What to Expect At Your Surrogate Ultrasound

As you’ve likely already gathered, your surrogate pregnancy means a lot of additional attention from doctors. You’ve already had weekly appointments to monitor your uterine lining and blood hormone levels, and now that you’re pregnant, you’re about to have your first of what is likely to be several ultrasound scans.

The first ultrasound is such an exciting day! The pomp and circumstance of this day is part of what makes it special. While a handful of intended parents will make the trip to your hometown to attend this milestone appointment, most will not be able to plan for this travel. That doesn’t mean that they are anything less than thrilled for the moment, though.

Your intended parents will likely ask to be included in this appointment through technology. Common ways to do this are through video calling with apps like Skype or Facetime, or by having them on the phone with you during the scan. Other surrogates will offer to record the appointment with their phone and then send the video to the intended parents after the appointment.

You will need to seek permission from your clinic in order to have a live video connection during the scan, perhaps even to record the scan. It is typically best to seek this permission in the weeks prior to the scan as opposed to on the day of. Our advice? Don’t overthink asking for permission. If you tend to see the same sonographer week after week, try explaining your unique situation to them during your monitoring scans and then just asking that one employee for permission as opposed to seeking permission from the clinic as a larger entity.

The procedure itself will not be much different from the monitoring ultrasounds that you’ve been completing over the last four to six weeks. The wand will be inserted vaginally, and the technician will scan the uterus to find out exactly how many embryos are growing inside of your uterus. It is the technician’s job to find these fetal sacs, count them, measure them, and record how many heartbeats are detected. They will also be noting the presence and size of any potential sub-chorionic hemorrhages inside of the uterus.

Finally, understand that finding a heartbeat today is not a guarantee. Surrogates tend to be scanned for a heartbeat during the very first days that it is even possible to find one. As a result, sometimes the gestational age may be a bit off, resulting in an ultrasound scan that is conducted just a bit too early for a heartbeat to be detected. If a heartbeat is not found, but everything else looks ideal, your IVF doctor may ask you to continue your medications and return to the clinic for a repeat ultrasound sometime in the next several days to ensure whether or not a heartbeat can be detected.


In other instances, an embryo will start to develop, even embedding into the uterine walls, but not result in a viable pregnancy. In these rare instances, sometimes called a chemical pregnancy, your body may even continue to produce rising levels of hCG, resulting in continued positive beta tests. Despite those tests, an ultrasound will reveal an empty sac with no fetal development, and likely no potential for fetal development. In these cases your IVF doctor will likely advise you to stop medications and wait for a miscarriage.

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors. She is the co-owner of Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019) as well as the children's book You Began as a Wish (Independent Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. She has two adult daughters.