High-tech surrogacy

HTDM is an IVF treatment in which an embryo, created with eggs and sperm from the intended parents or donors, is placed in the uterus of a surrogate who carries the pregnancy.

What is high-tech surrogacy?

High-tech surrogacy is an advanced medical procedure in which a surrogate carries an embryo that is not genetically related to her. The high-tech form of surrogacy means that IVF (or ICSI) treatment is carried out, combining eggs and sperm from the intended parents or donors.
HTDM offers an innovative solution for couples or individuals who are unable to carry a child themselves for medical or other reasons.

Who is HTDM suitable for?

High-tech surrogacy is available to intended parents who meet the medical criteria, such as the absence of a uterus, a medical contraindication to pregnancy, or male couples.

Finding a surrogate
Intended parents must find a surrogate themselves and, if necessary, an egg donor. Because of the medical risks and success rates, there are age limits for the egg donor and the surrogate. In addition, various inclusion criteria apply to be eligible for a treatment programme. We will never act as an intermediary between the intended parents and a surrogate.

No uterus or a non-functioning uterus

In the absence of a uterus (womb) or if the uterus does not function properly, such as in Asherman's syndrome. (RIF, recurrent implantation failure, is not an indication for high-tech surrogacy.)

High-risk pregnancy

When a pregnancy would be life-threatening for the intended mother or would worsen a serious condition she has.

Life-threatening risk to the unborn child

When there is a life-threatening risk to the unborn baby, for example because of repeated premature births.

Male couples

High-tech surrogacy can be a way for male couples to fulfil their wish to have a child.

Conditions:

At least one intended parent is younger than 45.
Genetic intended father: age not applicable (>45 years: higher risk of autism).
At least one intended parent has a life expectancy of at least 18 years.
Both are resident in the Netherlands.

How does HTDM work?

If you recognise yourself in the indications and conditions listed, you can register with us for an information consultation. It is important that your team – the surrogate and, if applicable, an egg donor – is complete before the treatment process starts.

A complex and costly process

High-tech surrogacy is a complex and costly process. In addition to the medical treatment, the intended parents, egg donor and surrogate receive extensive psychological and legal support. A positive evaluation is required before the IVF treatment can start.

This process falls under uninsured care, with estimated costs of between €25,000 and €30,000. These costs cover medical, psychological and legal support, as well as administration costs.

Consultation and preparation

After the information consultation and a positive recommendation from the doctor, the treatment process begins. It starts with extensive medical and psychological screening of the intended parents and the egg donor (if applicable). The proposed surrogate is then screened for medical and psychological suitability. The final step before treatment starts is an appointment with a lawyer, at which agreements are drawn up between all parties (intended parents, egg donor (if applicable) and surrogate) for the further arrangements of the process. This preparatory phase takes an average of 9–12 months.
In vitro fertilisation (IVF)

Eggs and sperm from the intended parents, or from an egg donor/sperm donor, are collected and fertilised in the laboratory to create embryos.
Embryo transfer

The surrogate undergoes hormonal treatment to prepare her uterus for the implantation of the embryo.
Pregnancy and birth

The surrogate is welcome for a first pregnancy scan. When we see a beating heart on the scan and the embryo is growing well, the treatment has been successful. The surrogate and the intended parents are referred to a specialist in their own region. The surrogate carries the pregnancy to term and, after the birth, the child is handed over to the intended parents.

Indications & conditions

Nij Clinics Elsendorp carries out high-tech surrogacy treatments in order of registration. Please read the following indications & conditions carefully.

Indications

Intended parents are eligible for this treatment if they meet one of the following indications:

No uterus (womb)
A uterus that does not function properly, such as in Asherman's syndrome. (RIF, recurrent implantation failure, is currently not an indication for high-tech surrogacy.)
Pregnancy is life-threatening or would worsen a serious condition in the intended mother
Pregnancy poses a life-threatening risk to the unborn child
Male couples

Conditions for heterosexual couples

Male-female couples using their own eggs:

Intended mother up to the age of 43 with a good ovarian reserve*
BMI below 35, ovaries easily accessible for egg retrieval. A BMI above 35 requires discussion; no treatment with a BMI above 40
Intended father: age not applicable (>45 years: higher risk of autism)
At least one partner has a life expectancy of at least 18 years
Both are resident in the Netherlands

*This age limit has been set in view of the ratio between the chance of pregnancy and the costs (cost-effectiveness).

Male-female couples using an egg donor:

At least one intended parent < 45 years
Intended father: age not applicable (>45 years: higher risk of autism)
At least one intended parent has a life expectancy of at least 18 years
Both are resident in the Netherlands

Conditions for male couples

Male couples:

At least one intended parent < 45 years.
Genetic intended father: age not applicable (>45 years: higher risk of autism).
At least one intended parent has a life expectancy of at least 18 years.
Both are resident in the Netherlands.

Conditions for the egg donor

Conditions for the egg donor:

Preferably younger than 36, maximum age 43 with a good ovarian reserve.
BMI below 35, ovaries easily accessible for egg retrieval. A BMI above 35 requires discussion; with a BMI above 40, the egg donor is not considered suitable.
The egg donor has preferably completed her own family.
If she is firmly convinced that she does not wish to have children, this will be discussed individually.

Conditions for the surrogate

Conditions for the surrogate:

The surrogate must not have been recruited through a commercial agency.
Resident in the Netherlands.
The surrogate preferably has a completed family at the time of the surrogacy.
The surrogate must have had at least 1 full-term pregnancy without serious complications, i.e. a pregnancy without (severe) pre-eclampsia, premature birth or growth restriction. Mild and moderate complications are assessed on an individual basis.
After a medical history, physical examination and any additional tests, no or minimal additional risks have been identified.
An acceptable increased risk of complications during pregnancy is permitted. In particular, there must be no high blood pressure requiring medication.
The BMI must not be higher than 30.
The surrogate must be willing to follow a number of rules of conduct set by the treatment team during the treatment period and pregnancy. (Examples of these rules: no unprotected sexual intercourse around the time of conception, no alcohol, no drugs and no smoking.)
If the surrogate has a registered partner, the partner must consent in writing to her decision to become a surrogate. The partner must also co-sign the contracts.
The surrogate is younger than 45 at the start of the IVF treatment (we advise allowing 12 months between the very first consultation at the clinic and the actual treatment).
The surrogate is referred for extensive preconception screening, and this screening must not result in advice against pregnancy.

Costs

What are the costs?

The costs of an HTDM treatment process consist of the appointments with specialists, the treatment, the medication and any storage costs for your own or donor material and/or embryos. For an indication of the costs, please consult our list of fees.

Uninsured care

High-tech surrogacy is a complex and costly process and is not covered by insured care. In addition to the medical treatment, the intended parents, egg donor and surrogate receive extensive psychological and legal support. A positive evaluation is required before the IVF treatment can start.

Please bear in mind possible additional costs (uninsured care):

Counselling session
Purchase of donor material
Storage costs for donor material
Storage costs for embryos
Treatment costs
Infection screening
Etc.

The costs of storing donor material are listed on our list of fees.

Counselling

Counselling within the surrogacy process is provided by an external healthcare psychologist (GZ-psycholoog). They screen the intended parents, the egg donor (if applicable) and the surrogate in individual and joint sessions. In this way, we safeguard the quality of care and clarify expectations and possible risks, so that everyone can make a well-considered choice. There is also room for aftercare and extra support during and after the process. We work together with ZED (Claudia Klatt) and Onspsychologie (Marin).

Success rates of HTDM treatment

29,8%

Chance of clinical pregnancy³
21,3%

Chance of ongoing pregnancy³

Pregnancy rates

The success rates of HTDM depend on various factors.

Explanation

A clinical pregnancy² is a pregnancy in which a gestational sac can be seen in the uterus on the ultrasound scan.
An ongoing pregnancy means that the pregnancy continues to develop, with a growing embryo and a beating heart.

²Not all clinical pregnancies lead to an ongoing pregnancy, as some end early in a miscarriage.
³The statistics shown are averages per transfer. No rights can be derived from them.