A gestational carrier is a woman who carries a pregnancy for someone else. It is important to note that the carrier does not provide any genetic contribution to the pregnancy. The RMANJ team works carefully to coordinate all care provided during a gestational carrier cycle. All patients have access to our Collaborative Wellness Team of mental health professionals and counselors who specialize in supporting individuals and couples in fertility treatment.
Who is eligible?
A physician must first determine that this treatment is appropriate. Our team approach helps to ensure that every stage of this process is coordinated with the highest levels of medical expertise and patient support every step of the way.
Selection and screening of gestational carriers
Being a gestational carrier is an important responsibility that includes many physical, medical, emotional and legal issues for participants to consider. RMANJ works closely with all carriers, beginning with an intensive physical and psychological screening process.
Selected carriers must:
- Take part in a preliminary phone interview with an RMANJ physician and mental health professional
- Furnish copies of medical records and history
- Complete preliminary paperwork
- Provide any additional requested materials
The carrier then meets with the recipient couple, nurse, physician and mental health coordinator at a “screening appointment.”
Following this appointment:
- Carrier will be briefed on medications used during this procedure.
- Coordinator reviews the contract between the carrier and the couple.
- Carriers and partners must complete a Personality Assessment Inventory (PAI) and participate in a series of interviews and tests.
Monitoring the treatment process
If the gestational carrier is located near an RMANJ clinic, our team will manage all monitoring during the treatment process.
If the carrier is located outside of driving distance to an RMANJ location, she is responsible for choosing a monitoring facility and providing RMANJ with all contact information. Once a monitoring center is selected, the carrier must schedule all monitoring appointments directly with that center, following guidelines provided by the RMANJ nurse coordinator.
Monitoring facilities must:
- Be open at least five days a week
- Be able to perform transvaginal ultrasound
- Obtain same-day results for blood tests to measure estrogen and progesterone levels
All fees for outside monitoring services used by carriers are paid directly by the intended parents to the treatment center, not through RMANJ.
All gestational carrier candidates must undergo a prep treatment cycle, unless a woman has already completed a gestational carrier cycle. The prep cycle helps to determine whether the carrier will respond to medications used to prepare the uterine lining. The carrier is given a medication such as Lupron® to temporarily stop the ovaries from producing hormones. Estrogen is introduced to stimulate the uterine lining to thicken. Progesterone is then used to end the prep cycle and the woman menstruates. The process takes 4-5 weeks and consists of six monitoring visits.
In the treatment cycle, which lasts 4-6 weeks, carriers receive nightly intramuscular injections of progesterone. The RMANJ nurse coordinator will advise on medications, dosages and monitoring requirements. Monitoring consists of a combination of at least four to six office visits for ultrasound or blood work.
The carrier returns to RMANJ for the embryo transfer, which is initially scheduled to take place three days after eggs are retrieved. In some cases the RMANJ embryologist will delay the transfer for up to three more days as needed. The RMANJ nurse coordinator monitors this process and coordinates all planning and schedules with the carrier.
Legal Contracts / Consents
Without exception, a complete copy of the executed legal contract between the gestational carrier and the intended parents must be provided to the RMANJ nurse coordinator before the start of the prep cycle and prior to the initiation of treatment involving any medications.
Treatment costs and payments
Prior to the start of a treatment cycle, intended parents must agree to the payment requirements for these services and receive a financial clearance from RMANJ. Any questions surrounding insurance coverage or other finance issues should be directed to the RMANJ Finance Department.
RMANJ is not responsible for any costs associated with medications and outside monitoring services for a carrier. These costs are paid directly by the intended parents. Any fees related to the use of RMANJ mental health professionals and counseling services are billed separately by RMANJ and are not included in the cost of treatment. Please contact the Collaborative Wellness Team for a fee schedule for these services.