Understanding IVF Success Rates in Surrogacy: What Impacts the Outcome?

By Dr. Naman Arya, MD, MPH, MSHCM

Reproductive Endocrinology and Infertility Division at Surrogacy4All.

Introduction

As a physician specializing in fertility and reproductive health, I’m often asked by intended parents and surrogates alike: What are the chances that IVF will work in surrogacy? It’s a deeply important question and one that deserves more than a quick percentage.

While IVF has come a long way thanks to medical innovation and years of data collection, success depends on many interconnected factors. In this blog, I’ll explain how IVF works in surrogacy, what influences its success, and what real-world numbers look like based on ASRM guidelines, CDC data, and clinical experience.

1. What Does IVF Look Like in Surrogacy?

In gestational surrogacy, an embryo is created in a lab using the egg and sperm of the intended parents (or donors), then transferred into the surrogate’s uterus. The surrogate shares no genetic connection with the baby.

Steps involved:

• Egg retrieval from the intended mother or donor
• Fertilization with intended father’s or donor sperm
• Embryo culture and development
• Embryo transfer into the surrogate’s uterus

2. IVF Success Rates: National Data

According to the CDC’s 2022 ART Success Rates Report, the average live birth rate per embryo transfer for women under 35 using their own eggs was approximately 55%–65%.

Surrogacy-specific outcomes:

• When using a gestational carrier, success rates are typically higher than average IVF cycles.
• Many clinics report live birth rates of 70%–80% per transfer when using donor eggs and a healthy surrogate.

Doctor’s Insight: These numbers reflect national averages. A well-managed surrogacy program with experienced clinicians can improve odds significantly.

3. Key Factors That Influence IVF Success in Surrogacy

A. Quality of the Embryo

• Embryos created using younger eggs (under 35) or donor eggs have higher success rates
• Preimplantation Genetic Testing (PGT-A) improves embryo selection by identifying chromosomally normal embryos

B. Uterine Health of the Surrogate

• Surrogates undergo a comprehensive medical evaluation to ensure optimal uterine conditions
• A healthy uterine lining of 7–12mm is typically ideal for implantation

C. Hormonal Preparation

• Hormones like estrogen and progesterone are used to prepare and support the surrogate’s uterus
• Adherence to protocols and proper monitoring greatly affect outcome

D. Laboratory and Clinic Experience

• Embryology labs vary in quality—clinics with high pregnancy rates often have superior technology and experienced staff

E. Number of Embryos Transferred

• Single embryo transfer (SET) is common to reduce risks of multiples
• Some intended parents opt for double embryo transfer (DET) for higher odds, but this increases risk for complications

4. Psychological Readiness and Support

Emotional preparedness of both surrogate and intended parents is critical. Studies show that lower stress levels are associated with better IVF outcomes.

Support systems include:

• Licensed counseling
• Peer support groups
• Open communication with the fertility team

Real Surrogate Story — Maria, 35, Florida: “The clinic gave me everything I needed, hormone tracking, mental health support, and regular check-ins. I felt totally prepared, and the transfer worked on the first try.”

5. Risks and Challenges

Even with optimal conditions, IVF isn’t always successful.

Common reasons for IVF failure include:

• Embryo quality issues
• Poor implantation
• Uterine or immune response problems

Next Steps After Failure:

• Review cycle data with your doctor
• Consider trying a new embryo, adjusting protocol, or using donor gametes if needed

Doctor’s Note: Failure doesn’t mean the end. Many families achieve success after one or more attempts.

6. Increasing the Odds of Success

If you’re an intended parent or surrogate, here’s what you can do to improve success rates:

For Intended Parents:

• Choose a clinic with strong IVF and surrogacy track records
• Discuss PGT-A testing with your doctor
• Use donor eggs if age or fertility history is a concern

For Surrogates:

• Maintain a healthy BMI
• Follow hormone instructions precisely
• Stay mentally and emotionally balanced

Doctor’s Tip: Surrogates often ask about diet and supplements. I recommend prenatal vitamins, hydration, moderate exercise, and avoiding caffeine and processed foods.

7. Final Thoughts: IVF in Surrogacy Is a Team Effor

What makes surrogacy work is not just science, it’s the synergy between the intended parents, the surrogate, and the medical team.

While IVF success rates in surrogacy are encouragingly high, it’s important to be realistic and prepared for all outcomes. Transparency, open dialogue, and comprehensive care make all the difference.

Real Surrogate Testimonial — Emily, 32, California: “Knowing the science behind IVF helped me feel empowered. I was part of something meaningful, and when it worked, it was nothing short of magical.”