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Commonly Used Medications During Surrogacy

Medication Administration Use Side Effects Timing

Low Dose Aspirin

(baby aspirin, 81mg)
Oral Tablet Increases blood circulation and lowers inflammation in the body - both may help with embryo implantation and placental development. Nausea, heartburn, easy bruising or bleeding Before embryo transfer and through 1st trimester of pregnancy (12 weeks)

Birth Control Pills

Oral Tablet The main purpose of taking birth control pills is for the clinic to be able to medically control when a surrogate will have her period and is therefore able to stop and start a surrogate’s cycle. Nausea, vomiting, headaches, spotting Prior to embryo transfer protocol

Lupron

(leuprolide acetate)

Lupron is a subcutaneous (SQ) injection administered in fatty tissue such as the abdomen.

The injection needle is small, a needle that resembles a diabetic insulin needle.

The injection will be administered by the surrogate or her spouse/partner daily.

GnRH is a gonadotropin-releasing hormone. Lupron is a synthetic hormone that temporarily suppresses a surrogate’s cycle. headaches, fatigue, hot flashes Prior to embryo transfer

Estrogen

Estradiol (Estrace) Vivelle Patches Estradiol- Valerate

Estradiol can be in pill or patch form or given as a subcutaneous (SQ) injection.

The injection (Estradiol Valerate) will be administered by the surrogate or her spouse/partner, most likely twice per week.

The patches (Vivelle) are most commonly applied to the abdomen and estrogen is absorbed through the skin.

(Pre-pregnancy) A hormone that stimulates the development of the lining within the uterus.

(During pregnancy) Estrogen is necessary to maintain an early pregnancy.

breast tenderness, nausea, bloating

(injections) soreness, redness at the injection site

(patches) skin redness, irritation or rash

Before embryo transfer & continuing through most of the 1st trimester.

Progesterone

Progesterone- in-Oil Endometrin Prometrium

Progesterone-in-Oil is an intramuscular (IM) injection administered into the muscle of the buttock.

Endometrin is a vaginal suppository, while Prometrium is a pill that is inserted vaginally.

(Pre-pregnancy) A hormone that prepares the uterine lining for embryo implantation.

(During Pregnancy) Progesterone is necessary to maintain an early early pregnancy.

Breast tenderness, headaches, dizziness, nausea, bloating, and fatigue

(injections) redness, pain and swelling at the injection site

(vaginal route) vaginal discharge

1-week prior to embryo transfer & continuing through the 1st trimester

Azithromycin

(Z-Pack)

Doxycycline

Oral tablet A broad-spectrum antibiotic taken to prevent pelvic infection from occurring. diarrhea, nausea, stomach discomfort, vomiting, and headache Typically a 5-7 day course starting prior to embryo transfer

Medrol

(Methylprednisolone)
Oral tablet A low-dose steroid that is used to suppress the autoimmune system from interfering with embryo implantation. headaches, mild stomach discomfort or bloating, dizziness Taken around time of embryo transfer

Valium

(Diazepam)
Oral tablet Taken to help relax the surrogate and the uterine muscles so the embryo transfer catheter can pass into the uterus without difficulty. drowsiness, muscle weakness, or loss of coordination 45-minutes prior to embryo transfer

*** There are other variations of protocols that may include these medications, but with differing lengths of time to be on them or there may be protocols with alternate medications, alternate instructions and/or alternate routes. Even though the ones listed above are common, it doesn’t mean they are the ones right for you. The Reproductive Endocrinologist you will be working with at your IVF Clinic will determine the protocol that is best for you!