Embryo transfer in surrogacy requires key steps and adequate preparation

Imagine you’re at the beginning of a journey that can change the lives of many people. A precise moment where hope, science, and excitement collide: that moment is embryo transfer in a surrogacy process . But what happens just before that crucial moment? How do you get there? And above all, how can you prepare for this step to be as successful as possible? Let’s break it down clearly, directly, and without complicated jargon.

Why is embryo transfer such a significant milestone?

This step marks the moment when science directly enters the process of bringing life into the surrogate mother’s uterus: the embryos have already been created through in vitro fertilization (IVF), are ready, and are inserted into the uterus of the woman who will carry the pregnancy.

It’s a time filled with excitement, anticipation, and a certain level of uncertainty. If proper preparation isn’t done, the chances of success can be diminished. That’s why it’s key to know the steps, understand what happens before, during, and after, and the decisions the intended parents and surrogate must make.

Key steps for an embryo transfer in surrogacy

Selection and pairing of the surrogate mother

Before any treatment begins, the surrogate mother must meet a series of medical, psychological, and legal requirements. For example, in a gestational surrogacy process, the surrogate mother must undergo complete medical tests, psychological reports, and legal clearance to protect both her and the intended parents. Then synchronizes the surrogate mother’s cycle with that of the egg donor or intended mother (if applicable) so that the uterus is ready to receive the embryo at the appropriate time.

Ovarian stimulation and fertilization

While the surrogate mother prepares, the intended parents or egg donor (if applicable) undergo ovarian stimulation, egg retrieval, and laboratory fertilization to create embryos. These embryos can be transferred fresh or frozen for a later cycle.

Preparation of the pregnant woman’s uterus

One of the key aspects before the transfer is that the surrogate mother’s uterus is in ideal condition: this includes ensuring the uterine lining (endometrium) is of adequate thickness, that hormones are regulated, and that there are no factors that hinder implantation. To achieve this, hormonal medications (estrogen, progesterone, and sometimes ovarian suppression) and ultrasound monitoring are used to verify that everything is ready.

Embryo transfer day

The day of the transfer is the day the embryo is inserted into the surrogate mother’s uterus using a fine catheter, guided by ultrasound. The procedure is relatively quick (10-15 minutes in many cases) and generally does not require anesthesia. Afterward, the surrogate mother rests and is instructed to avoid strenuous exercise for a few days, although complete rest is not always mandatory.

Wait and take a pregnancy test

Once the transfer is made, the so-called “two – week wait” begins. wait ) until a pregnancy test is performed using a blood test ( hCG hormone ) to verify whether implantation has been successful. If the result is positive, monitoring continues; if not, another cycle or transfer of an additional embryo may be considered.

Monitoring and care during pregnancy

Once the pregnancy is confirmed, the surrogate mother begins prenatal care, with ultrasounds, medical checkups, and coordination with the intended parents and the fertility center team. The birth will be the culmination of the surrogacy journey.

Proper preparation: keys to increasing success

For this process to have a greater chance of success, it is essential to:

• Choose a fertility center with experience in surrogacy and a good medical team.
• Ensure that the pregnant woman has a favorable medical history (previous pregnancies without complications, good health).
• Verify that the embryos are of good quality, ideally with genetic testing if possible (PGT-A) to minimize the risk of early miscarriage.
• Coordinate hormonal synchronization between the donor/intended mother and the surrogate mother very well.
• Maintain fluid communication between the surrogate mother, the intended parents, the medical team, and the legal team.
• Manage expectations: even the best protocol doesn’t guarantee 100% success. In fact, more than one transfer may be necessary.
• Take care of the emotional well-being of everyone involved, because this process is not only medical, but also psychological and relational.

What happens if something doesn’t go as expected?

If the pregnancy test is not positive, another transfer cycle can be restarted. This can be emotionally draining for both the surrogate mother and the intended parents. It is important to address this issue with psychological support.

It is also important to consider the potential for medical or legal complications: for example, transferring multiple embryos can increase the risk of multiple pregnancies, which carries greater risks. Therefore, carefully assessing the risks and preparing for different possibilities is part of sound planning.

Advantages of surrogacy

When analyzing surrogacy , we find several advantages that many couples or individuals see as arguments in favor of surrogacy:

• It allows people who cannot conceive (for medical or anatomical reasons, or because they are same-sex couples) to fulfill their desire to have their own baby.
• In cases of gestational surrogacy, the surrogate mother is not genetically related to the baby, which simplifies some legal and psychological aspects.
• It may be a faster option than other infertility or adoption paths (depending on the country and legislation).
• Advances in IVF and transfers mean that results are progressively improving, and with good preparation the chances are quite good.

Disadvantages of surrogacy

On the other hand, the disadvantages of surrogacy must also be taken into account:

• It is a process that requires a great emotional, financial and time investment.
• It is not without medical risks for the pregnant woman (multiple pregnancy, gestational complications) and for the baby.
• Laws vary widely by country and region: legal issues may arise regarding parentage, parental rights, etc.
• There is no guarantee of success: it may require multiple embryo transfers, which increases the cost and emotional burden.
• There may be tensions, high expectations, and the need to manage complex relationships between the surrogate and intended parents.

Debate in favor of surrogacy: arguments about surrogacy

In the debate in favor of surrogacy, proponents point out that surrogacy is a form of human solidarity and ethical and regulated family building. Arguments in favor of surrogacy include:

• Reproductive freedom: allowing people who want to become mothers or fathers to do so through a well-regulated process.
• Strengthening family ties: Many surrogates do so out of a desire to help another family, which has an altruistic component.
• Contribution to equality: It allows same-sex couples, single people, or women who are unable to conceive to access maternity/paternity leave.
• With a good medical, legal, and psychological protocol, risks are minimized and safety is maximized for all parties.

At the same time, the debate on surrogacy requires acknowledging the arguments surrounding surrogacy that point to risks, potential abuse, exploitation, or legal loopholes. Therefore, it is essential to work with professional, transparent, and regulated entities that safeguard the rights and well-being of both the surrogate mother and the intended parents.

How does it all relate to embryo transfer?

Embryo transfer is where all these dimensions converge: the medical process, legal coordination, emotional well-being, the parents’ hopes, and the surrogate’s generosity. If all parties are fully prepared at that moment—the surrogate with her uterus ready, the intended parents with their embryos, and the medical team with the appropriate protocol—the likelihood of the process flowing optimally increases.

On the other hand, if preparation fails (for example, the lining is inadequate, the synchronization is poor, the surrogate is not in optimal condition), the transfer may not produce the desired effect. And that’s where the disadvantages we mentioned come in.

Conclusion

Surrogacy is an increasingly visible alternative for building families when self-sustaining is not viable. Within this path, the embryo transfer process occupies a central place, because it is the moment where science meets hope. Adequate preparation, understanding each step, working with competent professionals, and managing expectations are key pillars for a successful transfer. At the same time, it is important to recognize the advantages and arguments in favor of surrogacy, as well as understand the disadvantages of surrogacy, in order to make an informed decision.

If you’re considering this path or simply want more information, on our website you can find guides, professional support, and guidance to make your journey as clear and safe as possible.

Frequently Asked Questions ( FAQs )

How long before the transfer should the surrogate mother prepare?

The surrogate mother should begin hormonal and cycle preparation several days or weeks before the transfer. Her cycle is synchronized with that of the donor or intended mother, and her uterine lining is regulated until it is ready to receive the embryo.

Is a frozen embryo always used, or can a fresh one be used?

A fresh or frozen embryo can be used. Frozen embryos (FET) are becoming more common because they allow greater flexibility and, according to some clinics, better outcomes.

How long does the transfer procedure take? Is it painful?

The procedure takes approximately 10 to 15 minutes and typically does not require anesthesia. Surrogates often describe it as mild discomfort, similar to a vaginal ultrasound.

How many embryos should be transferred?

Most clinics recommend transferring a single embryo to minimize the risk of multiple pregnancies, unless there are specific medical reasons.

What happens if the transfer is unsuccessful?

If the pregnancy test is negative, the medical team will evaluate the reasons, consider the quality of the embryo, and the surrogate’s readiness, and plan another attempt in a new cycle. It’s important to plan this scenario emotionally.

What are the main risks for the surrogate mother during this process?

These risks include those typical of pregnancy (such as premature birth and gestational complications), and in cases of multiple pregnancies, these risks increase. Therefore, preparation, monitoring, and careful selection of a surrogate mother are vital.