What IVF Medications Do Surrogates Take?

When it comes to IVF surrogacy, there's a lot going on behind the scenes—especially on the medical side. One of the most important aspects of a surrogate's journey is the medication protocol that prepares her body for a healthy embryo transfer and pregnancy. It’s not just about taking a few pills; it’s a carefully managed schedule of hormones and other medications designed to give the embryo the best chance of implanting and growing.

This article walks you through exactly what IVF medications surrogates take, why they’re needed, when they’re started and stopped, and how surrogates can best prepare themselves for the journey ahead.

How Does IVF Surrogacy Work?

In traditional pregnancy, the egg is fertilized naturally within the woman’s body. In gestational surrogacy, however, the process is more complex. An egg from the intended mother (or a donor) is fertilized with sperm from the intended father (or a donor) in a lab. The resulting embryo is then transferred into the surrogate’s uterus.

This process is called in vitro fertilization (IVF), and for the surrogate, it means taking specific medications that prepare her uterus to accept and support the embryo. Because the surrogate is not genetically related to the embryo, her body needs help recognizing and nurturing this pregnancy from day one.

What Medications Are Used During IVF by Surrogates?

Surrogates take a series of medications in a very specific order to sync their cycle and create the ideal environment for implantation and pregnancy. Here are the most common ones used in the protocol.

Estrogen

What it does: Estrogen plays a crucial role in building up the uterine lining (endometrium), which is where the embryo will implant. Without a properly thickened lining, the embryo may fail to attach, or the pregnancy might not progress.

How it's taken: Usually through pills, patches, or injections. The dose and delivery method are determined by the fertility clinic.

Timing: Estrogen is often started early in the cycle, usually after the surrogate’s natural period begins, and continues until at least the 10th week of pregnancy if implantation is successful.

Progesterone

What it does: Progesterone is essential for maintaining the uterine lining and supporting early pregnancy. It's the hormone that keeps the uterus “sticky” enough for the embryo to stay put and develop.

How it's taken: Typically via intramuscular injections (big needle alert), vaginal suppositories, or oral capsules.

Timing: Starts a few days before embryo transfer and continues for several weeks into the pregnancy. It mimics what the body would naturally produce after ovulation.

Lupron

What it does: Lupron (leuprolide acetate) is a gonadotropin-releasing hormone agonist that temporarily suppresses the body’s natural hormonal cycle. This allows doctors to control exactly when the surrogate ovulates—or, more accurately, prevents her from ovulating altogether.

How it's taken: A small subcutaneous injection, usually once a day.

Timing: Often started 2–3 weeks before the beginning of the main medication cycle and stopped shortly before the transfer.

When Do IVF Medications Start and End?

The medication protocol usually starts 3–4 weeks before the embryo transfer. Here's a rough breakdown:

1. Lupron: Starts first to suppress natural ovulation.
2. Estrogen: Begins about 1–2 weeks later to thicken the uterine lining.
3. Progesterone: Starts about 5 days before the embryo transfer to mimic natural hormonal cycles.
4. If the embryo transfer is successful and pregnancy is confirmed, estrogen and progesterone continue until the placenta can take over hormone production—usually around week 10 to 12 of pregnancy.

Exact timelines vary depending on the surrogate’s body, the clinic, and the specifics of the embryo transfer. Always follow your reproductive endocrinologist’s instructions closely.

For more details about medication schedules and hormone use, visit official sources like https://www.nichd.nih.gov/health/topics/infertility and https://www.cdc.gov/art/.

Are There Side Effects to IVF Medications?

Yep—like with any medications, IVF drugs can come with side effects. Most are manageable, but they can still be uncomfortable or emotionally taxing.

Common side effects:

• Bloating
• Mood swings
• Breast tenderness
• Fatigue
• Headaches
• Injection site irritation

Less common but possible: Allergic reactions, ovarian cysts, or strong emotional responses due to hormonal changes.

Every surrogate responds differently. It’s important to maintain open communication with the fertility clinic and report any severe or unusual symptoms.

For safety data and drug-specific info, you can also refer to https://www.fda.gov/drugs.

How Else Can Surrogates Prepare for Pregnancy?

Diet and Exercise

Eating a balanced diet rich in whole foods, lean proteins, and leafy greens helps regulate hormone levels and support uterine health. Light to moderate exercise—like walking, yoga, or swimming—can improve circulation and reduce stress, both of which benefit implantation and early pregnancy.

Skip intense cardio or anything high-impact around the time of embryo transfer unless your doctor says otherwise.

Prenatal Vitamins

Even before pregnancy is confirmed, surrogates are typically advised to start taking prenatal vitamins. These usually include folic acid, iron, calcium, and DHA—nutrients crucial for early fetal development.

Folic acid in particular helps reduce the risk of neural tube defects and is recommended by the https://www.cdc.gov/ncbddd/folicacid.

Massage

Light therapeutic massage—especially fertility or prenatal massage—can help relax muscles, improve blood flow to the reproductive organs, and relieve stress. Make sure it’s performed by a licensed massage therapist familiar with surrogacy and IVF protocols.

Conclusion

The IVF medication regimen is a critical part of the surrogacy process. While it can be intense and demanding, it’s designed with one goal in mind: giving the embryo the best possible environment to grow into a healthy baby. From estrogen and progesterone to Lupron and lifestyle support, every step has its role.

If you’re considering becoming a surrogate, understanding these medications—and how they work together—will help you feel informed, prepared, and confident in your decision. And as always, working closely with your fertility clinic ensures that your health and well-being stay a top priority throughout the journey.

Surrogacy isn’t just a medical process—it’s an act of generosity and love. And it all starts with preparation.