What to expect: the surrogacy process

A typical gestational surrogacy journey from research to delivery. Steps can overlap or vary in order. For example, many intended parents create embryos before matching a surrogate, while others match first and coordinate timing.

Timelines depend on location, agency vs independent path, donor vs own gametes, and how many transfers it takes to achieve a pregnancy.

1. 1

   Research & preparation

   Understand surrogacy, costs, and legal requirements before committing. Choose agency or independent path and select a fertility clinic.

   1–3 months

   • Learn gestational vs traditional surrogacy; gestational is most common (surrogate not genetically related).
   • Cost research: typical ranges, what's included, financing options (loans, grants).
   • Legal landscape: surrogacy-friendly vs restrictive states; international considerations.
   • Agency vs independent: matching support, coordination, escrow. Each has different costs and involvement.
   • Fertility clinic selection: IVF experience, success rates, location for transfers.
   • Consider counseling or support groups; the journey is emotionally demanding.
2. 2

   Gamete preparation & acquisition

   Get eggs and sperm ready for embryo creation. Can start before or overlap with surrogate matching. Timeline varies widely by source (own vs donor) and location.

   1–4 months

   • Sperm: Lifestyle prep (avoid alcohol 2–3 days before, certain meds, heat). Abstain 2–5 days before collection. Provide sample at clinic. Freeze (cryopreservation) if timing requires; pay ongoing storage.
   • Own eggs: Ovarian stimulation, monitoring, retrieval at clinic. Adds significant time and cost if needed.
   • Donor eggs: Select via agency or clinic. Legal agreements, compensation, donor screening. Coordinate fresh cycle or purchase frozen batch. Shipping if eggs/embryos come from another clinic or country.
   • Donor sperm: Bank selection, purchase vials, shipping to your clinic, storage if needed.
   • Note: Some intended parents create embryos before matching; others match first and coordinate timing.
3. 3

   Surrogate matching

   Find a surrogate through agency or independent channels. Screening, interviews, and mutual selection. Often the longest phase.

   2–8 months

   • Agency: Browse profiles, set criteria, agency-facilitated matching and screening.
   • Independent: Networking, matching sites, attorney or clinic referrals.
   • Surrogate screening: Medical history, psychological eval, social assessment. May include partner/family screening.
   • Interviews and compatibility: Mutual selection; chemistry and communication matter.
   • Be prepared for multiple matches or long waits depending on location and criteria.

   First match conversations

   When you meet a prospective gestational carrier, prompts can help you align on logistics, values, and communication before contracts—at the matching stage of your journey.

   IP–carrier conversation guide →
4. 4

   Legal contracts & escrow

   Separate attorneys for intended parents and surrogate (ethical standard). Contracts cover compensation, insurance, risks, and parental rights. Escrow holds funds for disbursement.

   1–2 months

   • IP attorney and surrogate attorney negotiate; each party has independent counsel.
   • Contract terms: Base compensation, expense reimbursements, insurance, risk scenarios (e.g., reduced/no comp if pregnancy loss), termination, parental rights.
   • Escrow account: Third party holds funds; disburses per contract schedule.
   • Contract signing and execution; some states require court approval.
5. 5

   Medical screening & insurance

   Surrogate and IP (if providing gametes) complete medical clearance. Review surrogate's insurance; secure gap or supplemental coverage if needed.

   1–2 months

   • Surrogate: Uterine evaluation (HSG or SIS), infectious disease panel, medical clearance, psychological clearance.
   • IP (if providing sperm/eggs): Infectious disease screening; genetic carrier screening if desired.
   • Insurance: Review surrogate's existing policy for surrogacy exclusions. Gap or supplemental policy often required.
   • Clinic coordination: Transfer clinic location; local monitoring for surrogate if she's in a different city.
6. 6

   Embryo creation

   IVF cycle (or thaw donor eggs), fertilization, embryo culture. PGT testing optional. Embryos may be shipped if surrogate's clinic differs from creation clinic.

   1–3 months

   • IVF cycle and egg retrieval, or thaw frozen donor eggs.
   • Fertilization (ICSI commonly used), embryo culture to day 5–6.
   • PGT-A (chromosomal screening) or PGT-M (specific genetic conditions) if desired.
   • Embryo selection; unused embryos can be stored for future transfers.
   • Ship embryos to surrogate's clinic if created elsewhere (domestic or international shipping).
7. 7

   Transfer cycle

   Surrogate prepares uterus with medications. Embryo transfer; pregnancy test ~2 weeks later. Multiple transfers are common if the first doesn't succeed.

   1–2 months

   • Surrogate: Estrogen and progesterone to prepare uterine lining; cycle may be natural or medicated.
   • Transfer: Single or double embryo transfer depending on clinic and preference.
   • Beta (hCG blood test) ~10–14 days after transfer.
   • If negative: Plan next transfer; may need another embryo or additional retrieval.
8. 8

   Pregnancy

   Prenatal care, monitoring, and support. Intended parents typically receive updates and may attend key appointments.

   9–9 months

   • OB care: Prenatal visits, ultrasounds, bloodwork.
   • Surrogate support: Communication level agreed in contract; many IPs receive regular updates.
   • Birth plan: Hospital, who attends delivery, feeding preferences (e.g., pumping for IPs).
   • Contingencies: gestational diabetes, multiples, complications. Discuss with your care team.
9. 9

   Birth & parentage

   Delivery, establish parentage, birth certificate, discharge to intended parents. International cases add parentage in home country and travel documents.

   0–2 months

   • Delivery: At planned hospital; IPs often present per birth plan.
   • Pre-birth order (surrogacy-friendly states): Court order naming IPs on birth certificate before delivery.
   • Post-birth adoption: In states without pre-birth orders; additional legal step.
   • Birth certificate, Social Security; discharge to IPs.
   • International: Parentage recognition in home country, passport/citizenship, travel home.
   • Escrow: Final disbursements to surrogate; close account.