LEGAL REGULATION OF GESTATIONAL SURROGACY IN UKRAINE

Ukraine is one of very few surrogacy friendly states in the world.
As cited above, if the embryo conceived by the spouses using Assisted Reproductive Technologies (ART) is transferred into the body of another woman, the spouses shall be the parents of the child (Article 123 of the Family Code of Ukraine). Thus, gestational surrogacy is absolutely legal in Ukraine, whereas the Family Code does not protect the rights of the gestational (biological) mother and conversely pays attention to the positions of agreement that has been concluded between the Surrogate mother and the Commissioning Parents.
Article 139 of the Family Code of Ukraine stipulates that a woman registered as the child’s mother in general may contest her maternal affiliation. However, contesting maternal affiliation of genetic mother by gestational mother is expressly prohibited in Part 2 of this Article.
Accordingly, the child is legally considered to be the child of the Intended Parents from the very moment of its conception and the Surrogate mother can’t keep the child after the birth under any reason or be registered as the child’s mother.
According to Instruction on Procedures for ART implantation of an embryo is conducted according to medical indications, provided voluntary written consent of both commissioning parents and surrogate and their statements on application of ART. These medical conditions are namely as follows:

  • Absence of a womb (inborn or acquired)
  • Deformation of the cavity or cervix uteri, making pregnancy and delivery impossible 
  • Synechi of womb cavity
  • Severe somatic diseases, making duration of pregnancy impossible
  • Multiple (more than 4) implantation failures associated with the transfer of high quality embryos.

Hence, the first prerequisite for application of ART is full medical examination of the Intended Parents that proves medical indications for in-vitro fertilization. Theoretical situation when a coupe is physically able to have a child and chooses the way of surrogacy in order to avoid gestation and delivery of a child by genetic mother for one reason or another, is not acceptable from legal point of view.  
At the same time it should be emphasized that according to Ukrainian legislation gestation of a child by surrogate mother is only possible if the Intended Parents are officially married. So they should present a marriage certificate as a second condition. In case of participation of foreign citizens this document should be duly legalized or apostilled in accordance to the provisions of Convention of 5 October 1961 Abolishing the Requirement of Legalisation for Foreign Public Documents.
According to Ukrainian Instruction on Procedures for ART a Surrogate has to be legally capable woman of majority age (over 18 years old) and have at least one healthy child of her own, to be physically and mentally healthy and capable to carry and deliver a child.
In this regard we note an obvious gap in Ukrainian legislation, since the provision of the Article 123 of the Family Code of Ukraine does not mention the consent of the surrogate’s husband, assuming that his interests are not involved herein. According to law, nobody, including husband or wife, may limit the reproductive rights of a person. Still, Article 122 of the Family Code of Ukraine presumes that the father of the child born to the registered marriage shall be the husband of a woman who delivered a child. Hence, a husband of the Surrogate can contest parental affiliation of the genetic father, since the Family Code of Ukraine does not prohibit contesting parental affiliation in case of embryo transfer conceived by the spouses. Under these circumstances we strongly recommend our clients to get consent of the Surrogate’s husband, if any, for participation of his wife in a surrogacy program in Ukraine.
            If the candidate meets all medical, psychological and individual requirements of the Intended Parents and they decide in favour of her, a Child-Carrying Contract is signed between them. A contract involving foreign citizens is to be executed in writing and before a notary in two copies – in Ukrainian and native language of the foreign party.
Traditionally a Child-Carrying Contract contains the following counter obligations:

  1. The Surrogate undertakes to gestate and deliver a child not genetically related to her complying to the best of her abilities with all provisions of the contract and relinquish custody of this child to the Genetic Parents.

The Genetic Parents should not hesitate to provide instructions for the Surrogate in fulsome detail that should facilitate uncomplicated course pregnancy and birth of a healthy child (e.g. to submit to medical examination and procedures, to follow all instructions and requirements of the physicians concerning daily schedule, nutrition regime, living conditions, to take medicines, not to smoke, drink alcoholic beverages, use any drugs, to avoid heavy physical activity and psychological stress, in case of any deviations in her health conditions urgently to inform the physicians etc.).

  1. The Genetic Parents undertake to take custody of the child born by the Surrogate and pay for her services.

According to the Article 623 of the Civil Code of Ukraine the contract price is fixed by agreement of the parties. The value of a Child-Carrying Contract is usually comprised of two components. The Genetic Parents have firstly to compensate actual expenses incurred by the surrogate (e.g. medical examinations and expenses associated with any testing done, living expenses, special clothing, telephone calls to the Genetic Parents etc.) The second part is namely remuneration of the Surrogate for gestation and delivery of a child.
It is also advisable that a Child-Carrying Contract contains additional provisions for regulation of such real-life emergencies as: birth of several children; birth of a child with deformity or with special needed which has nothing to do with the performance by the surrogate of her duties; stillbirth or miscarriage; situation when the pregnancy of the Surrogate does not occur as the result of the full cycle of medical procedures; necessary abortion on medical indications; divorce of the Genetic Parents; death of one or both Genetic Parents etc.
Besides, a Child-Carrying Contract should involve provisions pertaining to liability of the Parties for non-performance or improper performance of their duties. In this section the Parties could specify fine sanctions for the case of regular violation of contract’s provisions by the Surrogate or even stipulate her deprival of reward if she doesn’t follow all instructions and requirements which carries negative consequences for a foetus.
In addition to a Child-Carrying Contract the Genetic Parents also conclude a Contract of Rendering of Medical Services with a clinic that would undertake infertility treatment by virtue of ART.
As for birth registration of a child, it is worthy to note that Ukrainian legislation is very favourable in this regard, since the names of Genetic Parents are recorded in the birth entry of the Vital Statistics Office from the very beginning. Pursuant to the Rules for Vital Statistics Registration in Ukraine such registration upon applications of foreign citizens and stateless citizens is conducted in compliance with the Ukrainian legislation. If a child was born by the woman, impregnated with an embryo originating from the spouses, the birth registration is conducted upon the application of the married couple, who gave consent to implantation. It is only necessary to submit to the Vital Statistics Office a notarized consent of a Surrogate to record the names of the spouses as the child’s/children’s parents; the document, confirming the fact of the child’s birth and certificate on genetic relationship of Intended Parents to the child. In this case the spouses are duly registered as parents of their new-born child/children and only the column “Remarks” contains record indicating the name of Surrogate Mother. However this record is kept with the Vital Statistics Office and is confidential.
At the same time, foreign citizens may apply for the birth registration of their child to the Consular Office of their own country and get a birth certificate issued together with a child’s passport. However, it is only possible when surrogacy is legal in the county of residence of Genetic Parents. 
One more question that has to be answered is who should be considered as the child’s parents if an embryo was conceived by using of donated cells and biological material only from one of Intended Parents.
According to Paragraph 5.1 of the Instruction on Procedures for ART the embryo implantation is performed when anonymity of the donor and medical secrecy are protected. Thereby donor of gametal cells (eggs, sperm) can not acquire parental responsibilities and rights with regard to the child, which has to be born in the future (Paragraph 5.2). On the other hand, paragraph 7.11 of the Instruction regulates that birth registration of the child, born by using of ART with the method of surrogacy, is accomplished in accordance to the current legislation of Ukraine on the basis of the certificate stating the genetic relationship of the Intended Parents (mother or father) with the foetus. Hence, neither gametal cell donors, nor Surrogate mother acquire parental rights with regard to the children, born by virtue of the above mentioned ART. In this case parental rights and responsibilities belong to the spouses, who concluded the contract on gestational surrogacy program in Ukraine.

In the frame of the Law “On the Citizenship of Ukraine” there is no room for automatic acquisition of Ukrainian citizenship by a child born by surrogate mother in Ukraine as a result of transfer of an embryo, conceived by a foreign married couple. A child born within the territory of Ukraine by foreigners can acquire the citizenship of Ukraine only in the event that the child has not acquired the citizenship of his/her parents, and that the parents live permanently within the territory of Ukraine on legal grounds. Thus, we should apply conditions of 'Procedure of Entry to Ukraine for Foreigners and Stateless Persons, Their Exit from Ukraine and Transit through its Territory', according to which foreigners and stateless persons shall enter/exit Ukraine through the crossing points on the State frontier in case of presence of a national passport and a visa, if otherwise is not specified by the Ukrainian legislation. Citizens of the States which have concluded international agreements with Ukraine on visa-free travelling enter into/exit from Ukraine with a valid national passport. Hence, the Intended Parents have to take steps for obtaining passport or visa for their newborn child/ren as the last step of surrogacy program in Ukraine.

Surrogacy + Egg Donation in Ukraine

- Selection and medical screening of the Surrogate Mother
According to Ukrainian Instruction on Procedures for ART a Surrogate has to be legally capable woman of majority age (over 18 years old) having at least one child of her own, who gave her voluntary written consent to the use of Assisted Reproductive Technologies and has no medical contra-indications for pregnancy.
            Our company maintains our own database of Surrogate Mothers that are carefully screened on the following key factors:

  • Is the Surrogate physically healthy?

Your Surrogate’s physical health is extremely important, as it may impact the health of your baby when he or she is born. A thorough medical screening of the Surrogate is performed to ensure that she has no diseases or physical conditions that may cause problems during pregnancy and delivery.

  • Can she handle the emotional side of surrogacy?

There is no doubt – it is a “tough call” to carry a life inside one’s body for nine months and then just give it up. Whether or not the child is genetically related to the Surrogate, it has been a part of her.
We have an experience psychologist on our staff who performs psychological evaluation of potential Surrogate to ensure that she can handle the emotional impact of surrogacy. It is also important to learn how the Surrogate would handle situations that might occur in course of surrogacy program, such as abortion if the child shows signs of physical or mental disabilities, or using selective reduction in case of the multiples.
Our psychologist helps to determine the emotional status of the Surrogate, as well as provide professional support before, during and after pregnancy.

  • What is her motivation to act as a Surrogate Mother?

Altruism should be the prime motivating factor for Surrogate Mother candidates perceiving surrogacy as a way of obtaining a sense of value and achievement. If financial issues or dealing with feelings of guilt or anxiety about past actions (e.g. abortions …) are high on the list of priorities to become a Surrogate, this may rightfully raise a note of caution from psychological point of view.

  • Does she have a strong support network?

How a woman’s family and friends are handling the possibility of her becoming a Surrogate is a significant bearing on how she will handle it herself. If she is married, it is especially important that her husband is supportive of her decision.

  • Is she comfortable with the medical requirements of being a Surrogate?

Being a Surrogate requires a great deal of medical treatment, including daily injections, while the pregnancy may end up carrying and giving birth to more than one child. Our program coordinator will discuss these possibilities with the Surrogate to find out whether she stands up to this challenge.

  • Does the Surrogate understand the legal ramifications of surrogacy?

Before entering a surrogacy agreement, it is necessary to ascertain that she understands the rights the she will be giving up. To ensure that there are no misunderstandings or legal loophole, we provide our Surrogates with extensive legal advice pertaining to legal effect of surrogacy agreement and procedure itself.

            After you sign up with our company, we shall provide you with profiles of potential Surrogates for your review. We fully understand how important and life-changing choosing a Surrogate can be. We encourage you to contact us so that we can help you fulfill your needs and concerns throughout the process of choosing a surrogate.
            Though each Surrogate Mother candidate is pre-screened in the clinic, she undergoes final medical examination prior medical procedures are undertaken, to make sure that she is fit for surrogacy program at this very moment.

- Selection and medical screening of the Egg Donor

Requirements for egg donors in Ukraine:

  • Age from 20 to 32 years;
  • At least one previous pregnancy resulting in birth of a healthy baby;
  • Absence of visible associated traits;
  • Optimal somatic health;
  • No contraindications for ovarian stimulation;
  • Absence of hereditary disorders;
  • No alcohol and drug consumption.

Donor anonymity
Some recipients prefer a "designated donor" (with whom they have a pre-existing relationship), while others prefer an "anonymous donor" (with whom they have no relationship), which is both allowed by the Instruction on Procedures for Assisted Reproductive Technologies in Ukraine, adopted by the Order of the Ministry of Health of Ukraine No. 771 of 12/23/2008.
Anonymous programs keep the identity of the donor completely confidential, while open programs allow donors to permit contact by the child at a later date; to meet the recipients; or to establish relationships with the recipients.

Donor selection is a complex process that involves several influences. We will help you to match with an Egg Donor from based on the following factors:
Medical Evaluation: The initial medical evaluation involves a physical exam, including a pelvic exam, drawing of blood samples, screening for infectious and inherited diseases or disorders, and measurement of hormone levels. These tests are designed to detect preexisting health conditions that would affect a woman's candidacy.
Family History: If no outstanding problems are found, the potential donor completes a detailed questionnaire about her family's medical and psychological history, as well as her lifestyle and substance use. This provides a background of genetic problems and health hazards that could impact the egg donation process.
Assessment of Appearance and Personal Characteristics: The potential donor's personal characteristics and preferences are assessed in order to provide potential recipients with an understanding of possible genetic traits of the foetus. Some characteristics may include height, weight, race, eye colour, ethnic and cultural background, interests and hobbies. These characteristics are compiled into a profile, which recipients will use to make their donor selection.
Psychological Evaluation: Since egg donation involves complex ethical, emotional, and social issues, potential egg donors should be in a sound psychological state to face these issues. The psychological evaluation process is designed to help a woman discern her stance on egg donation, prevent emotional trauma, address her concerns about the process, and help ensure that she will fulfil her obligations to the recipient.

Notwithstanding each Egg Donor is pre-screened in the clinic, she undergoes final medical examination prior medical procedures are undertaken, to make sure that she is fit for egg donation program at this very moment.

- Sign up a contract with Surrogate (and Egg Donor, if applicable)
We shall provide you as well as your Surrogate with a draft Child-Carrying Contract. You and Your Surrogate will review the document in the appropriate native language, reach an agreement and sign the contract. Of course, our lawyers shall be available for all your questions and concerns regarding the content of surrogacy contract.
If you choose to use services of known Egg Donor, we shall help you to conclude an appropriate agreement with her. In case of anonymous donor you only conclude Medical Services Contract with fertility clinic for IVF with Egg Donation.

- Synchronization of cyclesand development of ovarian follicle
Once the contract(s) is signed, we shall inform IVF clinic giving them clearance to begin the medical procedures.
Firstly, the Egg Donor and the Surrogate undergo a process to synchronize their menstrual cycles. For these purposes the Egg Donor and the Surrogate take hormones (usually birth control pills).
Once the cycles are synchronized, the Egg Donor is given high doses of follicle-stimulating hormones that cause her ovaries to produce several eggs at once.
Meanwhile, the Surrogate Mother is seen several times during the treatment cycle for the purpose of monitoring her endometrium (lining of the uterus). Prior to the embryo transfer, she takes several medications that prepare the endometrium to receive the embryos.

- Egg retrieval and semen collection
The fertility clinic monitors egg development by using ultrasound and checking hormone blood level. When the follicles reach maturity the Egg Donor receives an injection of HGG (human chorionic gonadotropin), which is namely the start of final phase of the egg development.
Most egg retrievals are completed between 34 and 36 hours after HGG injection. The exact timing is extremely important to allow the best chance of successful conception.
Aspiration of eggs is guided by ultrasound and is performed in the operating room of fertility clinic with appropriate sedation to minimize nausea and discomfort. The patient usually spends an hour in recovery room and then is released to return home.

- Fertilization
Right after the egg retrieval, they are taken into the laboratory. The oocytes are put into a Petri dish with a culture medium. The dish is then placed in a special incubator which copies the conditions of the human body. After that the sperm is put into the medium with the eggs for fertilization. The embryos are monitored daily.

- The embryo transfer
Embryo transfer into the uterus is normally a painless procedure which does not require sedation or anaesthesia. It may not feel any different from an annual Pap smear.
The embryos are placed in a catheter along with a small amount of fluid, and then a tiny plastic tube is introduced into the uterus through the cervix and the embryo(s) are implanted into the endometrial cavity.

- After-transfer care
Generally, on the day of the egg retrieval the Surrogate will be prescribed to take progesterone that may come in many forms. On or about fourteen days after the embryo transfer a blood pregnancy test (FCG) is ordered to see if the transfer was successful and the pregnancy did occur. If the pregnancy test is positive, an ultrasound examination will be performed two weeks later to confirm the pregnancy.
In the event the pregnancy does not occur, you may begin another IVF cycle with your Surrogate.

- Pregnancy and delivery
You can be as involved as you and your Surrogate wish during the pregnancy. Our company will be available for you at all times in case you have any questions or concerns, want us to mediate your Surrogate, or just want to share your excitement! We shall be checking in regularly with your Surrogate to make sure she has everything she needs. You will get bi-weekly reports from us that should include information regarding Surrogate’s emotional state, well-being and activities.
In case of health emergency for the Surrogate, all practical measures will be taken to protect the Surrogate and the pregnancy, including arranging for physician and obstetrician appointments, medical tests, screening, hospitalization if appropriate.

Meanwhile, preparation of documents necessary for child’s birth registration in Ukraine and his/her travel back home with the Intended Parents takes place.

Several weeks before the delivery we move the Surrogate to Kyiv, where she will be observed till the highest point – delivery! Delivery services are organized in one of the leading maternity hospitals of Kyiv City, where your Surrogate would benefit from a dedicated, multidisciplinary team led by world-class obstetricians, gynecologists, midwives, nurse practitioners other experts in women's health. Ukrainian maternity wards have onsite Neonatal Care Units caring for babies born from 30 weeks gestation and there is always a Special Care Baby Unit for newborn babies who require intensive medical treatment due to e.g. being born early or because they have become unwell.
As soon as the child is medically ready to be discharged from the hospital, you can fully accept custody of take your new baby!

Embryo Donation in Ukraine

Embryo Donation and Embryo Adoption are similar concepts, and sometimes the terms are used interchangeably. Both refer to the giving and receiving of fertilized embryos that are created during an In Vitro Fertilization (IVF) cycle.

Embryo donation is an option if you and your partner require both egg and sperm donation, or if you are a single woman who cannot use your own eggs for medical reasons. In such cases the Intended Parents have no genetic link to the future child. Within the last few years embryo donation has become a new adoption choice! Rather than adopting a child who has already emerged from his/her mother's womb, embryo adoption allows the adopting family to begin the adoption journey with pregnancy and childbirth.

There are two types of embryo donation:

  • Fresh embryo transfer, when the couple is using freshly donated eggs that are fertilized with donor sperm and thereafter implanted into the body of Intended Mother after IVF. Ukrainian legislation stipulates that only frozen sperm can be used for embryo donation method.  
  • Frozen embryo transfer, when the Donating Parents have voluntary given a written informed consent for donation of their embryos that have been cryopreserved in the clinic bank upon IVF program(s). Through the use of IVF millions of couples have been able to become pregnant and the same couples may further find themselves with remaining embryos (perhaps one, perhaps 10) in storage. It is up to them to decide the destiny of those remaining embryos. Due to the fact that these couples are familiar with the physical and emotional struggles of infertility and have often gone through their own cycles of IVF unsuccessfully, they may choose to donate them to another couple experiencing the heartbreak of infertility.

In both cases donors undergo or have already undergone full medical examination according to current fertility legislation of Ukraine and are matched as closely as possible with the recipient couple for characteristics such as appearance (hair color, eye color). For more information on donor selection you are welcome to visit section “Egg Donation” on our website. Only embryos of high quality are used for embryo donation programs.

According to “Instruction on Procedures for Assisted Reproductive Technologies”, adopted by the Order of the Ministry of Health No. 771 of 12/23/2008, donors personality in cases of embryo donation and implantation constitutes medical secret.

- Preparation for the program
The cases of assisted conception using freshly donated eggs are carefully coordinated by medical specialists. Both the recipient mother and the female donor will be given hormones to get the fertility cycles synchronized. The donor needs to ovulate when the lining of Intended Mother’s uterus is able to support an embryo.
The egg donor will also be given fertility drugs to help her to develop several mature eggs for fertilization. When the eggs are ready, the donor will be given a sedation anaesthetic, and the doctor will perform egg retrieval using a fine hollow needle. Then the eggs are mixed in a laboratory with cryo-preserved sperm that has been thawed.

While using frozen embryos, the patient’s cycle does not need to be synchronized with the donor. This may make your treatment cycle less stressful. However, the freezing and thawing process of embryos may reduce your chances of becoming pregnant compared with using fresh embryos.

- Embryo transfer
Embryo transfer into the uterus is normally a painless procedure which does not require sedation or anaesthesia. It may not feel any different from an annual Pap smear.
The embryos are placed in a catheter along with a small amount of fluid, and then a tiny plastic tube is introduced into the uterus through the cervix and the embryo(s) are implanted into the endometrial cavity.
After the procedure the patient will need to have a bed rest for an hour, when her head down slightly and feet up. After going home, it is recommended to rest in bed till the end of the day. Kindly note that each clinic has their own protocol and will advise the patient to follow specified directions.

- After-transfer care
Generally, on the day of the egg retrieval the patient will be prescribed to take progesterone that may come in many forms. On or about fourteen days after the embryo transfer a blood pregnancy test (FCG) is ordered to see if the transfer was successful and the pregnancy did occur. If the pregnancy test is positive, an ultrasound examination will be performed two weeks later to confirm the pregnancy.

Surrogacy in Ukraine

- Selection and medical screening of the Surrogate Mother
According to Ukrainian Instruction on Procedures for ART a Surrogate has to be legally capable woman of majority age (over 18 years old) having at least one healthy child of her own, who gave her voluntary written consent to the use of Assisted Reproductive Technologies and has no medical contra-indications for pregnancy.
            Our company maintains our own database of Surrogate Mothers that are carefully screened on the following key factors:

  • Is the Surrogate physically healthy?

Your Surrogate’s physical health is extremely important, as it may impact the health of your baby when he or she is born. A thorough medical screening of the Surrogate is performed to ensure that she has no diseases or physical conditions that may cause problems during pregnancy and delivery.

  • Can she handle the emotional side of surrogacy?

There is no doubt – it is a “tough call” to carry a life inside one’s body for nine months and then just give it up. Whether or not the child is genetically related to the Surrogate, it has been a part of her.
We have an experience psychologist on our staff who performs psychological evaluation of potential Surrogate to ensure that she can handle the emotional impact of surrogacy. It is also important to learn how the Surrogate would handle situations that might occur in course of surrogacy program, such as abortion if the child shows signs of physical or mental disabilities, or using selective reduction in case of the multiples.
Our psychologist helps to determine the emotional status of the Surrogate, as well as provide professional support before, during and after pregnancy.

  • What is her motivation to act as a Surrogate Mother?

Altruism should be the prime motivating factor for Surrogate Mother candidates perceiving surrogacy as a way of obtaining a sense of value and achievement. If financial issues or dealing with feelings of guilt or anxiety about past actions (e.g. abortions …) are high on the list of priorities to become a Surrogate, this may rightfully raise a note of caution from psychological point of view.

  • Does she have a strong support network?

How a woman’s family and friends are handling the possibility of her becoming a Surrogate is a significant factor bearing on how she will handle it herself. If she is married, it is especially important that her husband is supportive of her decision.

  • Is she comfortable with the medical requirements of being a Surrogate?

Being a Surrogate requires a great deal of medical treatment, including possible daily injections, while the pregnancy may end up carrying and giving birth to more than one child. Our program coordinator will discuss these possibilities with the Surrogate to find out whether she stands up to this challenge.

  • Does the Surrogate understand the legal ramifications of surrogacy?

Before entering a surrogacy agreement, it is necessary to ascertain that she understands the rights the she will be giving up. To ensure that there are no misunderstandings or legal loophole, we provide our Surrogates with extensive legal advice pertaining to legal effect of surrogacy agreement concluded in Ukraine and procedure itself.

            After you sign up with our company for support of surrogacy program un Ukraine, we shall provide you with profiles of potential Surrogates for your review. We fully understand how important and life-changing choosing a Surrogate can be. Our full service staff is here to assist you in making the right decisions and making the best possible choices.
            Though each Surrogate Mother candidate is pre-screened in the clinic, she undergoes final medical examination to make sure that she is fit for surrogacy program at this very moment.

- Sign up a contract with the Surrogate
We shall provide you as well as your Surrogate with a draft Child-Carrying Contract. You and Your Surrogate will review the document in the appropriate native language, reach an agreement and sign the contract. Of course, our lawyers shall be available for all your questions and concerns regarding the content of surrogacy contract.

- Synchronization of cycles and development of ovarian follicle
Once the contract is signed, we shall inform IVF clinic giving them clearance to begin the medical procedures.  
Firstly, the Intended Mother and the Surrogate undergo a process to synchronize their menstrual cycles. For these purposes the Intended Mother and the Surrogate take hormones (usually birth control pills).
Once the cycles are synchronized, the Intended Mother is given high doses of follicle-stimulating hormones that cause her ovaries to produce several eggs at once.
Meanwhile, the Surrogate Mother is seen several times during the treatment cycle for the purpose of monitoring her endometrium (lining of the uterus). Prior to the embryo transfer, she takes several medications that prepare the endometrium to receive the embryos.

- Egg retrieval and semen collection
The fertility clinic monitors egg development by using ultrasound and checking hormone blood level. When the follicles reach maturity the Intended Mother receives an injection of HGG (human chorionic gonadotropin), which is namely the start of final phase of the egg development.
Most egg retrievals are completed between 34 and 36 hours after HGG injection. The exact timing is extremely important to allow the best chance of successful conception.
Aspiration of eggs is guided by ultrasound and is performed in the operating room of fertility clinic with appropriate sedation to minimize nausea and discomfort. The patient usually spends an hour in recovery room and then is released to return home.

- Fertilization
Right after the egg retrieval, they are taken into the laboratory. The oocytes are put into a Petri dish with a culture medium. The dish is then placed in a special incubator which copies the conditions of the human body. After that the sperm is put into the medium with the eggs for fertilization. The embryos are monitored daily.

- Embryo transfer
Embryo transfer into the uterus is normally a painless procedure which does not require sedation or anaesthesia. It may not feel any different from an annual Pap smear.
The embryos are placed in a catheter along with a small amount of fluid, and then a tiny plastic tube is introduced into the uterus through the cervix and the embryo(s) are implanted into the endometrial cavity.

- After-transfer care
Generally, on the day of the egg retrieval the Surrogate will be prescribed to take progesterone that may come in many forms. On or about fourteen days after the embryo transfer a blood pregnancy test (FCG) is ordered to see if the transfer was successful and the pregnancy did occur. If the pregnancy test is positive, an ultrasound examination will be performed two weeks later to confirm the pregnancy.
In the event the pregnancy does not occur, you may begin another IVF cycle with your Surrogate.

- Pregnancy and delivery
You can be as involved as you and your Surrogate wish during the pregnancy. Our company will be available for you at all times in case you have any questions or concerns, want us to mediate your Surrogate, or just want to share your excitement! We shall be checking in regularly with your Surrogate to make sure she has everything she needs. You will get bi-weekly reports from us that should include information regarding Surrogate’s emotional state, well-being and activities.
In case of health emergency for the Surrogate, all practical measures will be taken to protect the Surrogate and the pregnancy, including arranging for physician and obstetrician appointments, medical tests, screening, hospitalization if appropriate.

Meanwhile, preparation of documents necessary for child’s birth registration in Ukraine and his/her travel back home with the Intended Parents takes place.

Several weeks before the delivery we move the Surrogate to Kyiv (capital of Ukraine), where she will be observed till the highest point – delivery! Delivery services are organized in one of the leading maternity hospitals of Kyiv City, where your Surrogate would benefit from a dedicated, multidisciplinary team led by world-class obstetricians, gynecologists, midwives, nurse practitioners other experts in women's health. Ukrainian maternity wards have onsite Neonatal Care Units caring for babies born from 30 weeks gestation and there is always a Special Care Baby Unit for newborn babies who require intensive medical treatment due to e.g. being born early or because they have become unwell.
As soon as the child is medically ready to be discharged from the hospital, you can fully accept custody of take your new baby!

IVF + Egg Donation in Ukraine

- Egg donor selection

Requirements for egg donors in Ukraine:

  1. Age from 20 to 32 years;
  2. At least one previous pregnancy resulting in birth of a healthy baby;
  3. Absence of visible associated traits;
  4. Optimal somatic health;
  5. No contraindications for ovarian stimulation;
  6. Absence of hereditary disorders;
  7. No alcohol and drug consumption.

Donor anonymity
Some recipients prefer a "designated donor" (with whom they have a pre-existing relationship), while others prefer an "anonymous donor" (with whom they have no relationship), which is both allowed by the Instruction on Procedures for Assisted Reproductive Technologies in Ukraine, adopted by the Order of the Ministry of Health of Ukraine No. 771 of 12/23/2008.
Anonymous programs keep the identity of the donor completely confidential, while open programs allow donors to permit contact by the child at a later date; to meet the recipients; or to establish relationships with the recipients.

Donor selection is a complex process that involves several influences. We will help you to match with an Egg Donor from based on the following factors:
Medical Evaluation: The initial medical evaluation involves a physical exam, including a pelvic exam, drawing of blood samples, screening for infectious and inherited diseases or disorders, and measurement of hormone levels. These tests are designed to detect preexisting health conditions that would affect a woman's candidacy.
Family History: If no outstanding problems are found, the potential donor completes a detailed questionnaire about her family's medical and psychological history, as well as her lifestyle and substance use. This provides a background of genetic problems and health hazards that could impact the egg donation process.
Assessment of Appearance and Personal Characteristics: The potential donor's personal characteristics and preferences are assessed in order to provide potential recipients with an understanding of possible genetic traits of the foetus. Some characteristics may include height, weight, race, eye colour, ethnic and cultural background, interests and hobbies. These characteristics are compiled into a profile, which recipients will use to make their donor selection.
Psychological Evaluation: Since egg donation involves complex ethical, emotional, and social issues, potential egg donors should be in a sound psychological state to face these issues. The psychological evaluation process is designed to help a woman discern her stance on egg donation, prevent emotional trauma, address her concerns about the process, and help ensure that she will fulfil her obligations to the recipient.

- Additional screening of the Egg Donor
Though each Egg Donor is pre-screened in the clinic, she undergoes final medical examination to make sure that she is fit for egg donation program at this very moment.

- Synchronization of cycles
Once a candidate is chosen and screened for egg donation, she undergoes a process to synchronize her menstrual cycle with that of the recipient. For these purposes the recipient and the egg donor take hormones (usually birth control pills).

- Egg retrieval and semen collection
Once the cycles are synchronized, the donor is given high doses of follicle-stimulating hormones that cause her ovaries to produce several eggs at once. The donor must inject the hormones under the skin or into a muscle once a day for about ten days. Donors are carefully monitored to follow their progress and prevent over-stimulation of the ovaries. Prior to the embryo transfer, the recipient takes several medications that prepare her endometrium to receive the embryos.
When the eggs are ready for harvesting, the egg donor receives a final trigger shot (HGG injection). Between 34 or 36 hours after HGG injection the oocytes are removed from the ovaries in a minor outpatient surgical procedure that takes about 30 minutes. The donor is first given anesthesia for the surgery. After egg retrieval the donor usually spends an hour in recovery room and then is released to return home.

- Fertilization
Right after the egg retrieval, they are taken into the laboratory. The oocytes are put into a Petri dish with a culture medium. The dish is then placed in a special incubator which copies the conditions of the human body. After that the sperm is put into the medium with the eggs for fertilization. The embryos are monitored daily.

- Embryo transfer
Embryo transfer into the uterus is normally a painless procedure which does not require sedation or anaesthesia. It may not feel any different from an annual Pap smear.
The embryos are placed in a catheter along with a small amount of fluid, and then a tiny plastic tube is introduced into the uterus through the cervix and the embryo(s) are implanted into the endometrial cavity.
After the procedure the patient will need to have a bed rest for an hour, when her head down slightly and feet up. After going home, it is recommended to rest in bed till the end of the day. Kindly note that each clinic has their own protocol and will advise the patient to follow specified direction.

- After-transfer care
Generally, on the day of the egg retrieval the patient will be prescribed to take progesterone that may come in many forms. On or about fourteen days after the embryo transfer a blood pregnancy test (FCG) is ordered to see if the transfer was successful and the pregnancy did occur. If the pregnancy test is positive, an ultrasound examination will be performed two weeks later to confirm the pregnancy.

What is the fate of remaining embryos?
Most couples have embryos remaining after IVF procedures and have right to decide what they would like to do with them. There are a number of available options in the framework of current Ukrainian legislation, including cryopreservation and embryo donation. These options allow the patients to store the remaining embryos for their own future use or help other persons dealing with infertility.

While each case varies, the egg donation process typically takes about 2 to 3 months: a few weeks for screening, a few for menstrual synchronization, about 10 days for egg stimulation, and one day for retrieval surgery.