Surrogacy Medications


The medications involved in a gestational surrogacy cycle are listed below. We will answer any questions you may have and will walk you through all of the medications and their possible side effects. Please note that each surrogate responds differently to her individual protocol; some surrogates will experience no side effects at all. You will also have the opportunity to discuss the fertility clinic’s specific protocol with your IVF nurse at your medical evaluation appointment.


LUPRON (leuprolide acetate)

Lupron prevents the usual hormone exchange that causes follicle production and ovulation by suppressing the pituitary stimulation to the ovaries.

Administration: Lupron is an injection given subcutaneously (in the fatty tissue) by a ½ inch needle under the skin.

Side effects: Headache, fatigue, hot flashes.



Estrogen is a hormone that helps grow the lining of the uterus which maintains an early pregnancy.

  • Vivielle Patches (estradiol)

Administration: The patch is applied to the skin on the abdomen and the estrogen is absorbed through the skin.

Side effects: Skin redness, irritation or rash, nausea, fluid retention.

  • Estrace (estradiol)

Administration: Oral tablet or vaginal suppository.

Side effects: Bloating, mild nausea, or breast tenderness.



Progesterone is the hormone necessary for the preparation of the uterine lining for the implantation of the embryo and the maintenance of early pregnancy.

Side effects: Breast tenderness, mild nausea, diarrhea, bloating, stomach cramps and dizziness.

  • Prometrium

Administration: Oral tablet

  • Crinone/Prochieve

Administration: Vaginal gel

  • Endometrin

Administration: Vaginal tablet insert

  • Progesterone 

Administration: Intramuscular injection (into the muscle)

Side effects: Breast tenderness, injection site tenderness, mild nausea, diarrhea, bloating, stomach cramps and dizziness.


DOXYCYCLINE (antibiotic)

Doxycycline is a pre-cycle antibiotic that prevents any possible low-grade pelvic infection.

Administration: Oral tablet.

Side Effects: None, but varies per individual.


TETRACYCLINE (antibiotic)

Tetracycline is a broad-spectrum antibiotic taken orally starting a few days before transfer to help prevent infection from occurring.

Administration: Oral tablet.

Side effects: Minor gastrointestinal upset, sensitivity to sun.



Aspirin assists with cycle stimulation and impending embryonic implantation. This medication will continue until 12 weeks of pregnancy.

Administration: Oral tablet.

Side effects: Upset stomach, heartburn, easy bruising or bleeding.



MEDROL (methylprednisolone)

Medrol is a low-dose steroid pill to suppress the autoimmune system from interfering with embryo implantation.

Administration: Oral tablet.

Side effects: None.



Medical Risks of Surrogacy


Like any other pregnancy, gestational surrogate pregnancies involve the same medical risks of carrying a child and giving birth. These can include nausea from morning sickness, weight gain, swelling, back pain, heartburn and other uncomfortable side effects. Some more serious side effects are conditions that can develop during the pregnancy like gestational diabetes, hypertension or potential damage to your reproductive organs.

As with any pregnancy, there is also the risk of miscarriage or preterm labor. To reduce these risks, it’s important to keep in close contact with your doctor, take the proper medication, get the right amount of rest and follow their recommendations precisely.


With gestational surrogacy, there are also some minor medical risks associated with IVF treatments. Because you do have to take medicine for IVF with surrogacy, including injecting yourself with fertility medications at home, you can expect anything from slight needle bruising to temporary allergic reactions. As you take medicine to regulate your menstrual cycle and increase your chances of becoming pregnant, you may also experience increased pre-menstrual syndrome effects, like headaches or mood swings.

There are few risks associated with the embryo transfer process. You may experience slight cramping or bleeding from the procedure. As always, it’s important to stay in touch with your doctor; in rare cases, you may develop an infection that can be treated with antibiotics.

Because carrying multiple babies is common in surrogacy, you should also be aware of the risks of a twin or triplet pregnancy; preterm labor, low birth weight for the babies, placental abruption and the potential for a Cesarean-section may be more likely with multiples. If you are carrying multiple babies, your doctor will likely give you strict instructions on how to proceed safely with your everyday life.

To reduce surrogacy risks, it’s important that you follow your doctor’s recommendations and schedule an appointment as soon as possible if something feels wrong about your pregnancy. While your side effects may be completely normal, updating your doctor about your condition is one of the easiest things you can do to reduce the risks of being a surrogate mother.

Your surrogacy agency will also require you to complete an extensive medical screening before becoming a surrogate. These screenings are extremely helpful in informing you and your doctor about your medical condition and the possibilities of medical issues with your surrogacy. Make sure that you’re completely honest and open about your medical history during this screening. 

In addition to the medical risks of surrogacy, there are sometimes emotional challenges for potential surrogates to consider. While pregnancy in itself can be a difficult process, some women find surrogacy to be more emotionally challenging because, at the end, they will not be going home with the child they have lived with for nine months.

As with any pregnancy, you may be at risk for depression during and after the surrogacy process. While you’ll be excited and overwhelmingly happy for the intended parents, you may also experience some difficult feelings of grief and loss following the birth of the baby.

These feelings are why it’s so important to meet with a mental health professional, seek surrogacy counseling and establish boundaries and expectations for post-birth contact before you even become pregnant.

A key part of coping with any challenging emotions you may experience is creating a solid support system that you can lean on before, during and after your surrogate pregnancy. This should be a group of friends and/or family members who can talk to about your feelings — but it’s important that you are open and honest with them (and yourself) during the whole process.

In addition to the emotional effects that surrogacy may have on you, it’s important to recognize how your surrogacy will affect your family. If you have a spouse, you may need to abstain from sex while you are trying to become pregnant, and they may need to take on more duties around the house and with your family as you reach the final stages of your pregnancy. They will need to be 100 percent in agreement with your surrogacy decision, and they can act as one of the most important members of your support team.

You also should be honest about your feelings with the intended parents and your surrogacy case worker through the surrogacy process. If you are struggling emotionally, it may be helpful to talk to a therapist experienced in surrogacy issues. Remember, the emotional risks of surrogacy are completely normal and many other surrogate mothers experience them — so they’re nothing to be ashamed of.

While being a surrogate mother is a fulfilling experience and a wonderful way to give a gift to another couple, it also has some serious risks and side effects as well. It’s important that you fully research what surrogacy entails before you make this life-changing decision.

The risks of being a surrogate mother may be intimidating at first, but you will likely find that the positives of helping to create a family far outweigh the potential risks and medical issues with surrogacy. To reduce these risks, it’s best to work closely with an experienced surrogacy professional who can effectively respond to every challenge that may come your way. Every case is different, so talk extensively with your doctor, the intended parents, your fertility clinic and your family to determine whether surrogacy is right for you.