Understanding the Surrogacy Process in the United States

Surrogacy in the United States offers intended parents a structured, legally supported path to parenthood. Unlike countries with uniform federal policies, American surrogacy is governed by state laws, meaning your experience can vary dramatically depending on where your surrogate lives. However, regardless of geography, the overall process follows the same core milestones: deciding if surrogacy is right for you, assembling a trusted team, finding a compatible surrogate, finalizing legal agreements, completing the medical procedures and, finally, celebrating the birth of your baby. This guide synthesizes the key steps and decision points, drawing on expert resources and best‑practice recommendations to empower you with the knowledge needed to plan a successful surrogacy journey in the U.S.

What Is Surrogacy in the U.S.?

Surrogacy is an arrangement in which a woman – the surrogate or gestational carrier – agrees to carry a baby for an intended parent or couple. In the United States, surrogacy laws are determined at the state level, and there are two primary types of surrogacy:

• Gestational surrogacy: The surrogate has no genetic connection to the child. An embryo is created using the intended parents’ or donors’ gametes and transferred to the surrogate’s uterus via in vitro fertilization (IVF). This is the most common form of surrogacy today.
• Traditional surrogacy: The surrogate contributes her own egg, which is fertilized with sperm from the intended father or a donor through intrauterine insemination (IUI). Because the surrogate is the biological mother, traditional surrogacy raises complex legal issues and is permitted in fewer states.

Because surrogacy is regulated at the state level, some jurisdictions – such as California, Illinois and New Jersey – provide clear legal pathways for gestational surrogacy, including pre‑birth orders, while others impose restrictions or prohibit compensated surrogacy. A few states, notably Louisiana and Nebraska, make surrogacy contracts unenforceable. If you are considering surrogacy, work with an experienced attorney licensed in the surrogate’s state to understand your rights and obligations.

Step‑by‑Step Surrogacy Journey

While every surrogacy experience is unique, the general journey follows six critical steps. Understanding these stages will help you set expectations and plan for a smooth process.

Step 1: Decide if Surrogacy Is Right for You

The first step is self‑reflection. Becoming a parent through surrogacy requires a significant emotional, financial and time commitment. Prospective parents should research state laws, evaluate the pros and cons, speak with surrogacy professionals and assess their finances before proceeding. Many people choose surrogacy because it allows them to have a genetic connection to their child, to share in the pregnancy experience and to build relationships with their surrogate.

Step 2: Prepare for Surrogacy

Once you decide to pursue surrogacy, you’ll need to make a series of decisions about how your journey will unfold. First, determine which type of surrogacy you’ll pursue – gestational or traditional – and whether you will work with a full‑service surrogacy agency or coordinate the journey independently with the help of attorneys. Next, consider whether you need donor sperm or eggs and outline your preferences for the surrogate’s location, communication style and relationship. A comprehensive surrogacy plan will guide your matching process and ensure that expectations align.

Step 3: Find a Match

Matching is one of the most exciting phases of surrogacy. If you already know a potential surrogate (for example, a relative or close friend), you may only need an attorney to formalize the arrangement. Otherwise, surrogacy agencies facilitate matches by reviewing profiles of both surrogates and intended parents. Agencies use your surrogacy plan to identify compatible candidates and help both parties connect. During this stage, you’ll have opportunities to speak with prospective surrogates, discuss expectations around communication and medical decisions, and determine if you’d like to move forward together.

Step 4: Satisfy Legal Requirements

Before any medical procedures begin, each party must sign a legally binding contract outlining compensation, responsibilities, potential risks and parental rights. Each side is represented by separate attorneys to avoid conflicts of interest. In states that permit pre‑birth parentage orders, these documents will also be prepared during this stage to ensure that the intended parents’ names appear on the birth certificate immediately after delivery. Because surrogacy law varies by state, it’s essential to work with legal professionals familiar with the jurisdiction where your surrogate resides.

Step 5: Embryo Transfer and Pregnancy

After contracts are signed, medical procedures begin. Intended parents or donors undergo IVF to create embryos. Fertility medications prepare the surrogate’s uterus for implantation. Once a healthy embryo is transferred to the surrogate’s uterus, the pregnancy is monitored with regular blood tests and ultrasounds. Once a heartbeat is detected, the surrogate begins receiving base compensation and a monthly allowance. She will attend prenatal appointments as any pregnant person would, often with the intended parents present.

Step 6: Birth and Parentage

The culmination of the surrogacy journey is the birth of your child. Most intended parents join their surrogate in the delivery room to witness this life‑changing moment . If pre‑birth orders were secured, your names will be listed on the birth certificate and you will assume all parental rights immediately. Many intended parents choose to maintain a relationship with their surrogate after delivery as a sign of gratitude and mutual respect.

Timeline and Preparation

The entire surrogacy process typically takes 12 to 24 months from consultation to birth. Factors influencing the timeline include the time required to find a suitable surrogate, the number of IVF attempts needed and any legal complexities in the surrogate’s state. Early planning, financial preparedness and patience are key to navigating this extended timeline. A strong support system and clear communication with your surrogacy team will ease stress and help you stay focused on the joy of building your family.

Expert Quote

“Surrogacy is a partnership built on trust, compassion and comprehensive legal agreements. In the United States, understanding the nuances of state law and selecting the right team of professionals ensures that everyone’s rights are protected and the journey is positive for all involved.” — Dr. Kulsoom, MBBS

Patient Case Study

Case Study: Maria and David’s U.S. Surrogacy Journey

Maria and David, a couple from New York, struggled with recurrent miscarriages due to Maria’s medical condition. After consultations, they decided to pursue surrogacy in California because the state’s surrogacy laws are highly supportive. Working with Surrogacy4All, they were matched with Anna, a gestational carrier who lived in San Diego. Separate attorneys drafted a contract outlining compensation, medical decisions and post‑birth expectations. The contract also included a pre‑birth order, ensuring Maria and David’s names would appear on the birth certificate. After a successful embryo transfer, Anna became pregnant. Throughout the pregnancy, Maria and David attended prenatal appointments via video calls and visited San Diego for key milestones. The relationship blossomed into a friendship, and they were by Anna’s side when their son Lucas was born. Because the legal groundwork had been completed, they immediately assumed parental rights. Maria and David remain in contact with Anna, grateful for her selfless role in their family’s story.

Testimonials

From Intended Parents: “Our experience with Surrogacy4All was seamless. They matched us with a surrogate who shared our values and guided us through the legal and medical process. We felt supported every step of the way and are now proud parents of a beautiful daughter.” — Jessica and Mark.

From a Surrogate: “Carrying a baby for another family was one of the most rewarding experiences of my life. Surrogacy4All ensured that my health and needs were always prioritized. Seeing the intended parents hold their baby made every challenge worthwhile.” — Anna S.

From Intended Grandparents: “We were skeptical about surrogacy at first, but watching our son and daughter‑in‑law navigate the process with guidance from Surrogacy4All gave us confidence. Their surrogate became a cherished member of our extended family.” — Lydia K.

Keep Exploring

• Surrogacy Costs and Financing in the United States
• Legal Considerations for Surrogacy Across U.S. States
• Emotional and Psychological Aspects of Surrogacy
• Choosing the right surrogacy agency

Frequently Asked Questions 

Q: Is surrogacy legal in every U.S. state?

Ans: No. Surrogacy law is determined by each state. Some states, like California and Illinois, explicitly permit gestational surrogacy and allow pre‑birth orders. Other states, such as Arizona and Indiana, present legal hurdles, and Louisiana and Nebraska prohibit or void surrogacy contracts. It’s critical to work with a lawyer who understands the laws in the surrogate’s state.

Q: How long does the surrogacy process take?

Ans: From the initial consultation to bringing your baby home, surrogacy can take 12–24 months. Timelines depend on how quickly you find a surrogate, how many IVF cycles are needed and how complicated the legal process is.

Q: Can single parents pursue surrogacy?

Ans: Yes. Many surrogacy agencies work with single intended parents. However, some states may require additional legal steps, such as a second‑parent adoption or court hearing to establish parental rights. Consult an attorney to understand the requirements.

Next Steps with Patients Medical NYC

Ready to begin your surrogacy journey? Surrogacy4All and Patients Medical NYC work hand‑in‑hand to provide comprehensive medical and emotional support. Our physicians will evaluate your fertility, recommend appropriate treatment plans and coordinate with surrogacy agencies and legal professionals. We proudly partner with IndianEggDonors.com, EggDonors4All.com and Surrogacy4All.com to connect you with diverse donors and experienced surrogates. Contact us today to schedule your consultation and start building your family.