The IVF Process For Surrogates

How Exactly Does It Work?

Most of us have friends or family who have pursued fertility treatment in order to have a baby. In fact, 1 in 8 people in the United States struggle to have children, and many of those spend countless dollars and time only to still need a surrogate after failed attempts themselves.

As a Gestational Surrogate, you will learn a lot of terms and phrases, and may begin feeling a little overwhelmed about what it all means. Rest assured, Family Makers supports you throughout the process by explaining things step-by-step along the way.

In Gestational Surrogacy, an egg is fertilized in a fertility lab and grows to become an embryo. Once it has matured, it is placed into the uterus of a Surrogate during a very specific day and hour. The procedure is called an “embryo transfer” and is painless, usually lasting less than 10 minutes.

This is why you can become a surrogate with your tubes tied! Because the embryo is placed directly into the uterus using a small catheter, even women who have had this sterilization procedure can still be a Surrogate. The embryo is not biologically hers, yet she has a very special role for the next nine months if the procedure is successful.

There must be more to it, right? Absolutely.

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Time & Flexibility Required

Time & Flexibility Required

There is a lot of preparation that goes into having a baby for someone! The first step of the process is meeting with the fertility clinic, who will require extensive testing to maximize the chances of success. Many Surrogates have to travel to the fertility clinic a couple of times during a journey, and once is for this medical screening appointment. Over the course of 1-2 days, you will meet with the fertility specialist, the IVF nurse, a mental health provider and the lab. Some clinics will ask that your significant other accompany you during this trip if you are in a committed relationship. That person will usually be required to have blood testing and speak with a psychologist or social worker to go over their responsibility as your support person during the process. Silver lining – many Surrogates meet their Intended Parents for the first time during this trip!

Once you’ve returned home and received clearance to begin the IVF process, you will need to prepare to complete a few morning appointments leading up to embryo transfer. Whether you are a working mom or stay at home mom, your IVF nurse will provide you with a medication calendar in advance so you will know what mornings you will be attending appointments. These appointments are usually before 9:00am at an office close to you that is equipped to perform ultrasounds and blood work. Wait time at these offices are usually minimal, but your experience may vary. Regardless, you will have 4-5 appointments in the month leading up to embryo transfer, so be sure that your schedule and commitments will allow for them as they must be done on certain days.

After the fertility specialist has determined that your lining and body are ready for transfer, you will travel a second time to your Intended Parents’ clinic for the big day. Flying or driving there the day before allows you to visit with your Intended Parents and wake rested and ready Transfer Day. Depending on how far you traveled and the clinic’s protocol with regard to resting after transfer, you may be allowed to go home immediately after the procedure or you may be requested to stay 1-3 days before traveling home. Family Makers can let you know how long to expect to be away from home at the time you are matched so that you can plan accordingly.

Common Medications You May Take

Common Medications You May Take

One of the first questions we get is regarding injections. Are needles absolutely necessary? Are there people out there that really don’t mind shots? The answer is no, injections aren’t always required by the fertility specialist but every Surrogate must be prepared that they may have to.


Not every protocol or every medication works the same way for each person. What may work for one Surrogate may actually cause problems with another. Once we know what Intended Parents a Surrogate will be matched with, Family Makers reviews what medications will likely be required with the Surrogate so that she feels adequately prepared for what to expect. Common medications include:

Birth Control Pills

In addition to avoiding an unplanned natural pregnancy after committing to the Surrogacy process, taking birth control before IVF allows the fertility clinic to control the timing of a Surrogate’s menstrual cycle in preparation for starting medications. Many clinics will recommend starting a birth control as soon as medical screening is scheduled. A sample IVF calendar with birth control pills looks almost identical to one that doesn’t.


This hormone will almost always be included in your list of medications, and will be what builds your lining for a little embryo to have a place to grow. While usually prescribed as a pill, it can also be administered in the form of injections or patches.

Lupron/Leuprolide acetate

If you research this one, you’ll see that it’s used for a multitude of treatments. For the purposes of IVF, it suppresses your body’s ability to ovulate short term. This is administered as an injection only.


Antibiotics are prescribed as a preventative measure, and is meant to fight off any underlying infection or bacteria that could interfere with implantation.


This steroid may be prescribed right before embryo transfer. It is prescribed to prevent inflammation of the uterine lining and the body’s rejection of the embryo.


This hormone is vital and what makes the embryo stick to the uterine wall after it’s been transferred safely into the Surrogate. If pregnancy is achieved, it will be taken for another 8-10 weeks until the placenta can naturally support the baby. While it can be taken as a pill or vaginal suppository, it is most commonly taken as in intramuscular injection once a day.

Interested to see what a common medication and appointment calendar looks like?

OCP = birth control bill

Baseline U/S = 1st ultrasound performed in the month leading up to embryo transfer

E2 P4 = blood work for estrogen (E2) and progesterone (P4) will be taken

Estrace = estrogen; in this case, it is prescribed in pill form and dose varies throughout the cycle

Progesterone in Oil = in this case, it is prescribed as an intramuscular (IM) injection at night (PM) once a day

Medrol = steroid

Z-pac = antibiotic (azythromycin)

Bedrest = prescribed by some clinics, not all; may mean strict bedrest or simply light activity depending on the clinic

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Become a surrogate
Become a surrogate