What to Expect in the First 12 Weeks of Surrogacy (As the Surrogate)

The first 12 weeks as a surrogate can be a lot of work, but it's also an exciting time. You'll be helping to create a new life and make a difference in the lives of others.

Becoming a surrogate is an emotional decision that will fill you with questions. You have plenty of things for your mind and body to process when deciding whether surrogacy is right for you, but understanding what happens during the first 12 weeks may ease some uncertainty about how it works. One question that may arise for first-time surrogate applicants is what medical screenings and tests are involved. They may also have questions about the physical details of the transfer, what it feels like, or what the most challenging part is.

Surrogate Medical Screening

Before medical screenings and tests, surrogates will have completed the application and matching phases. In the screening phase, a surrogate undergoes a two-part screening process to ensure their body can carry a baby, as well as a psychological assessment.

In the pre-screening, your complete medical history will be reviewed. This will include any past pregnancies, annual physicals, and Pap smears you have had in previous years. If these checks are normal, you'll begin the next part of the medical screening process.

During this second stage, you’ll undergo a comprehensive physical examination and have a transvaginal ultrasound to check for any uterine abnormalities and ensure the uterine structure is normal. The ultrasound will also measure the thickness of your uterine lining and determine if you can carry a pregnancy. A standard blood test measures your hormone levels and a urine screening will test for any STDs, drug use, or nicotine consumption. If the results from the medical screenings are approved, the next step is when your doctor determines when to begin medication.

Before a surrogate can begin the medication protocol, they will need to have finalized all the legal paperwork. Only when this is completed can the IVF process begin.

IVF Medication Protocol

When you can begin taking medication is determined by the results of your screening tests. Your doctor will then decide when you’re able to begin medication or if you will need to hold off.

The IVF treatment cycle starts on day 1 of your period. When you begin taking medication, you'll take estrogen for 2-½ weeks which will help thicken your uterine lining and make it more receptive to implantation. At the end of the 2-½ weeks, you'll have another transvaginal ultrasound to ensure the uterus is responding properly to the medication. If the uterus progresses as it should, progesterone will start five days before the embryo transfer and will continue for up to 11 weeks after transfer, if a pregnancy is produced. The progesterone helps the fertilized egg become implanted in the uterus and establish a pregnancy.

The first few weeks on hormones can be especially difficult. Progesterone will make you moody and experience exhaustion. It’s especially important to make sure you have extra support from your family and friends during this time. 

Embryo Transfer

The embryo implantation is a short procedure, similar to a pap smear. The doctor inserts a long, flexible catheter into the uterus and uses an abdominal ultrasound to ensure an exact placement of the embryo. A surrogate and parents-to-be can watch the entire transfer process on the ultrasound screen. The entire transfer process takes about 15 minutes.

Following implantation, you’ll remain at the clinic for a half-hour to ensure that everything goes smoothly. Typical discomfort is usually minor and similar in nature to menstrual cramps. You’re encouraged not to return to the office that day and go easy over the next few days to ensure a stress-free and positive environment for the embryo. Ten days after the procedure, you will have an HCG blood test to determine if there is a pregnancy. If there is, two weeks later, you’ll have another ultrasound to confirm a heart beat.

The Weeks Following an Embryonic Transfer

Once the embryonic transfer is complete, it's important to have plenty of support from your family and friends. You’ll need help with things like household chores and taking care of children. It's also important for you to get plenty of rest and eat a healthy diet. The weeks following an embryonic transfer can be emotionally and physically demanding, so it's important to have a good support system in place.

Be open to letting your intended family help you as well. It’s a way for them to participate in the pregnancy, as they are unable to carry the baby themselves, and will want to do whatever they can to support you with the pregnancy. In most cases, your intended parents will not live close by, so they may want to hire someone to help with housekeeping or order grocery deliveries or meals to help you with daily needs and tasks. It can be fun to become creative in ways for the intended parents to be a part of the process when they are not able to be physically present. Always be sure to send them updates on how you are feeling and let them know if there is anything they can assist you with.

Learn more about surrogate medical screening

If you have questions about the required medical screenings and tests, have any questions about surrogacy, or just want to chat, Vermont Surrogacy Network is here for you. We can’t wait to meet you!