Prepare for some awkward moments, a whole lot of TMI, and a few things no one mentioned to you about the getting-her-pregnant part surrogacy. The intended parent(s) in this process can start by expecting the unexpected and knowing that there will be a myriad of things that may not have been mentioned on the dotted line of your surrogacy agreement. Here are 6 things to expect when preparing for your gestational carrier's in vitro fertilization (IVF) cycle.

Tests For Everyone!

Preparing for the surrogacy transfer will require a number of appointments and multiple tests for the initial screening process. In the surrogacy screening process, if the intended mother or egg donor will contribute her egg(s) she will have to undergo specific testing to ensure she can withstand the physical toll that comes along with an IVF stimulation and retrieval. The overseeing fertility clinic will test both the intended mother and intended father or partner for Social Disease Testing. This includes STD panels and various bloodwork requirements as part of the US FDA regulations, no matter if the embryo has been previously frozen or if this surrogacy will undergo a fresh IVF transfer.

As for that amazingly self-less gestational carrier, she will also have to undertake the full panel of Social Disease Testing as well as her spouse or partner. The process of gestational carrier screening is similar to a basic fertility workup. There is a lot of time, love, money and hope invested into preparing for the best possible outcome, a healthy pregnancy, and resulting birth. These tests make sure that all parties involved are cleared for take-off, medically speaking.

Embrace the TMI

A topic of great discussion will be over the nebulous prediction of menstrual cycles. If you have never been interested in another woman’s menstrual cycle, you will now! The IVF transfer date will be easier to forecast once your gestational carrier starts her period. This also will be the defining moment that prompts her to begin taking the recommended medications to prepare for the upcoming embryo transfer. This glorious day is called calendar day 1 and it is a day that the intended parents, gestational carrier, and the overseeing doctor are anxiously awaiting.

Do You Like Drugs?

Actually, let’s rephrase that, do you like paying for extra fertility drugs? Your fertility medication protocol just doubled. If you choose to go through a fresh transfer cycle, then the intended mother or egg donor will need to take a specific protocol of stimulation medications. Your gestational carrier will also have her own medication protocol. She will be required to take various medications that will help prepare her body for the transfer and likely will be asked by the overseeing fertility specialist to take these up until the end of the first trimester if the transfer results in a viable pregnancy. Both the increased expense of medications and the requirement to take additional medications after a confirmed pregnancy can be a surprise to both the intended parents and the gestational carrier.

The Transfer is Clinical

Sorry, there are no love ballads being played to set the mood. This is where you will need to cheer on your gestational carrier. She will be tasked to fill her bladder until it is uncomfortably full. The doctor who is guiding the catheter with the embryo(s) will need to be sure that they are placing them in the ideal location. A full bladder, when viewed with an ultrasound, helps guide them. Once the embryo(s) are transferred, everyone will anxiously await the beta test 14 days later. It is a controlled process, but the result if the transfer results in a positive pregnancy are nothing short of a medical miracle to all involved.

Emotions Are Elevated x2.

Whatever your reason for choosing to build your family through the option of surrogacy, it is a safe assumption to state that this may not be how you envisioned growing your family. With that, comes a broad spectrum of intense emotions. Visiting a fertility clinic when trying to get her pregnant and not yourself or your partner, might dredge up a mixed bowl of feelings and even introduce new ones, such as guilt. Recognize it, and be kind to yourself through this process.

Your gestational carrier will be working on her own set of elevated emotional challenges. It is an extreme amount of pressure and attention on a surrogate mother from day 1 to the day of your baby’s delivery. The fertility medications and pregnancy hormones just help escalate that to a new level of emotional complication. Recognizing what she may be experiencing and giving grace in times of stress goes a long way.

Call Me. Maybe?

Finally, the two-week wait is over! In surrogacy-terms, this might even feel a bit longer because now there are more people eagerly waiting the news. So who calls whom to confirm the pregnancy results? The answer— it depends. It will fully depend on each individual fertility clinic’s protocol. Some clinics will default to who the patient is, whereas others will contact who the intended parents would be. If the order of who is in the know first is something that is important to you or your gestational carrier than communication is the key. Ask your clinic prior to beginning your transfer protocol as to what their communication policy is for surrogacy partnerships. Also, consider talking to your gestational carrier too. Although we want more than ever to have all beta results to be positive, the gestational carrier may not want to be in the position to have to be the voice of bad news if the transfer ends in a negative beta test.

There is a lot more to surrogacy than what is in the textbooks. By knowing that each surrogacy partnership and situation is unique, and will undoubtedly come with its own set of challenges, will help you prepare for those no-one-told-me-this moments. And if your transfer is successful, the pregnancy will be a whole new thrilling adventure of new doctors and all things TMI. The thing about surrogacy is that it is a beautiful journey built on the foundation of love, trust, and sacrifice. There is nothing greater than the gift of helping build a family and there is no greater appreciation than for the one who helped build it.