The journey to becoming a gestational surrogate involves a rigorous medical evaluation designed to protect the health of both the carrying mother and the baby. Agencies and fertility clinics adhere to strict medical guidelines, and part of this comprehensive process is infectious disease screening, including testing for the Herpes Simplex Virus (HSV). While a diagnosis of HSV requires careful management, a prior infection does not necessarily disqualify a woman from pursuing surrogacy. The central focus of the medical review is determining whether the condition can be safely managed to ensure a healthy pregnancy and minimize any risk of transmission to the child.
Understanding Surrogate Screening
The initial phase of the surrogacy process involves a thorough medical and psychological screening to confirm a candidate is physically and emotionally prepared to carry a pregnancy. General health requirements typically include a Body Mass Index (BMI) within a specific, healthy range, often below 32, and a history of prior successful, uncomplicated pregnancies. These standards are in place to reduce the risk of common pregnancy complications like gestational diabetes or preeclampsia.
A detailed infectious disease panel is also routinely performed, which screens for conditions that could pose a risk to the developing fetus or the intended parents. This panel includes testing for viruses and infections such as Human Immunodeficiency Virus (HIV), Hepatitis B and C, Syphilis, and HSV-1 and HSV-2. The goal is to identify any pre-existing conditions that require medical intervention or may affect eligibility.
HSV Status and Eligibility Requirements
The presence of Herpes Simplex Virus (HSV) antibodies, which indicate past exposure, is handled differently than an active, uncontrolled infection. HSV-1 usually causes oral herpes or cold sores, while HSV-2 is generally associated with genital herpes, although both types can affect either area. Having a history of either type does not automatically lead to disqualification, provided the condition is well-managed.
The primary concern for fertility clinics is the potential for neonatal herpes, a rare but serious condition that can occur if the baby is exposed to the virus during birth. For this reason, eligibility depends heavily on the frequency and severity of past outbreaks. A history of infrequent, mild, and well-controlled outbreaks is often acceptable for program participation. Conversely, a history of frequent or severe outbreaks, or an active infection identified during the initial screening, may result in a temporary or permanent deferral. Fertility specialists assess the overall risk profile, recognizing that the presence of maternal antibodies from a long-standing infection offers some protective benefit to the fetus. Transparency and honesty about one’s complete medical history are paramount for a successful evaluation.
Reducing Risk During Pregnancy and Delivery
Once a surrogate with a history of HSV is accepted, specific medical protocols are implemented to actively minimize the risk of transmission. The most important preventative measure is the use of prophylactic antiviral medication, typically starting late in the third trimester, around 36 weeks of gestation. Medications like acyclovir or valacyclovir are prescribed to suppress viral replication and reduce the chance of an outbreak occurring near the time of delivery. This suppressive therapy is highly effective in decreasing the likelihood of active lesions and viral shedding in the birth canal at term.
If the surrogate enters labor without any signs of an active outbreak or prodromal symptoms, a vaginal delivery is usually considered safe. Prodromal symptoms, such as itching, tingling, or pain, can indicate that an outbreak is imminent, even if no lesions are yet visible. If a surrogate does have an active genital lesion or experiences prodromal symptoms when labor begins, a Cesarean section (C-section) is performed to prevent the baby from contacting the virus while passing through the birth canal. This proactive surgical intervention is a standard obstetric practice designed to safeguard the infant.