Surrogacy with Own Oocytes and Sperm Cost in Georgia

What is self–cycle Surrogacy and how does it work?

Gestational Surrogacy with the couple’s gametes is alternatively termed as self–cycle Surrogacy. This Surrogacy cycle involves the Georgian Gestational Carrier’s selection, the couple’s gametes’ collection, IVF—ICSI Fertilization, Embryo Culturing, Embryo Transfer Certificate issuing, Embryo Selection, and Embryo Transfer into the Gestational Carrier’s uterus for further gestation. Self–cycle Surrogacy doesn’t involve an oocyte donor until it is required. But self–cycle Surrogacy does have the medical criteria for the intended mother and intended father.

What inclusion criteria are set for the intended mother?

• 1–4 ng/ml Anti–Müllerian Hormone concentrations
• at least 6–8 Antral Follicles in the ovaries

The standard inclusion criteria for the intended mother include normal Anti–Müllerian Hormone concentrations in her blood sample and 6–8 Antral Follicles in her ovaries. The intended mother’s Anti–Müllerian Hormone concentrations in the blood sample should be above ‘1’ (1–4 ng/ml Anti–Müllerian Hormone concentrations). Anti–Müllerian Hormone (AMH) is a specific hormone that is ‘generated’ by granulosa cells of the ovaries. This hormone indicates the ‘balance’ of the ovarian reserve: low, normal or high. When the woman’s ovarian reserve’s ‘balance’ is down, this extremely interferes with her fertility.

If the concentrations of Anti–Müllerian Hormone in the blood sample are less than 1 ng/ml that seems that the ovarian reserve reached its ‘ultra–down mode’, and it is nearly impossible to collect the oocytes from the follicles as they are already nearly gone. The simplicity and transparency of Anti–Müllerian Hormone blood test impact the fertility Pro decision concerning the self–cycle surrogacy.

Plus, the intended mother should have at least 6–8 Antral Follicles (at least 3 Antral Follicles per ovary). The limit for the number of Antral Follicles (6–8 Antral Follicles) in the ovaries is not just required but is vital to initiate an IVF— ICSI cycle with its own oocytes. The fertility Pro performs ovarian Antral Follicle count test using a transvaginal ultrasound probe. A real-time three–dimensional ultrasound with inversion mode makes it possible to detail the structure of every follicle measured more than 1.0 mm in diameter.

If the intended mother has the Antral Follicles measured under 1.0 mm in diameter, the fertility Pro cannot identify them in the ovaries. When the Antral Follicles reach 2.0 mm in diameter, they become highly sensitive to the follicle-stimulating hormone medication that is routinely used in IVF for the maturation of more oocytes. Antral Follicles measuring 2.0 mm — 10 mm are ‘potential’ ones that might become mature while Antral Follicles measured above 10 mm in diameter are ‘dominant’ ones with the high potency of fertilization.

What inclusion criteria are set for the intended father?

• For the intended father, the minimal criteria include the sperm sample’s ‘characteristics’, the sperm cells’ ‘configuration’, and karyotype (the chromosomal configuration). The comprehensive semen analysis shows all the details that are essential for IVF—ICSI cycle. If the semen sample meets the medical criteria, an IVF—ICSI cycle can be designed. If the husband’s Semen sample’s Analysis shows the adverse results, the Georgian sperm donor can be chosen by the couple for the oocytes’ fertilization.
• Normal semen volume: 1.5—5.0 milliliters (ml). The semen volume below 1.5 ml is considered a low semen volume. The semen volume above 5.0 ml is considered a high semen volume.
• Normal sperm count (sperm concentration): 15—300 million sperm per milliliter of semen. The sperm count below 15 million sperm per milliliter of semen is considered as low. For IVF—ICSI the required minimum is usually set to 5 million sperm per milliliter.
• Not less than 20% of morphologically normal sperm per ml. Morphologically normal sperm cells are shaped like streamlined tadpoles with long tails and normal-sized heads.
• Normal sperm motility: 40% of sperm cells should be motile (or moving) per one ejaculate. The numbers below 40% are considered as low sperm motility. For IVF—ICSI the required minimum is 15% of motile sperm per semen sample.
• Normal sperm karyotype (normal chromosomal configuration). Exclusion of the chromosomal abnormalities’ configuration in sperm cells is one of the major goals for fertility Pros. Karyotyping is performed to reduce the possible risk to transmit genetic abnormalities and genetic alterations to the baby.

Molecular karyotyping is a non–invasive screening technique that doesn’t disrupt the genomic configuration of sperm cells allowing the fertility Pro to use the sperm cells for ICSI (Intracytoplasmic Sperm Injection). Comparatively to the other invasive techniques that are used for screening the sperm’s genomic configuration, molecular karyotyping has the ultra-powerful ‘detecting mode’ ‘configurable’ with ‘protective mode’. As a result, the sperm cells are secured and can be used for ICSI or IMSI fertilization technique.

The other genomic configuration verifying techniques are invasive ones (sperm DNA fragmentation, nuclear condensation, chromosomal structural rearrangements). These screening techniques not only interfere with genomic structure but may disrupt the genomic configuration, therefore, they can be used for screening only but the sperm sample cannot be used for ICSI or IMSI after their performance.

Legal restrictions for the couples wishing to do Surrogacy in Georgia.

Georgian law permits the Gestational Surrogacy cycles for heterosexual couples only. According to Georgian law, Surrogacy cannot be done for single men and single women, for gay couples and lesbian couples. Gay Surrogacy and lesbian Surrogacy are prohibited by the Georgian law.

Answering four most Frequently Asked Questions about Surrogacy in Georgia.

1. ‘When purchasing the Surrogacy package should I pay all fee at once or can I pay step–by–step?’

Purchasing the Surrogacy package in Georgia, you can do the money–transfer step–by–step. Usually, there are three or four money–transfers that are done in the established by the Surrogacy contract time frame.

• The first payment is done upon signing of the contract.
• The second payment is done after the pregnancy’s confirmation.
• The third payment is done on week 28 or 32 of pregnancy.
• The fourth payment is done after the baby has been born.

2. ‘Where in Georgia to do self–cycle Surrogacy?’

Meet our Georgian IVF clinics and Surrogacy Agencies where you can find the best self–cycle Surrogacy packages ever. From the basic standard self–cycle Surrogacy Bundles to the bundles labeled ‘multiple trials’, and those that are ideally integrable with Egg Donation, including the Silver and Gold Surrogacy with Egg Donation packages Pro with unlimited trials. Georgian IVF clinics and Surrogacy Agencies are ideal for the married heterosexual couples to have their newborns born through Surrogacy.

Select and Compare the Surrogacy packages in Georgia just at glance. Get in touch with Georgian IVF clinics and Surrogacy Agencies just in one click. Valid fees for 2019. No ‘shade’ fees. Not even hidden ones.

3. ‘What is in my basic Surrogacy process?’

• Agency fee for providing the surrogate mother’s selection and matching services, the management of the Gestational Carrier’s pregnancy, the assistance with issuing the Embryo Transfer Certificate and the birth certificate plus all documents needed for the Embassy. Agency service fee includes the assistance during the couple’s staying in Georgia and after the newborn has been born until the couple returns home with the baby or even twins!
• Notary fee for preparing the Surrogacy Contract between the intended parents and the Georgian Gestational Carrier that is used for issuing the baby’s birth certificate.
• Gestational Carrier’s Diagnostic Testing and Screening including all blood tests, hormonal tests, and the other screening procedures necessary for Surrogacy:
• Infectious Profile (STD Panel)
• Pelvic ultrasound scan of uterine and pelvic physiology and pathology
• Viral infections’ screening
• Fallopian tube patency test (HyCoSy)

Blood Screening Tests for the Gestational Carrier may include the following:

• Complete Blood Count test
• Blood Chemistry
• Blood Type
• LH (Luteinizing Hormone)
• FSH (Follicle-Stimulating Hormone)
• Estradiol (Estrogen Steroid Hormone)
• AMH (Anti–Müllerian Hormone)
• TSH (Thyroid Stimulating Hormone)
• Free T4 (Thyroxine)
• Prolactin
• Vitamin D Level
• Rubella blood test (Rubella is a contagious viral infection)
• Toxoplasma blood test
• HIV1
• HIV2
• Hepatitis B blood test
• Hepatitis C blood test
• Syphilis blood test
• Cystic Fibrosis Carrier Testing (the blood test)

Other tests required for women: 

• Infectious Profile (STD Panel)
• If necessary: sonohysterography or Saline Induced Sonohysterogram (SIS) — a Diagnostic Test that involves an infusion of the special water into the uterus to shape the uterine walls and uterine cavity. This test shows uterine abnormalities such as scar tissue inside the uterus, polyps, or fibroids.
• If necessary: Stress Test (EKG).
• If necessary: Diabetes (Hemoglobin Glycosylated) test.
• If necessary: Blood pressure monitoring is included in the Diagnostic Testing list.
• *Some Surrogacy Bundles’ basic fees include the intended mother’s Diagnostic Testing and Screening. Some of the self–cycle Surrogacy Packages’ basic fee doesn’t cover the Screening Tests for the intended mother. If the basic fee doesn’t cover the Diagnostic Testing for the intended mother, a new Screening Bundle is configured with surrogacy. These Bundles are available to be purchased by the couple in the IVF clinic or Surrogacy Agency.

The Diagnostic Tests for the intended mother may include:

• Antral Follicle Count (AFC)
• Infectious Profile (STD Panel)
• Pelvic ultrasound scan of uterine and pelvic physiology and pathology
• Viral infections’ screening
• Fallopian tube patency test (HyCoSy)

Blood Screening Tests that may be required to be done:

• Complete Blood Count test
• Blood Chemistry
• Blood Type
• LH (Luteinizing Hormone)
• FSH (Follicle-Stimulating Hormone)
• Estradiol (Estrogen Steroid Hormone)
• AMH (Anti–Müllerian Hormone)
• TSH (Thyroid Stimulating Hormone)
• Free T4 (Thyroxine)
• Prolactin
• Vitamin D Level
• Rubella blood test (Rubella is a contagious viral infection)
• Toxoplasma blood test
• HIV1
• HIV2
• Hepatitis B blood test
• Hepatitis C blood test
• Syphilis blood test
• Cystic Fibrosis Carrier Testing (the blood test)
• *If necessary: Diabetes (Hemoglobin Glycosylated) test.
• *If necessary: Blood pressure monitoring is included in the Diagnostic Testing list.
• Medication for the Gestational Carrier.
• Some of the Surrogacy Packages may cover medication for the intended mother.
• **Controlled Ovarian Stimulation of the intended mother (medication, ultrasound monitoring, hormonal monitoring). The basic self–Surrogacy Package may involve Controlled Ovarian Stimulation Protocol for the intended mother or can be designed without including this fee. If the Controlled Ovarian Stimulation is not included, a new bundle is configured with the current package. These bundles are available to be purchased by the couple in the IVF clinic or Surrogacy Agency.
• IVF with ICSI (one trial, two trials, three trials or multi–trials) including Oocyte Retrieval and collection, ICSI or IMSI Fertilization, Embryo Culture, Embryo Selection, Embryo Transfer to the surrogate mother’s uterus, remaining Embryo cohort’s Vitrification and Storage up to 12 months.
• ***PGS (Preimplantation Genetic Screening for 6, 8, 12, or 24 chromosomes ‘configuration) package can be synchronized with the basic Surrogacy Bundle’s fee and may cover screening up to 6 or 8 embryos (blastocyst stage). Every additional screened embryo may be charged an extra fee. If there is no PGS in the Surrogacy package, the intended parents may purchase the PGS Bundle. The cost starts at 3 500 USD. This fee covers screening up to 8 embryos. Every extra embryo biopsy will cost the couple 350 USD—400 USD.
• ***PGD (Preimplantation Genetic Diagnosis) for the single gene disorder package can be synchronized with the basic Surrogacy Bundle’s fee and may cover screening up to 6 or 8 embryos (blastocyst stage). Every additional screened embryo may be charged an extra fee. If there is no PGD in the Surrogacy Package, the intended parents may purchase the PGD Bundle. The cost starts at 3 500 USD. This fee covers screening up to 8 embryos. Every extra embryo biopsy will cost the couple 350 USD—400 USD.
• Gestational Carrier’s fee for the Embryo Transfer (one trial, two trials, three trials or multi–trials).
• Surrogate mother’s monthly fee.
• Pregnancy care fee that covers consultations, medication, and pregnancy monitoring.
• Maternity hospital fee that covers the natural delivery, medication, surrogate mother’s care, and newborn’s care for 4 or 5 days in the maternity hospital.
• Gestational Carrier’s final compensation fee.

4. ‘What is not included in my basic Surrogacy Bundle?’

• Maternity hospital or hospital extra fee is charged if the Gestational Carrier has the pregnancy complications and is transferred to the maternity hospital for further investigation. This fee cannot be estimated as it depends on the type of complication, the Diagnostic Tests, the Treatment Plan, the medication, the procedures, and the duration of the Gestational Carrier’s staying in the maternity hospital or in the other clinic or hospital.
• C–section delivery fee is charged as an extra fee if the natural delivery is impossible. Usually, Georgian maternity hospitals’ C–section fee is 500 USD.
• If after the Embryo Transfer the Gestational carrier ‘conceived’ twin pregnancy and twins are born, the couple pays 2 000 USD to the surrogate mother for carrying the twin pregnancy. Twin pregnancy fee is identical in all Georgian IVF clinics and Surrogacy Agencies.
• The Embryo Reduction fee for multiple pregnancies is not covered by the basic fee. The price for Embryo Reduction starts at 700 USD.
• The pregnancy termination fee is charged as an extra fee if serious abnormalities are detected into the fetus. This fee starts at 1 000 USD.
• Uterus loss fee is charged if the surrogate mother loses her uterus. This fee is approximately 2 000 USD.
• Sperm Vitrification and Sperm Storage fee is charged additionally if Sperm Vitrification is not covered by the basic package’s fee.
• Ectopic pregnancy fee is paid if the Gestational Carrier’s pregnancy resulted in ectopic. This fee covers the urgent surgery and the Gestational Carrier’s compensation.
• Laparoscopic Egg Retrieval fee is an extra fee that is charged for laparoscopic surgery.
• Amniocentesis non–invasive prenatal test fee is charged per fetus. This test costs 1000 USD.
• If the couple wants to stay in the maternity hospital in the same time frame the Gestational Carrier and their newborn are staying there (for 4 or 5 days). The International Patient Coordinator of the IVF clinic or the Surrogacy Agency can help the intended parents to book the private ward in the maternity hospital. Booking the ward for 4 or 5 days will cost approximately 1 000 USD — 1 600 USD.
• If the term newborn has been born, the extra fees that are not included in the basic Surrogacy Package are paid for the preterm newborn staying in the NICU (Newborn Intensive Care Unit). The basic fee for one night stay in the newborn intensive care unit starts at 350 USD — 400 USD.
• Some Georgian IVF clinics and Surrogacy Agencies offer to ‘configure’ the NICU (newborn intensive care unit) bundle with the basic Surrogacy Backage before the 12^th week of the Gestational Carrier’s pregnancy at a cost 5 000 USD per newborn. This fee adds tons of capacity as it allows to ‘book’ the NICU incubator for the preterm newborn and the medication. NICU package secures the couple from extra fees and extra nerves.
• The Gestational Carrier insurance fee in case if the newborn dies after the premature delivery or term delivery from the 20^th gestational week to 40^th gestational week covers the surrogate mother’s compensation. This fee also covers the dilation and curettage procedure if fertility Pro detects that the fetus contains genetic or developmental abnormalities. The Gestational Carrier insurance package is available for being purchased at 2 500 USD — 3 000 USD. The time frame for investing in this package is until 12 weeks of pregnancy.
• The second or third trial of IVF—ICSI and Embryo Transfer for self–cycle Surrogacy program fee. Second or third trial self–cycle Surrogacy with fresh Embryo Transfer (using own eggs and sperm plus Georgian Gestational Carrier) basic approximate fee is 6 050 USD. Purchasing the second or third attempt self–cycle Surrogacy package, the couple should know that the basic fee covers only Notary fee (the new Surrogacy Contract notarization), the Gestational Carrier’s medication, fresh IVF—ICSI cycle’s fee, and Embryo Transfer fee. The package usually does not cover the Diagnostic Screening, medication, consultations, and monitoring of the Ovarian Stimulation cycle of the intended mother.