A Step-by-Step Guide to the Surrogacy Process for Intended Parents

The surrogacy process involves a series of administrative, legal, and medical measures filled with emotional considerations that require careful planning and execution. It is a complex and personal process that can overwhelm many intended parents, especially when one is just beginning to recognize that they may need a surrogate mother to have the family of their dreams. As such, it’s essential for those considering surrogacy to understand the process and the steps they will need to take to ensure a successful surrogacy journey.

In this blog, we’ll provide a step-by-step guide to the surrogacy process, offering insights into each major checkpoint. From selecting a surrogacy agency, matching with a surrogate, navigating legal agreements and medical procedures, and preparing for the arrival of a new family member, we’ll cover all of the major steps in the surrogacy journey.

Whether you’re just starting to explore surrogacy or have already decided to pursue it, this guide will provide intended parents with a comprehensive roadmap for the surrogacy process and help you navigate each step with confidence.

Step-by-Step Overview of the Surrogacy Process for Intended Parents

To start things off, let’s examine a bird’s eye view of the entire surrogacy process for intended parents.

• Exploring Agencies
• Agency Consultation
• Sign Agency Agreement
• Pre-Match Surrogate Screening
• The Match
• Clinical Medical Screening
• Final Agency Screening
• Legal Contract: The Gestational Carrier Agreement
• Escrow
• Establishing Pregnancy
• The Pregnancy & Recognizing the Intended Parents as the Legal Parents
• The Birth of Your Child

As you can see, surrogacy is a complex process, so before we dive into each of these steps in detail, let’s first discuss how long the gestational surrogacy process with IVF takes.

How Long Does the Surrogacy Process Take?

The length of the entire surrogacy process can vary considerably depending on a range of factors, including the particular circumstances of the intended parents and gestational surrogate, the state the surrogacy is taking place, and of course, the potential of unforeseen complications or additional embryo transfers needed to establish pregnancy that may arise along the way.

Generally, however, the entire surrogacy process can take anywhere from 9 months to over two years, with an average between 15 and 18 months from the time an agency agreement is signed to the time an intended parent takes their baby home from the hospital.

The surrogacy process typically involves a series of stages, including the selection of a surrogate, medical and legal screenings, embryo transfer, pregnancy, and birth. A hiccup or delay in any one of these stages can significantly slow the process.

While the surrogacy process can be a lengthy and complex journey, intended parents find that the rewards of bringing a new child into their family make the experience well worth the effort.

Step 1: Exploring Agencies

For intended parents considering surrogacy, exploring multiple surrogacy agencies is an essential first step in the surrogacy process for finding an agency that fits their needs and preferences.

Each surrogacy agency has its unique approach, resources, level of experience, and cost, and intended parents should take the time to research and compare multiple options before making a decision.

By exploring multiple surrogacy agencies, intended parents can better understand the surrogacy process, the services offered, and the costs involved and start to build a relationship with the agency staff.

This exploration can also help intended parents identify any potential red flags or areas of concern and select an agency they feel comfortable working with over the entire surrogacy process.

Ultimately, exploring multiple surrogacy agencies can give intended parents greater control, confidence, and peace of mind as they embark on this life-changing experience.

Here are some key components that intended parents should at for when selecting a surrogacy program:

• Legal expertise: Most importantly, the agency should have a profound understanding of surrogacy’s legal requirements and implications. Failure to do so could result in unnecessary delays and accompanying emotional pain and suffering for the intended parents in securing parental rights or an inability to secure parental rights altogether. Surrogate Steps, is owned and operated by Yifat Shaltiel, a leading reproductive law attorney, and has a 100% success rate in securing parental rights.
• Experience: The agency should have a proven track record over many years of successfully matching intended parents with surrogates, navigating the surrogacy process, establishing parental rights, and helping the intended parents welcome a new member to their family.
• Licensed: Surrogacy is a surprisingly unregulated industry with many ma and pa programs. Working with a licensed surrogacy agency like Surrogate Steps is a basic yet essential qualification for any surrogacy agency you plan on working with. 
• Fertility clinic partnerships: The agency should have established relationships with reputable fertility clinics and medical professionals specializing in surrogacy.
• Transparency and communication: The agency should be transparent about the costs and fees involved in surrogacy and communicate regularly and clearly with intended parents throughout the journey.
• Surrogate screening and support: The agency should have a rigorous and transparent screening process for surrogates to ensure they are physically and emotionally prepared for the journey. They should also offer ongoing support and resources to the surrogate and intended parents throughout the process.
• Cultural sensitivity: The agency should be sensitive to the unique cultural, religious, and personal beliefs and preferences of intended parents and surrogates.
• Ethical standards: The agency should prioritize ethical practices and conduct itself with integrity and professionalism throughout the surrogacy process.

Step 2: Agency Consultation

The initial consultation with a surrogacy agency is an important first step for intended parents considering surrogacy as an option for building their family. 

During the initial consultation, the intended parents will have the opportunity to learn more about the surrogacy process, the services offered by the agency, the costs involved, and more. 

The agency will usually ask questions to help understand the intended parents’ preferences for their surrogate and the journey and any specific medical or legal considerations the intended parents are facing.

The initial consultation also provides an opportunity for intended parents to gain a sense of the agency’s approach and values and determine if they feel comfortable working with the agency throughout the surrogacy process, and ask any remaining questions they have about the surrogacy process.

Overall, the initial consultation is an integral first step in helping intended parents make an informed decision about pursuing surrogacy and selecting the right agency to guide them through the journey.

Next up is signing an agency agreement.

Step 3: Sign Agency Agreement

Intended parents will typically sign a surrogacy agency agreement or retainer once they have decided to work with a surrogacy agency. 

This agreement may be nothing more than an outline of payments based on certain milestones like it is at Surrogate Steps or it could be significantly more detailed. 

Some agency agreements may include details regarding the terms of the relationship between the intended parents and the surrogacy agency, including the services provided, fees involved, and the expectations and responsibilities of both parties. The contract may also address issues such as selecting and matching a surrogate, medical and legal screening, and ongoing support and communication throughout the surrogacy process. 

It’s essential for intended parents to carefully review and understand the terms of the agreement/retainer before signing, as it will form the basis of their relationship with the agency. 

Before signing the agency agreement, Intended parents should also ensure they are comfortable with the fees and costs outlined in the agreement and clearly understand how the agency will manage and account for these expenses. 

Overall, signing a surrogacy agency agreement or retainer is an essential and usually required step in working with any surrogacy program. It helps establish a clear and transparent working relationship between the intended parents and their surrogacy agency.

Step 4: Pre-Match Surrogate Screening

The process of screening and filtering potential surrogates is a critical component of the surrogacy journey that goes on behind the scenes of every surrogacy program. While intended parents are not directly involved in this process, their preferences are highly considered.

Surrogacy agencies typically have a rigorous screening process to ensure the surrogates they work with are physically and emotionally prepared for the serious role of a surrogate. At this point in the process, surrogate screening usually includes a lengthy psycho/social/medical questionnaire, an interview, and a medical records review. Any one of dozens of small details could disqualify a potential surrogate.

Once a pool of potential surrogates has been identified, the agency will filter and match these surrogates with intended parents based on the surrogate and intended parent’s preferences.

Ultimately, this process aims to find a surrogate who is well-suited to the intended parents’ needs and preferences, eager, and prepared to embark on the surrogacy journey with the intended parents.

Once a potential match is identified, the matching process begins.

Step 5: The Match

The match begins by sharing the surrogate’s profile with the intended parent and vice versa. If both parties see potential in the match, the surrogate’s medical records are sent to the intended parent’s fertility clinic for review.

Once the clinic approves the surrogate, a match meeting is scheduled.

The surrogacy agency (one of the Journey Coordinators here at Surrogate Steps) facilitates the match meeting, which may occur in person or virtually, depending on the circumstances. More often than not, they are conducted by a video conference call.

The match meeting is one of the most pivotal and exciting moments in the surrogacy journey, as it represents the first opportunity for the intended parents and a select surrogate to meet and confirm their mutual desire to work together to achieve their shared goal of building the intended parent’s family through surrogacy. It is also a chance to ensure that all parties are on the same page regarding critical aspects of the surrogacy journey, such as the expectations around communication, medical appointments, the birth, and financial arrangements.

The match meeting is a significant milestone in the surrogacy process. It marks the beginning of a close and collaborative relationship between the intended parents and their surrogate and lays the groundwork for a successful and fulfilling surrogacy experience for all involved parties.

Step 6: Clinical Medical Screening

Before the embryo transfer, the surrogate will typically undergo a comprehensive medical evaluation at the intended parent’s fertility clinic.

This evaluation may include a range of tests and procedures, such as bloodwork, ultrasounds, and hysterosalpingogram (HSG), sonohysterogram (SHG), and more. This testing corroborates that the surrogate’s reproductive system is fully functional and that no underlying health concerns could complicate the pregnancy or pose a risk to the surrogate or intended parents. 

Because the medical record review by the agency in the initial screening catches most reproductive or other physical issues that disqualify would-be surrogates at an earlier stage, few surrogates are eliminated due to the fertility clinic’s medical evaluation.

Still, the fertility clinic medical screening is a crucial step in the surrogacy process and one that should not be skipped for any reason.

Step 7: Final Agency Screening

After passing the medical examination, the surrogate will undergo a three-pronged psycho-social evaluation which will act as the final step of the surrogate’s evaluation and substantiate the carrier’s readiness to act as a gestational surrogate.

This screening commonly involves a range of evaluations, including a psychological assessment and home study by a licensed social worker and a criminal background check for the surrogate and any adult living in their household.

The psychological evaluation is typically conducted by a licensed social worker who conducts a detailed interview with the surrogate to assess her emotional stability, coping skills, and support network, among other factors. This ensures that the surrogate is emotionally and psychologically fit for the journey ahead and understands both the risks and challenges of carrying a child for another family.

The home study, meanwhile, is designed to evaluate the suitability of the surrogate’s living situation for the surrogacy journey. This evaluation may involve physically inspecting the surrogate’s home and interviewing any adults or children living there. The goal of the home study is to ensure that the surrogate has a safe and supportive living environment conducive to a healthy pregnancy and successful surrogacy journey.

Finally, a criminal background check ensures that the surrogate and any adult living in her household do not have a history of criminal activity. This check may involve a review of court records, a sex offender registry check, and other measures to ensure that the surrogate and her household are safe and trustworthy.

Overall, the final surrogacy agency screening is a critical component of the surrogacy journey as it helps ensure that the surrogate is fully prepared for the journey ahead and gives the intended parents confidence in the safety and likely success of the surrogacy journey.

Step 8: Legal Contracts: The Gestational Carrier Agreement

Drafting, negotiating, and signing the legal contract between the surrogate and intended parents is the next and crucial step in the surrogacy process. This contract, commonly called the gestational carrier agreement, outlines the rights and responsibilities of both the intended parents and the surrogate and provides a clear framework for the surrogacy pregnancy and more. The surrogacy agreement typically covers a wide range of topics, including compensation, medical procedures, insurance, termination of the agreement, and parental rights, among other issues. Therefore, both the intended parents and the surrogate must clearly understand the terms of the agreement before signing it.

Negotiating the gestational carrier agreement can be a complex process, and both parties should have independent and experienced legal representation to protect their interests. 

At Surrogate Steps, the initial draft is written and given to the intended parents by our founder and esteemed reproductive attorney, Yifat Shaltiel. 

Together, the intended parents, surrogate, and their respective counsel will then negotiate the terms of the agreement. Once the parties have agreed to the terms of the carrier agreement, all parties will sign the document, and become legally binding.

Step 9: Escrow Formation

After signing the gestational carrier agreement, the intended parents will typically need to set up an escrow account to manage the financial aspects of the surrogacy journey. This account is funded by the intended parents and is used to pay for the surrogate’s compensation, medical expenses, and other costs associated with the surrogacy process. A third-party escrow agent typically manages the escrow account and will ensure that funds are disbursed per the terms of the surrogacy agreement.

Setting up an escrow is a vital aspect of the surrogacy process and ensures proper financial management of the journey, enabling other elements of the surrogacy to run smoothly and successfully.

Step 10: Establishing Pregnancy

Establishing a gestational surrogate pregnancy involves an embryo transfer at the intended parent’s fertility clinic. 

Depending on the specifics outlined and agreed upon in the gestational carrier agreement, intended parents may be present at the clinic during the transfer, observe the transfer remotely through video conferencing, or follow along in another manner. 

Following the transfer, the surrogate will typically undergo a series of pregnancy tests to confirm the establishment of the pregnancy. These tests include blood tests to measure pregnancy hormones, and a fetal heartbeat check performed several weeks later to demonstrate the viability of the pregnancy. Once the pregnancy is confirmed via fetal heartbeat, the intended parents and surrogate will continue to work closely with their fertility clinic and other medical professionals to ensure a safe and healthy pregnancy.

Step 11: The Pregnancy & Recognizing the Intended Parents as the Legal Parents

Intended parents will be in regular contact with the surrogate during the surrogate’s pregnancy. Most intended parents video call their surrogates one to a few times per week.

During the pregnancy, the agency will ensure the surrogate is properly reimbursed and compensated by the Escrow per the Compensation Package and the Gestational Carrier Agreement (GCA). The surrogate must inform the agency and the Escrow to receive payment for reimbursements that are not in fixed amounts (examples include pharmacy bills, medical bills, etc.). The payment will need the intended parent’s approval.

Securing the legal parental rights for the baby begins with the gestational carrier agreement already in place. Once the surrogate enters the second trimester of pregnancy, the intended parent usually begins to work with their attorney on other necessities to ensure paternity rights. This will ensure that the intended parents are recognized as legal parents of the child and that the intended parents can make all medical and legal decisions on behalf of the child commencing at birth.

Around the 17-18th week of pregnancy, the agency will work with you to ensure that the intended parents, surrogate, and the hospital have certified copies of the parentage order.

Around the 26-30th week of pregnancy, the agency will begin to discuss the birth plan with the hospital social worker to secure a plan for the hospital stay. This includes ensuring intended parents have access to the delivery room (if applicable), the baby (post-delivery), and their own room in the hospital (if possible).

Around the 26-34 weeks of pregnancy, the agency will work with the intended parents to confirm that travel plans are in place for the birth.

Ultimately, the legal process to secure your parental rights may be affected by state or national laws, the surrogate’s marital status, and more. This is one of the reasons intended parents ought to work with experienced agencies and legal professionals who are knowledgeable about the laws and can help them navigate the process of establishing their parental rights calmly and efficiently and one of the benefits of working with a attorney directed agency like Surrogate Steps.

Step 12: The Delivery

The birth of the surrogate baby is the moment and a highly anticipated event for obvious reasons. 

During the final stages of pregnancy, the intended parents and surrogate will work closely with their medical professionals to prepare for the baby’s delivery. 

Depending on what is agreed upon, usually outlined in the gestational carrier agreement, the intended parents may choose to be present in the delivery room for the birth or wait outside. 

After the baby is born, the medical team will provide immediate care and attention to the newborn. 

In most circumstances, the intended parents can cut the umbilical cord, hold the baby, and begin bonding with their new child immediately after the healthcare team delivers and examines the baby. 

Once the baby is discharged from the hospital, the intended parents will take the baby home. 

While the surrogacy process can be complex and emotional, the birth of a surrogate baby is a joyful moment and the climax that marks the beginning of a new chapter in the intended parents’ lives.

Recap: The Surrogacy Process Step-by-Step

The surrogacy process is complex and emotional, often lasting between 15-18 months. But with the help of experienced professionals like surrogate steps and a supportive community, intended parents can achieve their dream of growing their family.

Whether you’re just starting to explore surrogacy or have already decided to pursue it, surrogate steps. is here for you as a trusted guide through the process; we welcome you to schedule a free consultation to see how we can help you have the family of your dreams.