Who Needs Surrogacy: Indications for Parents
The surrogacy program in Ukraine is conducted exclusively for medical reasons, which makes it impossible to use it for social reasons. Surrogacy is recommended in cases where a woman is unable to give birth to and carry a child on her own.
Main indications:
- Absence of the uterus (congenital or acquired), as well as uterine deformities that make pregnancy impossible.
- Incurable changes in the endometrium, in particular intrauterine adhesions or loss of receptivity, which cannot be treated.
- Severe systemic diseases in which pregnancy poses a risk to the mother’s health or life but does not affect the child’s health.
- Repeated failed IVF attempts (4 or more)—when, despite obtaining high-quality embryos, implantation does not occur.
- Recurrent pregnancy loss (repeated miscarriages).
Surrogacy is the last resort but the most effective method of assisted reproductive technology in cases of absolute infertility. By using the parents’ genetic material, the couple is given the opportunity to have their own, genetically related child.
Who Can Become a Surrogate Mother
To become a surrogate mother, a woman must meet strict medical and psychological criteria set forth in Order No. 787 of the Ministry of Health of Ukraine and the clinic’s internal protocols. These requirements are designed to ensure the reliability of the program and the child’s health.
Basic requirements for surrogates: Time intervals after childbirth and procedures: Careful selection of candidates is the key to a successful outcome. Each surrogate mother undergoes a multi-stage medical and psychological evaluation to ensure a safe pregnancy.
- Age. The candidate must be between 18 and 36 years old. This is the optimal reproductive age, ensuring minimal risks.
- Having a child. It is a mandatory requirement to have at least one healthy child of her own.
- Health status. Excellent physical and mental health is required. Women with HIV, tuberculosis, hepatitis B/C, syphilis, diabetes, cancer, or an acute inflammatory process in the body are not eligible for the program.
- Body Mass Index (BMI). The surrogate mother must be of normal weight; underweight or obese candidates are not eligible.
- Lifestyle. Harmful habits (smoking, alcohol abuse, and drug use) are strictly prohibited.
- Gynecological history. No chronic gynecological or genetic diseases.
- Vaginal delivery. At least 9–12 months must have passed since the last vaginal delivery (breastfeeding must be completed one month prior to the examination).
- Cesarean section. No more than one cesarean section is permitted, and it must have been performed more than 1.5 years ago.
- Egg donation. If a woman has previously participated in an egg donation program, egg retrieval must have taken place no earlier than 1–2 menstrual cycles prior to joining the surrogacy program.
Step-by-Step Program Protocol
The surrogacy program consists of two phases: preparation of the intended parents (embryo creation) and the surrogate mother’s participation (carrying the pregnancy to term). It all begins with the preparation and thorough medical evaluation of all participants.
Evaluation of the Intended Parents
Before fertilization and other medical procedures take place, the couple must undergo a comprehensive evaluation. This includes laboratory tests (hormone profile, infections, genetic screening) and consultations with a reproductive specialist. The goal of this stage is to rule out any contraindications to IVF, ensure the genetic material is of sufficient quality, and identify potential genetic risks. These steps are crucial to the program’s success.
Examination and Preparation of the Surrogate Mother
For the surrogate mother, this stage is completely free of charge and is conducted to ensure her health. The surrogate mother undergoes a comprehensive examination, which includes laboratory tests (hormones, infections), pelvic ultrasound, and consultations with various specialists: a general practitioner, a gynecologist, and a psychologist. The psychological evaluation is necessary to determine her readiness to participate in the program and her understanding that she will have no parental rights to the child.
Stimulation and Egg Retrieval for the Genetic Mother
After successful preparation, the genetic mother begins participating in the IVF protocol. As previously agreed upon by the parties, she is prescribed hormonal stimulation to mature several eggs (duration: 10–14 days). The goal of the procedure is to obtain not just one, but several eggs, which increases the chances of successful fertilization.
The next step is follicular aspiration (egg retrieval). This surgical procedure is performed under intravenous anesthesia once the follicles have reached the required size. On the same day, the genetic father provides a semen sample for fertilization using the ICSI method.
Embryo Transfer into the Surrogate Mother’s Uterus
The resulting embryos are cultured in the laboratory. If necessary, preimplantation genetic testing (PGT) is performed to select the highest-quality embryo.
The embryo is then transferred into the surrogate mother’s uterine cavity under ultrasound guidance.
Either a fresh protocol (with cycle synchronization) or a cryoprotocol (transfer of a thawed embryo) may be used.
Legal Aspects and Ukrainian Legislation
Surrogacy in Ukraine is fully legal and strictly regulated by a number of legal acts, which guarantee the protection of the rights of both the genetic parents and the surrogate mother.
Key regulatory documents: Documentation:
- Article 123 (para. 2) of the Family Code of Ukraine stipulates that the parents of a child born to a surrogate mother are the married couple who provided their genetic material.
- Order No. 787 of the Ministry of Health establishes medical criteria and requirements for surrogate mothers.
- Order No. 52/5 of the Ministry of Justice regulates the procedure for registering children born through assisted reproductive technology (ART) programs.
To begin the program and subsequently register the child, a number of documents must be prepared: Ukrainian legislation provides full legal protection for the genetic parents and precludes the possibility of the surrogate mother challenging her status as the child’s mother. Careful drafting of the contract and accompanying documents ensures that, from the moment of the child’s birth, the married couple becomes the child’s legal parents. Thanks to this set of legal provisions, the program in Ukraine is reliable and predictable.
- A surrogacy agreement between the married couple and the surrogate mother (with the husband’s notarized consent if she is married).
- The surrogate mother’s notarized consent to the registration of the genetic parents as the child’s legal parents.
- A clinic certificate confirming the use of assisted reproductive technology (ART) and the child’s genetic relationship to one or both parents.
