Tests during pregnancy: medical care in a surrogacy programme

1. Pregnancy tests: how medical monitoring works
2. First ultrasound in pregnancy: when it is performed and what it checks
3. Medical care within a surrogacy programme
4. How FHRG manages pregnancy care in its surrogacy programmes
5. Pregnancy screening by trimester
6. First trimester
7. Second trimester
8. Third trimester
9. Blood tests and other examinations during pregnancy

For intended parents involved in an international surrogacy programme, pregnancy is one of the most emotional stages. It is natural for both parents to want reassurance that the medical team is carefully monitoring the surrogate's health and the baby's development.

At Feskov Human Reproduction Group (FHRG), regular and transparent prenatal care therefore plays a central role in building trust between the intended parents and the clinic. This article explains how pregnancy care is organised, which tests are performed and how medical oversight is provided under FHRG programmes.

Pregnancy tests: how medical monitoring works

Medical monitoring starts as soon as a successful embryo transfer and pregnancy are confirmed. From that point until delivery, the surrogate is cared for by an obstetrician-gynaecologist who monitors the course of the pregnancy.

Before transfer, embryos are assessed in the laboratory and, if included in the programme, undergo genetic testing intended to reduce the risk of certain chromosomal and inherited conditions. Other structural abnormalities may be detected later during pregnancy through screening and ultrasound examinations.

Care is organised in line with the applicable medical protocols. The intended parents receive regular reports and ultrasound recordings. They may also join online consultations to speak with the doctor, discuss examination results and ask questions.

Pregnancy screening by trimester

Screening by trimester helps the team monitor the baby's development and the surrogate's health in a timely manner. Each stage requires particular attention. From an obstetric perspective, this is a pregnancy monitored according to the usual clinical principles, adapted to the individual's needs.

First trimester

The first trimester is particularly important because the fetus's major organs begin to develop during this period. In the first 12 weeks, the surrogate undergoes routine blood and other tests, infection screening and, when necessary, consultations with other specialists.

Second trimester

The second trimester focuses on fetal anatomy and placental assessment. Specific investigations include blood glucose testing, repeat blood and urine tests, and a detailed anomaly scan.

Third trimester

During the third trimester, monitoring also focuses on preparing for delivery. The doctor assesses the baby's estimated weight and position and the volume of amniotic fluid. If indicated, cardiotocography (CTG) is used to monitor the fetal heart rate.

These investigations may form part of routine care depending on medical indications and the applicable protocols.

First ultrasound in pregnancy: when it is performed and what it checks

An early ultrasound may be carried out at six to seven weeks to confirm that the pregnancy is developing and to detect the embryo's heartbeat. However, references to the 'first pregnancy ultrasound' often mean the more informative first-trimester screening scan, usually performed at 11–13 weeks.

This first-trimester scan allows the clinician to assess, among other things, the crown-rump length (CRL), the presence of the nasal bone and nuchal translucency (NT).

The scan may also be combined with biochemical blood testing. Together, these examinations make up what is commonly called first-trimester prenatal screening, which aims to assess the risk of certain chromosomal abnormalities early in pregnancy.

Blood tests and other examinations during pregnancy

Every test ordered during pregnancy serves a specific medical purpose. Key examinations include:

• Blood and urine tests to assess, among other things, kidney function, haemoglobin levels, and thyroid and liver function.
• Infection screening, which may include HIV, syphilis, hepatitis B and C, and other tests deemed necessary by the doctor.
• Screening for gestational diabetes, usually performed between weeks 24 and 28. The surrogate drinks a glucose solution and the body's response is then measured.
• Additional examinations where medically indicated, such as cervical-length measurement, Doppler ultrasound or consultations with other specialists.

These tests play an important part in protecting the health of the surrogate and the baby. They also help detect changes early that may require monitoring or medical intervention.

Medical care within a surrogacy programme

In its Portugal birth programme, FHRG uses an enhanced model of medical support for the surrogate. It includes:

• assessing the surrogate's health before she enters the programme, followed by regular monitoring of her well-being during pregnancy, with attention to nutrition, rest and general health;
• unannounced, selective laboratory testing for alcohol, drugs and their metabolites before embryo transfer and during pregnancy;
• documented monitoring of fetal development, with medical reports for the intended parents and opportunities to discuss key results directly with specialists;
• additional investigations where clinically indicated and covered under the chosen programme.

FHRG thus provides medical assistance at every stage of its surrogacy programme.

How FHRG manages pregnancy care in its surrogacy programmes

Under the structure of FHRG programmes, 12% of the price of a guaranteed package is allocated to pregnancy care. This covers tests, screening and regular monitoring of the surrogate's health with support from the clinic's medical team and technical resources.

The assisted reproduction stage of an FHRG programme may take place in Ukraine, while subsequent monitoring and delivery depend on the arrangements agreed for each family. This approach also reflects the Portuguese legal framework, under which surrogacy is allowed only on the terms established by applicable legislation and without a commercial element.

The surrogate remains under regular medical care throughout pregnancy. After the birth, FHRG specialists also provide legal assistance to parents with the steps required to establish parentage and obtain documents.