A prospective surrogate must undergo a thorough medical and psychological evaluation before carrying a pregnancy for intended parents. Gestational surrogacy is a process where an embryo, created via in vitro fertilization (IVF) using the intended parents’ or donors’ gametes, is transferred into the surrogate’s uterus. This means the surrogate is not genetically related to the child she carries. Comprehensive medical screening is a standard and necessary step to ensure the health of the surrogate, the developing fetus, and the successful outcome of the pregnancy.
Surrogate Screening for Infectious Diseases
The initial phase of the surrogacy journey involves a meticulous medical screening process to ensure the candidate is physically ready to carry a pregnancy to term. A significant component of this evaluation is an extensive infectious disease panel, which is mandated by fertility clinics and guided by standards from organizations like the American Society for Reproductive Medicine (ASRM). These laboratory tests are mandatory to safeguard the health of the intended parents’ gametes or embryos, protect the developing fetus from potential complications, and confirm the surrogate’s overall health status.
The infectious disease panel routinely includes testing for pathogens such as HIV, Hepatitis B and C, syphilis, chlamydia, and Herpes Simplex Virus (HSV), both Type 1 and Type 2. Testing typically involves blood work to detect IgG antibodies, which indicates past exposure or infection rather than an active outbreak. The goal of this screening is to identify potential risks so they can be appropriately managed.
Eligibility Based on Herpes Status
The presence of the Herpes Simplex Virus does not automatically disqualify a woman from becoming a surrogate. Herpes is a highly common viral infection, and many women with a history of HSV-1 (oral herpes) or HSV-2 (genital herpes) successfully carry healthy pregnancies. Eligibility hinges on the type of infection and, more importantly, how well the condition is managed and controlled. Fertility clinics and agencies prioritize candidates whose infection is asymptomatic, infrequent, and well-documented.
A positive antibody test, showing past exposure to HSV-1 or HSV-2, is typically not a disqualifier in itself. The main concern is the risk of transmission to the newborn, which occurs almost exclusively during delivery if active lesions are present. Clinics will carefully review a candidate’s medical history, focusing on the frequency of outbreaks and whether she has a history of primary infection during a previous pregnancy.
A history of frequent or poorly controlled outbreaks, or a primary infection occurring late in a prior pregnancy, may lead to temporary or permanent exclusion due to the higher risk profile. Candidates with HSV are often required to be completely honest about their history and may need to provide a letter from a physician confirming the condition is well-managed. The willingness to adhere to specific medical protocols, including suppressive medication, is a requirement for acceptance into most programs. While a history of herpes does not bar a woman from surrogacy, intended parents may occasionally prefer a surrogate without any infectious disease history, which can sometimes lead to a longer waiting time for a match.
Medical Management During Pregnancy
Once a surrogate with a history of HSV is accepted, the focus shifts to comprehensive medical management throughout the pregnancy to prevent transmission to the newborn. The primary strategy for risk mitigation is the use of suppressive antiviral therapy. Medications such as Acyclovir or Valacyclovir are generally considered safe during pregnancy and are the standard treatment for managing HSV in pregnant individuals.
Antiviral therapy is typically initiated late in the third trimester, usually beginning around the 36th week of gestation, and continues until delivery. The purpose of this prophylactic treatment is to significantly reduce the risk of a recurrent outbreak and limit asymptomatic viral shedding in the genital area at the time of birth. This reduction in viral activity lowers the chance that the baby will be exposed to the virus as it passes through the birth canal.
The method of delivery is heavily influenced by the presence of active lesions or prodromal symptoms, such as tingling or nerve pain, near the due date. If the surrogate has an active genital herpes outbreak at the onset of labor or when her membranes rupture, a Cesarean section is typically recommended to avoid contact between the baby and the lesions. If the surrogate has a history of recurrent HSV but has no active lesions or symptoms at the time of delivery, a vaginal birth is usually considered safe.