Guides
Your guide to surrogacy
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What is surrogacy?
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What is surrogacy?
Surrogacy is a family-building option in which a gestational carrier carries a pregnancy for an intended parent or couple.
While the term surrogate is commonly used, most fertility programs use the term gestational carrier. Both terms will be used throughout this guide.
Surrogacy can be a path to parenthood for individuals or couples who cannot carry a pregnancy themselves. This includes many heterosexual couples facing medical challenges, as well as same-sex male couples and single individuals pursuing parenthood.
Most surrogacy journeys take approximately 9-12 months or longer from initial consultation to embryo transfer.
This guide explains the major steps of the process and what to expect along the way.
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Is surrogacy right for you?
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Is surrogacy right for you?
Surrogacy is generally considered when carrying a pregnancy is not possible or would pose significant medical risk.
Examples of medical indications for surrogacy include patients born without a uterus, patients who have undergone hysterectomy, patients with medical conditions that make pregnancy unsafe, and other specific examples that may apply in your case.
During your consultation, your care team will review your medical history, discuss your goals, and determine whether surrogacy is the most appropriate path forward.
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Embryos
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Creating embryos
A gestational carrier treatment cycle requires embryos.
Some intended parents already have embryos available. Others first complete IVF using their own eggs and sperm, donor eggs, donor sperm, or a combination of these components.
Before moving forward, your physician or provider will review your available embryos and discuss whether any additional fertility treatment is needed before matching with a gestational carrier.
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Matching with a gestational carrier
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Matching with a gestational carrier
For most intended parents, identifying the right gestational carrier match is the longest part of the process.
Most intended parents work with a gestational carrier agency, although some use a friend or family member to act as their surrogate.
Matching can take time. Often several months. In addition to medical qualifications, factors such as availability, communication preferences, location, and personal expectations often influence the timeline of the process.
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Gestational carrier screening
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Gestational carrier screening
Once a match has been identified, screening begins.
Every proposed gestational carrier undergoes medical, reproductive, and psychological evaluation before treatment can proceed. This includes a review of medical records, pregnancy history, laboratory testing, and clearance from healthcare providers.
As part of this process, intended parent(s) and gestational carriers typically meet separately with a mental health professional experienced in third-party reproduction. There will also be a joint consultation involving both parties. These discussions help ensure that everyone understands the process, has aligned expectations, and is well prepared for the journey ahead.
Even if screening has already been completed through an agency, additional evaluation is required. Some testing expires over time, and our team independently reviews every gestational carrier before treatment is approved.
Not every gestational carrier candidate ultimately moves forward. While that can be frustrating, screening is one of the most important parts of the process.
Our responsibility is not simply to help intended parents find a gestational carrier. Our responsibility is to help create the safest possible environment for a healthy pregnancy and a successful delivery. For that reason, we place significant emphasis on thorough screening and individualized review of each gestational carrier.
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Legal agreements
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Legal agreements
Before treatment begins, legal agreements are completed between the intended parent(s) and the gestational carrier.
Each party works with independent legal counsel experienced in reproductive law. These agreements address parental rights, responsibilities, compensation, and expectations during the pregnancy.
Legal requirements vary by state and are a required part of the process.
Our team will help guide you to qualified legal professionals who specialize in reproductive law.
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Embryo transfer
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Embryo transfer
The embryo transfer itself is a brief outpatient procedure followed by pregnancy testing and early pregnancy monitoring.
Once medical, psychological, and legal requirements have been completed, the gestational carrier begins medication in preparation for embryo transfer.
Success rates depend on factors including embryo quality, and no fertility treatment can guarantee pregnancy or live birth.
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Pregnancy and delivery
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Pregnancy and delivery
Following a successful transfer, care gradually transitions from the fertility clinic to the gestational carrier's obstetrics provider (OB/GYN).
Throughout the pregnancy, intended parents, gestational carriers, agencies, attorneys, and medical providers continue working together to prepare for delivery and any required parentage documentation.
By the time delivery occurs, months of medical, legal, and logistical planning have already taken place to support a healthy pregnancy and a smooth transition home.
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FAQ
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Frequently asked questions (FAQs)
Who typically uses a gestational carrier?
Gestational carriers are most commonly used by individuals or couples who cannot safely carry a pregnancy themselves. This includes patients who have undergone hysterectomy, were born without a uterus, have medical conditions that make pregnancy unsafe, or have other circumstances that prevent carrying a pregnancy.
We work with intended parents from a wide variety of backgrounds, including heterosexual couples, same-sex couples, and single individuals pursuing parenthood through gestational carrier treatment.
How long does the surrogacy process take?
Most journeys take approximately 9-12 months or longer from initial consultation to embryo transfer.
Matching, screening, legal work, and treatment planning all contribute to the timeline.
Can I use a friend or family member as my gestational carrier?
Often, yes.
Many successful gestational carrier arrangements involve a friend or family member. However, known carriers complete the same medical, psychological, and legal evaluation process as any other gestational carrier.
How are gestational carriers screened?
If the agency already screened my gestational carrier, why does the fertility clinic repeat testing?
Agencies and fertility clinics have different responsibilities in the process.
Some testing must be repeated because results expire over time. Fertility clinics are also responsible for independently reviewing medical records, laboratory studies, and treatment eligibility before proceeding with care.
Ultimately, the physician overseeing the patient's care is responsible for the final review and approval of the gestational carrier, helping ensure that the proposed match is medically appropriate and that everyone feels comfortable moving forward.
Why is psychological screening required?
Psychological screening is recommended by professional organizations and is a standard part of most gestational carrier programs.
These discussions help ensure that everyone understands the process, has realistic expectations, and is well prepared for the journey ahead. Most programs require consultations for both the intended parent(s) and gestational carrier, as well as a joint consultation involving both parties.
Why do you transfer only one embryo?
What happens if an embryo transfer is unsuccessful?
A single unsuccessful transfer does not automatically indicate a problem with the gestational carrier.
Your physician will review the cycle and discuss whether additional transfers, additional evaluation, or changes in treatment strategy or surrogate should be considered.
Can my gestational carrier live in another state?
Often, yes.
However, surrogacy laws vary by state. Intended parents and gestational carriers work with attorneys experienced in reproductive law to ensure legal requirements are met before treatment begins.
Your care team can help connect you with appropriate legal resources and discuss any geographic considerations that may affect the process.
How much does surrogacy cost?
Costs vary considerably based on agency fees, legal expenses, insurance coverage, gestational carrier compensation, travel requirements, and fertility treatment costs.
Before treatment begins, your financial coordinator will review anticipated expenses and help you better understand the financial aspects of your individual journey.
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Related articles
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More on what to expect during your surrogacy journey
While every patient's experience and family-building goals are unique, we're there at every step of the way.