Women applying to become surrogates, are often unaware of the medical details surrounding the process. In particular they often wonder if a surrogate pregnancy differs from a personal pregnancy, and how this works physiologically.
The fact that surrogate pregnancies are not conceived naturally explains the need for hormone supplementation in order to prepare the uterus. Gestational surrogacy involves a process known as in-vitro fertilization. First, eggs are harvested from the intended parent or an egg donor. The eggs are fertilized in the laboratory and the resulting embryo(s) are then placed in the uterus of the gestational surrogate.
Surrogates are required to take medications in order to:
- Coordinate the menstrual cycle of the egg donor with that of the surrogate. This ensures that the surrogate’s uterus is primed and ready to accept the embryos.
- Prepare the surrogate’s uterus for pregnancy by providing two important hormones, estrogen and progesterone. Taken in sequence, these two hormones are meant to simulate the surrogate’s natural cycle. This combination maximizes the chances of pregnancy and helps to prevent a miscarriage.
Hormones administered during the surrogacy process may include:
- Estrogen: Estrogen is a hormone naturally produced by the ovary during the natural ovarian cycle. Estrogen thickens and builds the uterine lining. Estrogen is generally administered by mouth two or three times a week. It is taken from the beginning of the cycle and continued until a pregnancy is confirmed.
- Progesterone: Once the uterine lining reaches its critical thickness, a second hormone is added, progesterone. Progesterone makes the uterus receptive by inducing it to produce the proper nutrients to support the embryo. Progesterone is usually administered vaginally in the form of a vaginal insert or cream.
- Lupron: An injectable drug is occasionally administered in addition to estrogen and progesterone. Lupron prevents the surrogate’s cycle from “kicking in” at the wrong time. The injection is usually self-administered.
The combination of estrogen and progesterone is continued for approximately two weeks until the pregnancy test.
Hormone therapy for surrogacy includes natural forms of estrogen and progesterone administered in low doses and taken either orally or by vaginal inserts. In some cases, Lupron injections are added to the regimen to prevent the surrogate’s menstrual cycle from interfering with the process.
While the hormones are administered, weekly ultrasound examinations and blood tests are performed to ensure a proper response. Once pregnant, estrogen and progesterone are continued until the eighth or ninth week of pregnancy. At that point, the pregnancy produces its own hormones. Therefore, supplementation is no longer needed.
Are there side effects to these medications?
The medications used to prepare and support a surrogate for pregnancy are easy to take and have few, if any, side effects. Occasionally, a bloated feeling and mild cramping is reported.
Additional medications and lifestyle changes.
In order to provide the growing baby with the best environment, some lifestyle changes are helpful.
- Diet and Exercise: A healthy balanced diet is extremely important. If in doubt, consult the nutritionist at your obstetrician’s office for advice. Mild to moderate exercise is also highly recommended.
- Pre-natal Vitamins: The over-the-counter available pre-natal vitamin preparation packets provide a complete combination of vitamins required for the healthy growth of a baby. The vitamins should be started prior to the pregnancy and continued throughout.
A clear understanding of the surrogacy process as well as the medications required for a successful outcome is extremely important. The medications are necessary, easy to take, and provide you with the best chance of having a successful pregnancy.
Learn more about becoming a gestational surrogate