Maria Menounos Fertility: What She Has Said About Medication, Surrogacy, and Her Health Journey

What Maria Menounos Has Said About Her Fertility Journey

Maria Menounos has been direct and consistent in describing why she pursued surrogacy. She did not carry her daughter herself because of her health history, specifically the 2017 diagnosis of a meningioma, a type of brain tumor, that required surgery. In the years that followed, she has spoken about ongoing health management, including a 2023 pancreatic cancer diagnosis that she announced publicly.

In an interview with People magazine in 2023, Menounos confirmed the birth of her daughter Athena via surrogate and described the experience as one she had waited years for. She has referenced the emotional weight of not being able to carry a pregnancy herself, connecting it directly to her medical history rather than to infertility in the traditional clinical sense.

On her podcast Better Together with Maria Menounos, she has returned repeatedly to themes of health advocacy, body autonomy, and the choices women make when their bodies do not cooperate with their plans. She has not, as of the time of this article, published a detailed account of specific medications she or her surrogate took during the surrogacy cycle. Where specifics have not been confirmed, this article labels that clearly and provides the clinical context instead.

The Medical Background That Shaped Her Reproductive Choices

Brain Tumor and Surgical History

Menounos was diagnosed with a meningioma in 2017 and underwent surgery that same year. Meningiomas are the most common primary brain tumors and are disproportionately diagnosed in women, with a female-to-male ratio of approximately 2:1. Hormonal factors, including progesterone receptor expression on tumor tissue, are thought to contribute to this sex difference.

The relationship between reproductive hormones and meningioma growth is clinically meaningful. Some meningiomas express progesterone receptors, and there is documented concern in neurosurgical and gynecological literature about whether high-hormone states, including pregnancy or exogenous hormone therapy, could stimulate residual tumor tissue. A woman with a history of meningioma who wants to become pregnant or undergo fertility treatment would typically require joint assessment by a neurosurgeon and a reproductive endocrinologist before any protocol is started.

Pancreatic Cancer Diagnosis in 2023

In May 2023, Menounos disclosed on the Today show that she had been diagnosed with stage 2 pancreatic cancer and had undergone a Whipple procedure. Her daughter was born around the same time, meaning the surrogacy was already underway when the cancer diagnosis came. She has described this period as one of the most difficult of her life and has credited her support system, including her husband Keven Undergaro, for sustaining her through it.

Pancreatic cancer and its surgical treatment (the Whipple procedure, or pancreaticoduodenectomy) have significant implications for metabolic function, endocrine function, and overall systemic health. For a woman already managing a complex neurological history, the decision to use a surrogate rather than attempt to carry a pregnancy was medically sound and, as she has framed it, was not a choice made out of preference but out of necessity.

What Medications Are Involved in a Surrogacy Cycle

Because Menounos has not detailed the specific medications used in her surrogacy cycle, what follows is a clinical framework for what women in her position, specifically intended mothers and gestational carriers, typically encounter. This is labeled as general clinical context, not as a description of what Menounos personally took.

For the Intended Mother (Biological Egg Source or Recipient)

If the intended mother contributes her own eggs, she undergoes ovarian stimulation. This involves injectable gonadotropins, typically follicle-stimulating hormone (FSH) products such as follitropin alfa (Gonal-F) or follitropin beta (Follistim), sometimes combined with luteinizing hormone (LH) activity. The standard stimulation protocol also includes a GnRH agonist or antagonist to prevent premature ovulation.

If the intended mother is older or has diminished ovarian reserve, donor eggs may be used. In that case, the intended mother may not take any fertility medications at all, depending on whether she plans to have any biological connection to the embryo.

For the Gestational Carrier

The surrogate, or gestational carrier, undergoes the most medically intensive portion of the process. Her cycle is synchronized with the embryo transfer using a preparation protocol that typically includes:

• Estradiol (estrogen): Given orally, vaginally, or by transdermal patch to thicken the uterine lining. Doses are titrated based on serial ultrasound measurements of endometrial thickness. A lining of at least 7-8 mm is generally the target before transfer, per ASRM practice guidelines.
• Progesterone: Introduced approximately five days before a day-5 blastocyst transfer. Routes include intramuscular (IM) progesterone in oil, vaginal suppositories (Endometrin, Crinone), or, more recently, subcutaneous progesterone (Prometrium subcutaneous formulations in some protocols). IM progesterone remains the most studied route for frozen embryo transfers.
• Lupron (leuprolide acetate): Sometimes used in suppression protocols to prevent the carrier's own ovulation and ensure cycle control.
• Low-dose aspirin: Commonly added to improve uterine blood flow, though evidence for this specific indication is mixed.

After a successful transfer and confirmed pregnancy, progesterone support typically continues through 8-10 weeks of gestation, at which point the placenta takes over progesterone production.

Women With Complex Medical Histories

For a gestational carrier selected to carry a pregnancy for a woman with Menounos's medical profile, standard pre-transfer screening applies. This includes a uterine cavity evaluation (hysteroscopy or saline infusion sonography), infectious disease testing, and psychological evaluation for both parties. The ASRM has published guidelines for the medical evaluation of gestational carriers that clinics follow.

Life Stage Considerations: When Surrogacy Becomes the Right Path

Surrogacy is not a single-demographic option. Women encounter this path at different life stages and for different reasons. Understanding where you might fall helps clarify what the process looks like for you specifically.

Reproductive Years (Roughly Ages 18-40)

Women with conditions that make pregnancy medically dangerous, including certain heart conditions, severe autoimmune disease, prior organ transplant, or history of a brain tumor with hormonal sensitivity, may be advised against carrying a pregnancy even when their ovaries are fully functional. In these cases, using their own eggs with a gestational carrier is often possible. Ovarian stimulation for egg retrieval is the same process used in standard IVF.

ACOG has addressed contraindications to pregnancy across a range of systemic conditions, and a reproductive endocrinologist working with a specialist in maternal-fetal medicine can help determine whether carrying is safe or whether a carrier is the medically appropriate choice.

Perimenopause and Menopause

A woman in perimenopause or who has reached menopause may have diminished or absent ovarian function. If she did not preserve eggs or embryos earlier, her path to genetic parenthood narrows, though donor eggs remain an option. The uterus, even a postmenopausal one, can often be prepared for embryo transfer with estrogen and progesterone supplementation. Studies have shown successful embryo transfer rates in women over 45 using donor eggs, though obstetric risks increase with age and these women would also often choose a gestational carrier rather than carry themselves.

After Cancer Treatment

Cancer treatment, including chemotherapy and radiation, can damage ovarian function and compromise uterine receptivity. The timing of any fertility preservation steps, ideally before treatment begins, is addressed in ASCO guidelines on fertility preservation in cancer patients. Women who did not preserve fertility before treatment can still explore surrogacy with donor eggs or, in some cases, their own remaining ovarian function if it was spared.

Pregnancy, Lactation, and Contraception: The Clinical Picture for Intended Mothers

This section applies to women who are considering surrogacy or IVF and have questions about medications, safety, and contraception. Because the topic of this article is surrogacy rather than a specific drug taken by a named patient, this section covers the intended mother's position.

Pregnancy Safety for Intended Mothers Using Surrogacy

The intended mother in a gestational surrogacy arrangement does not carry the pregnancy, so traditional pregnancy drug safety categories apply to the gestational carrier, not to the intended mother. If the intended mother is contributing eggs, the ovarian stimulation medications, specifically gonadotropins, are used before any embryo is transferred and are not taken during pregnancy.

The FDA has not assigned formal pregnancy categories to gonadotropins used for IVF stimulation in the same way older drug labels carried letter categories. The concern is minimal because these drugs are used before embryo transfer and are cleared before implantation occurs.

Medications the Gestational Carrier Takes: Safety Profile

For the surrogate who carries the pregnancy, progesterone supplementation is safe and well-studied in early pregnancy. A 2019 randomized trial (the PRISM trial) published in the New England Journal of Medicine found that vaginal progesterone did not improve live birth rates across unselected populations, but a subgroup analysis suggested benefit in women with prior miscarriage and a uterine lining below 25 mm. Progesterone supplementation specifically for luteal phase support in IVF and frozen embryo transfer cycles is standard of care and is not the same clinical question as that trial.

Estradiol used in endometrial preparation protocols is synthetic 17-beta estradiol and is considered compatible with early pregnancy support when used under monitored IVF protocols.

Contraception for Women With Menounos-Type Medical Histories

A woman with a history of a meningioma or other hormone-sensitive tumor may be advised to avoid estrogen-containing contraception. The hormonal sensitivity of meningiomas means that combined oral contraceptives, the patch, and the vaginal ring, all of which deliver estrogen, may be discouraged by her neurosurgeon. Progestin-only options including the progestin-only pill (norethindrone), the hormonal IUD (levonorgestrel-releasing), or the implant (etonogestrel) may be preferable, though even progestin safety in meningioma patients has been debated given progesterone receptor expression on these tumors.

Non-hormonal options, including the copper IUD, are often the safest choice when both estrogen and progestin are a concern. Any woman with a complex neurological or oncological history should have a contraception conversation that specifically involves her specialist team, not just a primary care provider.

What Maria Menounos's Story Means for Women Navigating Similar Decisions

Menounos has used her platform to normalize the conversation around surrogacy and to push back against the idea that a woman's fertility journey has to look one particular way. Her willingness to discuss her brain tumor, her cancer diagnosis, and the birth of her daughter in the same breath has opened a conversation that many women with serious illness manage privately.

A few things her story illustrates that are worth naming directly:

Surrogacy is not a shortcut. The process involves extensive medical evaluation, legal agreements, psychological screening, and months of coordinated medical care. The emotional experience for the intended mother, watching someone else carry your child while you manage your own illness, is one that mental health professionals who specialize in reproductive medicine are trained to support. ASRM recommends that both the intended parents and the gestational carrier have independent legal counsel and access to counseling before any agreement is signed.

Medical complexity does not disqualify you from parenthood. Women with serious illness are often not counseled proactively about their reproductive options. A 2021 review in Fertility and Sterility noted that fertility counseling rates remain low among women diagnosed with non-reproductive cancers, even when their ovarian function and fertility may still be preserved.

The evidence gap is real. Women with meningiomas who want to use fertility medications or hormone therapy are working with limited direct clinical trial data. Most evidence about meningioma and hormonal exposure comes from observational and epidemiological studies, not randomized trials. Your care team's guidance in this situation should explicitly account for this uncertainty.

As WomanRx's reviewing clinician Elena Vasquez, MD, notes: "Women who have experienced serious illness, whether a brain tumor, cancer, or another condition that affects their ability to carry, often arrive at surrogacy after years of grief and decision-making that the outside world never sees. The clinical conversation should start much earlier, ideally at the time of diagnosis, so women understand their full range of options before a window closes."

Female-Specific Physiology: Why This Matters Beyond the Celebrity Story

The connection between female hormonal biology and conditions like meningioma is under-studied and under-discussed. An analysis published in JAMA Neurology confirmed the two-to-one female predominance of meningiomas and noted associations with hormone use including oral contraceptives and postmenopausal hormone therapy. The researchers did not establish causation, but the sex-specific pattern is consistent enough that hormonal factors are considered biologically plausible contributors.

For women, this means:

• A new or known meningioma diagnosis should prompt a conversation with both a neurologist and a gynecologist about any current hormonal contraception or therapy
• Women with meningiomas who are approaching menopause and considering hormone therapy for symptom management face a genuinely uncertain risk-benefit equation
• Fertility treatment involving high-dose gonadotropins does not appear in the literature as a documented trigger for meningioma growth, but the absence of data is not the same as established safety

ACOG's guidance on hormonal contraception in women with neurological conditions provides a starting framework, though meningioma-specific contraception recommendations typically come from the neurosurgical team.

Conditions This Topic Touches

Menounos's story connects to a cluster of women's health conditions that are often managed in silos but are deeply interrelated:

• Brain tumor (meningioma): Female-predominant; possible hormonal sensitivity
• Pancreatic cancer and Whipple surgery: Affects endocrine function, digestion, and overall metabolic health
• Infertility secondary to medical illness: A category distinct from primary infertility; requires specialist collaboration
• Surrogacy-related reproductive medicine: Involves estrogen and progesterone protocols for the carrier; IVF stimulation for the intended mother if using own eggs
• Perimenopause and menopause: Relevant if illness or treatment caused premature ovarian insufficiency

Women managing any of these conditions deserve care that connects the dots across specialties, not fragmented advice that treats each diagnosis as unrelated to the others.

Who This Information Is Right For (and Who Should Seek Specialist Input First)

This article is right for you if:

• You are exploring surrogacy as an option because carrying a pregnancy is medically risky or contraindicated for you
• You have been diagnosed with a condition that affects your hormonal environment and want to understand the reproductive implications
• You are trying to understand what the surrogacy medication process actually involves, for either the intended mother or the gestational carrier
• You are a woman with a history of brain tumor or cancer who wants a clear-eyed starting point for a fertility conversation with your doctor

You should speak directly with a reproductive endocrinologist before proceeding if:

• You have a history of a hormone-sensitive tumor and are considering any fertility treatment involving estrogen or gonadotropins
• You have had cancer treatment and are not sure whether your ovarian function has been affected
• You are considering surrogacy and need help understanding how to find and evaluate a gestational carrier through a reputable program
• You are perimenopausal or postmenopausal and want to know whether embryo transfer with donor eggs is still an option

The Society for Assisted Reproductive Technology (SART) maintains a clinic locator that includes live birth rate data by clinic. The ASRM's patient resources provide plain-language explanations of surrogacy and third-party reproduction that are a good starting point before your first specialist appointment.