Medication Expectations
Surrogacy Medications Explained
Medication protocols are an important part of your surrogacy journey with Circle. The treatments you’ll receive — typically estrogen and progesterone, and sometimes Lupron — usually begin a few weeks before your embryo transfer and continue until the placenta takes over hormone production.
We’ve walked alongside over 3,000 moms on their surrogacy journeys. We can help you understand the surrogacy medication process, so you know what to expect.
Why Do Surrogates Need to Take Medications for Pregnancy?
Building a family through gestational surrogacy starts with in vitro fertilization (IVF), in which embryos are created in a lab and later transferred to your uterus at a fertility clinic.
Before the embryo transfer, your fertility clinic may prescribe hormone supplements to help your uterus become receptive to an embryo. These treatments prepare the uterine lining and can support the early weeks of pregnancy until the placenta takes over hormone production.
We understand that this protocol may differ from your previous pregnancies, so we’re here to answer your questions and support you throughout treatment.
What Hormones Are Administered With Surrogate Medications?
While the medication process for surrogacy can vary depending on your clinic and doctor, treatments typically involve the following.
This hormone helps thicken and build the uterine lining to prepare for pregnancy. Your ovaries naturally produce estrogen during the ovarian cycle, but in a medicated embryo transfer cycle, your fertility clinic may prescribe supplemental estrogen.
Estrogen can be taken in several ways, including orally. Your dose, how often you take it, and how long you continue taking it will depend on your clinic’s specific transfer protocol. If pregnancy occurs, estrogen supplementation may continue during the early weeks of pregnancy.
After the uterine lining is at optimal thickness, you’ll begin taking progesterone. This hormone helps make the uterus more receptive by encouraging the production of the nutrients an embryo needs to thrive. Progesterone may be administered vaginally or by injection, depending on your clinic’s protocol.
Some clinics prescribe leuprolide acetate, commonly known by the brand name Lupron, which is an injectable medication, usually self-administered. Lupron controls your cycle so it aligns with the transfer timeline. We know self-administering an injection can feel unfamiliar at first, but your clinic team will show you exactly what to do.
Your Surrogacy Medication Timeline
In a medicated embryo transfer cycle, you’ll typically begin estrogen early in your menstrual cycle. Once monitoring confirms your uterine lining is appropriately prepared, you’ll begin progesterone, usually several days before the embryo transfer. You will continue taking both hormones through the transfer and until your pregnancy test, typically about two weeks later.
If the test is positive, you’ll keep taking these hormones as directed by your fertility clinic, often until around the eighth or ninth week of pregnancy, although the exact timing varies. By this stage, the placenta is producing these hormones on its own.
Around this time, you’ll also typically transition from your fertility clinic to your selected OB/GYN for care throughout the rest of your pregnancy.
Medication FAQs
If you have questions we haven't answered below, reach out to our team.
These medications are usually well tolerated, and your fertility clinic will walk you through how to take each one. Possible side effects include bloating, mild cramping, and mood changes. Progesterone is often suspended in sesame oil, and some surrogates notice pain, redness, or an allergic reaction at the injection site. A warm cloth or heat pack can help, and Circle’s mentors and community groups are a good place to get tips from people who have done this.
Surrogacy medications may produce symptoms similar to what you notice during your natural monthly cycle or have experienced during your previous pregnancy, like mood swings. Mood changes can occur as your body responds to hormonal shifts. If your mood changes feel severe or concerning, contact your clinic.
You may have to inject yourself (or have a friend or your partner help) with hormones. While the injections may be a bit uncomfortable, many of our surrogates say the injections become routine after the first week or two.
Yes, most surrogates can continue working while taking surrogacy medications. Your experience may vary depending on the medications you take and how your body responds. You may need to schedule your regular monitoring appointments around work responsibilities.
While it’s important to take your medications as prescribed, we know that life gets busy and mistakes happen. We recommend contacting the clinic you're working with as soon as you notice, and following any instructions for missed doses they've given you.
If your side effects are more intense than you had expected, you don’t have to try to manage the symptoms on your own. We recommend sharing your concerns with the clinic physician, who can offer reassurance and medical guidance on managing the unique side effects you’re experiencing.
Ready to Begin Your Surrogacy Journey?
Understanding medication for the surrogacy process is an important step in preparing for your journey. Circle is here to walk alongside you as you help make parenthood possible for others. We invite you to take the first step by applying to become a surrogate, or connecting with our team.