If you not already taking oral contraceptives, you may receive a prescription for birth control pills. These are given to help regulate your cycle and will allow the physician to coordinate your cycle with that of the Intended Mother and/or egg donor. You may be asked to start birth control prior to having the contract signed.
Surrogates must refrain from sexual intercourse once the medications begin. You will be extremely fertile during this time! You will also be asked to either abstain from sexual relations, or to use a combination of effective barriers prior to starting any of the medications and to completely abstain from the beginning of suppression medications. You will also be asked not to take part in any heavy exercise after the embryo transfer stage. Please discuss your questions regarding sexual activity with the primary physician. If you become pregnant during the medication stage, the cycle would have to be canceled and you may be in breach of contract.
On approximately day 21 of her cycle a surrogate will begin the first of her medications; a medication called Lupron Depot in a single intramuscular injection. A medical professional will teach you how to administer this to yourself if you are not able to attend a clinic to receive this injection. Lupron is not a fertility medication and is given to keep the ovaries from ovulating. A different form of Lupron is used by some IVF centers and is given as a one time injection. You may have a menstrual flow within a week to ten days. An ultrasound and blood work may be performed to make sure the ovaries are quiet. Usually this happens approximately 3 weeks after the injection was given. Once the donor and recipient are synchronized, the next medication will be administered. Occasionally, Surrogates have complaints of hot flushes, moodiness and headaches. We have found that if Surrogates lead active lives, they generally have fewer complaints and many have no complaints at all. Please discuss all potential side effects with the primary physician.
Once suppressed by the Lupron you will commence an estrogen medication called Estrace. This medication causes the lining of the uterus to become thick to prepare for the upcoming implantation of the embryo(s). In addition you may be required to take a daily Lupron injection subcutaneously (under the skin) in the evening. After approximately 10 days on the Estrace pills you will be required to have an ultrasound done to measure the lining of your uterus to check that the Estrace has been thickening the lining appropriately. If so, then the donor will commence her ovarian stimulation and you will stay on the Estrace pills until she is ready for egg retrieval. There are other medications that might possibly be used and they may require oral and/or intramuscular administration. Please discuss all potential side effects with the primary physician. Please note that the medication protocol may vary dramatically between fertility centers. This protocol mentioned above is an example of a widely used protocol. Not until you meet with the physician will your actual protocol and medications be explained to you.
The day before the egg retrieval you may be asked to reduce the dosage of your Estrace, stop the Lupron and commence intramuscular injections of Progesterone in Oil and Progesterone suppositories vaginally. If you become pregnant, you may be required to continue on this regime for the first trimester of the pregnancy.
At the time of the embryo transfer which usually takes place 3 – 5 days after the egg retrieval, the embryos are loaded into a very fine catheter and the doctor inserts them into your uterus through your vagina (insemination) using an ultrasound to guide the way. There is no pain or discomfort with this procedure. The embryos are slowly released into the uterus, you will lay down for an hour or two. The majority of Surrogates are able to go home within two hours after the transfer. If you had to fly to the clinic, you will be required to stay through the day and may be able to fly home the following morning. Some physicians require a Surrogate to not travel for two days after an embryo transfer - this will be explained to you well in advance.
THERE ARE POTENTIAL RISKS INHERENT WITH ALL ASPECTS OF THE SURROGACY MEDICAL PROCESS AND PROCEDURES, INCLUDING TAKING ANY MEDICATION. IT IS THE SOLE RESPONSIBILITY OF THE SURROGATE TO INVESTIGATE ALL SUCH RISKS AND TO DISCUSS ALL MEDICAL ISSUES WITH THE PRIMARY PHYSICIAN.