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.