasons. North Cyprus IVF is the only patented clinic to offer this method in the entire world except for the Americas. North Cyprus IVF Centre combines low-cost affordable treatments, the highest level of technology and know-how with high success rates for its patients. Both patients and the IVF centres converge on one ultimate aim – success! This is a common goal for both patients and their fertility specialists. For patients, a Successful fertility treatment translates into a successful pregnancy which will result in a healthy baby nine months later. For IVF clinics, success translates into prestige- it is an indication that the clinic is doing its job right! This makes pregnancy a mutual goal for both patients and their fertility specialists.
The Dogus IVF Centre has become one of Cyprus best clinics in the field of In Vitro fertilization as well as all other fertility treatments for over 20 years. Dogus Fertility Clinic and its team of highly qualified specialists ensure that each case is treated with unique and continuous care, and all treatment is done in an affordable and time-conscious manner. With patients from all over the world, Dogus fertility clinic and its team assure you its most dedicated efforts towards helping your family goals come true. From your very first consultation to the completion of your treatment, Dogus Fertility Clinic assures your state of the art equipment, advanced technological procedures, highest-ranking specialized doctors and above all, meticulous caregivers who will guide you through your journey to successfully attaining a healthy and loving family. In addition to the cutting-edge and uniquely personalized fertility treatment plans, Dogus Fertility Clinic offers In-Vitro Fertilization (IVF), Egg Freezing, Egg Donation, Surrogacy, Pre-Genetic Implantation Screening and/or Diagnosis (PGS/PGD) as well as, above all, the best doctor-patient relationships. With the advancement of Assisted Reproductive Technology (ART), many clinics all over the world now offer various advanced procedures, however, only the most successful clinics match technology with patientcare by putting just as much time and effort into being the best doctors, counsellors, and advisors to their patients.
British Cyprus IVF Hospital, Cyprus has a cumulative 23 years of experience in the fields of IVF, donation and reproductive treatment. Our success rate of 97.82% is attributed to the use of the latest technology together with an experienced professional team of staff. Many tests and methods that are not applied to any other centre in Cyprus are implemented in our hospital. We are transforming the dream of thousands of families into reality every year, with the use of the latest technology such as CGT (Recombine) which enables scanning of hundreds of genetic diseases, ERA test which increases the pregnancy rate, and IMSI which enables selection of the best quality sperm. We are one of the largest families in the world, with over 50,000 healthy IVF baby successfully born over the course of 23 years. Our experienced professional team comprises of the best in this field, together with the use of the latest technology we are maintaining a success rate of 97.82%. We are the only IVF hospital in Cyprus who screens donors medically and genetically endeavouring to provide the healthiest of donors.
Surrogacy is a process involves the insemination of the male sperm into the uterus of the surrogate mother who then carries the embryo of a child till its birth for the Intended Parents. here you can find the list of Top 3 Best Surrogacy Centre in Kenya, East Africa with Surrogacy packages, Success Rates, Services & working fertility specialist in Kenya, East Africa:
Footsteps for Fertility Foundation organizes 5 Kilometer events held annually to promote infertility awareness and educate couples about how to get grants and affordable treatment options for in vitro fertilization, frozen embryo transfers and intrauterine insemination. Footsteps for Fertility Foundation has hosted 26 races in 4 different states since its inception. The efforts of Footsteps for Fertility Foundation and its supporters have provided a total of 144 fertility grants to date! Our Clinical Partners deserve a special thank you for their annual donations and understanding our vision. Footsteps for Fertility Foundation is a charitable organization created to raise awareness surrounding infertility, and provide grants for those who require fertility treatments such as: In Vitro Fertilization, Frozen Embryo Transfer, and Intrauterine Insemination through donations and strategic partnerships with fertility clinics.
Vinsfertility IVF Centre has been in service since 2004 and is the first Medical Centre in Kenya to provide IVF (In Vitro Fertilization) in treatment of infertility. We offer a wide range of Assisted Reproductive Technologies including IVF and ICSI (Intracytoplasmic Sperm Injection), Egg and Sperm Donation, Embryo and Sperm Cryopreservation, Intrauterine inseminations (IUI), Ovulation induction and others. Our highly motivated and professional team’s work is aimed at providing efficient and high-quality services to our patients in solving their fertility problems. Our IVF laboratory is equipped with modern equipment to provide safe embryo culture conditions during the treatment to achieve the highest possible clinical results. We are located at LandMark Plaza, off Argwings Kodhek Road, opposite The Nairobi Hospital. Please make yourself familiar with the provided services and feel free to request information via our online form.
Keyna IVF is Kenya’s top Fertility Clinic and IVF Treatment Centre. We are based in Nairobi and we provide All Kind of Advanced Fertility Treatments. From conceptualization and strategy to final-stage execution, we implement your entire Fertility Treatment strategy. Because we adopt a 360° approach to Make Pregnancy Possible, our treatments include IVF, IUI, ICSI, IMSI, TESA/MESA/PESA, Surrogacy and Egg Donation. Kenya IVF centre welcomes all the people across the globe to visit this centre one if they are dealing with the severe cause of infertility and they are not able to conceive naturally after having unprotected regular intercourse for more than 12 months. The fertility experts at Kenya IVF centre are highly skilled and trained professionals who offer the best assisted reproductive treatments to all childless couples so that they will able to conceive their baby and also, wish that every couple when leave from this centre have the smile on their face and baby on their lap. We are the one who focuses on our every patient without biasing between poor, payee or needy people and offers them with the same international standard quality of the treatment and that too at a very reasonable cost. All the patients whosoever travel to Kenya we provide them with the 24/7 medical support so that they will not face any challenges during their fertility treatment. The fertility experts are that professional who helps you in conceiving your baby with the use of their experience and education in the field of fertility management.
Surrogacy is an arrangement, often supported by a legal agreement, whereby a woman (the surrogate mother) agrees to bear a child for another person or persons, who will become the child’s parents after birth. here you can find the list of Top 3 Best Surrogacy Centres in Chandigarh with Surrogacy packages, Success Rates, Services & working fertility specialists in Chandigarh. The best surrogacy centers in Chandigarh are chosen based on surrogacy success rates in Chandigarh, treatment quality, patient’s opinion, doctor’s qualification, and location accessibility:
Cosmo multi-speciality Hospital is the Best Infertility Hospital in Chandigarh Mohali to provide you with Best Infertility Treatments in Chandigarh. Cosmo Hospital is considered one of the best Test Tube Baby Hospital in Chandigarh, Panchkula and Mohali that offers a comprehensive range of Infertility Treatments under one roof and the Hospital is known for its innovation, integrity, medical and technical excellence and consistent willingness to accept patients facing the most difficult medical challenges. For couples struggling with Infertility, the options they face can be stressful and overwhelming. Recognizing this, Cosmo Hospital has established a state of the art Infertility Clinic and IVF Test Tube Baby Centre in the Hospital at Mohali. This Centre is staffed with highly trained Test Tube Baby Doctors and professionals to provide our patients with personalized care second to none. It is complemented by Departments of Andrology (male infertility and sexual dysfunction), Obstetrics(pregnancy) and Neonatology(newborn care) which completes the journey to happy parenthood.
Jannee Fertility Centre, the best IVF center in Chandigarh is a young & independent entity that is fighting the problem of infertility. Our center and its team are striving to bring to life the dreams of millions of couples who have difficulty in achieving parenthood naturally. The primary concern of our center is the safety of the patients and their gametes and embryos which constitute the very beginning of a new individual’s life. We understand the distress and the helplessness experienced by the patients; hence a lot of time is spent on the counseling sessions of both the partners. The social, emotional and financial aspects are taken into consideration and we make sure that patients are well informed about the treatment being offered to them, the reason for suggesting a particular form of treatment and alternative therapies available if any. A patient-friendly atmosphere is our quality. We are the first in Chandigarh in introducing the ovum donation and surrogacy program. Our dedicated team caters to patients from India and abroad in collaboration with the leading centers of Punjab for obstetric & gynecological services. Dr. Nirmal Bhasin, the founder of Jannee, is a post-graduate from Minsk who has 16 years of experience in infertility treatment. She has her expertise in In-Vitro Fertilization (IVF or test tube baby) and Intra Cytoplasmic Sperm Injection (ICSI). She’s also a visiting embryologist at various IVF Centers in North India.
Reviva Infertility Clinic was started in 2010 under the direction of Dr. Sandeep Cheema Sohi. Reviva Infertility Clinic is unique as this is the only center that caters solely to infertility issues and is not diluted by Gynae & Obs practice. With consistent growth & success leads us to open another sister unit in Patiala in a very short period. Both the branches have complete IVF lab setup with high-end technology. We have our in-house team of well qualified & experienced doctors, Embryologists, Andrologists, Anaesthetists & IVF staff, etc. Our mission at Reviva Infertility and IVF clinic is to help infertile patients to become parents by providing them with the exact fertility treatment program with the highest success rates. And we also focus on individualized care and attention.