Your surrogate will be on a closely monitored medical protocol for a long time. Beginning roughly a month before your embryo transfer, and lasting many weeks into a confirmed pregnancy, it can feel like she’s taking medications endlessly. We understand that there is some peace of mind that comes with the announcement that she has been released from medications, and that the moment you receive that message is highly anticipated.
In most basic terms, this announcement signifies that doctors believe her body is able to sustain the pregnancy on its own without medical intervention. And that is a really good feeling for any intended parent.
When your surrogate will be weaned off of her medications is based on a variety of factors, and you should understand that the end date will not be uniform between surrogates. Sometimes it’s not even uniform for multiple transfers or pregnancies completed with the same surrogate, same doctor, and same intended parents. The mark for discontinuing medicines is determined more by how her body responds to medication and the pregnancy than it does a date on a calendar. Let us explain.
IVF allows doctors to create an embryo outside of the body, and then transfer it into an awaiting uterus. It is necessary to create, through medical manipulation, uterine conditions that mimic exactly how a fertile woman’s uterus would look if it were attempting to achieve a natural pregnancy at the same time. This is accomplished, primarily, through use of hormone therapy.
Your surrogate will be on some form of estrogen and some form of progesterone to help this process. While estrogen helps her uterine remain blood-rich and thick in lining, progesterone directs the body to begin creating a placenta and sustaining a pregnancy until the newly formed placenta is able to take over.
In nature, the fertilization of the egg and its implantation into the uterine wall would direct the body to begin producing, increasing, and sustaining these hormones. But, since the fertilization and first several days of embryo life are happening outside of the body in pregnancies achieved through IVF, doctors need to manipulate the body to create these hormones artificially. Without adequate levels of these hormones the pregnancy would fail to be viable.
Your surrogate’s doctors, typically with the help of a monitoring clinic close to her home, will test her hormone levels weekly from about a month prior to transfer through about week 10 or 13 of gestation. The point of this is to monitor and react to levels that may not be high enough to allow her body to sustain an IVF pregnancy in the early stages. At some point late in the first trimester, typically between weeks ten and thirteen, the surrogate’s body will begin to produce these two hormones in earnest, and she will be permitted to slowly wean off of the artificial hormone therapy.
Doctors tend to be cautious with allowing the weaning, and different doctors have different targets in mind for establishing when the body is capable of maintaining the pregnancy on its own. This is partly why there can be such a wide variance in stop dates between surrogates and even within different transfer cycles for the same surrogate.
Once weaned from IVF protocol, most surrogates will only be required to take the standard prenatal vitamins for the duration of the pregnancy.
Of course, if a transfer is not successful or if an early pregnancy results in miscarriage, your surrogate will be released from medications almost immediately.