The vast majority of surrogacies today are gestational surrogacies, in which an embryo is created in a clinical setting with the intended parent’s or donor egg and/or sperm, then transferred by a fertility doctor into the uterus of a surrogate. With gestational surrogacy, the baby is not genetically related to the surrogate, as her egg was not used to create the embryo. While the process of getting pregnant as a surrogate may sound simple, it is more complex than it may initially seem.
The procedure a surrogate undergoes to get pregnant is In Vitro Fertilization (IVF), but without the egg retrieval. Once a surrogate has been medically cleared by the intended parent’s fertility clinic, and after the intended parent(s)’s embryos have been created and frozen, a surrogate will begin medications for the frozen embryo transfer (FET). Each fertility doctor has their own unique medication protocol, but essentially all of them involve the use of supplemental hormones taken beginning on precise days within the surrogate’s menstrual cycle.
Nearly all fertility clinics utilize supplemental estradiol and progesterone for gestational surrogacies, as these hormones are vital to maintaining a pregnancy. Estradiol supplementation — which can be taken orally, transdermally, or as an intramuscular injection – is generally started 2-3 weeks prior to the transfer date and continued until weeks 9-15 of pregnancy. Progesterone supplementation — most commonly prescribed via intramuscular injection but can also be taken as a vaginal suppository — is typically started 5 days prior to embryo transfer and continued until weeks 9-15 of pregnancy. Other commonly prescribed medications include birth control pills to help regulate a surrogate’s cycle and prevent ovulation. Lupron is also frequently prescribed as it is more effective than birth control at preventing ovulation. Throughout the medication protocol, bloodwork and ultrasounds are done to monitor the surrogate’s uterine lining and hormone levels. The goal is to achieve an optimal uterine environment for implantation of an embryo.
Once the fertility doctor determines that a surrogate’s uterine lining is receptive and hormone levels are ideal, the surrogate will travel to the fertility clinic where the embryos are stored for an embryo transfer procedure. The procedure, in which an embryo is thawed and transferred through a thin catheter into the uterus, is quick and relatively painless, though mild cramping afterwards is common. The surrogate, and intended parent(s) if present, can view the embryo (which appears as a droplet) passing into the surrogate’s uterus on an ultrasound screen during the procedure. It is an extremely exciting and hopeful event for both a surrogate and intended parent(s)!
If you would like to know more about becoming a surrogate or are hoping to find an excellent surrogate, our team at Stronger Together Surrogacy would love to answer any questions you may have. We have all been surrogates or intended parents ourselves, so we fully understand the process and are here to help!
If you’re interested in applying to become a surrogate today, please see our surrogate application form.
