Cassie’s Story: The Painful Part of Surrogacy No One Talks About

When people think about surrogacy, they picture the big moments—positive pregnancy tests, ultrasound pictures, and finally, the moment intended parents meet their baby. But what often gets overlooked is everything a surrogate goes through before pregnancy even begins.

What is the most challenging aspect of the process? Daily hormone injections prepare a surrogate’s body for an embryo transfer. They’re not just a requirement to prepare for pregnancy as a surrogate. The shots are challenging, meaningful, and difficult to do. 

What Is Endometrial Preparation?

Before an embryo transfer, surrogates follow a strict medication protocol that typically includes estrogen and progesterone shots. These hormones thicken the uterine lining to help the embryo implant successfully.

Pretty easy, right? Except that most women experience soreness, some bruising, and it can become tricky when she needs to inject herself in an airport or another public place.  

🎥 Watch Cassie’s Story: Unboxing Her Meds + Sharing What It’s Really Like

Cassie Martinez, a former surrogate and case coordinator at SmartPath Fertility, remembers how she felt when her box of medications arrived.

“I saw the needles, and my first thought was—oh wow, this is really happening. The progesterone needle looked HUGE. But after a few times, I got the hang of it.”

In this video, Cassie shares what it’s like to give yourself these injections daily, along with simple tips that helped her get through it.

What It’s Like Giving Yourself Daily Shots

If you're a surrogate preparing for IVF meds, here’s what to expect—and some tips that can help.

👉 Lupron (stomach shots):

These are usually the easier ones. Most surrogates describe the needle as a quick pinch since the needle is small. On their first try, some people find using an ice pack manageable.

👉 Progesterone in oil (muscle shots):

These are more challenging. The progesterone needle is long and the medication is thick. 

These tips can make it easier:

• ✔ Rub the vial between your palms to warm it up, which thins the medication

• ✔ Apply a heating pad to the area before the shot, as it may relax the muscle

• ✔ Massage the area after the shot to avoid knots or lumps

• ✔ Alternate injection sites to reduce soreness

Timing is also crucial. Shots are often scheduled for the same time each day—which sometimes means giving yourself an injection in an airport bathroom or the backseat of a car. Surrogates find a way, no matter what.

What Intended Parents Might Not Realize

It’s easy to focus on the milestones—transfer day, pregnancy tests, ultrasounds. But behind the scenes, your surrogate shows up every day with dedication, even when it’s hard.

She’s not just following a medical protocol. She’s making a deep, personal sacrifice for your family.

A simple message from you—“Thinking of you today” or “We appreciate everything you’re doing”—can mean more than you know.

Final Thoughts

Endometrial preparation is a vital part of the surrogacy journey—and one of the most physically and emotionally demanding.

“The first couple of times, I had to psych myself up,” Cassie said. “But after that, it just became part of my routine. And when I thought about the family I was helping, it made it all worth it.”

If you’re a future surrogate, know that you’re not alone and that you're stronger than you think. And if you’re an intended parent, take a moment to recognize this part of the process. It’s one of the hardest steps your surrogate will take—and she’s doing it for you.