How Does Surrogacy Work? A Step-by-Step Guide

If you’re wondering, “How does surrogacy work?” and considering it as a way to start or expand your family, then you’re in the right place. Surrogacy can be a demanding and complex process, but with the right approach and guidance, it can also be a fulfilling and rewarding experience for all involved parties.

In this blog, we will dive into the nine steps that will guide you toward a successful surrogacy experience. We’ll cover everything you need to know, from understanding the surrogacy process to finding the right surrogacy professional for your needs and more.

steps to the surrogacy

So, whether you’re new to surrogacy or already have some knowledge of it, join us as we explore the ins and outs of this life-changing journey.

Step 1: Understanding Surrogacy

Duration: 1-6 months

Surrogacy is a method of assisted reproduction where a woman carries and gives birth to a baby for someone else. It is often an option for couples or individuals who are unable to have a child naturally due to medical conditions, fertility issues, or same-sex couples. Surrogacy allows these hopeful parents to fulfill their dreams of having a family.

Step 2: Decide If Surrogacy Is Right for You


Before starting your journey, you need to decide if it’s the right path to parenthood for you.
You can start by educating yourself about the basics of surrogacy, including the medical and legal aspects of the process. Understanding what surrogacy demands of you from an emotional, legal, medical, and economic perspective is essential to making an informed decision.

In addition, women wanting to become a surrogate need to keep in mind that all IVF clinics have specific requirements. The most common ones are:

  • Being of legal age.
  • Being in good health.
  • Having had at least one full-term and healthy pregnancy.
  • Being a non-smoker.
  • Residing in a surrogacy-friendly location.

Step 3: Create Your Surrogacy Plan

Duration: 1 month

Once you have decided to start your journey, think about what your expectations are, list your preferences, and secure the necessary surrogacy experts. The goal is to draft a plan of what you want your journey to look like. During this phase, you will need to answer several questions:

What Type of Surrogacy Do You Prefer?

The first choice is between traditional surrogacy and gestational surrogacy. The main difference between these two forms of surrogacy is whether the surrogate’s eggs are used.

  • Gestational Surrogacy: In this option, the gestational surrogate (also known as gestational carrier) will become pregnant after receiving an embryo created through IVF. The surrogate’s eggs are not used in the IVF process, so the baby is not genetically tied to her.
  • Traditional Surogacy: here, the surrogate’s egg will be used to create the embryo.

Agency or Independent?

The next significant decision is to decide whether you want to work with a surrogacy agency or pursue an independent process. Both options have their advantages and disadvantages, so it’s essential to educate yourself on the differences to make an informed decision.

  • Working with a Surrogacy Agency: Surrogacy professionals can provide invaluable support and guidance for prospective parents and surrogates. However, it’s important to research the costs and services offered by the agency and reach out to references to ensure that they align with your needs. You can explore top surrogacy agencies in USA.
  • Independent Surrogacy: If you choose to go the independent route, a surrogacy attorney is a must-have to handle all the legalities and paperwork involved in the process.

In this planning phase, take your time to define your objectives and preferences before moving forward.

Step 4: Find Your Match


Finding the right match can be one of the most challenging steps of the journey, but it can also be very exciting. It is normal if a lot of conflicting emotions emerge during the search. Remember to stay calm and to be patient. Indeed, it is not the easiest thing to do in this situation, but it is, nevertheless, necessary.
Whether you are looking for a surrogate or intended parents, the time it takes to find the right match can vary widely. This process can take weeks and months or just a matter of days.

If you are pursuing the independent route, your options for finding a match are online communities, Facebook, surrogacy classifieds, or recommendations from relatives and friends.

On the other, if you work with a surrogacy agency, you will probably match faster because you will be able to take full advantage of the agency’s pre-established networks.

Regardless of the path you choose, remember that you must know in advance what you are looking for in a surrogate mother or prospective parents – religion, education, location, marital status, amount of contact, etc. – before you start your search.

how much surrogate get paid

Step 5: Go Through the Screening Process

Duration: 2-4 months

Once you choose your match, both parties must undergo a psychological evaluation (performed by a licensed therapist) and medical screening to verify that the prospective parents and the surrogate mother are in a healthy place mentally and physically.

There will also be a medical screening that will include bloodwork and a physical exam. The medical staff will perform this at the IVF clinic.

These exams, medical and psychological are mandatory. They are there to reduce the possibility of complications during the journey and help increase the odds of having a healthy, full-term pregnancy.

Typically, the IVF clinic will be chosen by the prospective parents. If you’re working with a surrogacy agency, they can recommend some reputable IVF clinics as well as therapists who specialize in third-party reproduction. However, it’s perfectly acceptable for you to choose your own fertility clinic and/or therapist. Before you choose your medical specialists, you must do your own research. The goal is to learn about their success rates, procedures, and fees. You may also want to look for referrals.

Step 6: Create and Sign a Surrogacy Contract

Duration: 1-3 months

From a legal standpoint, surrogacy regulations can be complex and confusing, especially because laws vary from country to country and even state to state. For example:

  • In the US, there are no federal laws that govern the legal process of surrogacy. Each state has its own regulations, which are geared toward commercial surrogacy.
  • Similarly, all surrogacy arrangements in Australia are regulated by the states.
  • Canada has a federal law that only allows for altruistic surrogacy. However, each province and territory has its own laws regarding the birth registration process.
  • In the UK, surrogacy must be altruistic, but surrogacy agreements are not enforceable by law.
  • Finally, in Ukraine, surrogacy is enforceable under federal legislation but is limited to heterosexual couples.

As you can see, the legal aspects of the process can be pretty confusing. Because these laws vary from country to country (and even region to region within the same country), it is important to have the guidance of an experienced lawyer who is acquainted with surrogacy laws specific to the region in which the process is taking place. This guidance will help you avoid potential missteps.

A surrogacy agreement guarantees that both parties are informed of their rights and obligations. Your lawyer will oversee the process and answer any questions you might have. This step also defines compensation and actions to be taken in case of emergencies or unexpected events.

During this process, all parties should have individual representation to ensure that their legal rights and interests are protected. Also, remember that most fertility clinics require a legal agreement to be in place before proceeding with the transfer.

For prospective parents pursuing a surrogacy process abroad, professionals recommend seeking legal advice in both their home country and abroad to ensure that they meet all the legal requirements necessary to register the birth of the child.

Step 7: Undergo the Surrogacy Medical Process

Duration: 2-6 months

Once you have completed the necessary screenings and legal paperwork, you can move forward with the medical protocol. Here’s a breakdown of the five stages of the gestational surrogacy medical process.

Create the embryos via IVF with donor sperm or egg if needed.

  1. Prepare the surrogate’s body for embryo transfer.
  2. Transfer the embryo to the surrogate’s uterus
  3. Confirm the pregnancy by testing hormone levels ten days after transfer and performing an ultrasound six weeks later.
  4. Provide prenatal care, including hormones and doctor appointments throughout the pregnancy.

If you are considering traditional surrogacy, the process of getting pregnant will be different. It typically implies the artificial insemination of a traditional surrogate with the intended father’s sperm (or donor sperm) via intrauterine insemination (IUI).

pros and cons of IVF and IUI

Step 8: Prepare for Delivery

Duration: 9 months

As long as there are no complications, the delivery will take place at the agreed-upon hospital or birthing center. Most times, the prospective parents will be part of the delivery.

The surrogate and prospective parents will discuss and agree upon the details of the birth plan during the legal agreement phase so that everyone is on the same page when the time for delivery arrives.

Step 9: Post-Birth

Duration: 1 month

After the birth, a surrogacy lawyer will assist with the legal paperwork (DNA requirements, Declaration of Parentage, Birth Order, etc.). Once the intended parents have completed said paperwork, they will return home.

A common question is: What happens after surrogacy birth?
While there is no established set of rules surrounding communication between the surrogate and IPs after the birth, this is typically discussed during the matching phase.

In some cases, surrogates choose not to keep the line of communication open after the birth of the child, while in others, they will continue the relationship, sharing updates and photos of their families. Some surrogates might even repeat the process to provide a sibling for the child they previously gave birth to.

Final Thoughts

Certainly, surrogacy is a complex and lengthy process that requires proper preparation and understanding from all parties involved. As a prospective surrogate or hopeful parent, it’s essential to learn how surrogacy works and what it entails.
Fortunately, numerous professionals in the surrogacy field specialize in guiding individuals through the process. If you have any questions or need further information, don’t hesitate to contact them. They will help you navigate the journey and make informed decisions every step of the way.

Share This Post
Written by David
I work daily to make surrogacy available to as many intended parents, surrogate mothers and egg donors around the world as possible.

Leave a Reply