From Screening to Transfer: The Surrogate’s Medical Process, Explained by a Fertility Doctor

Surrogates often begin their journey excited, hopeful, and ready to help a family grow, but few truly understand the depth of the medical steps involved. In this conversation, Eloise Drane sits down with reproductive endocrinologist Dr. Shannel R. Adams to demystify every stage of the surrogate medical and IVF process, breaking it down into simple, reassuring, and practical explanations. Eloise guides listeners through the realities of medical screening, clearance, genetic discussions, mental health evaluations, and partner requirements, bringing clarity to the questions surrogates commonly ask but rarely get answered fully. Together, they unpack why timelines vary, what doctors look for at each step, and how clinics ensure safety for both the surrogate and the baby she carries. Dr. Adams also walks through the IVF medication protocol, embryo transfer, ultrasound schedule, hormone monitoring, and what actually happens when things don’t go as planned. She explains the “why” behind the rules, from avoiding THC to requiring birth control. Whether someone is preparing for their first journey or wanting deeper insight into the medical side of surrogacy, this episode offers a clear path forward for anyone who wants to feel confident and supported. Guest Bio: Shannel R. Adams, MD, FACOG is a board-certified reproductive endocrinologist and infertility specialist. Highly skilled in all areas of reproductive health, Dr. Adams has a particular expertise and interest in third party reproduction, oncofertility, fertility preservation, male fertility, and holistic care of both mind and body. Dr. Adams graduated from Duke University with an undergraduate degree in Ethics and went on to medical school at Oregon Health and Science University. She completed residency at the University of Hawai’i John A. Burns School of Medicine and her REI fellowship at the University of Cincinnati. You’ll hear about: Why surrogates are surprised by the medical timelineWhat OB clearance involvesGenetic and psychological screening requirementsPartner testing and FDA rulesKey blood work surrogates must completeTubes, fibroids, and conditions needing treatmentMedication protocols explained simplyLining checks and hormone levelsHow embryo transfer actually worksPregnancy confirmationUltrasounds and early monitoringBleeding in early pregnancySingle embryo transfer guidance Episode Resources: Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss -https://www.amazon.com/Not-Broken-Approachable-Miscarriage-Recurrent/dp/0998714607 Planting the Seeds of Pregnancy: An Integrative Approach to Fertility Care -https://www.amazon.com/Planting-Seeds-Pregnancy-Integrative-Fertility/dp/0996348727 Related episodes: Ep 118 – Surrogacy and the Emotional Journey to Motherhood https://thefertilitycafe.com/podcast/ep-118-surrogacy-and-the-emotional-journey-to-motherhood/ Ep 93 – U.S. Surrogacy for International Parents https://thefertilitycafe.com/podcast/ep-93-u-s-surrogacy-for-international-parents/ Ep 85 – Surrogacy for Same-Sex Couples: Carnell Roberts Tells His Story Chapters (00:00:00) - The Process of Surrogacy and IVF(00:01:28) - Dr. Chanel Adams(00:02:26) - What drew you into reproductive endocrinology in the first place?(00:06:49) - What To Know About The Surrogacy Process(00:09:02) - The Medical Timeline of Surrogacy(00:11:22) - What is the Medical Screening Every Surrogate Completes(00:14:54) - OB Clearance for Surrogates(00:17:06) - Surrogacy Medical Screening(00:19:40) - What about sexual screening during pregnancy?(00:22:33) - How To Get pregnant with a Surrogate(00:27:22) - Uterine lining and contraception(00:31:17) - Transfer of an Embryo 1(00:36:39) - Is bed rest required on the day of the transfer?(00:37:51) - How to Tell If You Are Expecting a Pregnancy with a(00:41:08) - How long should a surrogate wait to get a pregnancy ultrasound? ((00:48:09) - Transfer and pregnancy 1, Sex during pregnancy(00:48:55) - Is surrogacy high risk for children?(00:51:22) - Dr. Chanel Adams on Surrogacy(00:53:52) - Do we Transfer More Embryos than One?