Surrogacy Medications Explained

Surrogacy is a journey that begins well before a positive pregnancy test. For the process to succeed, it requires careful planning, coordination, and — most importantly — medical support. Among the most critical components of a surrogate pregnancy are the medications. If you're considering becoming a surrogate, you've probably heard about hormone shots and fertility meds, but what are they really for? Are they safe? And how do they work?

This article breaks it all down. No sugarcoating — just the facts, explained clearly and professionally.

Why Do Surrogates Need to Take Medications for Pregnancy?

Surrogacy doesn’t happen like a typical pregnancy. In traditional conception, the body naturally prepares for and supports a pregnancy with its own hormones. In gestational surrogacy, however, the embryo is created outside the body using IVF (in vitro fertilization) and then transferred into the surrogate's uterus. That means the body doesn’t go through the usual hormone shifts that would naturally occur after ovulation or conception.

To ensure the uterine lining is ready for the embryo and to support the pregnancy once it begins, surrogates take a carefully timed combination of medications. These medications "trick" the body into thinking it’s pregnant and maintain the right hormonal environment until the placenta can take over hormone production — usually around 10-12 weeks of pregnancy.

The medications are critical to the success of the embryo transfer and early pregnancy. Without them, the uterus wouldn’t be prepared to accept the embryo, and the chances of implantation would drop dramatically.

What Hormones Are Administered With Surrogate Medications?

Estrogen

Estrogen is usually one of the first medications you’ll start in a surrogate cycle. Its role is to build up the endometrial lining — the layer of tissue inside the uterus where the embryo will implant. A thick, healthy lining increases the chances of successful implantation.

Estrogen is commonly administered via pills, patches, or injections. The dosage is adjusted based on your body’s response, monitored by ultrasound and blood tests.

Some women may be surprised to learn they’re taking estrogen even if they’re not yet pregnant. But in surrogacy, you’re essentially preparing your body to act like it’s pregnant before the embryo is even transferred.

Progesterone

Progesterone stabilizes the lining and creates an environment that allows the embryo to implant and begin developing. It is typically given as an intramuscular injection (in the upper buttock area), although some protocols include vaginal inserts or gels as well.

You’ll start taking progesterone a few days before embryo transfer and continue for several weeks afterward — usually until the 10th to 12th week of pregnancy.

Progesterone can cause some uncomfortable side effects, but it’s absolutely essential for the pregnancy to "stick."

Lupron

Lupron (leuprolide acetate) is used at the very beginning of a surrogacy cycle to suppress your natural cycle. It basically “quietens” your ovaries and prevents your body from ovulating on its own, which allows doctors to control the timing of everything precisely.

Lupron is administered via subcutaneous injection — typically a small needle just under the skin. You’ll take it for a short period before switching to estrogen and progesterone.

Many surrogates report that Lupron is the easiest injection of the bunch in terms of pain and side effects, but as with any medication, responses can vary.

Around this point in your journey, you may be asked to review official safety and side effect information. The FDA provides detailed drug data sheets, which you can find here.

The CDC also offers IVF-related guidance for patients considering surrogacy and assisted reproductive technologies: https://www.cdc.gov/art/index.html

Medications FAQs

Are there side effects to these medications?

Yes, there can be side effects — some minor, some more noticeable. Here’s a quick breakdown of what to expect:

1. Estrogen: Bloating, headaches, breast tenderness, mood changes. Some women feel emotional or experience nausea.
2. Progesterone: Injection site pain, fatigue, mood swings, bloating, sore breasts. The intramuscular shots can be physically uncomfortable, especially with daily use.
3. Lupron: Hot flashes, headaches, moodiness, insomnia. These usually go away once the medication is stopped.

It’s important to keep your fertility clinic informed about any symptoms you’re experiencing. They can adjust dosages or offer solutions to make things easier.

For more information about medication safety during fertility treatments, the National Institutes of Health maintains a useful drug reference resource: https://www.nlm.nih.gov/medlineplus/druginformation.html

Will the medications have an emotional effect on me?

Yes, they can. These hormones don’t just affect your body — they can influence your mood too. Some surrogates report feeling more sensitive, irritable, or emotional while on medications, especially during the hormone-heavy weeks before embryo transfer and early pregnancy.

This isn’t a sign of weakness or something to feel bad about — it’s a normal response to powerful hormones. Having a support system in place (friends, family, a surrogacy coordinator) can really help during this time.

Also, don't be afraid to speak up if you're feeling off. Your team is there to support you, medically and emotionally.

Do I have to give myself shots?

In most cases, yes. The hormone medications used in surrogacy — especially progesterone and Lupron — are administered via injection. Some clinics may offer nurse-administered shots at appointments, but the majority of surrogates either self-inject or have a partner/friend help out.

1. Lupron: Subcutaneous shot (smaller needle, easier to administer).
2. Progesterone: Intramuscular shot (larger needle, needs to go deep into muscle).

Don’t worry — you’ll be trained thoroughly, and your medical team will guide you every step of the way. The first few days may feel intimidating, but most surrogates get the hang of it quickly. Some even say the shots become just another part of their daily routine.

Conclusion

Surrogacy medications are a vital part of helping a pregnancy take hold and thrive. While the idea of daily injections and hormonal changes can feel overwhelming at first, the truth is — you won’t be alone. From your medical team to your surrogacy agency, there will be plenty of guidance, support, and resources available every step of the way.

Understanding why these medications are needed and what to expect from them gives you the power to walk into your surrogacy journey informed and confident. And while the hormone rollercoaster isn’t always easy, the end goal — helping create a family — is one of the most meaningful things you can ever do.

Got more questions? Your agency and fertility clinic are there to answer them. No question is too small, and no concern is too silly.

You’ve got this.