What a Surrogate Mother Needs to Know About Gestational Surrogacy & the Medical Process

Be a surrogate

Surrogate Mothersare the most important component in surrogacy. Through their generosity, a childless couple can fulfill their dream of building a family. For anyone interested in becoming a surrogate, it is important to gain an understanding of the various steps involved in the medical process.

Gestational Surrogacy Process

In Gestational Surrogacy, surrogates are implanted with an embryo made through In Vitro Fertilization (IVF), the process of fertilizing the egg and sperm in a laboratory. The embryo, depending upon the intended parents’ health and personal preferences, may use the egg and sperm of a donor or the intended parents’ own genetic material instead of using an egg from the surrogate mother. This means the surrogate will not be genetically related to the child, but rather a combination of both donating parents, and is an important distinction in surrogacy today.

As an overview, we’ve included information on five key stages of the process:

Screening Tests

Once a surrogate is selected, she must undergo several routine medical tests, including psychological and physical exams, to ensure that she passes the requirements to become a surrogate mother. The fertility center, chosen by the intended parents, examines the surrogate’s uterus through a process called hysteroscopy. This is when a tiny camera is painlessly inserted into the uterus. However, other centers may suggest different tests to examine the general health of the uterus. Routine blood tests are administered to rule out AIDS, STDs, hepatitis, Tuberculosis, polio, and other communicable diseases.

Pre-IVF Preparations

Then, once a surrogate passes the screening tests and is deemed healthy, all parties involved sign consent forms to progress to the next stage. This is to ensure that all procedures and possible issues are made clear before moving forward. The surrogate then meets with the clinic’s physician to discuss preparation for the IVF process.

Several medications may be given to the surrogate to ensure the health of the uterus for conception:

  • First, the surrogate is given standard birth control pills. After a 14 days, the surrogate will be given Lupron or Synarel to suppress body’s normal hormone production and control the cycle. This is to ensure that the surrogate’s uterus is prepared to receive the embryo at the right time.
  • After menstruation, the surrogate is examined with an ultrasound. If the ultrasound looks good, the surrogate is then prescribed an estrogen product, usually Estrace, to prepare the lining of her uterus.
  • Once the donor’s eggs are harvested, the surrogate will be given injections of progesterone, another hormone that will help prepare the uterus for the implantation process.
  • Antibiotics may also be given to counter any undiagnosed or unnoticed infections.

IVF (In Vitro Fertilization)

Once the surrogate’s uterus is ready for implantation, the surrogate will visit the clinic for the embryo transfer. The IVF clinic collects the eggs from the egg donor and sperm from either an intended father or the sperm donor for fertilization and a maturation period of 2-5 days.

The embryo is then transferred into a specially designed syringe with thin and flexible catheter at the end. This syringe is then inserted through the cervix and into the uterine cavity. Depending on the clinic, some doctors may use an ultrasound to ensure that the embryos are implanted properly. The experience is as harmless as a pap smear.

After the implantation process, the surrogate will be asked to rest. Recommended bed rest time ranges from a couple hours to a couple days. The surrogate is then required to continue to take estrogen and progesterone a for a period afterwards.


Then, roughly two weeks after the implantation, a blood test is performed to confirm pregnancy. Success rates for IVF vary depending on the health of the uterus, the timing of the transfer, the program handling the case, the embryo quality and other extenuating factors. A successful implantation process is founded on the timeliness of each phase.

If the implantation fails, the intended parents can decide to try again after a week. The doctor will discuss the reason for the failure and advise how to ensure that the next IVF will be successful.


If the IVF is successful, the surrogate mother will become pregnant. She is then prescribed with vitamins and medication to ensure a healthy delivery.

Intended parents will choose the reproductive endocrinologist, a fertility specialist who prescribes hormones during the pre IVF stage, while the surrogate mother can choose her own OBGYN. More specialized medical practitioners, such as maternal fetal specialists that treat high risk pregnancy, will be decided by both surrogate and intended parents together.

Additional Info and Resources

Understanding the basics of the surrogacy process and the medical steps involved is a key step toward deciding whether or not this endeavor is a good option.

While this provides an overview of what to expect with the surrogacy process, it’s always a good idea to find out more. Learn more about the requirements involved in becoming a surrogate, the medications involved, and for the type of compensation a surrogate might receive, check out this helpful Surrogate Reimbursement table.