Medications in Surrogacy: Why exactly do I need them?
How exciting! You’ve done it! You’ve passed your medical clearance. You are physically, emotionally, and mentally prepared for this journey into gestational surrogacy. You’ve been chosen by the intended parents. You can’t wait to give joy to a family by bringing a child into the world for them, but…you have heard that you’ll need to take medications, maybe a lot of them, and you’re wondering what you’ll be on and why they are needed.
Our bodies are amazing. During a normal pregnancy, a woman’s hormones, namely estrogen and progesterone, kick in creating all manner of changes to prepare for the growth of a child including thickening in the uterine lining and an increase in blood volume. A surrogate mother’s body needs to be prepared medically in order to mimic these same changes.
So…what exactly happens? To maximize a successful transfer and pregnancy, you’ll likely be prescribed a number of medications. These will suppress your own natural cycle and help prepare your uterus for embryo transfer at the right moment. Each woman will have a different protocol, but here are some common medications that a surrogate mother takes to prepare and synchronize her body to help with implantation and fetal growth:
Lupron controls the levels of estrogen in the surrogate mother. It 
suppresses the pituitary stimulation in the ovaries by preventing follicle production and ovulation. This medication is taken approximately seven days prior to the start of the menstrual cycle. It’s given as an injection into fatty tissue (subcutaneously), by a ½” needle under the skin. It is usually given simultaneously with birth control. Birth Control helps synchronize menstrual cycles with the intended mother, or egg donor, and the surrogate mother prior to the embryo transfer. Lupron is discontinued prior to the egg retrieval in either the intended mother or egg donor.
Estrogen is needed to thicken the lining of the uterus and supports growth of an implanted embryo. Lining thickness is important because too thin or thick of a lining can cause the transferred embryo not to implant. This medication is started approximately halfway through the Lupron cycle and continues through the 12th week of pregnancy. Common medications for this are Vivelle patches, which are applied to the skin either on the abdomen or back or Estrace which is administered by either an oral tablet or vaginal suppository.
Progesterone, given either by intramuscular injection or a vaginal suppository, helps the body to successfully implant and promote growth of the embryo. It is essential for getting and staying pregnant. This hormone signals the uterus to support and nurture the transferred embryo. You will begin this medication a few days prior to transfer and continue it until the 12th week of pregnancy.
You may be asked to take a low dose Aspirin or Children’s Aspirin. Studies suggest it can improve implantation rates in certain women. If this is prescribed it is usually taken orally until the end of the first trimester.
To prevent and treat infections, you will take the oral antibiotic Tetracycline a few days before transfer. Additionally, Doxycycline may be prescribed and taken before and after transfer to eliminate any low grade pelvic infection. Medrol is a low dose steroid that suppresses the autoimmune system. All of these are oral medications and may decrease rejection of the embryo and increase the chance of a successful transfer.
Whatever your protocol is, make sure you take all medications on time. Spend a moment to fulfill all your prescriptions in advance, if appropriate, to make sure you have all medications on hand when you need them. Timing of medication during your surrogacy is extremely important to the success of a cycle. As with any medication, there may be side effects associated with them. It’s important to discuss each medication with your specialist to ensure you understand what to expect. If you have any questions regarding your medications, or you are expriencing any complications or side effects, please contact the nurse at the fertility center. If it is after hours or you have a pressing question, it’s perfectly acceptable to reach out to the on-call doctor.
If you would like more information about becoming a surrogate mother or about surrogacy in general, please contact Surrogates Across America. If you’re ready to become a surrogate, please fill out our application.