Most surrogates get pregnant within 1-3 embryo transfers. Many achieve success on the first attempt.

If you’ve been through multiple IVF failures, this news probably feels too good to be true. But here’s what’s different: surrogacy bypasses many of the issues that made your IVF attempts unsuccessful.

At American Surrogacy, our thoroughly screened surrogates and comprehensive support give your embryos the best possible environment to succeed. You can finally move forward knowing each transfer has genuine potential to work.

Contact us today to learn how our screening process maximizes your chances and gets you matched with a surrogate in 1 - 4 months.null

How Many Embryo Transfers Does It Take for a Surrogate to Get Pregnant?

Most surrogates become pregnant within 1–3 embryo transfers, and many succeed on the very first attempt.

That’s because surrogates are thoroughly screened for proven fertility and optimal uterine health, giving your embryos the best possible environment to succeed.

Surrogate Embryo Transfer Success Rates: What You Can Actually Expect

First-time embryo transfers with surrogates succeed 55-65% of the time with quality embryos. This is significantly higher than continued IVF attempts after multiple failures.

If you’ve struggled with repeated IVF disappointments, surrogacy offers a different path with better odds from day one.

Your Chances Improve With Each Attempt

Here’s the encouraging news: your odds get better with each transfer. Families with three genetically tested embryos have about a 95% chance of achieving pregnancy.

Most intended parents don’t need three transfers. Because our surrogates are so thoroughly screened, many families succeed on their first or second attempt.

Why Surrogacy Success Rates Stay High

You’re working with someone whose body has already proven it can achieve and maintain pregnancy, traditional IVF often requires multiple attempts, while surrogacy typically succeeds faster.

How Many Embryos Do You Actually Need?

You don’t need a huge stockpile of embryos to succeed with surrogacy.

Three Embryos Give You Excellent Odds

While there’s no strict requirement, having three quality embryos gives you strong assurance of success. This accounts for the reality that not every embryo will result in pregnancy, even under optimal conditions.

With three embryos and surrogacy’s higher success rates, your chances of achieving pregnancy are excellent.

Options When You Have Fewer Embryos

If you have fewer than three embryos, you still have several paths forward:

• Create additional embryos through another IVF cycle before starting surrogacy
• Use donor embryos for your surrogacy journey
• Consider double donor IVF to create fresh embryos

Our team helps you evaluate which approach makes the most sense for your situation and timeline. Our embryo planning guide walks you through these options.

Only One Embryo Left? How American Surrogacy Supports You

Most agencies won’t work with families who have just one embryo. We do.

We understand the emotional weight of feeling like this might be your “last chance.” Your single embryo deserves the absolute best opportunity for success.

Enhanced Support for Single-Embryo Families

When you have one embryo, every detail matters more. We provide additional surrogate screening, optimized medical protocols, and intensified emotional support throughout your journey.

Our experience with single-embryo transfers helps us maximize success even when you have limited resources.

We understand the emotional and financial pressure that comes with having one embryo left, which is why we offer unique safeguards through our Limited Risk Program.

If any of the following happens, we apply your fees to your next match:

• If the surrogate is no longer eligible for medical reasons
• Surrogate is not approved by your fertility clinic
• Unforeseen personal circumstances that cause the surrogate to back out

If you’re facing this situation, contact us today to speak with someone who understands exactly what you’re going through.

What Actually Determines If a Surrogate Gets Pregnant?

The success of your embryo transfer depends on factors you can finally control through surrogacy.

Your Surrogate’s Proven Track Record

Every surrogate we work with has successfully carried pregnancies before. Their bodies have already proven they can get pregnant, stay pregnant, and deliver healthy babies.

This is completely different from using your own body after multiple IVF failures. You’re working with someone whose reproductive system works exactly as it should.

A Uterine Environment That Works

Your surrogate’s uterus is optimally prepared for pregnancy. Her hormone levels, uterine lining, and overall reproductive health create the ideal conditions for your embryo to implant and thrive.

No more wondering if your uterine lining is thick enough or if your hormone levels are preventing implantation.

The Same Quality Embryos, Better Environment

Your embryos aren’t the problem. Leading fertility clinics use advanced techniques to assess and prepare embryos for transfer, giving each one the best chance of success.

The difference is where they’re being transferred. Your healthy embryos finally get the healthy environment they need.

What Happens When the First Transfer Doesn’t Work?

First transfers don’t always succeed, and that’s completely normal. Here’s what happens next.

An unsuccessful first transfer doesn’t mean failure. It’s part of the natural process, and successful pregnancy often happens on the second attempt.

Your surrogate remains ready for pregnancy, unlike situations where you might need months of recovery between IVF cycles.

Getting the Emotional Support You Need

An unsuccessful transfer can bring disappointment, but the difference with surrogacy is having a support system designed specifically for your journey.

Unlike going through IVF alone, surrogacy connects you with professionals who understand fertility challenges and can help you process each step.

What makes surrogacy support different:

• Professional counselors who specialize in fertility treatments understand that each transfer carries emotional investment and provide practical coping strategies
• Support groups connect you with other intended parents who’ve walked this path, sharing stories of success after multiple transfers
• Experienced agencies acknowledge the emotional aspects while helping you stay focused on your goal, treating you as a whole person rather than just a medical case
• Ongoing guidance throughout the process so you’re never navigating this experience in isolation

Having this comprehensive support network helps you maintain perspective and makes the entire experience more manageable, regardless of how many transfers your journey requires.

Quick Turnaround for Your Next Attempt

If you have additional frozen embryos, your next transfer can usually be scheduled quickly. You don’t need extended recovery time, and you can move forward when you’re emotionally and physically ready.

Fertility specialists may make small adjustments to protocols, but often the second transfer succeeds simply because the process has been optimized.

Why Surrogacy Works When IVF Doesn’t

Surrogacy solves the specific problems that made your IVF attempts unsuccessful.

Bypassing Your Body’s Challenges

Many IVF failures happen because of uterine factors, implantation issues, or reproductive health problems that persist despite medical intervention.

Surrogacy completely solves these challenges. You’re working with a surrogate who has a track record of successful pregnancies.

Better Medical Oversight

Surrogacy involves enhanced medical monitoring specifically designed for surrogate transfers. Every aspect of the process is optimized for success.

The screening process ensures you work with someone whose body provides the ideal environment for implantation and development. This goes far beyond what’s possible when using your own body after multiple IVF failures.

Proven Results

Research consistently shows that embryo transfers with surrogates have higher success rates than traditional IVF, especially for intended parents who’ve experienced multiple failures.

This isn’t just hope. It’s medical reality backed by data and experience.

How American Surrogacy Supports You Through Each Transfer

Your success is our primary focus. We’ve developed support systems that maximize your chances with each attempt.

Before Your Transfer

We coordinate closely with your fertility clinic to ensure perfect timing and preparation. Every detail gets reviewed: your surrogate’s readiness, medication protocols, and legal protections.

All surrogacy laws and contracts are finalized before any medical procedures begin.

During Your Transfer

You have direct access to our support team throughout the entire process. We manage communication between you, your surrogate, and the medical team so everyone stays informed and supported.

Getting to know your surrogate creates trust and comfort that benefits everyone involved.

The Two-Week Wait and Beyond

We maintain close contact during those crucial two weeks after transfer. We coordinate follow-up appointments, manage communication about results, and provide emotional support regardless of the outcome.

Financial Protection That Actually Protects You

We offer financial protection that reduces your risk if transfers don’t succeed as planned. Our programs include guarantees like unlimited matching with new surrogates and refunds if pregnancy isn’t achieved within certain timeframes.

Our different program structures offer varying levels of support and financial security. Some include multiple transfer attempts in the base cost, while others offer insurance-style protection against unsuccessful outcomes.

We also work with families to explore payment options like installment plans and fertility-specific loans to spread costs over time. Understanding the full picture upfront helps you choose the protection level that makes sense for your situation.

We’re With You Until You Bring Your Baby Home

Whether you succeed on your first transfer or need multiple attempts, we’re committed to supporting you throughout the entire journey. We offer both full-service and independent program options to meet your specific needs.

For families concerned about costs, we partner with Sunfish to provide financing solutions and help you understand total costs upfront.

Contact our team today to speak with a surrogacy specialist who can provide personalized guidance for your situation.

You’ve already proven your dedication to becoming parents. Now let us help you find the path that finally leads to your baby.

It’s natural to think that transferring two embryos might double your chances—or even lead to twins. But the truth is, double embryo transfer (DET) is not always the safest or most successful choice.

Research shows that single embryo transfer (SET) often provides better outcomes for both surrogates and babies.

Ready to explore your options? Contact a surrogacy specialist today and get guidance tailored to your family-building goals.

Whether you’re hoping for twins or simply want to shorten your journey, there are proven alternatives that protect your surrogate’s health while giving you the best chance of growing your family quickly.

Can You Do a Double Embryo Transfer in Surrogacy?

Yes, DET is possible, but most fertility specialists and surrogacy agencies recommend single embryo transfer as the gold standard.

• Why: The American Society for Reproductive Medicine (ASRM) guidelines generally advise SET when high-quality embryos are available.
• Who Decides: The choice ultimately rests with you, your surrogate, and your fertility team. Factors include embryo quality, medical history, and your surrogate’s comfort.
• Surrogate Preference: Many surrogates favor SET because it reduces health risks and complications—a preference that’s both personal and medically sound.

Honest conversations about transfer preferences should happen early in the matching process to ensure everyone is aligned.

Disclaimer: This article is for informational purposes only and is not intended as medical advice. Decisions about embryo transfer protocols should always be made in consultation with a qualified reproductive endocrinologist or fertility specialist.

Multiple Single Transfers  vs. Double Embryo Transfer: Success Rates, Risks, and Safer Alternatives

Studies show that transferring two embryos at once can lead to higher chances of a live birth compared to transferring just one—about 42% with double embryo transfer versus 27% with a single transfer.

However, the risk of twins or multiples is much higher with double transfers, occurring in nearly 29% of cases compared to only 2% with single transfers.

When doctors follow up a single transfer with an additional frozen single embryo transfer, the overall live birth rate (38%) ends up very close to that of a double transfer (42%), but with almost no risk of multiples.

These outcomes held true regardless of the woman’s age, fertility history or embryo quality.

Will Transferring Two Embryos Guarantee Twins?

Yes, double embryo transfer significantly raises the likelihood of twins by 27% but the outcomes can vary. Both embryos may implant, resulting in twins, or just one may implant, leading to a singleton pregnancy.

In some cases, neither embryo implants, which means the cycle fails, and there’s also the rare possibility that one embryo could split, creating a triplet pregnancy with very high risks.

Importantly, DET does not guarantee higher success rates, since high-quality single embryo transfers often achieve similar outcomes without the additional risks.

The Hidden Risks of Double Embryo Transfer for Surrogates

Multiple pregnancies create greater medical risks for surrogates:

• Higher rates of gestational diabetes, preeclampsia, and preterm labor.
• Preterm birth in ~60% of twin pregnancies, compared to 10% in singletons.
• Longer NICU stays and greater risk of developmental complications for babies.
• Increased likelihood of C-section delivery and longer recovery times for surrogates.
• Emotional and lifestyle impacts: more restrictions, bed rest, and strain on family life.

These risks explain why many surrogates prefer SET and why medical professionals increasingly recommend it.

Want Twins or a Quicker Path to Parenthood? Here’s a Safer Way

The longing for twins—or to complete your family sooner—is real. Fortunately, there’s a safer, smarter approach: dual staggered journeys.

A dual staggered journey allows intended parents to work with two surrogates on overlapping timelines, offering a safer and more efficient path to family building. The benefits include:

• Safer pregnancies: Each surrogate carries a singleton, avoiding the higher risks of twin or triplet pregnancies.
• Two chances at success: You increase the odds of at least one successful pregnancy instead of relying on a single transfer.
• Shorter timeline: Children can be born close in age, giving you the experience of siblings growing up together.
• Reduced emotional pressure: If one journey encounters complications, the other may still progress, offering reassurance and stability.
• Better long-term value: While the upfront investment is higher, dual journeys are often more cost-effective than double embryo transfer or waiting through back-to-back surrogacy processes.

 While this requires more upfront investment, many families find it more cost-effective than risking DET or waiting through back-to-back journeys.

Dig deeper: Our dual staggered journeys

How We Provide The Ability to Work with Two Surrogates so You Can Grow Your Family Faster

At American Surrogacy, we’ve designed our dual staggered journeys to give families a safer alternative to double embryo transfer while still helping them grow faster.

This approach allows both women to carry single pregnancies—dramatically reducing health risks—while still making it possible for your children to be born close in age.

With our extensive surrogate network, most families find both matches in as little as 1 - 4 months.

We recommend beginning the second journey once the first surrogate reaches 20 weeks, which helps balance safety with efficiency.

We also personalize matches based on geography, communication style, and family preferences, ensuring strong, healthy relationships on both journeys.

 Take the Next Step Toward a Safer, Smarter Family-Building Journey

Building your family is one of the most important journeys of your life, and you deserve a path that is safe, effective, and designed for long-term success.

At American Surrogacy, we combine medical expertise with compassionate support to help you make confident decisions about embryo transfer and family building.

Don’t leave your family’s future to chance. Fill out our form today to speak with a surrogacy specialist and begin your journey toward parenthood.

You can significantly reduce your risk of ovarian hyperstimulation syndrome (OHSS) through proven prevention strategies, proper hydration and working with experienced fertility clinics that use modern protocols.

With these precautions, most patients undergo egg retrieval safely without serious complications.

American Surrogacy can help you find fertility specialists who prioritize OHSS prevention while maintaining excellent success rates for your family-building journey. Contact us today.

Understanding OHSS prevention empowers you to make informed decisions, recognize early warning signs and work effectively with your medical team throughout the egg retrieval process.

What is OHSS and Why It Matters for Your Surrogacy Journey

OHSS occurs when the ovaries become overstimulated by fertility medications, causing them to swell and leak fluid into the abdomen and sometimes the chest cavity.

This condition can range from mild discomfort to serious medical complications requiring hospitalization.

When you’re working with fertility medications to stimulate egg production, your ovaries can sometimes respond too enthusiastically, leading to swelling, fluid retention and other concerning symptoms.

The good news is that modern fertility medicine has developed highly effective strategies to minimize this risk while maintaining excellent success rates.W

Learn more about the medications involved in ovarian stimulation and egg retrieval preparation.

OHSS Risk Factors You Should Know About

Understanding your personal risk factors helps you and your medical team creates the most effective prevention strategy.

• Higher risk factors include:
• Women under 35 years old
• Polycystic ovary syndrome (PCOS) diagnosis
• High estradiol levels during stimulation
• Large numbers of developing follicles (typically over 20)
• Previous history of OHSS
• Lean body mass or low BMI

The emotional impact: Beyond physical symptoms, OHSS can create anxiety and stress during an already emotionally challenging process. Understanding prevention strategies helps you feel more confident and in control of your journey.

Medical Prevention Strategies Your Doctor May Use

Your fertility specialist has multiple tools to prevent OHSS while maintaining treatment effectiveness.

• Medication protocol adjustments: Your doctor may use lower doses of stimulation medications, switch to different drug combinations, or use GnRH antagonist protocols that reduce OHSS risk compared to traditional approaches.
• Trigger shot modifications: Instead of using hCG to trigger final egg maturation, many clinics now use GnRH agonist triggers, which significantly reduce OHSS risk while maintaining good egg quality.
• Coasting technique: If estradiol levels become too high, your doctor may temporarily stop stimulation medications while continuing monitoring, allowing hormone levels to decrease before proceeding with egg retrieval.

How much water should I drink after egg retrieval to prevent OHSS?

Proper hydration plays a vital role in preventing OHSS after egg retrieval and is something you can actively control.

Optimal hydration guidelines:

• Drink 2-3 liters (8-12 cups) of fluid daily following your procedure
• Start increasing fluid intake immediately after egg retrieval
• Focus on water, but electrolyte drinks can also be beneficial
• Monitor your urine color – it should be light yellow
• Continue increased hydration for at least one week post-retrieval

Adequate fluid intake helps your kidneys process fertility medications more efficiently and reduces the concentration of hormones that can trigger OHSS.

Proper hydration also helps maintain healthy blood pressure and reduces the risk of blood clots.

Activities and Foods to Avoid After Egg Retrieval

Certain activities and substances can increase your OHSS risk or worsen existing symptoms.

Activities to avoid for one week:

• Intense exercise or heavy lifting
• Sexual intercourse until cleared by your doctor
• Hot baths, saunas, or hot tubs that cause dehydration
• Long periods of immobility that increase blood clot risk

Dietary modifications:

• Limit sodium intake, which can worsen fluid retention
• Avoid alcohol, which interferes with recovery and hydration
• Reduce caffeine consumption to prevent dehydration
• Skip gas-producing foods that worsen abdominal discomfort

Medications requiring medical approval:

• NSAIDs (ibuprofen, naproxen) may affect kidney function
• Any new medications should be approved by your fertility team

Learn more about what you can expect during your egg retrieval recovery.

Recognizing OHSS Symptoms: When to Contact Your Clinic

Early recognition of OHSS symptoms allows for prompt treatment and can prevent progression to severe complications.

Mild OHSS symptoms:

• Abdominal bloating and discomfort
• Mild nausea
• Weight gain of 2-5 pounds
• Mild pelvic or abdominal pain
• Moderate OHSS symptoms:
• Increased abdominal pain and bloating
• Nausea and vomiting
• Weight gain of 5-10 pounds over 3-5 days
• Difficulty eating normal amounts

Severe OHSS – seek immediate medical attention:

• Severe abdominal pain and significant bloating
• Persistent nausea and vomiting preventing fluid intake
• Weight gain of more than 10 pounds
• Difficulty breathing or shortness of breath
• Decreased urination despite adequate fluid intake
• Dizziness, fainting, chest pain, or rapid heartbeat

Understanding OHSS Timing and Triggers

Knowing when OHSS is most likely to occur helps you stay vigilant during critical periods.

Early OHSS (3-7 days post-retrieval): Related to stimulation medications and fertility drugs still circulating in your system. This type responds well to supportive care and hydration.

Late OHSS (10-14 days post-retrieval): Usually triggered by pregnancy hormones if conception occurs. This is why freeze-all cycles are often recommended for high-risk patients.

The role of pregnancy: If pregnancy occurs after egg retrieval, the resulting hCG production can worsen existing OHSS or trigger late-onset symptoms. Your clinic will monitor you closely if fresh embryo transfer is planned.

How OHSS Could Affect Your Surrogacy Timeline

While OHSS prevention strategies are highly effective, understanding potential impacts helps you plan realistically.

Most cycles proceed normally: The vast majority of egg retrieval cycles proceed without significant OHSS, especially when working with experienced clinics that use modern prevention protocols.

Potential timeline adjustments:

• Prevention strategies like coasting may add 2-3 days to stimulation
• Freeze-all approaches typically delay embryo transfer by 1-2 months
• Recovery from mild OHSS usually takes one week
• Moderate cases may require 2-3 weeks of careful monitoring

Future cycle planning: If OHSS occurs, your clinic will adjust protocols for future attempts to minimize recurrence risk while maintaining effectiveness. This experience helps create an even safer approach for subsequent cycles.

Learn more about what to expect after egg retrieval and how proper planning supports your journey.

How American Surrogacy Can Help You Find the Right Fertility Clinic

Even with excellent prevention strategies, having comprehensive support systems ensures everyone receives appropriate care if complications arise.

• Clinic selection guidance: American Surrogacy helps you identify fertility clinics with strong OHSS prevention protocols and low complication rates in your area.
• Coordination assistance: We help facilitate clear communication between you, your fertility clinic, and any
• Journey continuity: Even if OHSS causes temporary delays, our support systems help maintain momentum toward parenthood once recovery is complete.

Choosing the Right Fertility Clinic for OHSS Prevention

Not all fertility clinics have equal expertise in OHSS prevention.

Questions to ask potential clinics:

• What is your OHSS rate compared to national averages?
• How do you modify protocols for high-risk patients?
• What trigger options do you offer beyond traditional hCG?
• How quickly can you adjust medications based on monitoring results?
• What after-hours support do you provide for complications?

Moving Forward Safely with Confidence

Understanding OHSS prevention empowers you to work with experienced professionals who prioritize safety while maintaining excellent success rates.

American Surrogacy helps you find experienced fertility clinics that prioritize safety, and once your embryos are ready, we can match you quickly with a qualified surrogate.

Start building your family with the right medical team and surrogate support – reach out today.

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For many trans men, IVF and gender dysphoria often intersect when hormone therapy must be paused, or when fertility procedures trigger physical changes and clinical experiences that feel misaligned with one’s identity.

Whether you’re early in your transition or already on testosterone, you deserve options that support your well-being, not just your biological goals.

The path is yours to define—we’re here to walk it with you. Contact us today to learn more about how surrogacy can be a self-affirming option to grow your family.

This guide is here to help you understand what to expect from IVF as a trans masculine parent and how surrogacy and egg donation can help lessen the burden of gender dysphoria.

Can IVF Cause Gender Dysphoria?

Yes, IVF and gender dysphoria often intersect for trans men.

Stopping testosterone for egg retrieval can trigger the return of unwanted physical changes, while procedures like ultrasounds and hormone injections may intensify dysphoria, especially in gendered medical settings.

For many, the experience can feel emotionally disorienting—but with affirming providers and support, IVF is still possible.

Learn more about the egg retrieval process for IVF and surrogacy.

Options Beyond Traditional IVF: How Surrogacy Can Support Trans Masculine Parents

For many trans men, IVF and gender dysphoria are deeply intertwined. Creating embryos—whether for personal IVF or surrogacy—still requires egg retrieval and a temporary pause in testosterone, which can trigger significant physical and emotional discomfort.

The process may involve invasive procedures and time spent in clinical settings that feel misaligned with one’s identity.

Depending on your needs and comfort level, there are affirming paths forward:

• Donor egg IVF: You might consider using donor eggs, which allows you to avoid the dysphoria associated with hormone stimulation and retrieval while still building a family through IVF.
• Surrogacy: If you’re comfortable with egg retrieval but not with pregnancy, surrogacy may be an ideal fit, allowing you to create embryos with your own eggs while a surrogate carries the pregnancy.
• Donor egg surrogacy: If you want to avoid both the IVF process and pregnancy, donor egg surrogacy removes both the physical and psychological stressors while still allowing you to become a parent.

At American Surrogacy, we understand that every path to parenthood is personal. We’re here to help you explore your options with care, clarity, and compassion—so you can make the decision that’s right for you.

Need help deciding what feels right? Reach out today to explore paths that align with your emotional well-being, family goals and identity.

Should You Pause Testosterone for IVF? What to Know

If you intend to use your own eggs for IVF or surrogacy, most fertility clinics require trans men to pause testosterone to support a successful egg retrieval process.

Pausing HRT, often for several weeks, can lead to the return of physical traits tied to one’s assigned sex at birth, which may intensify IVF and gender dysphoria symptoms.

Knowing what to expect can make a major difference. Emotional shifts, body changes and discomfort with medical procedures are common—but they’re not unmanageable.

Working with affirming providers and preparing mentally and physically ahead of time can help ease this process.

Talking to Your Clinic: How to Advocate for Gender-Affirming Fertility Care

Navigating IVF and gender dysphoria starts with choosing a clinic that respects your identity. Not all fertility providers are experienced in working with trans men, and many environments can unintentionally trigger dysphoria through misgendering, invasive procedures or lack of inclusive language.

Before starting treatment, ask about the clinic’s experience with LGBTQ+ patients, their approach to trauma-informed care, and whether staff are trained in gender-affirming practices. Your emotional well-being matters as much as your medical outcome.

At American Surrogacy, we help intended parents connect with supportive clinics that prioritize comfort, respect and affirming care—because every step of your journey should feel like it belongs to you.

Need help finding a gender-affirming fertility provider? Reach out to start your journey with support you can trust.

When IVF Isn’t Right: Why Some Trans Men Choose Surrogacy First

For some trans men, IVF and gender dysphoria are too closely linked to pursue comfortably. The idea of stopping HRT, undergoing invasive procedures, or facing a pregnancy that feels misaligned with their identity can be overwhelming.

In these cases, surrogacy isn’t a last resort, it’s a deliberate, affirming choice.

Surrogacy offers a path to biological parenthood without compromising emotional safety. At American Surrogacy, we support trans intended parents in choosing what feels right for them whether that means IVF or surrogacy.

Fertility Planning for Trans Men Considering Surrogacy: Step-by-Step Guide

If you’re exploring surrogacy as a path to parenthood, here’s what you need to know, especially when navigating IVF and gender dysphoria along the way:

Step 1: Decide If You Want a Genetic Connection

Surrogacy can allow you to have a biological child using your own eggs. If you haven’t started testosterone, egg retrieval may be easier to schedule without interruption.

Step 2: Consider Your HRT Timeline

If you haven’t started testosterone yet, freezing your eggs now may reduce the risk of unsuccessful egg retrieval, and may allow you to avoid the need to pause HRT later.

If you’re already on HRT, plan for a pause—often 1–3 months—to allow your body to resume egg production.

Step 3: Coordinate With a Fertility Clinic

Schedule an initial consult with a clinic to evaluate your fertility and discuss egg retrieval logistics.

Step 4: Prepare for IVF and Gender Dysphoria

The IVF process includes hormone injections and an invasive procedure. If pausing HRT, undergoing ovarian stimulation or completing the egg retrieval process feels too dysphoric, or is unsuccessful, egg donation remains a viable and affirming alternative.

Step 5: Choose a Surrogacy Agency That Affirms You

Partner with an agency (like American Surrogacy) that understands the needs of trans intended parents. Once you have embryos ready, we can match you with a surrogate who is excited to work with you and your partner.

Your Next Step: Compassionate, Personalized Support

Whether you’re early in your transition, already managing IVF and gender dysphoria, or considering surrogacy as a more affirming option, your path to parenthood deserves care and support.

At American Surrogacy, we guide LGBTQ+ intended parents through every step—with trusted clinics, inclusive professionals and surrogates who honor your identity and goals.

You’re not alone in this journey and you don’t have to navigate it without a team that understands.

Connect with a surrogacy specialist today to explore the options that align with your identity, timeline and dreams of building a family.

Check out our surrogacy programs for LGBT parents.

Parenthood may be part of your vision for the future. But if you’re currently on testosterone, you may not be sure what’s possible when it comes to fertility.

You deserve information that affirms your identity and gives you real choices. In this guide, we’ll cover how testosterone affects fertility and provide options for next steps. We can help you find the right path that aligns with your identity, comfort and goals.

If you’d like more information, fill out our form to connect with one of our surrogacy specialists.

Can a Trans Man Get Pregnant While on Testosterone? What to Know

Technically, yes, a trans man getting pregnant while on testosterone is possible, but unlikely. Testosterone generally suppresses ovulation and may affect an embryo’s ability to implant in your uterus.

Because of this, the chances of a trans man on hormones getting pregnant are very low. However, with fertility preservation and temporarily stopping hormones, pregnancy may be possible.

Does Fertility Change in Trans People With Hormone Treatment?

Yes, testosterone impacts both the consistency and quality of egg production. Over time, it suppresses ovulation and usually stops periods altogether.

The effect depends on how long you’ve been on testosterone, your age and your reproductive health.

Because egg quality naturally declines with age, and testosterone can add complexity, early planning matters.

In addition to impacting egg production, testosterone may also affect the uterine lining, which can make it more difficult for an embryo to implant successfully.

Can a Trans Man Do IVF? How it Works At Different Stages of HRT

Yes, IVF is a viable option for many trans men, but it involves important considerations depending on where you are in your hormone journey.

If You Are Pre-HRT

If you have not yet started hormone therapy, it is typically recommended to freeze your eggs before beginning testosterone. This helps preserve your fertility at its current baseline.

 If you decide to pursue pregnancy later, you will still need to pause testosterone during the embryo transfer phase of IVF.

If You Have Already Started HRT

If you are already on HRT and haven’t preserved your eggs, you’ll need to stop testosterone prior to starting ovarian stimulation and remain off it through the egg retrieval process, and possibly through the embryo transfer as well.

Additionally, the effects of testosterone on the ovaries and reproductive system may make egg retrieval more complex for those who have been on HRT long term.

Research from Boston IVF found that trans men who paused testosterone for around four months had similar egg retrieval outcomes to cisgender women undergoing IVF.

This pause can be physically and emotionally difficult, particularly for a trans man on hormones getting pregnant.

Why Do Trans Men Need to Stop Testosterone to Get Pregnant with IVF?

In addition to suppressing ovulation, testosterone may also thin or destabilize the uterine lining, which can make it more difficult for an embryo to implant successfully.

For a trans man on hormones getting pregnant, stopping testosterone may improve the chances of a healthy implantation, which is critical for pregnancy.

What to Expect from IVF as a Trans Man

1. If currently undergoing HRT, you’ll pause testosterone under medical supervision
2. Begin ovarian stimulation with hormone injections
3. Monitor egg development via ultrasounds and bloodwork
4. Undergo egg retrieval with light sedation.

Given the emotional and physical demands of IVF, it’s important to work with providers who affirm your identity. Some fertility clinics offer mental health support and gender-affirming care as part of the treatment process.

Fertility Preservation Before or After Starting HRT

If you’re thinking about starting testosterone or are considering pausing HRT to grow your family, fertility preservation can help you keep biological options open.

Here are two common methods:

• Egg Freezing: Involves harvesting eggs and freezing them unfertilized. This is often done before starting testosterone, but in some cases, it’s possible after stopping.
• Embryo Freezing: Embryos are created by combining your eggs with a partner’s or donor’s sperm. The resulting embryos are frozen for later use. This may be ideal if you know you want to pursue surrogacy later.

While outcomes are usually better before starting HRT, some trans men have preserved fertility even after hormone use.

Learn more about how embryos are frozen for surrogacy.

IVF Limitations After Long-Term Hormone Use

It’s important to acknowledge that long-term testosterone use can affect the success of IVF.

While many trans men have successfully completed IVF after pausing HRT, the effects of prolonged testosterone therapy on egg quality and uterine receptivity may lower the chances of implantation and overall IVF success.

For trans men who have been on hormones for several years, the reproductive system may respond less robustly to stimulation medications and the endometrial lining may not easily return to a state conducive for implantation.

Even with egg retrieval and fertilization, embryo transfer may not result in a pregnancy.

This is one reason why surrogacy may be a more effective and emotionally supportive path to parenthood, especially for a trans man on hormones getting pregnant or preserving fertility.

Why Surrogacy for Trans Men May Be a Better Option

If IVF is not successful after HRT or it doesn’t feel right for your body or identity, surrogacy is an option..

Higher Chances of Successful Implantation

From a medical perspective, surrogacy may offer a higher chance of success for trans men who have been on HRT long term. Testosterone can affect both egg quality and uterine receptivity, which can make pregnancy or embryo transfer more complex.

With surrogacy, these barriers are removed, and the embryo is transferred to a gestational surrogate whose body is fully prepared to carry a pregnancy.

You Won’t Have to Pause HRT for the Embryo Transfer

If you froze your eggs in advance or use donor eggs, surrogacy allows you to maintain your HRT regimen without interruption, avoiding the physical changes and emotional challenges that may come with pausing treatment for the embryo transfer or pregnancy.

Even if you pause testosterone for egg retrieval, that’s still less time that you have to pause treatment than if you carried the pregnancy yourself.

Avoiding Potential Gender Dysphoria Caused by Pregnancy

Surrogacy can help you avoid dysphoria that may arise from the hormonal shifts, body changes, sensations and psychological stress of pregnancy or childbirth.

This makes it an emotionally safer choice for a trans man on hormones getting pregnant or planning a family.

Surrogacy comes with emotional, financial and legal considerations, but for many, it provides a path that honors their identity and offers greater comfort.

Learn more about our LGBTQ+ surrogacy programs designed specifically for trans and queer families.

Can a Trans Man Use His Eggs in a Surrogacy Journey?

Yes, a trans man can use his own eggs to create embryos.

If you have frozen eggs or are willing to pause testosterone for egg retrieval, IVF allows your eggs to be fertilized with your partner’s sperm or a donor’s sperm. The resulting embryos can then be transferred to a surrogate.

Pausing HRT for the egg retrieval process can bring up dysphoria for some trans men, as it may involve temporary physical changes and emotional stress. Having a supportive and affirming care team can make a significant difference.

To support your well-being:

• Work with gender-affirming fertility providers.
• Request mental health support throughout treatment.
• Be prepared for side effects like bloating or hormonal shifts.
• Lean on your support system—friends, partners, therapists, and LGBTQ+ healthcare providers.

Using Donor Eggs: When Your Own Eggs Aren’t an Option

If using your own eggs doesn’t feel right for you, or if it isn’t possible, egg donor surrogacy is a valid and empowering alternative.

Many trans men choose this path for comfort, medical reasons or simply personal preference. Working with a surrogacy agency can help you explore egg donor options that align with your values and goals.

Your Family-Building Plan Starts Here

Family-building is a personal journey. Every trans man deserves options that honor and affirm who they are. We’re here to help. Reach out to connect with a surrogacy specialist and begin planning your future on your terms.

As more families seek low-intervention options, natural cycle surrogacy has become an increasingly popular alternative to traditional, hormone-heavy protocols.

These protocols promise fewer hormones and a more “in sync” experience, but are they as reliable as they sound?

Contact us today to speak with a surrogacy specialist about your embryo transfer options. We’re ready to support you whichever path you choose.

In this guide, we’ll walk you through everything you need to know about natural cycle surrogacy, including how it works, how it compares to medicated cycles and what success rates really look like.

What Is Natural Cycle Surrogacy?

Natural cycle surrogacy refers to a type of frozen embryo transfer (FET) in which the surrogate’s own natural menstrual cycle is used to guide the timing of the embryo transfer, rather than manipulating her cycle entirely with synthetic hormones.

This approach can feel more intuitive and less invasive for many surrogates, though it still involves some medical support, such as:

• A trigger shot (typically hCG) to precisely time ovulation
• Progesterone supplementation post-ovulation to support the endometrial lining

At American Surrogacy, we work closely with fertility clinics to determine if this low-intervention method is right for your surrogate and your goals.

Learn more about the embryo transfer process during your surrogacy.

Do Surrogates Have to Take Hormones? Here’s the Truth

It’s easy to assume that natural cycle surrogacy means no medications—but that’s not the full story. While often promoted as a “low-intervention” alternative, a natural frozen embryo transfer still involves hormonal support.

Even in a natural cycle, most surrogates will need:

• A trigger shot to force ovulation at the right time
• Progesterone supplementation to maintain a uterine lining suitable for implantation

Bottom line: Even in natural protocols, surrogates still take some hormones, but much less than in medicated protocols.

Reddit users share their experiences with medication protocols in natural surrogacy throughout this thread.

Natural vs. Medicated Embryo Transfer: What’s the Difference?

While natural cycle surrogacy offers lower hormone exposure, it also introduces more complexity, unpredictability and potential for disruption. Here’s how the two approaches compare:

Natural Cycle Surrogacy:

• Relies on the surrogate’s body, introducing unpredictability and a higher chance of rescheduling
• Minimal hormone use; requires ovulation trigger and progesterone
• Requires intensive tracking with bloodwork and ultrasounds; small deviations can derail the cycle
• Low flexibility; timing can be thrown off by natural variability

Medicated FET

• Fully controlled by the clinic, offering precise timing and fewer surprises
• High hormone use with consistent dosing of estrogen and progesterone for controlled results
• Predictable protocol with fewer monitoring demands once the schedule is set
• High flexibility for coordinating schedules across all parties

Natural cycle surrogacy often demands more time, vigilance and patience without guaranteeing better outcomes. Always consult with your clinic to determine which protocol offers the most reliability for your unique case.

Why Natural Cycle Surrogacy Isn’t Always the Simpler Option

For some intended parents and surrogates, the appeal of a natural frozen embryo transfer lies in its lighter medication load and alignment with the body’s natural rhythm.

But despite the name, natural cycle surrogacy is far from hands-off and its benefits can come with tradeoffs that aren’t always obvious at first.

Pros:

• Fewer synthetic hormones than a medicated protocol
• Potentially lower medication costs
• May feel more “natural” or emotionally intuitive for some surrogates
• Some surrogates report fewer side effects and a smoother physical experience

Cons:

• Requires frequent, precise monitoring (blood draws, ultrasounds)
• Offers limited flexibility—timing depends on the surrogate’s body, not the calendar
• Higher risk of cancellation or delay if ovulation is missed or mistimed
• Not suitable for surrogates with irregular cycles, hormonal imbalances, or inconsistent responses to triggers

Natural cycle surrogacy can seem like a simpler or more holistic route, but in practice, it often demands more vigilance, tighter coordination and an openness to uncertainty.

Still unsure? American Surrogacy helps you evaluate your surrogate’s eligibility to make the right choice for your family-building plan. Fill out our easy form today.

Natural Frozen Embryo Transfer Success Rates: How Effective Is It Really?

Success rates for a natural frozen embryo transfer are often described as comparable to medicated protocols but that comparison comes with caveats.

While some studies do show similar pregnancy outcomes, those results typically apply to a narrow set of ideal conditions.

Natural cycle surrogacy may deliver strong results when:

• The surrogate has highly predictable ovulation
• Endometrial thickness reaches the clinical threshold
• The embryo quality is excellent

However, these factors are harder to control in a natural cycle. Slight variations in timing or hormone levels, things a medicated cycle is designed to regulate, can have an outsized impact on outcomes.

At American Surrogacy, we help you weigh the real-world success rates alongside your personal priorities so you can make the choice that aligns with both your values and your outcome goals.

This guide explains embryo transfer success rates in greater detail.

Why Some Intended Parents Choose Natural Cycle Surrogacy

Intended parents may be drawn to natural cycle surrogacy for a variety of reasons:

• Minimizing hormone exposure for the surrogate
• Positive past experiences with natural frozen embryo transfer
• A desire for a more holistic process aligned with the body’s rhythm
• A sense of greater emotional balance throughout the cycle

Surrogates often report feeling more in tune with their body and experiencing fewer side effects, which can lead to a smoother emotional journey overall.

Making the Decision: Which Protocol Is Right for You?

The decision to pursue natural cycle surrogacy should be made collaboratively with your agency, fertility clinic and surrogate. This approach can offer a more natural experience but requires:

• A surrogate with regular menstrual cycles
• Willingness for intensive monitoring
• Comfort with the possibility of schedule shifts or delays

At American Surrogacy, we support both natural and medicated embryo transfer protocols, ensuring that your journey is medically sound and emotionally supported every step of the way.

If Natural Cycle Surrogacy Is the Path, Our Surrogates Meet the Standard

While natural cycle surrogacy isn’t right for every journey, there are cases where fertility clinics will recommend it, especially if the surrogate has a consistent history of ovulation and previous success with frozen embryo transfers.

If your clinic supports this path, you can feel confident knowing American Surrogacy is fully prepared to match you with a highly-qualified surrogate.

Every surrogate in our program undergoes:

• Pre-screening and a review of her medical history
• A physical assessment conducted by a fertility clinic
• Confirmation of at least one previous successful pregnancy

We work closely with your clinic to ensure that any surrogate recommended for a natural cycle protocol is medically qualified, emotionally prepared and logistically reliable. That means no guesswork, just a clear, coordinated plan built around your family’s goals.

That means no guesswork, just a clear, coordinated plan built around your family’s goals.

Your Next Step: Talk to American Surrogacy

Whether you’re curious about natural frozen embryo transfer or need guidance on hormone protocols for your surrogate, American Surrogacy is here to help.

Contact us today to explore the best embryo transfer option for your family.