Gestational surrogacy requires candidates to meet stringent medical qualifications established by fertility clinics and reproductive specialists. The safety of both the surrogate and the fetus is the primary concern. A prior pregnancy history is closely scrutinized to confirm the candidate’s body can successfully sustain a healthy gestation. A history of preeclampsia is among the most significant medical issues requiring careful evaluation, as it poses serious risks in any subsequent pregnancy.
Understanding Preeclampsia
Preeclampsia is a hypertensive disorder that develops after 20 weeks of gestation, characterized by high blood pressure and signs of damage to organ systems, most often the liver and kidneys. Affecting 5% to 8% of all pregnancies, it ranges from mild to life-threatening. The disorder can cause dangerously high blood pressure, leading to complications like decreased platelet count, fluid in the lungs, or impaired kidney function.
Preeclampsia can escalate into eclampsia (seizures) or HELLP syndrome, a life-threatening variant. It also compromises blood flow to the placenta, potentially restricting fetal growth or necessitating early delivery. Delivery is the only definitive resolution for the condition, though symptoms may persist for weeks after childbirth.
Assessing Future Recurrence Risk
Medical professionals assess the likelihood of preeclampsia recurrence, as rates are highly variable, ranging from less than 10% to over 60%. The risk depends heavily on the characteristics of the initial episode. The most significant factor is the gestational age at which the condition first occurred; an earlier onset indicates a substantially higher risk.
For instance, preeclampsia occurring at 37 weeks or later carries an approximate 12.9% recurrence risk. If the condition occurred before 28 weeks, the risk climbs significantly to about 38.6%. Other factors that increase risk include chronic hypertension, a high Body Mass Index (BMI), kidney disease, or diabetes. Fertility specialists must weigh these specific factors carefully during evaluation.
Surrogate Screening and Medical Clearance Process
A potential surrogate with a history of preeclampsia must undergo a medical clearance process to be considered eligible. The initial requirement is the submission of complete medical records from the prior pregnancy, including prenatal, labor, and delivery notes. This documentation allows the medical team to accurately assess the severity, timing, and resolution of the previous preeclampsia episode.
Following the records review, the candidate must complete a mandatory in-person medical screening and comprehensive physical examination at the fertility clinic. Specific laboratory tests are conducted to ensure the candidate has made a full recovery and that no residual damage exists. These tests typically include baseline blood pressure checks, kidney function tests, and urinalysis to check for protein excretion. Finally, a reproductive endocrinologist or a high-risk obstetrician must review the entire medical profile and officially sign off, confirming that carrying a surrogacy pregnancy does not pose an undue risk.
Factors That Determine Eligibility
The final decision regarding a surrogate candidate rests with the medical director of the fertility clinic. Severe preeclampsia, especially cases resulting in significant end-organ damage or complicated by HELLP syndrome or eclampsia, usually leads to automatic disqualification. Preeclampsia that required delivery before 34 weeks of gestation is also typically a contraindication due to the high risk of recurrence and severity.
A candidate with a history of mild, late-onset preeclampsia, occurring at or near full term, may still be approved following a thorough evaluation and documented full recovery. These cases are evaluated individually, provided the candidate has no current chronic medical conditions that could compound the risk. The medical team must be confident that the residual risk is minimal and that the candidate is medically stable to proceed.