Now that you’ve completed your IVF, it’s time to transfer your embryo to your surrogate. The most important step is proper endometrium preparation. Correct stimulation of the endometrium requires a mix of science and artistry. This is one point where your doctor’s experience can really pay off!

endometrium preparationFor most surrogate mothers, the most critical factor in preparing for an embryo transfer is increasing the thickness of the endometrium and the receptivity of the uterus. The endometrium is the nutrient-rich layer that appears in the uterus wall during a woman’s menstrual cycle. Endometrial thickness should be greater than 8 mm and less than 15 mm. Doctors will disagree on the “perfect” measurement, but a good target will be around 12 mm.

To help prepare the endometrium, surrogates undergo stimulation injections, which are light hormone treatments that will boost her body’s readiness to receive an embryo. Stimulation usually lasts from 15 to 18 days.

There are also other factors in the readiness of your surrogate, including her hormone levels and her overall health. Your doctor will be monitoring all of these throughout the stimulation process.

The start of stimulation often includes some compensation to your surrogate (if you are working with a U.S. surrogate), followed by another payment when the embryo transfer happens.

Remember that endometrium stimulation is a biological process, and not all women react the same to the stimulation medication. Some women need a higher dosage (or the same dosage for more days) and some need less. The process requires some artistry to carefully balance the treatments.

If you are a surrogate (or just trying to become pregnant), it’s important to follow your doctor’s orders and attend your consultations — you should be well informed of the process and comfortable with the next steps. On each consultation the doctor will explain how your is responding and what you may do to improve your receptivity and likelihood of pregnancy.

Meanwhile, your agent should be doing the same for the intended parents (with help from the clinic’s case manager).

It’s important to note that the stimulation procedure is not a single recipe for all patients. There are different combinations of medicines, dosages and durations that can be used under different situations. In some cases your doctor may adjust the stimulation strategy if he finds your surrogate is not responding to the first choice. Acknowledging that will help you overcome a lot of stress.

If the doctor makes adjustments to your surrogate’s stimulation protocol, that does not mean that it will be less successful or more successful. The changes are all made to reach the same ultimate goal, a healthy surrogate mother with a receptive uterus to carry your pregnancy.


About the authors

  • Bill-Houghton
  • Author: William Houghton

    Bill Houghton is the founder of Sensible Surrogacy, author of the Sensible Surrogacy Guide, 2x surrogacy dad, and a dedicated advocate for secure, legal and ethical Gestational Surrogacy. Read Bill's Biography

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