The Medical Side of Being a Surrogate: What to Expect from Start to Finish
Learn the full surrogate medical process, from IVF medications and screenings to embryo transfer and pregnancy care. A complete, expert-backed guide for women considering surrogacy with Over the Rainbow
Becoming a surrogate is an extraordinary decision rooted in compassion, generosity, and strength. While many women are drawn to surrogacy because of the emotional impact of helping someone grow their family, it is equally important to understand the medical journey involved. Knowing what to expect medically can bring confidence, clarity, and peace of mind as you move forward.
This guide walks you through the surrogate medical process from start to finish, including screenings, IVF medications for surrogates, the embryo transfer experience, pregnancy care, and postpartum recovery. At Over the Rainbow, we believe that informed surrogates feel empowered, supported, and respected every step of the way.
Overview of the Surrogate Medical Process
The medical side of surrogacy is carefully structured to prioritize safety, success, and long-term health. Every step is overseen by experienced reproductive endocrinologists and guided by evidence-based protocols.
In general, the medical journey includes:
Pre-screening and medical clearance
IVF cycle preparation and medications
Embryo transfer
Pregnancy monitoring and routine prenatal care
Delivery and postpartum recovery
Each phase is intentional and designed to support both the surrogate and the intended parents.
Medical Pre-Screening and Evaluation
Before a woman is medically approved to become a surrogate, she undergoes a thorough evaluation. This step ensures that pregnancy is safe and appropriate for her body.
Medical History Review
Physicians review your full medical and obstetric history, including prior pregnancies, deliveries, and any complications. Most fertility clinics require that surrogates have previously carried at least one healthy pregnancy to term.
These standards are guided by the American Society for Reproductive Medicine (ASRM), which sets national medical guidelines for third-party reproduction and gestational surrogacy.
Physical Exam, Lab Work, and Uterine Evaluation
Surrogates typically complete bloodwork, infectious disease screening, and a uterine evaluation using ultrasound or a saline sonogram. These tests help confirm that the uterus is healthy and ready for embryo transfer.
IVF Medications for Surrogates
One of the most common questions women have is about IVF medications for surrogates. While the term IVF can sound intimidating, surrogate medication protocols are very different from those used for egg retrieval.
Why Medications Are Used
Medications are prescribed to prepare the uterine lining for implantation and to synchronize the surrogate’s cycle with the embryo.
According to the Society for Assisted Reproductive Technology (SART), these medications are widely used and considered safe when properly monitored by a fertility specialist:
Common Medications
Most surrogate medication protocols include:
Estrogen to thicken the uterine lining
Progesterone to support implantation and early pregnancy
Cycle-regulating medications such as Lupron
Progesterone may be given by injection, vaginal suppository, or oral medication depending on the clinic’s protocol.
Side Effects
Side effects are usually mild and temporary and may include bloating, fatigue, breast tenderness, or mood changes. Over the Rainbow works closely with fertility clinics to ensure surrogates receive clear medication education and ongoing support.
The Embryo Transfer Experience
The embryo transfer experience is often described by surrogates as one of the most meaningful moments of the journey.
What to Expect on Transfer Day
Embryo transfer is an outpatient procedure that typically takes less than 15 minutes. No anesthesia is required, and most women describe it as painless or mildly uncomfortable.
The Cleveland Clinic offers a detailed medical overview of embryo transfer procedures and what patients can expect before and after transfer:
After the procedure, surrogates usually rest briefly and then return to normal daily activities while continuing prescribed medications.
Pregnancy Monitoring and Prenatal Care
Once pregnancy is confirmed, care transitions from the fertility clinic to a trusted OB-GYN or midwife.
Early Pregnancy Care
Early monitoring includes bloodwork and ultrasounds to confirm hormone levels, heartbeat, and viability. After the first trimester, most surrogates follow a routine prenatal schedule.
Prenatal care follows guidelines established by the American College of Obstetricians and Gynecologists (ACOG), which outlines best practices for maternal and fetal health during pregnancy.
Ongoing Support
Throughout pregnancy, Over the Rainbow remains actively involved, helping coordinate communication while ensuring the surrogate’s medical decisions remain her own.
Delivery and Postpartum Recovery
Delivery planning is collaborative and centers on the surrogate’s health and comfort.
Birth and Hospital Care
Hospitals experienced in surrogacy work closely with medical, legal, and care teams to ensure a smooth experience for everyone involved.
Postpartum Recovery
Postpartum recovery for surrogates mirrors that of any pregnancy. This includes follow-up appointments, physical recovery, and emotional support as needed.
The Mayo Clinic provides a trusted medical overview of postpartum recovery and what women can expect after delivery.
Over the Rainbow continues to support surrogates during this transition, recognizing the importance of postpartum care.
FAQs: The Medical Side of Being a Surrogate
Is the surrogate medical process safe?
Yes. Surrogacy follows established medical protocols designed to protect the surrogate’s health. Thorough screening and ongoing monitoring are key components of the process.
Do IVF medications affect long-term health?
Current research does not show evidence of long-term health risks associated with IVF medications when used under medical supervision.
Does embryo transfer hurt?
Most surrogates report little to no discomfort. The procedure is quick and does not require anesthesia.
How many medical appointments are required?
Appointments are more frequent during screening, medication preparation, and early pregnancy. After that, care typically follows a standard prenatal schedule.
Why Medical Support Matters at Over the Rainbow
At Over the Rainbow, we believe the medical side of surrogacy should feel informed, supported, and never overwhelming. Our team works closely with leading fertility clinics to ensure surrogates receive:
Clear education and expectations
Compassionate advocacy
Respect for both physical and emotional wellbeing
If you are considering surrogacy and want a team that prioritizes your health and your voice, we would love to connect.
Ready to Start Your Journey?
Becoming a surrogate is one of the most generous, life-changing decisions you can make. It takes heart, preparation, and commitment—but the gift you provide is immeasurable. At Over the Rainbow, we deeply value every surrogate and are devoted to providing resources, guidance, and support every step of the way.