What to Expect for Embryo Transfer as a Surrogate

So you’ve matched with the intended parent(s) of your dreams, and—similar to many new relationships—you’re beginning to wonder, what’s next? Well, a lot, but that’s putting it a little too simple, so let’s get specific about one thing in particular: preparing for embryo transfer as a surrogate.

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Let’s cut to the chase: When it comes to embryo transfer, a gestational carrier (GC) has to go through the process of in vitro fertilization (IVF), where an embryo created in a laboratory—with no biological relation to you—is transferred into your uterus. (More on that later). 

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But there’s a lot more that goes into an embryo transfer than what occurs on the actual day of the procedure. Keep reading to learn more about what the IVF process is like, what a successful embryo transfer requires, and even a few ideas to keep you comfortable during the process. 

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What is an embryo transfer? 

We’ve already established that embryo transfer is exactly what it sounds like—this is the time when an intended parent’s embryo makes its way into your uterus. 

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“Basically, embryo transfer is very similar to having a pap smear,” says Kelsey Ennis, Nodal’s women’s health nurse practitioner. “It is quick and relatively painless.”

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Nodal’s founder and CEO Brian Levine, M.D. agreed, adding that the process takes 3 to 5 minutes from start to finish, “is completely painless, and requires no anesthesia or medication.”

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How do you prepare for an embryo transfer?

OK, so here’s the deal: The easiest part of embryo transfer is the actual transfer. It’s the process leading up to IVF, however, requires weeks of preparation and medications for a successful pregnancy, says former surrogate and Nodal Head of Community Brianna Buck. 

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“The actual embryo transfer is so quick and easy compared to everything you had to do to get there,” Buck says. “You don't physically feel any different, which is just such a juxtaposition compared to the big lead-up to that day.”

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What is that “big lead-up” exactly? Typical embryo preparation protocols will include a series of pills, injections, patches, and vaginal suppositories that correspond to your cycle. With Nodal, you can expect to be trained on giving yourself an injection and have access to a support team who can provide you with additional educational resources to help guide you through the process.

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Although preparing for embryo transfer is often the most challenging part for first-time gestational carriers, once you become familiar with all the medications, you will find your groove.

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“Once I was officially pregnant and had gotten used to all the injections, it was much easier,” Buck says, adding that it took about two weeks before she could administer injections without flinching. “I felt like I could exhale after holding my breath for weeks. I was pregnant and now taking all the medications felt more meaningful because it was what I had to do to keep the little fella growing.”

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Related: How to Become a Surrogate: 8 Things to Consider Before You Apply

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What else should I know about embryo transfer? 

While taking hormones in preparation for embryo transfer, the fertility clinic will take periodic blood tests and transvaginal ultrasounds to monitor how your body responds to the treatment. It is normal to have adjustments made to your protocol depending on your results. You will likely have the most doctor appointments during this period. And, yes, while it may feel like you are just in and out of offices for these few weeks, this is temporary. Once your uterine lining, called the endometrium, has thickened and is ready for embryo implantation, your transfer will be scheduled.

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The most uncomfortable part? “Arriving to the procedure with a full bladder!” Buck laughed, noting that while it might make for a clearer ultrasound during the procedure, it is not the most comfortable state for the surrogate.

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Related: My Surrogacy Journey as a Surrogate

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Let’s make embryo transfer more comfortable

While there is no one-size-fits-all embryo transfer experience, Ennis says she likes to quote her mother in these situations: “Control the controllables!”

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That means gestational carriers can prepare for the embryo transfer by contacting their clinic to ensure they know what to expect. “Every clinic does things slightly differently, and it’s essential to get all the instructions,” Ennis says, adding that, for example, some clinics allow partners to be present while others don’t. 

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Ennis also offers the following tips:

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- Plan your transportation: Do you need a ride to and from the appointment? Do you have directions to the hotel/lodging (if applicable)?

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- Consider snacks: It doesn’t hurt to have a few quick options in your bag (e.g., banana, trail mix, food bar). Also, consider treating yourself to dinner out afterward.

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- Ask questions: Post-procedure is the time to ask what to expect, including rules around activity levels, medications to take, possible side effects, and when to call a doctor.

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- Don’t over-research: Try to avoid Googling every symptom, which most often only serves to up the ante on your anxiety.

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- Follow discharge instructions: This might seem like a no-brainer, but simply following your clinical team’s advice is the best measure you can take post-embryo transfer.

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The bottom line.

While the lead-up to embryo transfer can be detail-oriented, the procedure itself is fairly uncomplicated. The best you can do is follow instructions from your clinic and take steps beforehand to ensure a comfortable process. 

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