Surrogacy has become a beacon of hope for many individuals and couples yearning to have children but who face various fertility challenges. As surrogacy becomes more common, so do questions about eligibility and health requirements for potential surrogates. One health concern that frequently arises is HPV [1], or Human Papillomavirus, which is prevalent among sexually active individuals. The aim here is to address whether having HPV affects one’s ability to become a surrogate and what considerations need to be taken into account.
Understanding Surrogacy
Surrogacy is a method of assisted reproduction where a woman, known as the surrogate or gestational carrier, agrees to carry and give birth to a child for another person or couple.
Types of Surrogacy: Traditional vs. Gestational
There are two primary types of surrogacy: traditional and gestational.
Traditional Surrogacy
In traditional surrogacy, the surrogate is also the egg donor, meaning she is the biological mother of the child. The surrogate’s egg is fertilized through artificial insemination using the intended father’s sperm or donor sperm.
Gestational Surrogacy
Gestational surrogacy involves implanting an embryo created using the egg and sperm of the intended parents or donors into the surrogate’s uterus. In this case, the surrogate has no genetic link to the child.
The Role and Responsibilities of a Surrogate Mother
A surrogate mother plays a crucial role in the surrogacy process. She must undergo rigorous medical and psychological evaluations to ensure she is fit for the responsibility. Once selected, she must adhere to a healthy lifestyle, attend regular medical appointments, and maintain open communication with the intended parents throughout the pregnancy.
- Medical Appointments: Regular check-ups are essential to monitor the health of both the surrogate and the baby.
- Lifestyle Commitments: Surrogates must commit to maintaining a healthy lifestyle, which includes a balanced diet, regular exercise, and avoiding harmful substances such as alcohol, tobacco, and illegal drugs.
- Emotional Support: Being a surrogate is emotionally demanding. Surrogates often work with counselors or support groups to navigate the complex emotions that can arise during the surrogacy journey.
- Legal and Ethical Obligations: Surrogates must adhere to the legal agreements established before the pregnancy.
What is HPV?
HPV, or Human Papillomavirus, is a common virus with more than 100 different strains. It is transmitted primarily through sexual contact, including vaginal, anal, and oral sex. While most HPV infections are harmless and resolve on their own, some can lead to serious health issues.
Types of HPV: Low-risk vs. High-risk
HPV strains are categorized into low-risk and high-risk types.
- Low-risk HPV: These strains can cause genital warts, which are benign growths on the skin and mucous membranes. Genital warts can appear on the vulva, vagina, cervix, penis, scrotum, anus, or throat. They can be small or large, raised or flat, or shaped like a cauliflower.
- High-risk HPV: These strains are associated with various cancers, including cervical, anal, and throat cancers. The most concerning types are HPV-16 and HPV-18, which are responsible for the majority of HPV-related cancers. High-risk HPV infections can cause changes in the cells of the cervix, which can lead to cervical dysplasia [2] (precancerous changes) and, if left untreated, cervical cancer.
Common Symptoms and Health Implications of HPV
Most HPV infections are asymptomatic, meaning individuals often do not realize they are infected. However, some may experience symptoms such as genital warts or abnormal changes in cervical cells detected through a Pap smear. Persistent infections with high-risk HPV types can lead to precancerous lesions and, if left untreated, cancer.
- Genital Warts: These appear as small bumps or groups of bumps in the genital area.
- Cervical Dysplasia: This refers to abnormal changes in the cells on the surface of the cervix, which are usually detected through a Pap smear.
- Cancer Risks: High-risk HPV infections can lead to various cancers, most notably cervical cancer.
Surrogacy Requirements
Surrogacy agencies and fertility clinics have stringent surrogacy requirements to ensure the safety of both the surrogate and the baby. Key health criteria typically include:
Physical Health
- Age: Generally, surrogates should be between 21 and 40 years old.
- BMI: A healthy Body Mass Index (BMI) is important, typically between 19 and 32.
- Reproductive History: Surrogates should have had at least one successful, uncomplicated pregnancy and delivery.
- General Health: Good overall health, with no chronic conditions that could complicate pregnancy (e.g., diabetes, hypertension).
Mental Health
- Psychological Screening: A thorough psychological evaluation is conducted to ensure the surrogate is mentally prepared for the surrogacy process.
- Support System: Having a strong support system of family and friends is crucial.
Medical Screenings and Evaluations
- Blood Tests: These tests screen for infectious diseases such as HIV, hepatitis B and C, syphilis, and other sexually transmitted infections (STIs).
- Pelvic Exam: A thorough pelvic exam is conducted to assess the health of the surrogate’s reproductive organs.
- Ultrasound: An ultrasound may be performed to evaluate the condition of the uterus and ovaries, ensuring there are no structural abnormalities that could affect pregnancy.
- Review of Medical History: A detailed review of the surrogate’s medical history helps identify any potential risks or complications that could arise during pregnancy.
Lifestyle and Behavior Considerations
- Diet and Nutrition: Surrogates should follow a balanced diet rich in essential nutrients to support a healthy pregnancy.
- Exercise: Regular physical activity is important for maintaining physical health and preparing the body for the demands of pregnancy and childbirth.
- Substance Use: Surrogates must abstain from smoking, illegal drugs, and excessive alcohol consumption.
- Mental Well-being: Emotional health and understanding the pros and cons of being a surrogate is just as important as physical health.
HPV and Surrogacy
The possibility of becoming a surrogate if you have HPV depends on several factors. From a medical standpoint, having HPV does not automatically disqualify a woman from being a surrogate. However, specific conditions and considerations must be addressed.
Risks Associated with HPV in Pregnancy and Childbirth
While HPV is generally not a barrier to a healthy pregnancy, there are a few risks to consider:
- Genital Warts: If present, genital warts may grow larger during pregnancy due to hormonal changes, sometimes necessitating treatment.
- Cervical Changes: Persistent high-risk HPV infections can lead to cervical dysplasia (abnormal cell changes), which may require monitoring and, in some cases, treatment before pregnancy.
- Transmission: The risk of transmitting HPV to the baby during childbirth is low, but it can happen, leading to a condition called recurrent respiratory papillomatosis (RRP), where warts grow in the infant’s throat. This is rare but a consideration.
Guidelines from Surrogacy Agencies and Fertility Clinics Regarding HPV
Surrogacy agencies and fertility clinics have their guidelines regarding HPV. Generally, they require surrogates to undergo thorough medical evaluations, including HPV testing. If a potential surrogate has a history of high-risk HPV or abnormal Pap smears, further investigation and clearance from a healthcare provider are necessary.
- Medical Clearance: Surrogates with HPV must obtain medical clearance from their healthcare provider, ensuring there are no active or untreated infections that could pose a risk during pregnancy.
- Individual Assessment: Each surrogate’s case is unique, and agencies will assess potential surrogates on an individual basis.
Medical and Legal Considerations
To become a surrogate, medical clearance is mandatory. For those with HPV, this involves:
- Detailed Medical History: Providing a complete medical history, including HPV status and any treatments received.
- Pap Smears and Colposcopies: Regular screenings to monitor cervical health and detect any abnormalities early.
- Consultation with Specialists: If necessary, consulting with a gynecologist or an oncologist to ensure there are no active or untreated issues.
Legal Aspects and Contractual Obligations
Legal contracts are a critical part of the surrogacy process. These contracts protect the rights and responsibilities of both the surrogate and the intended parents. For surrogates with HPV, contracts may include clauses about disclosing health information and adhering to medical recommendations. It is essential to work with a legal professional specializing in reproductive law to ensure all aspects are covered.
Disclosure Requirements and Ethical Considerations
Transparency is key in the surrogacy process. Surrogates must disclose their HPV status to the surrogacy agency and the intended parents. This honesty builds trust and ensures that all parties are fully informed and can make decisions based on complete information. Ethical considerations also involve ensuring that the surrogate’s health is not compromised and that any potential risks are adequately managed.
Learn More With Surrogacy By Faith
Becoming a surrogate is a generous and life-changing decision, one that requires careful consideration of various health factors, including HPV. While having HPV does not automatically disqualify a woman from becoming a surrogate, it necessitates thorough medical evaluation and adherence to specific guidelines.
Speak with Surrogacy By Faith to have your questions answered. If you’re interested in becoming a surrogate or a parent through surrogacy, be sure to contact us today to learn more.
Sources:
[1]https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-20351596
[2] https://my.clevelandclinic.org/health/diseases/15678-cervical-intraepithelial-neoplasia-cin