Surrogacy Miscarriage and What to Expect

Before becoming a Surrogate, I had heard the statistics. I knew miscarriages were common, but like many women who have had healthy pregnancies, I never really thought it would happen to me.

Miscarriage can happen in any pregnancy, including a Surrogate pregnancy. While it's something no Surrogate or Intended Parent wants to think about, understanding what to expect medically, emotionally, and logistically can make an incredibly difficult situation feel a little less overwhelming.

As a Surrogate who experienced a miscarriage during my journey, I know firsthand how heartbreaking it can be. I also know how important it is to have the right support system around you when it happens.

How Common Is Miscarriage During Surrogacy?

One of the biggest misconceptions about IVF is that once you have a positive pregnancy test, you're in the clear.

Unfortunately, that's not always the case.

Many Intended Parents transfer genetically tested embryos, which can reduce the risk of miscarriage. However, even genetically tested embryos do not guarantee a successful pregnancy.

Studies have found that the miscarriage rate after transferring a genetically tested embryo is typically around 5%–15%, depending on factors such as embryo quality, uterine conditions, and other medical factors.

Sometimes, despite everyone doing everything right, pregnancy loss still occurs.

That was one of the hardest lessons I learned during my journey.

What to Expect Medically If You Experience a Miscarriage as a Surrogate

Every miscarriage is different, and your fertility clinic will guide you through the next steps based on your specific situation.

Some Surrogates experience light spotting, while others experience heavier bleeding and cramping. While bleeding in early pregnancy occurs quite frequently and is not an automatic cause for alarm, sometimes it is an indication of an impending miscarriage. In some cases miscarriages are considered missed, and there is no outward sign like bleeding. These losses are typically identified by ultrasound. Depending on the circumstances, your clinic may recommend monitoring, medication, or a D&C procedure. Your health and safety is the priority.

The Emotional Impact of a Surrogacy Miscarriage

One of the most unique parts of miscarriage during surrogacy is that you're not grieving alone.

As Surrogates, we carry more than a baby. We carry our Intended Parents' hopes, dreams, and plans for the future.

One of the hardest parts of the experience is worrying about your Intended Parents. My own Intende Parents had already experienced previous losses, including a second trimester miscarriage. When they needed some time before reaching back out, I completely understood, but I still couldn't help feeling like I had somehow let them down. Even though everyone around me reassured me that I had done nothing wrong, it was difficult not to blame myself.

If you've experienced a miscarriage during a Surrogate pregnancy, please hear this:

It is not your fault.

Sometimes pregnancy loss happens despite perfect beta numbers, a beautiful heartbeat ultrasound, and doing everything exactly as instructed. In a surrogacy the hard truth is that you can do everything right, and it does not guarantee success. But the hope is this, that many Surrogates are able to try again and do go on to have success. At Hatch 60% of first transfers do result in a live birth and when another attempt is needed 80% of second transfers result in a live birth. It doesn’t feel good to be in the minority percentage of experiencing an unfavorable outcome but it is helpful to know the odds are in your favor if you stick it out.

How Hatch Supports Surrogates and Intended Parents During a Miscarriage

One thing that made a tremendous difference during my journey was support.

I leaned heavily on my case manager and counselor while navigating my emotions and waiting for medical clearance. They helped me process what had happened, answer my questions, and understand what the next steps might look like.

At Hatch, everyone you work with has either been a Surrogate or an Intended Parent themselves. That lived experience matters during difficult moments because you're working with people who genuinely understand what you're going through.

My case manager also helped handle practical concerns. When medical bills related to the miscarriage started arriving, I felt guilty submitting them. She immediately reminded me that pregnancy related medical expenses were covered and handled everything promptly, allowing me to focus on healing.

At Hatch we have been helping build families for more than 35 years. In that time, we’ve supported thousands of Surrogates and Intended Parents through both the joyful moments and the difficult ones. While every journey is unique, there's comfort in knowing you're not facing challenges alone.

What Comes Next After a Surrogacy Miscarriage?

One of the most common questions Surrogates ask after a miscarriage is:

"Can I try again?"

The answer depends on your specific medical situation and the recommendations of your fertility clinic.

Following my miscarriage, I underwent additional testing and waited for blood work and medical clearance. During that waiting period, there was a lot of uncertainty.

Would I be able to try again?

Would my Intended Parents still want to move forward?

Would this experience end my surrogacy journey?

Not all, but many Surrogates do receive medical clearance after a first trimester miscarriage to try again, if they feel up for doing so.

My Personal Story

As a mom of four, I had never experienced a miscarriage before becoming a Surrogate.Getting pregnant had always been easy for me. I had healthy, full term pregnancies with very few complications, so pregnancy loss was never something I expected to experience personally.

After our embryo transfer, everything seemed perfect. My beta levels were strong, and my Intended Parents were overjoyed.When we saw the heartbeat for the first time, my intended mother joined by FaceTime. I'll never forget her reaction.

She was so excited that she mailed me prenatal vitamins, even though I already had some. She simply wanted to share in the experience and be part of the journey. That small gesture represented something much bigger: hope. For the first time, she truly believed she was going to have her baby. That's why the loss felt so profound, not just for me, but for everyone involved.

Shortly afterward, my clinic identified a large subchorionic hematoma and placed me on modified bed rest. At the time, I wasn't overly concerned. I followed the instructions, rested, and continued believing I would be delivering a healthy baby later that year.

Unfortunately, things changed quickly. The spotting turned into bleeding. The bleeding turned into cramping, and the pregnancy ultimately ended in miscarriage. Due to the amount of bleeding, my clinic recommended a D&C.

The physical recovery took a few days, but the emotional recovery was harder.

The miscarriage was heartbreaking and humbling. It gave me a deeper appreciation for the pain many Intended Parents carry and reinforced the importance of compassion, patience, and support throughout the surrogacy process.

Tips for Taking Care of Yourself After a Miscarriage

If you're navigating a miscarriage as a Surrogate, give yourself permission to grieve.

• Lean on your support system.
• Talk to your case manager.
• Take advantage of counseling resources.
• Rest when your body tells you to rest.
• Most importantly, don't isolate yourself.
• Prioritize self care- something as simple as a hot shower, making a spotify list, journaling, gentle movement and stretching, whatever feels right for you as you heal

Many Surrogates feel guilty after a miscarriage, but guilt and responsibility are not the same thing. Pregnancy loss is unfortunately a possibility in any pregnancy, and experiencing a miscarriage does not mean you failed your Intended Parents.

A Happy Ending After Heartbreak

Fortunately, our story didn't end with miscarriage. After additional testing and medical clearance, we moved forward with a second embryo transfer. That transfer was successful. Today, my Intended Parents have a beautiful son to call their own.

Looking back, miscarriage was the hardest part of my surrogacy journey, but it also made the ending that much more meaningful. If there's one thing I hope other Surrogates take away from my story, it's this: you are not alone. Surrogates carry more than a baby. We carry our Intended Parents' hopes and dreams, and sometimes we walk through heartbreak with them, too.

Miscarriage is one of the challenges that can arise during a surrogacy journey, but choosing the right agency means you never have to face those challenges by yourself. With the right support, guidance, and care, there can still be hope on the other side of heartbreak and sometimes, a beautiful ending waiting for you there, also.