Twins & Other Medical Questions for Single & Gay Men

Embarking on the journey to fatherhood through surrogacy is an exciting decision. As a fertility expert, I know that understanding the medical process is key to feeling empowered and making informed choices. This guide addresses the most common medical questions from single and gay intended fathers, from embryo creation to the moment you hold your child.

The Foundation – Creating Your Embryos

This module covers the initial medical steps of IVF, which are the same whether you are using a gestational surrogate or not.

• The IVF Process for Intended Fathers: A step-by-step explanation of how eggs from a donor are fertilized with sperm to create embryos. We’ll cover egg retrieval, fertilization (conventional IVF vs. ICSI), and embryo development in the lab.
• Genetic Testing of Embryos (PGT-A): Why preimplantation genetic testing for aneuploidy is highly recommended. It significantly increases the chance of a successful pregnancy by identifying embryos with the correct number of chromosomes, reducing the risk of miscarriage.
• Sperm Source Considerations:
  • Using Your Own Sperm: The importance of a semen analysis to assess count, motility, and morphology. We’ll discuss what happens if parameters are suboptimal and how IVF/ICSI can overcome many male factor issues.
  • Using a Sperm Donor: How to select a donor from a reputable cryobank, understanding the medical and genetic screening they undergo.

The Transfer – From Embryo to Pregnancy

This module focuses on the medical procedure that involves your gestational surrogate.

• The Embryo Transfer Procedure: A detailed look at what happens on transfer day. It’s a simple, quick clinical procedure where a selected embryo is transferred into the surrogate’s uterus via a thin catheter.
• Fresh vs. Frozen Embryo Transfer: Why frozen embryo transfers (FET) are now the gold standard in surrogacy arrangements. FET allows for complete genetic testing of embryos and optimal preparation of the surrogate’s uterine lining, synchronizing cycles for the best chance of success.
• Medication & Surrogate Preparation: An overview of the hormonal medications your surrogate will take to prepare her uterus to receive an embryo, creating a perfect environment for implantation.

The Twins Question – Risks, Rates, and Realities

A crucial module addressing one of the most common questions from intended parents.

• How Twins Occur in IVF: Explanation of the difference between fraternal (dizygotic) twins, which result from transferring more than one embryo, and identical (monozygotic) twins, which can rarely occur spontaneously, even with a single embryo transfer.
• Single vs. Double Embryo Transfer (SET vs. DET):
  • Elective Single Embryo Transfer (eSET): This is the strongly recommended approach for most cases, especially with genetically tested (PGT-A) embryos. It maximizes the chance of a healthy singleton pregnancy while drastically reducing the risks associated with twins.
  • The Reality of Twin Pregnancies: A direct discussion from a medical perspective: twin pregnancies are considered high-risk. They carry a greater chance of preterm birth, low birth weight, and complications for both the babies and the gestational carrier.
• Making the Decision: We will guide you and your surrogate through a shared decision-making process with your IVF physician, weighing the very real medical risks against your personal family-building goals.

Maximizing Success & Mitigating Risk

Proactive steps you can take to improve your journey’s outcome.

• Understanding IVF Success Rates: How to interpret clinic SART/CDC success rate reports. We focus on the live birth rate per single embryo transfer as the most important metric, as it reflects the quality of the lab and medical team.
• The Impact of Egg Donor Choice: The egg donor is the single largest biological factor in your success. We’ll discuss the medical screening criteria Surrogacy4All uses, including age, AMH levels, and prior donation history, to connect you with high-quality donors.
• The Surrogate’s Medical Screening: The thorough medical and psychological evaluation every surrogate undergoes to ensure she is physically and mentally prepared for a healthy pregnancy.