Our body prepares an expectant mother by releasing all the hormones necessary to carry a child till its birth. It makes the uterus ready for conception and then helps the embryo to be stable and grow. But in the case of a surrogate mother, she needs to be given medications before and after the pregnancy to supplement the required hormones released naturally to others.
Surrogate mothers in India receive same medications that is being followed elsewhere in other parts of the world. In the run up to this a surrogate mother is given anti biotic to rule out any possible pelvic infection. Once the vital parameters of a surrogate mother are within the reference range and all the screening process gets completed, the surrogate receives medication to start the treatment. The cycle of the surrogate mother should match with the egg donor. If the cycle of the surrogate mother doesn’t match with that of donor, the cycle is matched by giving hormonal pills ie. birth control pills or progesterone pills. Lupride acetate is the medicine that need to be started from day 2 of recipient’s cycle to supress her ovaries and prevent hormonal interference in the pregnancy. Birth control pills may be started about a fortnight before Lupron. Injection of Lupron completely shuts down the surrogate’s own cycle medically and a synchronized cycle with egg donor is started. Lupron should be stopped prior to egg donation of the intended mother or egg donor.
Hormonal injections/medications will be given to enhance thickness of the endometrium. These hormones are known as Estrogen and Progesterone. Estrogen helps to thicken the lining of the uterus and it can be taken orally or other methods like injection or via abdomen skin patch to get absorbed in the body. Once the lining thickens and reaches critical thickness, hormone progesterone is administered to make the secretory changes in endometrium to make it receptive for implantation and to maintain pregnancy. Progesterone also can be given subcutaneous, orally or as vaginal tablet. In the journey towards Surrogacy weekly ultrasound and blood tests will be performed to check the thickness of the lining and hormonal level. Ultrasound and Blood test confirming the level of Progesterone helps IVF Specialist to understand whether the uterus is ready for the embryo and attained the optimum level of conception. On the 5th day of progesterone injection, blastocyst ie. Day 5 embryo is transferred to the recipient. The topic of Blastocyst embryo transfer will be discussed separately. To maintain a stable balance and help the uterus to retain the embryo, Progesterone should be continued till beta hCG test that confirms pregnancy and is continued further if pregnancy test is positive.
Once the implant is successful and the pregnancy is confirmed, Estrogen and Progesterone are generally continued till first trimester. The placenta then takes over hormone production and these medications are not required routinely. In some cases Aspirin is given orally to improve implantation rates. The rest of the medication is as per pregnancy similar to other pregnancies. A surrogate mother will have to take vitamin supplements and iron tablets during her pre natal journey. She should have a healthy diet along with medication with some exercise to keep her fit and prepare suitably for the journey.
Side Effects of the hormone injections could be bloating, irritability and tenderness of the injection site. Some experience dizziness and fatigue also with vaginal discharge. Oral tablets can cause constipation, minor stomach upset. There are many good Surrogacy treatment centres in India where surrogate mom’s medication gets full attention as every woman is different from the other and needs a separate medication chart.