What Medications Do Surrogates Take—and Will You Need Injections?

For a hormone-prepared embryo transfer, surrogacy medications usually include estrogen and progesterone, and one or both may involve injections¹. I am Vivi at LittleBee. If the needles worry you more than the transfer, that deserves a conversation before the first dose. You’ll want to know what each medicine does, who will teach you and your helper, and whom to call if a dose is missed or something feels wrong. Your own medication calendar puts those answers in one place.

What medications will I take, and what does each do?

Estrogen builds your uterine lining¹; progesterone prepares that lining for an embryo to implant². The names on the boxes may be unfamiliar, but their jobs are easier to understand.

In a programmed cycle, the prescribed hormones prepare the uterus without relying on your own ovulation. Progesterone replaces support your body is not producing in that cycle⁵. That is why taking it on the assigned schedule matters even if you feel completely well.

A modified-natural cycle uses your own cycle and can still include prescribed progesterone support⁶. Hearing “natural” doesn’t tell you whether you’ll have injections. Look at the medicines and forms actually ordered for you.

Other medicines may also appear on your calendar. Ask your clinic what each one is for and how long you need to take it. Keep following the instructions you were given; don’t stop a prescribed medicine on your own. Your pharmacist can help explain instructions that are unclear (FDA medicine safety guidance⁷).

I would focus on recognizing your own boxes and matching each one to its place on the calendar. You don’t have to memorize every drug name before you can ask a useful question. If you already take a prescription, vitamin or supplement, see what to discuss about your current medications before transfer preparation starts.

When do medications start, and how long will I stay on them?

Medication can begin several weeks before transfer; progesterone support may continue through the first trimester if you become pregnant². A positive pregnancy test can mean more weeks of hormone support⁵.

There are different clocks within that stretch:

1. The lead-in, if your plan has one. A frozen-transfer schedule may include 3–4 weeks of birth-control pills before the baseline blood test and ultrasound⁸. This comes before the lining-preparation phase.
2. Preparing the uterine lining. A programmed frozen-transfer schedule can include about 3–4 weeks of uterine preparation⁹. Blood tests and ultrasound check how the lining is responding.
3. Starting progesterone for transfer. The clinic uses the progesterone start and the embryo’s developmental stage to time transfer⁵. Put the assigned start date and time on your calendar, alongside the monitoring appointments.
4. Supporting early pregnancy. Progesterone may continue through the first 8–12 weeks of pregnancy¹. Count those as pregnancy weeks; the clock does not start on transfer day. Your calendar needs the actual stop instruction for your treatment.

Before you start, check that your calendar lists each medicine, its prescribed amount and form, and its start time and stop instructions. Keep it alongside the pharmacy labels so you can spot anything that does not match.

These phases explain why a friend’s “I was on meds for a month” can be hard to compare with your plan. She may be counting only the days before transfer. A start date, transfer date and end date tell you much more than one total.

Monitoring can lead to another appointment or a revised calendar. Keep the latest version where you and your helper can both find it, and mark which one replaces the older copy. I would use the confirmed medication dates to arrange childcare and work breaks, while leaving room around a transfer date that is still tentative.

For the stages outside this medication period, use the full surrogacy timeline. The embryo-transfer guide covers the appointment itself.

Will I need injections, and who can help me learn?

You may need injections: progesterone can be prescribed as an intramuscular injection or a vaginal product². If your prescription includes shots, ask for a nurse-led practice session before the first dose¹⁰. You can ask for help even if everyone around you seems comfortable with needles.

The injection type on your prescription tells you where the medicine goes:

Ask the nurse to demonstrate with the supplies you actually received, identify the right site for each medicine, and watch you or your helper practice. For a buttock injection, you can ask the nurse to mark the site¹⁰. A video from your clinic can help you remember the demonstration; an unfamiliar online video cannot check what is in your own box.

Your helper can learn with you. A partner or family member can learn to help with your injections¹⁴. Ask the clinic to include the person who will give your injections¹⁵. Bring up the evenings they work late, the school pickup that overlaps with a dose, or a trip that would leave you without them. Find out how a backup person can learn, too.

Giving the shot yourself may fit better when nobody else is reliably home, but you need to feel able to follow the demonstrated technique. A trained helper can take the needle out of your hands, but you then depend on that person being available. If reaching the prescribed site is difficult or fear makes it hard to continue, bring that up during teaching so you can work out a practical plan.

Soreness deserves attention. For progesterone in oil, nurse instructions include a warm compress and gentle massage after the injection¹². Ask your nurse to show you these measures and how to alternate the sites they have identified. The next section explains which symptoms need a call to the clinic.

If you have felt faint around needles before, say so before the demonstration. Ask to lie down, have your helper present, or look away while someone trained gives the shot¹⁶. You can also ask for another teaching session if the first one leaves you unsure. I would rather you say “I still don’t feel ready to do this at home” while someone can watch and help.

Sometimes the hardest part is not knowing what the first evening will look like. Maya was comfortable with embryo transfer but afraid to inject herself. She worried that one mistake could ruin the cycle. Her nurse reviewed her calendar, showed her how to store each medicine and watched her practice with the supplies. Maya chose her sister as a backup. The needle still wasn’t pleasant, but she understood what to do and whom to call.

You can bring those same worries to your nurse; you don’t have to pretend the needle feels easy.

How might the medicines feel, and when should I get help?

You may notice breast tenderness, nausea or tiredness; severe or persistent symptoms need a call to your clinician¹⁷. Knowing the possible effects can help you describe what is happening, rather than trying to decide what it means for the transfer.

The form matters. Estrogen used in transfer preparation can cause nausea, bloating, headache or breast discomfort⁴. Vaginal progesterone may cause tiredness or mood changes¹⁷. Progesterone-in-oil injections can leave pain, irritation or redness at the injection site¹³. You may experience some of these, or none of them.

Call your fertility clinic about symptoms that persist or get worse. That includes redness that does not settle, hives, a rash, itching, or prolonged hip, leg or buttock pain after an injection¹². Report the medicine’s name and form, when the symptom began, and whether it is worsening. If a rash appears, the actual product matters: some progesterone-in-oil preparations contain sesame oil and benzyl alcohol¹³.

The emergency group is different:

For those emergency symptoms, get help directly instead of waiting for a clinic callback. Tell the emergency team which medicines you have taken.

Before you start, save the clinic’s daytime and after-hours numbers. Ask what to do if a concerning symptom begins when the office is closed. That conversation gives you a contact plan while you feel well, so you aren’t searching for the right number when you feel awful.

What should I do if I miss a dose or something goes wrong?

Call your fertility-clinic nurse for instructions about the actual medicine and missed dose¹⁹. You don’t need to work out the answer before making that call.

Have your medication calendar and the box or vial in front of you. Tell the nurse:

1. Which medicine and form you were supposed to use.
2. When it was scheduled, and when you realized it was missed.
3. What you have actually taken or injected, and at what time.

Be straightforward, including if you are unsure whether a dose was given. The useful information is what happened. Tell the nurse separately about the dose you missed and any later dose you took.

Your prescribing team gives the instructions about changing, replacing or stopping medication. We relay instructions confirmed by that team; we don’t adjust your medication ourselves. Follow the progesterone instructions for your prescription²; don’t use another person’s catch-up advice or assume that taking extra is the answer.

If a new box, label or set of supplies looks different, ask the pharmacist to check it and resolve the instructions with your prescriber⁷. If you have already taken the wrong medicine or possibly an extra dose, get individual advice from Poison Control at 1-800-222-1222²⁰ and tell your treating clinic what you took. For the emergency symptoms above, use emergency care first.

Once you receive instructions, write them beside the affected date and tell the person helping you. That way, you and your helper both know what to do next.

How can I fit medication into work, family life and travel?

Start with the hours your medication calendar requires, then arrange the supplies, storage and help you’ll need at home or away. A dose that lands during the evening school run needs a place in the family plan, too.

At home and work, make the setup easy to use. Set reminders for the assigned times, and record a dose after taking it. Choose a private space where you and your helper can concentrate. Keep medicines in their original containers, out of children’s sight and reach²¹. Store each product as its label directs¹³; putting every fertility medicine in the refrigerator can be wrong. If a package arrived warm or medicine was left somewhere hot, ask the pharmacist about it even if it looks normal²².

Put used needles straight into a sharps container and keep it away from children and pets²³. A small portable container helps when you are away. Check the local disposal option before the container fills; some collection, mail-back or pickup services charge a fee²⁴.

Before a trip, settle these three things:

• Timing: Give your clinic the itinerary and time zones so it can confirm the medication schedule²⁵.
• Packing: Keep medication in its original labeled packaging in your carry-on, with the supplies you need. For US airport screening, unused syringes must travel with injectable medication and be declared²⁶. Medically necessary liquids can exceed the ordinary liquid limit in reasonable quantities²⁷. Use cooling packs when the actual product needs them.
• Entry rules: For travel abroad, check the destination and any country where you pass through customs for medicine and needle restrictions²⁸.

Order before the cupboard is empty. Check refill availability and pickup or delivery arrangements with the pharmacy, allowing for weekends and holidays²⁹. If there are no refills left, the prescriber may need to send another prescription. If you are running out, a delivery is late or you have lost medication, call the pharmacy and tell the clinic which doses are at risk.

I would also ask about payment before placing the first order: who pays for the medicine, needles, sharps container and delivery, and what happens if a prescription changes? You should be able to plan that without an unexpected bill landing among the family’s regular expenses. For transfer and prenatal-visit travel, we arrange reimbursement of actual travel expenses for you and your companion under your agreement. Check the arrangements for your trip before booking.

For the appointment that comes before medication preparation, see surrogate medical screening. You can also browse our Surrogacy Process guides.

If you’re considering becoming a surrogate and want to talk through how treatment could fit around your children, work and support at home, tell me where you live, your birth history and what worries you most. I am Vivi, and I handle initial surrogate inquiries at LittleBee. Start your LittleBee surrogate application so we can discuss your next step.

References

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2. Progesterone supplementation during IVF patient education fact sheet — reproductivefacts.org, 2023
3. Oral contraceptive pills (OCP) during IVF cycle — uihc.org, 2021-12
4. Frozen Embryo Transfer Medication — gatesheadhealth.nhs.uk, 2025-07-30
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6. Progesterone and IVF: So why do I need this? — fertility.wustl.edu, 2019-08-12
7. FDA Pharmacists Help You Use Medicines Safely — fda.gov, accessed 2026-10-10
8. Frozen Embryo Transfer (FET) — shadygrovefertility.com, accessed 2026-10-10
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15. Fertility Medication Injection Teaching — chinbaby.com, accessed 2026-10-10
16. Trypanophobia (Fear of Needles): Symptoms & Treatment — my.clevelandclinic.org, 2022-04-12
17. Progesterone Vaginal: MedlinePlus Drug Information — medlineplus.gov, 2026-02-15
18. Anaphylaxis: MedlinePlus Medical Encyclopedia — medlineplus.gov, 2026-01-20
19. Boston IVF’s Frequently Asked Questions — bostonivf.com, accessed 2026-10-10
20. Medication errors: What to know — poison.org, accessed 2026-10-10
21. Storing your medicines: MedlinePlus Medical Encyclopedia — medlineplus.gov, 2026-01-14
22. Temperature Tips For Safe and Effective Medication Storage — baystatehealth.org, 2023-08-08
23. DOs and DON’Ts of Proper Sharps Disposal — fda.gov, accessed 2026-10-10
24. Best Way to Get Rid of Used Needles and Other Sharps — fda.gov, accessed 2026-10-10
25. Staying on Track With Fertility Medications While Traveling — aspirefertilityhouston.com, 2026-06-05
26. Unused Syringes — tsa.gov, 2017-11-16
27. Disabilities and Medical Conditions — tsa.gov, accessed 2026-10-10
28. Traveling with Prohibited or Restricted Medications — cdc.gov, 2025-04-23
29. How to Order Fertility Medication — vfppharmacygroup.com, accessed 2026-10-10

About this guide: I am Vivi, a LittleBee client manager for surrogate applicants. This guide draws on the patient resources listed above and Maya’s story. Last reviewed October 10, 2026.