Gestational surrogacy is a remarkable process that allows intended parents to fulfill their dreams of starting a family. At the heart of this journey is in vitro fertilization (IVF), a medical procedure that plays a key role in the surrogacy journey.
For surrogates, understanding the IVF process and the medications involved is necessary prior to choosing to help a family in this incredible way.
The Role of IVF in Gestational Surrogacy
In vitro fertilization (IVF) is a form of Assisted Reproductive Technology (ART) that enables surrogates to carry a child with no genetic connection to them. This is achieved by combining eggs and sperm in a lab to create embryos, which are then implanted into the surrogate’s uterus via embryo transfer.
The genetic material of the embryo can come from either a donor or the intended parents. Since this is gestational surrogacy, the surrogate’s eggs cannot be utilized in this process, providing fewer potential complications in terms of legal aspects.
IVF Medications: Types and Purposes
Medications are integral to the IVF process, especially for surrogates. There are three primary types of IVF medications for surrogacy: Hormonal injections, oral medications, and vaginal suppositories. They help regulate the surrogate’s menstrual cycle, prepare her uterine lining for embryo implantation, and maintain a supportive environment for the developing embryo.
| Medication | Type | Purpose | Administration | Notes |
|---|---|---|---|---|
| Lupron | Hormonal Injection | Suppresses natural ovulation and controls cycle timing | Self-injected (or partner-assisted) | Typically administered in the abdomen or thigh |
| Progesterone | Hormonal Injection | Maintains uterine lining and supports early pregnancy | Self-injected (or partner-assisted) | Often continued through the first 8-12 weeks of pregnancy |
| Estradiol | Oral Medication | Regulates menstrual cycle and helps build uterine lining | Pill form | May also be available as patches or injections |
| Birth Control Pills | Oral Medication | Synchronizes surrogate’s cycle with intended mother/donor | Pill form | Usually taken before starting other medications |
| Progesterone Suppositories | Vaginal Suppository | Provides additional hormonal support for early pregnancy | Inserted vaginally | May complement progesterone injections |
| Endometrin | Vaginal Suppository | Maintains progesterone levels during early weeks | Inserted vaginally | Often used multiple times daily |
1. Hormonal Injections
Hormonal injections regulate ovulation, prepare the uterine lining, and maintain hormonal balance during early pregnancy. Common medications include:
- Lupron: Used to suppress natural ovulation and control the timing of the cycle. It temporarily suppresses the pituitary gland’s hormone production, effectively preventing natural ovulation and giving fertility specialists precise control over the timing of the surrogacy cycle. Lupron is typically administered as a daily subcutaneous injection (just under the skin) using a small needle. Some surrogates may experience temporary menopausal-like side effects such as hot flashes, headaches, or mood fluctuations, but these generally subside as the body adjusts to the medication.
- Progesterone: Essential for maintaining the uterine lining and supporting early pregnancy. Progesterone in oil is typically administered as an intramuscular injection, requiring a longer needle inserted into the upper outer quadrant of the buttocks. Many clinics recommend these injections be given at the same time each day to maintain consistent hormone levels. While these injections can cause soreness at the injection site or occasionally develop small knots in the muscle, techniques like warming the oil before injection, massaging the area afterward, and rotating injection sites can help minimize discomfort.
During the early stages of the surrogacy process, medications like Lupron and Progesterone are often self-injected by the surrogate. Many surrogates may also have their partner assist them with these injections to ensure proper administration and support.
2. Oral Medications
Oral pills are used to regulate the menstrual cycle and synchronize the surrogate’s cycle with the intended mother or donor. These medications help ensure that the surrogate’s body is ready for the embryo transfer.
- Estradiol (Estrogen): Helps build and thicken the uterine lining, creating an optimal environment for embryo implantation. Estradiol is typically taken in pill form 1-3 times daily according to a specific schedule determined by the fertility specialist. Some surrogates may experience mild side effects such as breast tenderness, mild nausea, or headaches. For those who have difficulty with pill form, estradiol is also available as patches (changed every few days) or injections, providing flexibility in administration while achieving the same important hormonal effects.
- Birth Control Pills: Used to control the surrogate’s menstrual cycle timing to match it with the embryo creation schedule. This synchronization is crucial for timing the embryo transfer correctly. Birth control pills are typically taken daily for 2-4 weeks before beginning other medications. They provide the medical team with greater control over the surrogacy timeline and help prevent any unexpected ovulation that could interfere with the carefully planned protocol.
3. Vaginal Suppositories
Vaginal suppositories are often prescribed to provide additional hormonal support, especially for maintaining progesterone levels during the early weeks of pregnancy. They help create an optimal environment for the embryo to implant and grow.
- Progesterone Suppositories and Endometrin: Used to maintain optimal hormone levels during the critical early weeks of pregnancy. Suppositories are inserted vaginally according to a prescribed schedule (often 2-3 times daily) and slowly dissolve to release the hormone. Many surrogates find suppositories less uncomfortable than progesterone injections, though they may produce a waxy discharge that requires the use of panty liners. Some fertility protocols use both injections and suppositories simultaneously to ensure adequate progesterone levels, while others may transition from injections to suppositories as the pregnancy progresses.
Importance of Following Medical Protocols
Strict adherence to the prescribed medication schedule is one of the most important steps in the surrogacy journey. Timing and dosage significantly affect the success of the embryo transfer and implantation.
Surrogates should maintain open communication with their fertility clinic, report any side effects promptly, and use tools like medication calendars to stay organized.
Both surrogates and intended parents should take the time to understand IVF medications and their roles in the gestational surrogacy process prior to starting their surrogacy experience.
These medications prepare the surrogate’s body for embryo transfer, support early pregnancy, and maximize the chances of success.
By following carefully designed medical protocols and maintaining open communication with fertility specialists, surrogates can ensure their bodies are optimized for pregnancy, contributing to the overall success of the surrogacy journey.
Let Us Guide You
Choosing a longstanding agency for your surrogacy journey can provide you with the guidance, resources, and support to help make your experience as seamless as possible.
The Fertility Agency is here to support you every step of the way.
With years of experience and a dedicated team of former surrogates, The Fertility Agency offers personalized care to ensure a successful surrogacy process.
Our comprehensive services include outstanding matching services, guidance navigating the IVF process, and providing emotional and logistical support throughout the journey.
Our commitment to excellence and compassionate care makes us the ideal partner for intended parents and surrogates alike.
