6.3 Understanding the FET Calendar for Surrogates

The Frozen Embryo Transfer (FET) calendar is a carefully timed medication schedule designed to prepare your body for implantation and early pregnancy. Following it precisely is essential—each dose plays a role in supporting the uterine lining, hormone levels, and embryo transfer timing. If you're ever unsure about a medication, dosage, or how to administer something, your case manager is always available to review your instructions, confirm the schedule, and guide you through the process.

Best Practices for Managing Your FET Calendar

Before you begin, take time to fully understand your FET calendar—know when and how each medication should be taken. To maintain accuracy and consistency in medication use, we ask our surrogates to follow these best practices:

• Make sure you’ve watched the how-to videos so you feel confident with each injection.
  Visit: Freedom MedTEACH® | Freedom Fertility Pharmacy for detailed video instructions.
• Use phone alarms or a written schedule to help you stay on track every day.
• If something doesn’t seem right or you’re unsure, don’t guess—reach out and ask.
• Before taking any medication, double-check that the dosage matches your calendar for the day.
• Store your medications properly—some go in the fridge, others stay at room temperature.
• Keep an eye on your supply so you don’t run out of medications or essential items.
• Always use a sharps container for used needles—never throw them in regular trash.
• Be gentle and precise when handling medications to avoid any waste—they’re delicate and costly.

Key Components of the FET Calendar

Every surrogate’s medication plan is different. Your fertility doctor will customize your protocol based on your medical records and the clinic’s preferences. Not everyone will be prescribed the same medications or dosages.

1. Oral Medications: Timing & Administration

Oral medications help regulate hormone levels and must be taken at the same time each day to be most effective. Here are some medications that are commonly prescribed during a typical FET cycle. Your own medication list may look different, depending on your doctor’s plan for you.

Medication	Purpose
Estrogen (Estrace/Estradiol)	Helps thicken the uterine lining
Doxycycline	Prevents infection before transfer
Medrol (Methylprednisolone)	Lowers immune response to support implantation
Baby Aspirin	Improves blood flow to the uterus

2. Injectable Medications: Purpose and Proper Administration

InInjectable medications are essential for preparing your body for embryo transfer and supporting early pregnancy.

Medication	Purpose	Injection Type
Lupron (Leuprolide Acetate)	Prevents ovulation	Subcutaneous (stomach/thigh)
Estrogen (Delestrogen, Estradiol Valerate)	Thickens uterine lining	Intramuscular (buttock)
Progesterone in Oil (PIO)	Supports implantation & early pregnancy	Intramuscular (buttock)

Here are a few helpful tips to stay comfortable and on track with injections:

• Stick to a consistent schedule. Taking your injections at the same time each day helps maintain hormone balance.
• Rotate injection sites. Switching sides can reduce soreness and irritation.
• Warm the progesterone oil slightly before injecting to help it flow more easily.
• Use a warm or cold pack before or after the injection to reduce discomfort.

3. Vaginal Suppositories: Application & Frequency

Some FET protocols include vaginal progesterone suppositories to support early pregnancy.

Tips for use:

• Take them exactly as prescribed, usually two to three times per day.
• After inserting, try to stay reclined for a few minutes to help with absorption.
• Minor discharge is normal—wearing a panty liner may help.
• Staying well hydrated can help reduce cramping or discomfort.

4. Monitoring Appointments & Key Milestones

Throughout your FET cycle, your clinic will schedule a few important check-ins to make sure everything is progressing as expected. These usually include ultrasounds and blood work to track hormone levels and check how your body is responding to the medications.

Here are the key appointments you can expect:

• Baseline scan: Done before starting medications to make sure your body is ready to begin the cycle.
• Lining check: An ultrasound to measure the thickness of your uterine lining before the embryo transfer.
• Hormone blood work: Usually done a day or two before transfer to confirm your estrogen and progesterone levels are where they should be.
• Pregnancy test (beta hCG): A blood test about 10 to 12 days after transfer to confirm if implantation was successful.

Whenever possible, try to schedule morning appointments—this helps the clinic get results back the same day and make any needed adjustments quickly.