The preparation of the surrogate mother starts one month prior to the embryo transfer.
Birth control Pills
The Surrogate Mother (SM) is started on BCP on day 1 or 2 of her menses and the pills are given such that she withdraws them 4-5 days prior to the Intended Mother stopping her pills for planning the fresh cycle.
In case of FET (Frozen Cycles), the pills are withdrawn 20-25 days prior to the scheduled date of FET.
Related Link : Surrogate Process Overview
Luprides can be given as a depot preparation on day 18 of BCP. This suppresses the follicle (egg) formation in the surrogate mother herself in the up coming cycle.
Lupride can also be given as a micro dose, this is started on day one of the cycle along with the estradiol and continued till the embryo transfer.
Folic acid, calcium and Multivitamins are started atleast a month prior to the embryo transfer. Folic acid prevents neural tube defects.
Once the SM gets her menses in the month scheduled for the Embryo Transfer, the following schedule is followed:
Day 1: Pelvic scan, to rule out presence of any follicular cyst in the ovaries and to see the endometrial linning.
Day 2: Preparation of the endometrial linning is started. Estradiol valerate is given on a daily basis and continued for the first seven days till a scan is repeated to evaluate the response of the endometrium. Inj Lupride is added if the daily micro dose regimen is followed.
Day 7: Pelvic scan, to evalutate the endometrial thickness and the blood flow along with the ovarian status. On an average it takes 12-16 days for the endometrial lining to be ready for the transfer, but may take longer also.
Day 9: Pelvic scan, to evalutate the endometrial thickness and the blood flow along with the ovarian status.
Day 11: Pelvic scan, to evalutate the endometrial thickness and the blood flow along with the ovarian status. Please note that the exact scan dates can only be confirmed post previous scan reports and endometrial growth. There is a possibility that they may need 2-3 more scans for accuracy.
Embryo Transfer (ET)
Once the endometrial linning is ready, Inj. Lupride is withdrawn and Injectable Progesterone along with other supportive medication is added to the protocol. The ET is scheduled on day 2 or 3 post egg retrieval in a fresh cycle or 3-4 days prior to an FET.
Post this the surrogate is admitted in the clinic for observation and support. You may read more in Antenatal Care