Dictionary of surrogacy terms II

1. Dictionary of surrogacy terms II In the world of fertility in general and surrogacy in particular, there are a number of important terms and concepts that it’s recommended to understand.

2. Amniocentesis • Amniocentesis is a medical procedure that involves extracting a small amount of amniotic fluid from the sac surrounding the fetus in the uterus. This fluid contains cells and other substances that provide important information about the baby’s health. The procedure is typically performed between the 16th and 22nd weeks of pregnancy, when a thin needle is inserted through the surrogate mother’s abdomen and guided by ultrasound to collect amniotic fluid.  • While amniocentesis is generally safe, it is an invasive procedure and carries certain risks such as the possibility of miscarriage, infection, or injury to the fetus or uterus. 2

3. Non-Invasive Prenatal Testing (NIPT) • NIPT is a screening test used during pregnancy to assess the risk of certain genetic conditions in the fetus. It analyzes small fragments of fetal DNA that circulate in the pregnant woman’s blood. These DNA fragments, known as cell-free DNA (cfDNA), originate from the placenta and are found in the mother’s bloodstream. • A basic NIPT is typically performed after the 10th week of pregnancy and primarily screens for chromosomal abnormalities including: • Down syndrome (Trisomy 21): Tests for the presence of an extra chromosome 21. • Edwards’s syndrome (Trisomy 18): Tests for the presence of an extra chromosome 18. • Patau syndrome (Trisomy 13): Tests for the presence of an extra chromosome 13. 2

4. What is this trisomy and monosomy that appears everywhere? • Each person has 23 pairs of chromosomes – a total of 46 chromosomes, with half coming from the biological mother and half from the biological father. This is a normal, healthy situation. When do we have a problem? There are three problematic situations that these tests detect: • Monosomy- instead of a pair of chromosomes we have only one. That is, only one chromosome was received from one of the biological parents. • Trisomy – as its name is, “tri” (3): instead of one chromosome, two chromosomes were transferred from one of the parents and now instead of a pair we have triplets. • The last problematic situation is when the chromosome passed down from the parent has a deficiency, that is, it is not “whole”. • As mentioned, the basic test includes 3 common syndromes and there are more extended tests that examine 7 syndromes and those that examine even 100 syndromes or more. 2

5. Triple Test (also known as Maternal Serum Alpha-Fetoprotein Test) • The triple test is a prenatal screening test performed during the second trimester of pregnancy. • The three substances measured in the triple test are: • Alpha-fetoprotein (AFP): AFP is a protein produced by the fetal liver. AFP levels in a pregnant woman’s blood can help assess the risk of neural tube defects (such as spina bifida) and abdominal wall defects. • Human chorionic gonadotropin (hCG):hCG is a hormone produced by the placenta during pregnancy. High levels of hCG may indicate an increased risk of chromosomal abnormalities such as Down syndrome (trisomy 21). • Unconjugated estriol (uE3):Estriol is an estrogen produced by the fetus and placenta. Low levels of estriol may be associated with certain genetic disorders including Down syndrome and trisomy 18. 2

6. Glucose Tolerance Test (GTT) • Commonly known as a “sugar load test,” a glucose tolerance test is a medical examination that assesses how well the body processes glucose, the primary sugar found in the blood. There are different types of GTTs, depending on the specific situation of the individual, and they are designed for: • Oral Glucose Tolerance Test (OGTT): This test is specifically used to diagnose gestational diabetes in pregnant women and involves the following steps: • 50-gram glucose load: A screening test where a blood sample is taken from the pregnant woman after fasting. • 100-gram glucose load: In cases where the standard glucose load yields readings above 140 milligrams per deciliter (approximately 15% of women), or if the treating physician recommends it, the pregnant woman will undergo a 100-gram glucose load. • Intravenous Glucose Tolerance Test (IVGTT): In this test, glucose is administered intravenously, and blood samples are taken at various intervals to assess how quickly glucose is cleared from the bloodstream.  2

7. Interpretation of GTT results Normal: Blood sugar levels rise after consuming the glucose solution and then fall as insulin helps the glucose enter the cells. Impaired glucose tolerance (pre-diabetes): blood sugar levels are higher than normal but not high enough to be classified as diabetes. Diabetes: blood sugar levels remain high above a certain threshold. 2

8. Conclusion Understanding these key terms is essential, so if you are considering getting involved in the surrogacy process, we wish you the best on your exciting journey towards starting a family. Visit Us - www.tammuz.comPhone-0737838058 2