How Surrogacy Works

A complete step-by-step guide to the surrogacy process — from application through birth and final payment.

Gestational Surrogacy Only: This guide covers gestational surrogacy — the standard form practiced by virtually all U.S. agencies today. In gestational surrogacy, you carry an embryo created from the intended parents' (or donors') genetic material. You have no genetic connection to the baby you carry. Traditional surrogacy (using the surrogate's own eggs) is rarely practiced and not covered here.

Full Surrogacy Timeline

Application & Agency Screening 1–3 months
Matching with Intended Parents 1–4 months
Legal Contracts 4–8 weeks
Medical Prep & Embryo Transfer 4–8 weeks
Pregnancy ~40 weeks
Total: Application to Birth 18–24 months

The Surrogacy Process, Step by Step

1

Application & Initial Screening

Submit your application. We forward it to licensed agencies in your area. An agency coordinator will contact you for a phone screening to discuss your background, pregnancy history, motivations, and lifestyle. This is a conversation — ask as many questions as you have. You are not committed to any agency at this stage.

2

Medical & Psychological Evaluation

Comprehensive medical screening at the fertility clinic: physical exam, bloodwork, uterine evaluation (hysteroscopy or sonohysterogram), STI screening, and review of your obstetric records. You and your partner (if applicable) will also complete a psychological evaluation with a licensed mental health professional. All costs are covered by the agency or intended parents.

3

Matching with Intended Parents

Once medically and psychologically cleared, the agency presents you with intended parent profiles. You can review profiles and decide if you'd like to proceed. A mutual match meeting (video or in-person) typically follows. You always have the right to decline a match — this is one of the most important safeguards in the process. A good agency match considers shared values, communication preferences, and expectations about contact during and after the pregnancy.

4

Legal Contracts

A gestational surrogacy agreement is drafted by a reproductive attorney. The contract covers compensation (all components — base, allowances, reimbursements), medical decision-making, contact expectations, selective reduction/termination clauses, life insurance, and legal parentage. You are represented by your own independent attorney, paid for by the intended parents. Never proceed to a medical cycle without a fully executed legal contract.

5

Embryo Transfer Preparation & Transfer

You'll take hormone medications (typically estrogen and progesterone) to prepare your uterine lining for implantation. This preparation phase usually takes 3–5 weeks, with several monitoring appointments. The embryo transfer itself is a simple, painless procedure — a catheter is used to place the embryo directly into your uterus. It takes about 10 minutes and requires no sedation. You'll be advised to rest for the remainder of the day.

6

Pregnancy & Monthly Compensation

If the transfer is successful, your pregnancy is confirmed by a blood test ~10 days post-transfer. Once a heartbeat is confirmed (around 6–8 weeks), you transition to your own OB for prenatal care. Monthly allowance payments begin per your contract. The agency coordinator remains your support contact throughout. Contact with the intended parents during pregnancy varies widely by arrangement — some surrogates maintain close relationships; others have minimal contact.

7

Birth, Recovery & Final Payment

You'll give birth at an agreed-upon hospital. The intended parents will typically be present. Parentage is established by a pre-birth order obtained before delivery (in most states) so the IPs are listed on the birth certificate from day one. Post-partum allowances continue for 4–6 weeks after delivery. Final compensation installments are paid per your contract — typically within 1–2 weeks of delivery.

Ready to See What You Could Earn?

Calculate your compensation estimate, then apply in 5 minutes.

Ready to take the next step?

The surrogate application takes about 10 minutes. Agencies review applications within 48 hours and reach out to qualified candidates.

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