Surrogacy and Selective Reduction: How Does This Process Work?

No one enters into the surrogacy process thinking that they might need to have a selective reduction. To be honest this procedure was needed much more in the past years when more than one embryo was transferred during an IVF process than currently when single embryo transfers are the norm. Still, in rare cases, the selective reduction is needed and it is best to know what the procedure is like and under what circumstances one might need a reduction at all. 

If for some reason an embryo transfer results in more than 2 fetuses then the reduction is often considered. The outcomes for carrying multiples can be vary depending on the health of the carrier. It is very stressful on a body to carry two babies let alone three or four. Not to forget the growing fetuses where lack of room and nutrients could cause a miscarriage of the entire pregnancy, preterm birth, or rupture of the uterus among other concerning medical issues. 

The selective reduction is usually carried out within the first trimester of pregnancy. The fetuses are evaluated by several medical tests. This helps the doctor to determine which fetus might be less healthy, which might cause the biggest negative issue in the pregnancy, and which might be in the best location for a successful reduction. 

Once the fetus to be reduced is determined by the professionals involved, Potassium Chloride is injected into the heart using ultrasound guidance. The heart then stops and the fetus dies. Because this procedure is done early in the pregnancy the fetal matter is usually reabsorbed into the surrogate’s body. 

Any risks are rare but could include bleeding, retained placenta, infection, and miscarriage. It’s always wise to weigh any risks of selective reduction against the risks of carrying three or four babies to term. Often a second opinion is required in order to make this very heart-wrenching decision. No one starts a surrogacy journey thinking that one or more embryos might be reduced but it is best to be informed of the facts as this issue is often added into a surrogacy contract. 

If you have any questions regarding selective reduction, it is always best to discuss it with your medical professional.

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