What Medications Are Involved in Surrogacy?

What medications are involved in surrogacy? What kinds of surrogacy medications will you take at different stages in the medical process as a gestational surrogate? Find the answers to these questions and more.

You likely have some questions about the medical process of becoming a surrogate. Understandably so — gestational surrogacy is an entirely different way of becoming pregnant. An important aspect of the process is the medications that gestational surrogates must take.

In this guide, we’ll tackle some of those questions and outline the medications you’re likely to take leading up to and during your surrogate pregnancy. Remember, your medical protocol will vary depending on your body and your unique circumstances, and a doctor is the only person who can prescribe the best surrogacy medications for you. While we hope you find the information in this article useful, it is not intended to be and should not be taken as medical advice.

Common Questions about Gestational Surrogacy Medications

Common initial questions about gestational surrogacy medications include:

1. What are the side effects of surrogacy medication?

The side effects of surrogacy medication can vary from person to person, and they also depend on the specific medication you take — which can also vary depending on the fertility clinic you work with. Different fertility clinics may prescribe a different surrogacy medication regimen than the one we’ve outlined here, but they’re all designed with the same purpose. Often, these medications come with side effects like headaches, mood swings and breast tenderness, but we’ve included some common side effects for specific surrogacy medications below.

2. Can I pursue surrogacy without medications?

No. All gestational surrogates will need to take medication — honestly, quite a few medications. If you’re unable or unwilling to do so for any reason, becoming a surrogate is probably not the right path for you, unfortunately.

3. Do surrogates have to have shots?

Yes. It’s helpful if you’re able to administer these injections yourself, but many surrogates ask a partner to help them with their shots, which must be given at the same time every day.

4. Do surrogates have to take hormones?

Yes. First, to control your cycle and prepare your body for the embryo transfer. Then to give the embryo the best possible chance at implanting, and if you get pregnant, to give that pregnancy the best chance at remaining viable.

5. What’s the surrogacy medication timeline like?

The surrogacy medication timeline will vary somewhat for each woman based on how your body responds to the medications and your fertility clinic’s individual approach, but it’ll likely look something like what we’ve outlined below. You’ll need to adhere to your clinic’s instructed timeline very carefully, because the timing of your cycle needs to be just right.

Medication Timeline

Again, the medications that you take and the timeline that you take them on may vary somewhat from this outline based on what your fertility clinic prescribes for you and how your body responds. But most surrogates will follow a surrogacy medication timeline that looks something like this:

Step 1: Birth Control Pills

This is your first step. Even if your tubes are tied, you’ll still need to take birth control pills. That’s because the fertility clinic is trying to synchronize your cycle to line up with your embryo transfer date. You’ll need to begin, and discontinue, taking these pills exactly when they tell you to get the timing just right for transfer.

Step 2: Lupron

This will be your next addition to the birth control pills. Lupron is an injection that you’ll administer for just short of a month. Side effects can include hot flashes and light- and sound-sensitive headaches, but most surrogates say the injections themselves don’t particularly sting.

Step 3: Estrogen

You’ll next add estrogen into your surrogacy medication regimen, usually about two weeks after you’ve begun the birth control pills and Lupron. This is commonly in the form of pills (typically twice a day) and/or a patch, but sometimes by injection. Side effects of the estrogen can include heavier vaginal discharge, breast tenderness and other symptoms you may have experienced in the course of previous menstrual cycles.

Step 4: Test Time: Repeat or Move Forward

Most fertility clinics will schedule an appointment with you at about the 22-day mark after you’ve been on these medications for a while. At this test appointment, you’ll usually have a transvaginal ultrasound to check the thickness of your uterine lining and/or bloodwork to check your estrogen levels.

If your fertility clinic clears you to proceed after that test, you’ll move on to the next step. If not, you may need to spend a few more days on your current gestational surrogacy medications until your uterine lining is thick enough and your estrogen levels high enough.

Step 5: Progesterone

Five days before transfer, which corresponds with the age of the embryo(s), you’ll start taking progesterone. This injection involves a larger needle and you’ll need to administer it intramuscularly rather than subcutaneously, so it can sting more than the Lupron. You’ll also need to take care to rub the injection site thoroughly each time to disperse the medication properly. Side effects for progesterone can include a rash at the injection site and headaches.

If the embryo transfer is successful, you’ll continue taking progesterone until your 12th week of pregnancy to help maintain a stable pregnancy.

Additional Medications You Might Take


Your fertility clinic might put you (and sometimes also your partner or spouse) on a course of antibiotics at some point before and/or after your embryo transfer. The purpose would be to clear your body of any possible infections and to encourage successful embryo implantation. This is a common tactic for giving the transferred embryo the best possible chance.


Another way that fertility clinics sometimes improve the chances of a successful embryo implantation is with a low-dose oral steroid called Medrol. Not all clinics will recommend this medication for everyone, so follow the recommendations of your doctors.


Some clinics will also suggest that you take a daily low-dose aspirin, which may improve implantation rates. This would be taken during the first 12 weeks of your pregnancy, if prescribed by your doctor.

Prenatal Vitamins

Prenatal vitamins are commonly recommended and encouraged, but your doctor may have some opinions on when you should start taking them and what kinds. They’re typically taken before your transfer and throughout your pregnancy.

An important note about taking any other additional medications:

Let your fertility clinic know about everything you take — even minor over-the-counter remedies like supplements or pain relievers — so they can make sure you don’t have any interactions with your medications. It’s better to give them too much detail than not enough. This is important for your health, the health of the future baby, and for the intended parents who are hoping for a successful pregnancy.

The feeling of medical micromanagement can certainly be frustrating. It’s probably not something you had to deal with in your previous pregnancies. Try to be patient and remember the amazing reason you’re doing this.

Timing Is Everything

One of the most important things you should know about surrogacy medications: they must be taken at the same time every day!

If you’re unable to commit to that schedule, you may need to reconsider if becoming a surrogate is right for you at this point. Here are some tips that former surrogates recommend for working with the surrogacy medication timeline:

  • Plan on taking your medication at a time you know for sure you’ll be home every day.
  • If you have to travel, confirm in advance that you can take your medication with you and keep things refrigerated when necessary.
  • Many surrogates find that they need someone to help them with their injections — these can be tricky to administer on your own sometimes. If you think you’ll need help administering injections, you’ll need to have your spouse or someone on hand at the same time every day who can commit to helping you.
  • Have a calendar or checklist mapped out to help you keep track of appointments, medication start and end times, what you’ve taken each day and more. Tape it to your bathroom mirror, your bedside table, or your door to make it part of your routine.
  • Setting alarms or reminders for yourself on your phone can be helpful to keep you on schedule with your medications.
  • Keeping your medications organized in cheap plastic drawers that you can label will help you keep track of when you need refills. This can also help keep any needles away from young children.

The surrogacy medication timeline is a major commitment, just like becoming a surrogate is, but it can yield amazing results. Contact American Surrogacy at 1-800-875-BABY(2229) to talk to a surrogate specialist about gestational surrogacy medications and becoming a surrogate today.