If you’re thinking about becoming a surrogate, it’s normal to have a lot of questions. You’ve probably already spent some time looking for the perfect agency, thinking about what kind of intended parents you want to carry for, and researching what your relationship will be like afterward. But if you’re like many women new to this journey, one of your biggest questions will probably be, “What is the medical surrogacy process?”
The medical surrogacy process can feel a bit complicated at first. But with this guide, you’ll have the answers you need about what to expect. If you have any questions, you can always fill out our online form to get free information.
Please note that this article is only here to provide helpful information as you start your surrogacy journey. It should not in any way be construed as medical advice. If you have any in-depth questions related to the gestational surrogacy medical process, please reach out to a medical professional.
Step 1: The screening processes
The first step for any potential surrogate is the screening process. This is done to make sure that your body is ready to carry a surrogate pregnancy for the intended parents. In general, this process includes:
- A pap smear and physical
- Bloodwork to check for any infectious diseases, such as HIV or hepatitis
- A hysteroscopy, which is an examination of your uterus and fallopian tubes
- A saline sonogram, a process where your uterus is flushed to check for fibroids or any other obstructions that could interfere with a pregnancy
- Drug screening
- And more
The surrogacy medical process is relatively simple. We know that the beginning of any medical procedure can make you feel understandably anxious. But with your surrogacy specialist and an experienced medical professional, you have little to worry about. As a part of your screening, you will also have to undergo a social and psychological screening to ensure that you’re ready for the surrogacy process.
Step 2: A mock cycle
To help prepare your body for the rest of the surrogacy medical process, your medical professional will need to prepare your body for the IVF transfer process. This is where a mock cycle may come in.
During this step, you’ll start taking the same medications as you would leading up to the embryo transfer process to help your body prepare for the real thing. Your reproductive endocrinologist will then check your hormone levels to make sure your body is responding well to the medications. You might also undergo bloodwork and ultrasounds to check the lining in your uterus.
Not all fertility clinics will perform a mock cycle — it all depends on your unique circumstances and the recommendations of the doctors you and the intended parents are working with.
Step 3: Prepare for the embryo transfer
When the fertility clinic deems you ready, you’ll start preparing your body for the embryo transfer. The timing of transfer will depend on whether the intended parents are using a fresh or frozen cycle during your surrogacy medical process.
If the embryos are transferred frozen, then they will usually be transferred five days after your mid-cycle. If fresh embryos are used, then your cycle will need to be synced with that of the intended mother or egg donor. In this case, you might need to take birth control pills to shut down your hormone production and give your doctors more control over your cycle. This way, they can make sure that your uterus is ready at the exact time as the embryo transfer. Your fertility clinic will prescribe additional medications and injections to help ensure the best chances of a successful pregnancy, and you will be monitored closely leading up to your transfer date to ensure things are progressing well.
“I had sonogram appointments regularly the whole month before transfer,” former surrogate Codi said. “That was to make sure that my uterine lining was thickening at the right pace. They didn’t want it too thin, but they didn’t want it too thick. That way, they could change our med protocol as needed.”
While you’re busy preparing for the transfer, the intended mother or egg donor will be taking injectable fertility hormones to stimulate her ovaries to produce several eggs. Once the healthy, viable eggs are retrieved, embryos will be created for the IVF surrogacy process. After the fertility clinic determines which ones are the healthiest and when the best time for transfer is, it will be time for the most exciting step of the medical surrogacy process: the embryo transfer!
Step 4: Embryo transfer
Once the embryos are ready for transfer, they will be moved using a catheter, which will be inserted through your cervix to the uterus. At this point, you will have stopped taking Lupron injections and instead switched to taking progesterone before the surrogacy treatment. This is done to establish and maintain an appropriate number of hormones for a successful implantation and a stable pregnancy. You’ll also start taking estrogen replacements in addition to the progesterone until around 12 weeks of pregnancy.
The transfer process is relatively quick and easy, and you won’t be under anesthesia. In fact, many women are surprised at how straightforward this step really is.
“I was so scared that it was going to be this huge ordeal, but it was like having your yearly checkup,” former surrogate Chelsea said.
Jewel had a similar experience.
“The transfer was nothing,” she said. “It was like a two-hour process — not even a two-hour process — where you just go in, wait for a while to be prepared to do the transfer. The transfer is like three seconds, and then they make sure the embryos have gone in. Once you’re done there, you go and lay down for a little bit, then you go home.”
However, it’s a good idea to take some time off after the transfer to help your body recover after the surrogacy treatment. During Alicia’s embryo transfer, she was only gone for around two days, and that’s including the embryo transfer and recovery period. She noted how the process itself is incredibly simple.
“You go home after the clinic and the bedrest is just to relax in your room for at least 24 hours, and I was able to leave the following day and get back to my child,” she said.
Before you know it, you’ll move on to the next step of the surrogacy process.
Step 5: Confirmation of pregnancy
About a week after the embryo transfer, you will return to the fertility clinic
to that the doctor can confirm your pregnancy. When you arrive, you’ll undergo a Human Chorionic Gonadotropin (or HCG) blood test that measures the level of pregnancy hormones in your body. A level of over 50 will indicate a positive, stable pregnancy. A few days later, you will undergo another HG C test to make sure that your pregnancy hormone levels are increasing. They should double about every two days.
“After transfer, I had blood draws very frequently,” former surrogate Codi said. “For me, it was almost every four days — just to make sure that the pregnancy was sustaining itself. After that, it became fairly regular, standard appointments with your OB.”
Finding out that you are officially pregnant is an exciting time in the medical surrogacy process for you and the intended parents. But if it doesn’t take after the first try, please know that it’s normal to undergo another transfer process. How many rounds you’ll go through will be determined early on in your surrogacy contract.
Step 6: Six-week ultrasound
After your pregnancy is confirmed, you will return to the clinic six weeks later for an ultrasound to confirm the heartbeat. Once a heartbeat is heard, you will start receiving your surrogacy compensation. After your ultrasound, you will continue with your regular appointments to check your hormone levels and make sure your pregnancy is stable. Depending on your agreement with the intended parents, you may undergo another ultrasound around 12 weeks.
Step 7: Prenatal Care
Afterwards, you can start visiting your regular, local OGBYN just like you would with any other pregnancy. You will continue to receive regular prenatal care for the medical surrogacy process, but you may have more visits to make sure that everything is going well. Once your pregnancy is over, you will give birth with the intended parents there and complete the surrogacy medical process.
Although the surrogacy medical process seems simple when you go down the list of steps, there is actually a lot you need to know. While the surrogacy medical process isn’t always easy or comfortable, you are doing something amazing that will forever change the life of a family. This will be an experience unlike any other. If you have any questions, please don’t hesitate to reach out to us to get more information.