As a surrogate, you’re prepared for a wide variety of medical screenings, medications and, yes, injections.
But one shot in particular is typically administered under very specific circumstances: we will explore what RhoGAM is, the injection behind it, and why some people are encouraged to get it during pregnancy.
RhoGAM, short for Rho (D) Immune Globulin, is the brand name of a sterile solution made from human blood plasma and given to Rh-negative women in the form of an injection. Rh, or Rhesus, is a protein on the surface of red blood cells that most people naturally have.
If you have the protein, you are considered Rh- positive. If not, you are Rh-negative. And while it generally doesn’t matter if you’re positive or negative, pregnancy can be a concern if you are Rh-negative and the fetus is Rh-positive.
By getting a RhoGAM shot, you are preventing the gestational carrier or intended mother’s system from attacking the fetal blood.
Whether it’s a gestational carrier or an intended mother who utilized an egg donor, it’s very possible that the baby will have a different blood type. We all have two aspects to consider:
Any blood type may require the RhoGAM shot depending on Rh. If the gestational carrier or intended mother is Rh-negative, but the baby is Rh-positive, she could develop antibodies that attack and destroy Rh-positive blood. This may cause fetal anemia, which can develop into hydrops fetalis, a condition that leads to internal bleeding, shock, and heart and kidney failure.
Not only is it a risk throughout the pregnancy, but it could also be harmful to any future Rh-positive fetuses in subsequent pregnancies. In fact, if you are Rh-negative, your doctor will likely suggest you have a RhoGAM shot after a miscarriage, especially in the first trimester, within 72 hours. This will help prevent the antibodies from circulating any further and reduce future risks.
A RhoGAM shot acts almost as a vaccination, which introduces the body to a dosage of a virus that is too small to cause serious illness. Thus, the body learns to fight the virus effectively and prevents major reaction or sickness if exposed later. In this case, a RhoGAM shot contains antibodies to Rh-positive blood, but not in a high enough amount that it will hurt the fetus.
When the gestational carrier or intended mother’s body detects the antibodies, her immune system reacts as if it has already fought the foreign Rh-positive red blood cells. Since her immune system doesn’t react to the fetal blood, she doesn’t become sensitized to it.
Women have experienced side effects to RhoGAM. Some of the more common side effects may include:
It’s also possible for RhoGAM to interact with other prescription and over-the-counter medications, so it’s important to have a thorough evaluation and discussion with your doctor to determine the best course of action.
For a first pregnancy, RhoGAM is typically injected at about 28 weeks and then again within 72 hours post-delivery. For any subsequent pregnancies, RhoGAM is administered regularly during the second half of the pregnancy. It will stay in the body for approximately 3 weeks, but can be detected for as long as 8 to 12 weeks and is typically detected at delivery.
We know that both surrogacy and egg donation come with many medical questions; we’re here to support you in finding resources and answers. If you’d like to learn more, please don’t hesitate to contact our team.
All Things Conceivable is a blog dedicated to sharing the knowledge and expert opinions of the dedicated team at ConceiveAbilities, a Chicago-based egg donation and surrogacy agency.