Before proceeding with a surrogate embryo transfer, we conduct a mock cycle to evaluate how the surrogate’s uterine lining responds to hormonal stimulation. During this simulated run, the surrogate is prescribed estrogen, and we perform serial transvaginal ultrasounds to measure endometrial thickness, pattern (ideally trilaminar), and blood flow. A diagnostic hysteroscopy is frequently recommended beforehand to rule out any intrauterine adhesions, polyps, or anatomical anomalies. In certain specific scenarios, specialized molecular tests like an Endometrial Receptivity Analysis (ERA) may be considered. These preparatory steps help ensure optimal timing, though individual protocols should always be tailored by your fertility specialist.
For more, read Understanding Surrogate Meaning And The Process Of Surrogacy; consult Dr. Rajat N Kumar; reference: NIH / NICHD.
A mock cycle serves as a crucial dress rehearsal before the actual transfer. It allows us to observe the surrogate’s endometrial growth under standard hormone replacement therapy (HRT). We monitor the lining via high-resolution ultrasound, looking for adequate thickness and receptive vascularity. In Indian clinical practice, we also evaluate the cavity for subtle signs of chronic inflammation or past infections such as genital tuberculosis through hysteroscopy or targeted endometrial biopsy if clinically indicated. While advanced receptivity testing like the ERA exists, its use is selective rather than universal. I advise discussing the exact protocol with your fertility consultant to best suit your surrogate's clinical profile.
For more, read Understanding Surrogate Meaning And The Process Of Surrogacy; consult Dr. Srilatha Gorthi; reference: NIH / NICHD.
Preparing a surrogate requires careful optimization of the uterine environment. In our protocol, a mock cycle involves administering estrogen to mimic the transfer cycle, closely tracking the surrogate's endometrial thickness and triple-line appearance through transvaginal scans. Baseline cavity assessments—typically a 3D ultrasound, saline infusion sonography, or a diagnostic hysteroscopy—ensure the uterine cavity is clear of structural irregularities or inflammation. Blood tests to evaluate hormone levels such as serum progesterone and estradiol are also routinely tracked. Because every surrogate’s physiological response varies, your treating medical team will determine the most appropriate preparatory tests under current ART guidelines.
For more, read Understanding Surrogate Meaning And The Process Of Surrogacy; consult Iswarya Fertility Centre - Madurai; reference: NIH / NICHD.
The goal of uterine receptivity testing in surrogacy is to pinpoint the most favorable window for embryo implantation. During a mock cycle, the surrogate receives estrogen supplements while we monitor the endometrial lining’s development, ensuring it reaches adequate thickness and texture. We often incorporate a diagnostic hysteroscopy to confirm an unobstructed, healthy cavity. Blood tests to monitor circulating hormone levels are done in parallel. These steps minimize surprises during the actual cycle and allow necessary medication adjustments. Because medical guidelines and individual needs differ, it is essential to consult your reproductive specialist for a personalized evaluation plan.
For more, read Understanding Surrogate Meaning And The Process Of Surrogacy; consult Dr. Anupam Goel; reference: NIH / NICHD.
A mock cycle gives us valuable insight into how the surrogate’s endometrium behaves, without placing an embryo at risk. We give prescribed hormones and perform serial pelvic ultrasounds to check whether the lining develops the desired trilaminar pattern and thickness. In addition, assessing the uterine cavity via diagnostic hysteroscopy helps us detect any hidden polyps, micro-adhesions, or chronic endometritis, which is relatively common and treatable. While these tests help refine the transfer protocol, every surrogate responds differently, so I always recommend having a detailed discussion with your fertility doctor to plan the exact preparatory pathway safely.
For more, read Understanding Surrogate Meaning And The Process Of Surrogacy; consult Dr. Suparna Bhattacharya; reference: NIH / NICHD.
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18 September 2026