We all know that a lot of hormones are important for a successful surrogacy pregnancy. But do you know which hormone plays what role in pregnancy?
During a surrogacy pregnancy, fertility specialists specially look after hormone levels in a Surrogate Mother because of the following reasons:
- In a natural pregnancy, a woman’s body produces hormones or increases certain hormone levels to bring changes in the body necessary for carrying a pregnancy. But, in gestational surrogacy, these changes do not come by themselves, and medications are required to make it happen.
- Surrogate Mothers need hormonal medications to synchronize the menstrual cycle with the egg donor so that her uterus is ready for successful IVF embryo transfer.
- Prepare the Surrogateโs uterus for pregnancy by administering two essential hormones, progesterone and estrogen. These hormones reproduce the Surrogateโs natural cycle in order to increase the chances of pregnancy and prevent miscarriage.
Now that we know why hormones are so important for surrogacy pregnancy, let us take a look at the chief hormones and their functions:
Human Chronic Gonadotropin
This is the hormone that a pregnancy test detects in female urine or blood for a positive outcome.
It is produced in the placenta following implantation, and itโs important for the development of the โcorpus luteumโโ a temporary structure formed in the ovaries during early pregnancy. Corpus luteum is responsible for the production of progesterone and estrogen in the early months of pregnancy.
The hCG levels increase by the eleventh week of pregnancy.
Estrogen
Estrogen is one of the essential hormones during pregnancy and one you might have heard about before. This hormone behaves in a cyclical pattern during the monthly cycle, increasing until ovulation and decreasing shortly after.
Estrogen produces several feel-good hormones, including endorphins and serotonin, and its monthly reduction before menstruation may be the reason why many women feel down in the week preceding their period.
During pregnancy, the levels of estrogen are always on the rise until labor, when they peaked. The corpus luteum originally produces estrogen before the placenta takes over its production.
There are three different types of estrogen:
Estrone or E1
Estrone is produced in the female body after menopause. Although it is a weaker form of estrogen, it can be converted into the other stronger types if need be. This brings us to –
Estradiol or E2
This is the most common type of estrogen in womenโs bodies during adulthood.
Very high levels of estradiol, especially if itโs extremely high relative to progesterone, can bring about symptoms like acne, sore breasts, loss of libido, painful periods, osteoporosis ( a decrease in bone density), and so on.
Estriol or E3
Estriol is the most noteworthy type of estrogen during pregnancy. It assists in the development of the womb lining, and its level increases throughout the whole pregnancy.
Estriol levels peak just before delivery and then reduce dramatically.
Progesterone
Progesterone is an endogenous hormone that plays a key role all through a womanโs lifetime. The levels of progesterone go up after ovulation and sharply decrease before menstruation if the woman isnโt pregnant.
But in case the woman actually is pregnant, its levels will continue to increase during the whole pregnancy. The reason for this is that progesteroneโs primary role is to develop the womb lining to prepare the uterus for pregnancy.
It causes the womb to be more receptive by stimulating it to produce the nutrients necessary for embryo development.
Besides being a key player in developing the uterine lining, progesterone also prevents the womb from contracting and cause premature labor. This is the reason why it is one of the medications recommended in the early days of surrogacy pregnancy.
Progesterone is usually administered vaginally in the form of vaginal inserts or creams. Corpus luteum secretes most of the progesterone during pregnancy before the placenta takes over the production of the hormone.
While estrogen energizes the body, progesterone helps calm the body, and declining progesterone can result in anxiety issues during premenstrual syndrome and the postpartum phases.
Prolactin
Prolactin not only helps with the development of the fetus, but it also plays a key role in breastmilk production. This hormone is one of the main causes of sore breasts, vagina dryness, and several other symptoms following childbirth.
The levels of prolactin are usually low in women who are not pregnant, and higher levels of this hormone can cause infertility.
Relaxin
As the name suggests, relaxin helps prevent the womb from contracting, especially in the early pregnancy days. It also helps relax the surrogateโs body in preparation for delivery.
It can be seen that these female hormones carry out different roles during pregnancy. Understanding these changes and their side effects can make you feel in absolute control of your body.
Hormone changes and their effects in the first trimester of surrogacy pregnancy
The first trimester of pregnancy is known for frequent fatigue, tender breasts, morning sickness, new cravings, weight fluctuations, increased urination, and headaches.
Rapidly-fluctuating hormones are among the causes of these symptoms.
The levels of hCG, estrogen, progesterone and relaxin increase more than ever during pregnancy, and thereโs no way these changes will occur without causing alterations in the body.
Some of these pregnancy symptoms and the hormone changes that cause them are:
Morning Sickness
There is varying evidence regarding what causes morning sickness during pregnancy. However, it is believed that hCG plays a certain role.
Besides inducing the development of the corpus luteum, human chorionic gonadotropin (hCG) improves your sense of smell. This can lead to several food aversions that you previously donโt have, and in many cases, vomiting and nausea.
Constipation
As said earlier, both progesterone and relaxin help calm the muscles to forestall muscle contractions and preterm labor. Sad to say, but that is not limited to your uterus alone. It also affects your digestive tract.
A more relaxed GIT means less constipation.
Fatigue
In the early weeks of pregnancy, your body is experiencing record-high spikes in hormones like progesterone and estrogen that are important for your monthly cycle.
As progesterone enhances the feeling of calmness, this may also result in increased fatigue.
Hormone changes you would experience during the second trimester of the surrogacy pregnancy
Many of the first trimesterโs bothersome symptoms, such as morning sickness, disappear or decrease significantly in the second trimester due to declining hCG levels.
However, this pregnancy phase also has its own set of symptoms, like body aches, sinus issues, facial and extremity swelling, and darkening of the skin around the nipples and other body parts.
Again, hormones are responsible for these symptoms too. In the second trimester of pregnancy, hormones like prolactin, estrogen, and progesterone continue to increase, while hCG decreases once the corpus luteum is formed.
These hormone fluctuations can cause several changes:
Skin pigmentation changes
This is also called melasma, or the โmask of pregnancy.โ
Like other symptoms mentioned above, this is also primarily due to fluctuating hormones. The changes in hormone levels during the second trimester can induce the growth of melanin-producing skin cells.
A lot of pregnant women witness an increase in darker skin patches, especially after sun exposure.
However, there is no need to be concerned if you are experiencing melasma. Itโs not harmful and will naturally go away post-delivery.
Bear in mind that changes in skin pigmentation can also be a side effect of hormonal contraceptives.
Sinus issue
If you have ever been pregnant, you may have noticed an increase in nasal blockage or nosebleeds in the 2nd trimester of pregnancy. This is also due to hormones. As estrogen and progesterone levels continue to rise during this phase, they impact the noseโs mucous membranes, resulting in sinus problems.
Increased hair and nail growth
One symptom of pregnancy most women like is the noticeable increase in hair and nail growth.
Many women begin to observe improved nail growth and a thicker, fuller head of hair around the twentieth week of pregnancy. This is also due to your ever-increasing estrogen, which encourages the growth of hair and nails. Improved blood flow during pregnancy also contributes to it.
Changes you will notice in the third trimester
Estrogen, prolactin, and progesterone will have already peaked in the third trimester in preparation for delivery. Higher levels of estrogen and progesterone can bring about several positive emotions and good moods.
However, a lot of women also experience some unpleasant symptoms during this phase, including insomnia, heartburn, hemorrhoids, mood swings, increased swelling, contractions, and shortness of breath etc.
Below are examples of how hormones might be contributing to these pregnancy symptoms:
Water Retention
As we mentioned earlier, estrogen will have gotten to its peak in the last trimester. Increased estrogen level is accompanied by swelling, and this is why your hands, ankles, and face may feel a bit puffy when pregnant.
Heartburn or Acid Reflux
Discomfort after eating is not only due to the baby increasing in size every day. Like how progesterone can relax the digestive tract in the 1st trimester and result in constipation, it can relax the esophagus as well.
This causes more liquid and foods to travel back up, which may ultimately lead to heartburn.
Tender, Sore Breasts
This is probably one symptom you will have to experience over the course of your pregnancy. However, for many women, breast tenderness reaches its peak in the third trimester.
The reason is that thereโs an increase in prolactin production in the body in preparation for breastfeeding. Also, your breasts may start to leak a little at this period, which is entirely natural.
Changes occurring in the postpartum
Postpartum transition is not an easy thing!
But the good news is โ unlike when the pregnancy is yours, you will be passing through postpartum without having to cater to a new baby, so you will have enough time to focus on your wellness and health.
Our levels of progesterone and estrogen, which have been on the increase the entire pregnancy, decline significantly after childbirth.
On the contrary, prolactin will still be very high. The hormone changes can lead to several physical and emotional changes in the body.
Menopause-like symptoms
A lot of pregnant women also experience menopause-like symptoms, including vaginal dryness post-delivery. This is completely natural and is due to the prolactin production in the body, which makes it more difficult for the vagina to self-lubricate.
Baby blues to postpartum depression
Our levels of progesterone and estrogen, which have been continuously increasing all through the pregnancy, reduce after delivery. This can result in a lot of things, from baby blues that last just for a few weeks to more severe postpartum depression.
Although itโs normal to experience certain levels of mood swings and feel down after the birth of the baby, you should speak to your physician if you find that it is affecting your daily life and exceeding the normal lows and highs.
Hair loss
While an increase in hair thickness is a sign of pregnancy, temporary loss of hair is one of the popular side effects of childbirth.
After delivery, you lose your placenta โ the all-important organ that had been synthesizing most of your estrogen while pregnant. In the absence of the placenta, estrogen production reduces, and your hair is no longer stimulated to remain in an actively growing phase.
As a result, you experience a temporary period of hair loss. But thereโs no need to be worried. The hair of most pregnant women will return to its normal thickness before pregnancy.
How to relieve symptoms of hormonal fluctuations
The key to improving the symptoms of hormone changes during surrogacy pregnancy and postpartum is by making minor healthy lifestyle changes.
However, no matter how good your lifestyle is, your hormones will be going through radical changes when you are pregnant, and pregnancy symptoms cannot be avoided.
Nutrition
Sure, proper nutrition is essential for healthy fetal development, but it doesnโt end there. The food we eat can play a key role in balancing our fluctuating hormones.
Generally, an anti-inflammatory diet is the best when you are pregnant since it helps the rest of the body to keep working properly alongside your fluctuating hormones.
Even though this varies from one person to another, increasing your intake of veggies, proteins, and healthy fats is a good recipe for balanced, happy hormones.
Exercise
Although our bodies are made to support various kinds of movement, not all exercises are equal.
Some women may be okay with cycling or running, while others may do so well with Pilates and yoga. However, it is important that you reduce the intensity of your workouts when you are pregnant.
Once your doctor has given you the go-ahead to exercise postpartum, you can promote accelerated hormone balance by managing stress and regulating the levels of sugar in the blood. Hence, you need to remember not to over-exercise, as this can increase your cortisol levels and result in a chronic stress response.
Stress management
Cortisol is an adrenal hormone that triggers our fight or flight response. While a little bit of cortisol is good for the body, todayโs society has brought up the cortisol in our bodies to chronically-high levels, which ultimately affects our adrenals.
Elevated cortisol levels can also cause increased androgens and sex hormone imbalances, therefore raising the risk for embryo transfer and pregnancy complications.
Lifestyle
A lot of makeup products and house cleaners usually contain harmful chemicals are referred to as endocrine disruptors. These compounds can mess with your internal balance and possibly cause severe harm to the developing baby.
It is best to have these harmful products replaced with healthier ones. Doing so will be beneficial to both you and the baby.
Note: you need to consult with a certified medical practitioner before changing your exercise routine or diet, particularly if you are carrying a baby.
Final Words
Carrying another personโs baby can bring about several physiological and emotional changes in your body, and hormones are no exception.
Hormones like estrogen, progesterone, hCG, and prolactin play a big role in preparing the body for a healthy pregnancy and delivery. But these changes come with their own side effects. Therefore, as a Gestational Surrogate, itโs essential that you know why you might be experiencing some symptoms and set yourself up for a successful surrogacy journey.
Coastal Fertility has partnered with Physician’s Surrogacy, the nation’s only OB-managed surrogacy agency. If you are interested in becoming a surrogate, fill out the application form.
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