5.3.4 Thyroid Health and Surrogacy: Why It Matters for a Healthy Pregnancy

At GSHC Surrogacy, ensuring the health and well-being of every surrogate mother is a top priority. Thyroid function plays a critical role in surrogacy, as it directly impacts pregnancy, fetal development, and overall health. Before beginning the surrogacy journey, every surrogate mother undergoes medical screening, including thyroid testing, to ensure optimal conditions for a healthy pregnancy.

1. Why Is Thyroid Function Important in Surrogacy?

Your thyroid helps regulate hormones, energy levels, and metabolism—all of which are important during pregnancy. If your thyroid isn’t working properly, it can increase the risk of miscarriage, preterm birth, and complications like preeclampsia or low birth weight. That’s why clinics check your thyroid levels during the medical screening process.

2. Understanding Hyperthyroidism vs. Hypothyroidism in Surrogacy

There are two main types of thyroid imbalances:

• Hyperthyroidism means your thyroid is overactive. You might feel anxious, lose weight quickly, sweat more than usual, or have trouble sleeping. It can affect your heart and increase the chance of complications during pregnancy.
• Hypothyroidism means your thyroid is underactive. Common symptoms include fatigue, weight gain, dry skin, or feeling cold all the time. Left untreated, it can lead to developmental delays in the baby or a higher risk of miscarriage.

3. What Are Normal Thyroid Levels for a Surrogacy Pregnancy?

Doctors usually check two key numbers: TSH (thyroid-stimulating hormone) and free T4. These levels vary slightly depending on the stage of pregnancy, but generally:

• 1st trimester: 0.1 – 2.5  mIU/L
• 2nd trimester: 0.2 – 3.0 mIU/L
• 3rd trimester: 0.3 – 3.5 mIU/L

That said, during the initial medical screening for surrogacy, most clinics prefer to see your TSH level between 0.4 and 2.5 mIU/L. If your numbers fall outside this range, your doctor may request additional testing or follow-up before approving you to move forward.

For free T4, while reference ranges can vary slightly by lab, most clinics expect levels to fall within a standard range—typically around 0.8 to 2.0 ng/dL. Your doctor will review both TSH and T4 together to assess whether your thyroid is functioning properly.

4. What Happens If a Surrogate Mother Has Abnormal Thyroid Levels?

Don’t worry—thyroid issues are common and usually manageable. If your TSH is too high, you may be prescribed medication like levothyroxine. If it’s too low, further testing will help figure out the cause, and treatment will be adjusted accordingly. In most cases, once your levels are stable, you can move forward with the surrogacy process.

For more serious cases, your clinic may require a longer follow-up period, or in rare cases, disqualify a match if the condition presents too high a risk.

5. Should a Surrogate Mother See a Specialist for Thyroid Issues?

Yes! If a surrogate mother has abnormal thyroid levels, a fertility doctor may refer her to an endocrinologist (a hormone specialist). This isn’t a bad thing—it just means they want to make sure your thyroid is well-managed before and during pregnancy. The specialist may run more tests, recommend treatment, and help monitor your progress.

6. Ongoing Thyroid Monitoring for Surrogate Mothers During Pregnancy

If you’re already being treated for a thyroid condition, it’s important to take your medication consistently and keep up with any follow-up appointments. Before you're approved as a surrogate, your doctor may ask you to re-test your thyroid levels to make sure they fall within the acceptable range for medical clearance. Once you’re pregnant, your OB will continue to monitor your thyroid function and adjust your medication if needed. Keeping your levels stable helps reduce the risk of complications like preterm labor or low birth weight and ensures a healthier journey for both you and the baby.

7. Should I Be Worried If I Am Diagnosed with Hypothyroidism or Hyperthyroidism?

Not necessarily. Many people live with thyroid conditions and have healthy pregnancies. The key is knowing about it early and making sure it’s under control before starting your journey as a surrogate.

If you have a history of thyroid issues, let your case manager and fertility clinic know. It’s better to be proactive so we can support you every step of the way. Managing your health is an important part of helping someone build their family—and we’ll be here to guide you through it.