1. Egg Donation

The IVF cycle is performed on the donor (or intended mother) using one or more fertility drugs to increase the number of eggs produced. Multiple follicles (the part of the ovary that contains the eggs) are needed to increase the number of eggs retrieved, thereby increasing the number of embryos developed and hence the chances for conception.

The process begins with the synchronization of both donor and carrier's menstrual cycles and may require using the medication Lupron. The donor will also be taking daily injections of Fertinex, Follistim, or Gonal-f to encourage this multi-follicular development. Follicular maturation is evaluated by daily blood levels and ultrasound. At a time determined by the physician, an injection of human Chorionic Gonadatropin (hCG) is given to bring the eggs to final maturity. Approximately 35 hours after this injection, the donor will undergo the egg retrieval that is done in the clinic on an outpatient basis.

2. Preparing The Uterus For Implantation

The carrier will be hormonally synchronized to the donor using Estrogen and Progesterone. The carrier's endometrial receptivity will be evaluated similarly using blood tests and ultrasounds. In addition, the angle and depth of the cervix and uterus will be determined using a catheter identical to the one that will be used for the actual embryo transfer.

3. Egg Retrieval

Aspiration of follicles for eggs is performed through an ultrasound guided approach under IV sedation. The retrieval consists of aspirating the ovarian follicles and identifying the eggs in the follicular fluid under a microscope. The eggs are then held in an incubator until the time of insemination in the laboratory. On this day, the sperm donor (or intended father) will be expected to produce a sperm sample that will be used to inseminate the eggs.

4. Embryo Transfer

The embryo transfer may be done 3-5 days after the retrieval. The physician performing the transfer will discuss with the carrier and the intended parents the status of the embryos and the number to be replaced. The number of embryos transferred varies according to their quantity and quality. At this point, there may be an opportunity to cryopreserve any remaining embryos that continue to develop normally, for possible transfer in future cycles.

The embryo transfer is done under sterile conditions, in a reclining position with legs up, as if having a pap smear. The transfer is easy and virtually pain free in most cases. Following the transfer the carrier is required to lie flat for a half hour and afterwards may return home to relax for the remainder of the day.

5. Testing for Pregnancy

Approximately 2 weeks after the transfer, the carrier will take a blood pregnancy test. If it is positive, the clinic will generally monitor you for several more weeks before discharging you to your own obstetrician.

Also one of the big factors in deciding to become a gestational surrogate is the amount of meds used during the IVF Cycle. Clinics use a mix of injectables, patches, pills, suppositories and nasal sprays. I am going to attempt to cover what the meds are and then give several examples of the total medicine consumption used during one IVF cycle. The examples will show you the variations of what you could expect to go through. Lets start with the meds and their purpose.

Gonadotropin releasing hormone (GnRH) agonists (Synarel, Lupron) are medications that inhibit the brain from secreting hormones that control the menstrual cycle. The ovaries enter into a state of rest, and the patient's cycle can be completely controlled. These medications prevent premature ovulation and allow the patient's cycle to be coordinated as needed.

Lupron is a subcutaneous injection and Synarel is a nasal spray. They are usually started one week before the gestational surrogates period is expected or in the very beginning of the cycle. These medications are usually well-tolerated, and most women do not have any side effects when taking these medications for a short time. However, some women may have hot flashes, fatigue, headaches, irritability or nausea.

Estrogen is the hormone that thickens the lining to the endometrium (inner wall of the uterus). Estrodial can be given as an oral tablet, intramuscular injection, or patch on the skin. Some women may experience vaginal irritation, dizziness, lightheadedness, headache, stomach upset, bloating, nausea, weight changes, increased or decreased interest in sex, or breast tenderness.

Progesterone is the hormone produced by the ovary after ovulation. This medication can be given to improve the uterine lining, which may improve implantation of the embryo. It is usually started in the second half of the cycle, several days before the embryo transfer. Progesterone can be given as an intravaginal suppository, oral capsule, or an intramuscular injection. Side effects can include bloating, irritability, and breast tenderness.

Antibiotics (doxycycline) and/or Steroids (methylprednisone) may be used as anti-rejection tactics.

As I have stated before, this question has several answers according to the clinic and the gestational surrogate herself. Everyone's body reacts differently to the meds and so the total amount will vary from person to person.