Gestational surrogates become pregnant through the process of in vitro fertilization (IVF) and not through traditional means. As a surrogate, you take medications to prepare your body to accept the fertilized embryo. These are mostly hormonal medications that trick your body into believing you’re pregnant. A Reproductive Endocrinologist (RE) analyzes your medical history and tailors your medications to what your body needs.
Not every surrogate will have the same medications or same timeframe for taking them. Follow the directions given to you rather than what you have heard of others doing and feel comfortable asking questions if anything seems unclear. It’s common for at least one of your medications to be as self-administered injections and you’re thoroughly educated on how to perform your injections properly. Below are some of the most common medications you might be asked to take as a surrogate.
Progesterone is a natural hormone that is normally produced by your ovaries. You take this to thicken your uterine lining for the embryo implantation and early pregnancy maintenance. Progesterone is most popularly in the form of an injection, but some people are prescribed a vaginal suppository or gel. Possible side effects may include tenderness at the injection site, vaginal discharge, dizziness, or breast tenderness.
Estrogen is typically taken before the embryo transfer until around the end of the first trimester. It helps to grow the lining of the uterus and keep early pregnancies. It might be taken through oral pills, injections, vaginal tablets, or transdermal patches on your stomach that allow you to absorb estrogen through your skin. The frequency of taking estrogen varies depending on which form you are using. You continue to take estrogen until your placenta takes over production around the 12th week of pregnancy. Possible side effects may include bloating, breast tenderness, or slight nausea.
Taking birth control pills early in your cycle will help you sync your cycle with that of the intended mother or egg donor. You don’t want to accidentally get pregnant with your own child and birth control helps with that as well. It is usually taken in conjunction with Lupron.
Leuprolide Acetate is commonly called Lupron. You typically start taking it about two weeks after starting birth control and lessen your dosage when your menstrual cycle begins. Its purpose is to stop you from ovulating by overstimulating your production of certain hormones. You should still avoid sex while on Lupron, unless approved by your doctor. Lupron is taken as an injection into fatty tissue. Injections are discontinued before egg retrieval from the intended mother or egg donor. Possible side effects may include headaches, hot flashes, fatigue, or irritation of the injection area.
Doxycycline or Tetracycline
Doxycycline and tetracycline are both antibiotics taken as oral tablets. Either might be taken for a few days prior to your embryo transfer to prevent infections. Doxycycline typically doesn’t have any side effects, but tetracycline may cause slight gastrointestinal irritation or sensitivity to sunlight.
Medrol is a low-dose steroid, most commonly in pill form, used to avoid inflammation of your uterine lining. Inflammation could prevent the embryo from implanting successfully. Most women experience no side effects from Medrol.
I know my surrogacy medications and doses. Now what?
It’s important to be very organized with your medication routine. Have a plan for whether you will be self-administering injections or if a spouse or other person will handle this. Plan to take your medications at the same time each day. Setting a daily alarm can help you remember.
Keep all of your medications organized in a medicine cabinet, tackle box, or other organizer. Injection supplies need to be disposed of properly. Put plastic caps back on needles and place in a container that is out of reach from pets and children. These needles shouldn’t be thrown in the garbage. Check with local medical professionals about acceptable places for disposal.
This is not an exhaustive list of everything you may be asked to take and you may not take every medication on this list. Speak to a medical professional to find out what the best options would be for your personal situation. If you start to notice any uncommon side effects or think you took the wrong dose of a medication, inform your doctors as soon as possible.