By Dr. Arnold Mahesan
Fertility SpecialistBeverly Hills Babies
Dr. Arnold Mahesan is a board-certified fertility specialist with extensive experience in IVF, fertility treatment, and gestational surrogacy. He is committed to helping intended parents navigate their journey with personalized care and expert guidance
Becoming a gestational surrogate involves fertility treatment, pregnancy, delivery and postpartum recovery. Screening helps identify avoidable risks, but even a healthy woman with uncomplicated previous pregnancies can develop a complication in a later pregnancy.
You should understand those possibilities before agreeing to the journey. Your own health remains central throughout the arrangement.
1. Risks during transfer preparation
Medication may cause symptoms such as headaches, breast tenderness, bloating, mood changes or irritation at an injection site. The specific risks depend on the medication and your medical history. Rare but serious complications, including blood clots with some hormonal treatments, require an individualized discussion.
Embryo transfer can cause cramping or light spotting; infection is uncommon. If a uterine finding requires a separate procedure, that procedure has its own consent discussion. Unlike an egg donor, a gestational surrogate does not undergo ovarian stimulation and egg retrieval to create the embryos for the journey.
2. Risks during pregnancy
Pregnancy can involve miscarriage, an ectopic pregnancy, diabetes, hypertensive disorders such as preeclampsia, placental complications or premature delivery. Some conditions require hospital care or a change to the delivery plan.
Your previous pregnancies help us assess risk, but they do not predict every outcome. Current health, age, surgical history and findings during the new pregnancy can also influence care. If a concern develops, your clinicians should explain its significance and the available options.
3. Why the number of embryos matters
Multiple pregnancy increases the risk of premature birth and other complications for the woman carrying the pregnancy and the babies. That is a central reason to favor single-embryo transfer in gestational surrogacy.
One embryo substantially reduces the risk of a multiple pregnancy compared with transferring more than one, but it does not eliminate it: an embryo can occasionally divide into identical twins. No transfer plan makes pregnancy risk-free.
4. Delivery and recovery carry their own risks
Delivery can involve bleeding, infection, injury or an unplanned cesarean. Rare complications can have lasting consequences, including effects on future fertility. Recovery may require more time or support than expected, even if your earlier deliveries were straightforward.
Postpartum care should address physical recovery and emotional health. Sleep disruption, changes in mood and the effects on your own household deserve attention. Support should continue after the baby has gone home with the intended parents.
5. Know how to seek help
Ask which team handles urgent questions during fertility treatment and when responsibility transfers to your obstetric clinician. Severe pain, heavy bleeding, chest pain, difficulty breathing or other concerning symptoms need prompt medical assessment. Do not wait for a routine coordination call when urgent care is needed.
At BHB, I want the decision to become a surrogate to follow a clear discussion of your own circumstances, treatment and pregnancy risks. Contact us to begin that conversation and review your medical history.
