What to Expect at Your Medical Clearance Appointment at the IVF Clinic

You've been matched, your records have been reviewed, and now there's a date on the calendar: your medical clearance appointment at the fertility clinic. For a lot of surrogates this is the moment it all starts to feel real — and also the moment the nerves show up. Good news: none of it is a mystery. Here's a walk-through of what actually happens that day, so you can show up informed instead of anxious.

Your medical clearance (sometimes called your screening appointment) is the final medical step before you're cleared to move toward embryo transfer. It's run by the reproductive endocrinologist — the fertility specialist, often called the RE, who will eventually perform your transfer. Depending on the clinic, plan on anywhere from a couple of hours to most of a day.

Before You Go

• Complete your forms ahead of time and bring a photo ID.
• Arrive early. Build in time for traffic and parking so you're not walking in flustered.
• Ask about your partner. If you have a spouse or intimate partner, the clinic will usually want them screened too. Often they'll ask your partner to attend; if that's not possible, the clinic can send lab orders to complete near home.
• Consider an OTC pain reliever. Some clinics suggest taking something ahead of time, since the uterine imaging can cause mild cramping. Ask what they recommend.

What Happens During the Appointment

Every clinic has its own rhythm, but most clearance visits include some version of the following:

• History and physical. You'll sit down with the RE to go through your health and pregnancy history, and have a standard physical exam.
• Bloodwork and labs. Expect blood draws to check hormone levels and screen for infectious diseases (required under FDA guidelines), plus things like a urinalysis, cultures, a pap smear, and a drug screen.
• Uterine evaluation. Using a saline sonogram (saline infusion sonogram) or sometimes a hysteroscopy, the doctor looks inside your uterus to check for anything — polyps, fibroids, scar tissue — that could get in the way of implantation. This is the step that can cause brief cramping.
• Trial (mock) transfer. Many clinics do a practice run of the transfer itself: a thin catheter is gently passed through the cervix to map the best path into the uterus, so the real transfer day goes smoothly. It's quick and not the same as a full mock cycle.
• Reviewing the IVF plan and consents. The RE will walk you through the medications, the steps, and the risks, and you'll sign IVF consent forms. This is a great time to ask every question you've got.

Two Things That Sometimes Get Added

• A mock cycle. Some clinics have you run through the same medication protocol you'd use for a real transfer, so they can see how your uterine lining responds and fine-tune timing or dosage before any embryo is thawed. Results from a mock cycle can take up to a month.
• Small tune-ups. It's common for the clinic to flag little things — a vaccine that's due for a booster, a low vitamin D level — and give you a simple plan to address them. These are routine, not red flags.

After Clearance — What's Next

Most test results come back within about a week (the mock cycle being the exception). Once the RE reviews everything, the clinic issues a formal medical clearance letter. From there, it's typically around two to three months until transfer day — time your team uses to finalize the legal agreement and to prepare your body with a carefully timed medication protocol, with lining checks along the way to confirm everything is on track.

It's a lot to take in over one appointment, and feeling a little overwhelmed is completely normal. You won't be doing it alone — your coordinator is there to prep you beforehand and to answer whatever comes up after.

Getting ready for your clearance appointment? Reach out any time with questions — that's what we're here for. Call 510-808-6948 or email info@onfertilityground.com.

This article is for general education and is not medical or legal advice. Surrogacy eligibility is always determined case by case by a fertility clinic's physician and a licensed reproductive attorney, and surrogacy laws vary by state. For guidance on your specific situation, reach out to our team.