Can you apply with an IUD in place?
Yes. You can apply to be a surrogate with an IUD, an implant, the pill or the shot in place. Your birth control is removed or stopped before the medical cycle begins, not before you apply.
Private Label Surrogacy screens and matches you with your birth control in place. Screening usually takes one to two months and matching about six months, so there is no reason to go without contraception during that time. Keep using what works for you until your case manager and the clinic give you a date.
Note your method on the prescreen. It helps your case manager plan the timing, and it matters most if you use Depo-Provera, for the reasons below.
When is the IUD removed and who pays?
After matching, and usually one to two cycles before the mock cycle. Your case manager and the clinic set the exact date. A mock cycle is a trial run of the transfer medications, used to check how your uterine lining responds. See the mock cycle.
Removal is a short office visit, usually with your own OB or gynecologist. Most women go back to normal activity the same day.
The intended parents reimburse the cost of removal as a medical expense, paid from the independent escrow account. Keep the receipt or the explanation of benefits from your insurer.
Copper IUD versus hormonal IUD timing
The two kinds of IUD work differently, so they come out at different times.
Copper IUD (Paragard). A copper IUD contains no hormones. You keep having your own natural cycle with it in place. It can stay until the clinic schedules your cycle.
Hormonal IUD (Mirena, Kyleena and others). A hormonal IUD releases a small, steady dose of progestin into the uterus. That thins the uterine lining, which is part of how it prevents pregnancy. It is usually removed one to two cycles before the mock cycle, so the clinic can see your natural lining before medications start.
| Method | When it is removed or stopped | Typical wait before the medical cycle |
|---|---|---|
| Copper IUD | When the clinic schedules your cycle | Little or none |
| Hormonal IUD | One to two cycles before the mock cycle | One to two cycles |
| Nexplanon implant | One to two cycles before the mock cycle | One to two cycles |
| Pill | When the clinic tells you; some clinics use the pill to time the start of the cycle | Set by the clinic's protocol |
| Patch or ring | When the clinic tells you | Usually one cycle |
| Depo-Provera | Timing planned with PLS at prescreen | Six to twelve months for cycles to return after the last shot |
| Tubal ligation | Nothing to remove | None |
If your tubes are tied, that does not affect a gestational pregnancy, because the embryo is placed directly in your uterus. See surrogacy after tubal ligation.
What about Nexplanon, the pill and Depo-Provera?
Nexplanon. The implant in your arm releases progestin, like a hormonal IUD. It is usually removed one to two cycles before the mock cycle.
The pill, the patch and the ring. These are short-acting. Your natural cycle usually returns soon after you stop. Some clinics have you continue the pill, or start it, for a short time to line up the start of your medical cycle. Follow the clinic's instructions on when to stop.
Depo-Provera. The shot is the exception. It can suppress your cycles for six to twelve months after the last injection. You can still be a surrogate, but the medical cycle waits until your periods return regularly. Tell PLS at prescreen if you use it, so the timing can be planned from the start.
Why clinics need to see a natural cycle
Before a transfer, the clinic needs to know your uterus responds the way it should. A natural cycle shows that your hormones and your lining are working on their own, without a device or a contraceptive dose shaping them.
Hormonal methods thin the lining on purpose. A lining that is too thin is less likely to accept an embryo. When the method is gone and your own cycle returns, the clinic can measure your lining on ultrasound, then build it up with estrogen and progesterone on a schedule it controls. See surrogate medications.
Do you need birth control during the surrogacy cycle?
Not in the usual sense, but you do need to avoid an unplanned pregnancy of your own. Gestational carrier agreements typically require you to avoid intercourse without barrier protection during the cycle. The restriction usually runs from the start of medications until the clinic confirms the pregnancy.
The reason is simple. The medications prepare your body for pregnancy. If you ovulate and conceive naturally in the same cycle as the transfer, you could become pregnant with your own child, alongside or instead of the intended parents' embryo. The barrier rule prevents that. Your clinic and case manager explain the exact window.
If you meet the surrogate requirements, your birth control is not a reason to wait. Start at See if I qualify.