How Surrogacy Works: A Step-by-Step Overview 

There’s strength in asking for support, especially when it involves bringing a child into your world. At First Fertility, surrogacy is more than a medical path. It’s a deeply collaborative effort built on trust, transparency, and science-backed care, all designed with you in mind.  

If you’ve found yourself researching how surrogacy works, exploring options, or wondering what the future might look like, you’re in the right place. This is a step-by-step overview of how your surrogacy journey can unfold, step by step, with care that keeps you at the center.  

Types of Surrogacy: Which Route May Be Right for You 

There’s rarely one reason people turn to surrogacy. More often, it’s a blend of circumstances that lead someone to our surrogacy clinic, each layered, valid, and deserving of understanding.  

Families are created in all kinds of ways. In surrogacy, there are two core paths: 

• Gestational Carrier Surrogacy: This is the most common and involves a carrier who has no genetic connection to the baby. An embryo is created through IVF, using egg and sperm from the intended parents or donors, and then transferred to the carrier.  

• Traditional Surrogacy: This method uses the surrogate’s egg, meaning there is a genetic link. It’s far less common due to legal and emotional complexities, but still an option some choose with the right legal guidance. 

Whichever type you explore, what matters is that it aligns with your values, your needs, and your vision for the future. 

Step-by-Step Surrogacy Timeline: From IVF to Embryo Transfer 

The IVF process can begin before or after a surrogate is chosen. The goal is to develop embryos that can be safely transferred to the gestational carrier. With your team’s support, this process might include: 

1. IVF planning and embryo development: eggs are retrieved from the egg source after hormone stimulation, then fertilized in the lab using sperm from an intended parent or donor. 

2. Embryo development monitoring: the lab observes a developing, dividing embryo and may recommend genetic testing to assess chromosome number, based on clinical context. 

3. Embryo transfer preparation: medicine and science work together here, using medications such as estrogen and progesterone to prepare the uterine lining and support timing. 

4. Embryo transfer: a clinician places the embryo into the uterus using a thin catheter, guided by ultrasound. 

5. Early monitoring and transition of care: the fertility team coordinates early ultrasounds and labs, then transitions care to an OB team at the appropriate stage. 

You stay involved throughout, approving plans, reviewing results, and choosing next steps with your team. 

Surrogacy Screening and Matching: Safety, Support, and Alignment 

Matching isn’t transactional. It’s personal. You’ll be encouraged to find a connection, not just someone who qualifies medically, but someone you feel comfortable entrusting with something so intimate. 

Surrogates themselves are supported too. They go through extensive screenings—medical, psychological, emotional—and are required to have had at least one prior uncomplicated delivery. They’re often people who feel called to help others experience parenthood. 

Matching also includes logistics (travel, appointment preferences, location) and shared expectations around contact after birth. 

FAQs 

What does the gestational carrier screening consist of?

The typical gestational carrier screening checklist includes: 

• Age range and prior pregnancy history review 

• Physical exam, blood work, and medical records assessment 

• Counseling conversations to confirm readiness and support systems 

• Review of lifestyle factors such as nicotine, alcohol, or drug use 

• Planning for communication expectations during and after pregnancy 

Can intended parents use donor eggs or donor sperm in gestational carrier surrogacy?

Yes. Gestational carrier surrogacy can use eggs or sperm from intended parents, donors, or a combination. Your clinic team can explain screening, consent steps, and lab processes that fit your plan. 

Is the term “surrogate” outdated?

The word surrogate is still used, but in many cases, people are actually referring to a gestational carrier. A gestational carrier is someone who carries a pregnancy for another person or couple using an embryo created through IVF, according to the American Society for Reproductive Medicine (ASRM).* The gestational carrier has no genetic connection to the baby. 

A surrogate, sometimes called a traditional surrogate, contributes both the egg and carries the pregnancy, meaning she has a genetic link to the baby. This method is rarely used today due to complex legal and emotional considerations.  

What are the legal requirements surrounding surrogacy?

In the U.S., gestational carrier arrangements are governed through state statutes, court opinions, and related policies, and the country lacks a single federal law that covers every arrangement.  

Many intended parents are encouraged to work with an attorney who focuses on assisted reproduction to build contracts that address: 

• parental rights and pre-birth or post-birth orders (as applicable) 

• medical decision-making boundaries 

• financial responsibilities and reimbursements handled through appropriate channels 

• expectations around communication and privacy 

Our surrogacy clinic can coordinate with your attorney and agency so timelines stay aligned. 

How Surrogacy Works: Schedule a Consultation Today 

Surrogacy can bring a lot of moving pieces together, and you deserve a team that keeps the plan clear, the support steady, and your voice central. Reach out to First Fertility with questions about surrogacy, types of surrogacy, screening steps, or legal coordination. A thoughtful conversation can turn a big concept into a real, step-by-step plan you can feel confident carrying forward. 

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*Source: ASRM