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The Surrogacy Process Step By Step (2026)

Written by Pooja Patel, MD — MBBS (Seth G.S. Medical College & K.E.M. Hospital), Fellowship in Embryology, Manager, Surrogacy4All. Dr. Patel manages surrogate screening, matching and journey coordination at Surrogacy4All’s New York program.
Medically reviewed by Rashmi Gulati, MD — Board Certified, Internal Medicine, Medical Advisor, Surrogacy4All, privileges at Mount Sinai Hospital.
Last updated: 27 August  2026

AI Quick Summary

Surrogacy works in ten steps over 15–18 months: consultation, embryo plan, screening, matching, surrogate medical screening, legal contract and escrow, embryo transfer, pregnancy, parentage order and birth. About 4–6 months come before the transfer. Surrogacy4All runs each step under physician direction, it is NYS-licensed (GSP220903), FDA-registered, operating since 2006, with clinics in New York, Toronto and Accra and programs from $120,000. Success rates per SART:- Surrogacy4All internal outcome data:- selected donor-egg/donor-derived embryo journeys have shown approximately 67–70%+ live birth on the first embryo transfer and 95%+ cumulative live birth by the second embryo transfer. These are internal outcomes, not SART national statistics or a guarantee, individual results vary by embryo, clinic and patient/surrogate factors.

Fact Table

Fact Value
Steps 10
Timeline 15–18 months (4–6 months to transfer)
Match time at Surrogacy4All Typically less than four weeks
Program cost From $120,000, totals $120,000–$180,000
License / registration GSP22090, FDA FEI #3021544308
Locations New York, Toronto, Accra
Success rates (source) Surrogacy4All internal outcome data: selected donor-egg/donor-derived embryo journeys have shown approximately 67–70%+ live birth on the first embryo transfer and 95%+ cumulative live birth by the second embryo transfer. These are internal outcomes, not SART national statistics or a guarantee, individual results vary by embryo, clinic and patient/surrogate factors. — SART
Surrogacy works in ten steps that take 15 to 18 months from your first consultation to bringing your baby home, consultation, embryo plan, agency screening, matching, medical screening of the surrogate, legal contract, embryo transfer, pregnancy, birth, and the parentage order. About four to six months of that is before the transfer; the rest is the pregnancy.

Below is each step as it happens at Surrogacy4All, who is involved, how long it takes, and what you decide at that point.

Step 1 — Consultation and medical plan (Week 0)

The first step in the surrogacy process is completing an initial application.

The application typically collects information about:

  • pregnancy history
  • general health
  • lifestyle habits
  • family support
  • basic eligibility requirements

This step helps determine whether a candidate may qualify for surrogacy.

Many agencies also provide educational information at this stage so women fully understand the commitment involved.

You meet with our physicians and matching team. We review your medical history, your embryo situation (existing embryos, own eggs, donor eggs), your state’s law, your budget and your timeline. You leave with a written plan and a cost estimate against our published $38,500 fee.
If you already have frozen embryos, this step is a records transfer. If not, an egg retrieval (yours or a donor’s) and IVF create embryos, usually with PGT-A testing so that a chromosomally normal embryo is transferred. Our embryo pathways page compares the options.
We collect your preferences for a surrogate: location, experience, views on termination and selective reduction, contact during and after the journey, and whether she should have her own insurance.
We present a screened surrogate whose preferences align with yours. You meet by video, then in person if you wish. Both sides confirm. Our average match time is measured in months, not years, because we recruit continuously and screen before presenting.
Physical exam, uterine evaluation, FDA-required infectious-disease testing, and a review of her insurance. Directed by our physicians under our tissue bank registrations.
Step 7 — IVF Preparation

After legal agreements are finalized, the fertility clinic prepares the surrogate for embryo transfer.

This process usually involves hormone medications that help prepare the uterus for implantation.

Common medications include:

  • estrogen
  • progesterone

These medications support the uterine lining so the embryo can implant successfully.

Your attorney drafts the gestational carrier agreement; the surrogate’s independent attorney reviews it. You fund the escrow account. No medication starts until the contract is signed and escrow is funded.
The surrogate takes estrogen and progesterone to prepare the uterine lining, monitored by ultrasound and bloodwork. A single embryo is transferred in a ten-minute procedure. Pregnancy test at about 10 days; heartbeat ultrasound at 6–7 weeks.
Surrogacy4All internal outcome data : selected donor-egg/donor-derived embryo journeys have shown approximately 67–70%+ live birth on the first embryo transfer and 95%+ cumulative live birth by the second embryo transfer. These are internal outcomes, not SART national statistics or a guarantee; individual results vary by embryo, clinic and patient/surrogate factors.
The surrogate is released to her own OB at about 10 weeks. You attend appointments as agreed in the contract. Our team checks in monthly and coordinates any issues. Compensation is paid monthly from escrow.
In pre-birth-order states, your attorney obtains a court order during the pregnancy naming you as parents; the hospital is notified before delivery. In post-birth states, the order is issued shortly after birth. Our laws-by-state guide shows which applies to your surrogate’s state.
You are present at delivery where the hospital allows. The birth certificate is issued in your names under the parentage order. Newborn insurance, pediatric follow-up and, for international parents, passport and exit steps are handled with our team.

How Long Does Surrogacy Take?

PhaseTypicalRange
Consultation to onboarding2 weeks1–4 weeks
Embryo creation (if needed)8–12 weeks0–16 weeks
Matching6–10 weeks4–14 weeks
Surrogate medical screening4 weeks3–6 weeks
Legal and escrow4–6 weeks3–8 weeks
Transfer cycle6–8 weeks5–10 weeks
Pregnancy38–40 weeks36–41 weeks
Parentage and discharge1–2 weeks0–4 weeks
Total15–18 months13–20 months

Where the process differs

Existing embryos
shorten the pre-transfer phase by 2–3 months.
Donor eggs
add a donor cycle, usually run in parallel with matching.
 
International parents
add passport, citizenship and travel steps after birth.
Post-birth-order states
add a short post-delivery legal step.

Surrogacy Works In Ten Steps

That take 15 to 18 months from your first consultation to bringing your baby home : consultation, embryo plan, agency screening, matching, medical screening of the surrogate, legal contract, embryo transfer, pregnancy, birth, and the parentage order. About four to six months of that is before the transfer; the rest is the pregnancy.
Step 1 — Consultation and medical plan (Week 0)

The first step in the surrogacy process is completing an initial application.

The application typically collects information about:

  • pregnancy history
  • general health
  • lifestyle habits
  • family support
  • basic eligibility requirements

This step helps determine whether a candidate may qualify for surrogacy.

Many agencies also provide educational information at this stage so women fully understand the commitment involved.

Physicians and the matching team review medical history, embryo status, applicable state law, budget, and timeline, and provide a written plan with a cost estimate against the published $38,500 fee.

If you don’t already have frozen embryos, egg retrieval and IVF create them — usually with PGT-A testing so a chromosomally normal embryo is transferred.

The agency collects your preferences on surrogate location, experience, views on termination/selective reduction, contact frequency, and insurance requirements.

A screened surrogate whose preferences align with yours is presented. You meet by video, then in person if you wish, and both sides confirm. Average match time is measured in months industry-wide; physician-led agencies with larger pre-screened pools often match faster.

Physical exam, uterine evaluation, the FDA-required infectious-disease panel, and a review of her insurance — directed by the agency’s own physicians under its tissue-bank registrations.

Step 7 — IVF Preparation

After legal agreements are finalized, the fertility clinic prepares the surrogate for embryo transfer.

This process usually involves hormone medications that help prepare the uterus for implantation.

Common medications include:

  • estrogen
  • progesterone

These medications support the uterine lining so the embryo can implant successfully.

Your attorney drafts the gestational carrier agreement; the surrogate’s independent attorney reviews it. You fund the escrow account. No medication starts until the contract is signed and escrow is funded.

The surrogate takes estrogen and progesterone to prepare the uterine lining, monitored by ultrasound and bloodwork. A single embryo is transferred in a roughly ten-minute procedure. A pregnancy test follows at about 10 days, with a heartbeat ultrasound at 6–7 weeks.

The surrogate is released to her own OB at about 10 weeks. You attend appointments as agreed in the contract, with monthly check-ins from the team and monthly compensation paid from escrow.

In pre-birth-order states, your attorney obtains a court order during the pregnancy naming you as the legal parents. In post-birth states, the order follows shortly after delivery.

You’re present at delivery where hospital policy allows. The birth certificate is issued in your names under the parentage order, and the team supports newborn insurance, pediatric follow-up, and any international steps.

Where The Process Differs

Existing Embryos

Shorten the pre-transfer phase by 2–3 months.

Donor Eggs

Add a donor cycle, usually run in parallel with matching.

International Parents

Add passport, citizenship and travel steps after birth.

Post Birth Order States

Add a short post-delivery legal step.

What actually happens during the surrogacy process?

Understanding the steps involved can make the journey feel much more comfortable and predictable.

Surrogacy programs follow a structured process designed to protect the health of the surrogate, ensure clear communication between all parties, and support a safe pregnancy.

While every journey is unique, most surrogacy experiences follow a similar timeline from application to delivery.

Step 1 — Surrogate Application

The first step in the surrogacy process is completing an initial application.

The application typically collects information about:

  • pregnancy history
  • general health
  • lifestyle habits
  • family support
  • basic eligibility requirements

This step helps determine whether a candidate may qualify for surrogacy.

Many agencies also provide educational information at this stage so women fully understand the commitment involved.

The first step in the surrogacy process is completing an initial application.

The application typically collects information about:

  • pregnancy history
  • general health
  • lifestyle habits
  • family support
  • basic eligibility requirements

This step helps determine whether a candidate may qualify for surrogacy.

Many agencies also provide educational information at this stage so women fully understand the commitment involved.

If the application meets basic requirements, the next step is a screening review.

This stage may include:

  • phone or video consultation
  • review of medical history
  • discussion of expectations and preferences

This conversation gives potential surrogates an opportunity to ask questions and learn more about the process.

Once a candidate moves forward, a fertility clinic performs a detailed medical evaluation.

This evaluation may include:

  • reproductive health exam
  • uterine ultrasound
  • blood tests
  • infectious disease screening

These tests help confirm that the surrogate’s body is ready for pregnancy.

Surrogates also participate in a psychological screening.

This evaluation ensures that the surrogate:

  • understands the emotional aspects of surrogacy
  • feels comfortable with the process
  • has appropriate family support

Psychological readiness helps ensure a positive experience for both the surrogate and the intended parents.

Once screening is completed, the next step is matching with intended parents.

The matching process considers:

  • personal preferences
  • communication styles
  • expectations during pregnancy
  • geographic considerations

Many surrogates enjoy meeting the intended parents and developing a supportive relationship during the journey.

Before any medical procedures occur, legal contracts are established.

Each party typically has independent legal representation to ensure everyone fully understands the agreement.

Legal contracts clarify:

  • parental rights
  • financial arrangements
  • expectations during pregnancy
  • medical decision guidelines

This step ensures the process is transparent and legally structured.

Step 7 — IVF Preparation

After legal agreements are finalized, the fertility clinic prepares the surrogate for embryo transfer.

This process usually involves hormone medications that help prepare the uterus for implantation.

Common medications include:

  • estrogen
  • progesterone

These medications support the uterine lining so the embryo can implant successfully.

After legal agreements are finalized, the fertility clinic prepares the surrogate for embryo transfer.

This process usually involves hormone medications that help prepare the uterus for implantation.

Common medications include:

  • estrogen
  • progesterone

These medications support the uterine lining so the embryo can implant successfully.

The embryo transfer procedure is performed at a fertility clinic.

This procedure is typically quick and painless.

Doctors place the embryo inside the uterus using a small catheter.

After the transfer, the surrogate usually rests for a short period before returning home.

About 10–12 days after the embryo transfer, a blood test confirms whether pregnancy has occurred.

Once pregnancy is confirmed:

  • compensation payments typically begin
  • prenatal care appointments are scheduled
  • ongoing pregnancy monitoring starts

Throughout the pregnancy, surrogates receive regular prenatal care from their obstetrician.

Medical visits typically include:

  • routine prenatal checkups
  • ultrasounds
  • fetal development monitoring
  • health assessments

Surrogates remain supported throughout the pregnancy by both medical professionals and the surrogacy program.

At the end of the pregnancy, the surrogate delivers the baby at a hospital.

The intended parents are usually present for the birth whenever possible.

For many surrogates, this moment is the most rewarding part of the journey—seeing the intended parents finally hold their child.

Typical Surrogacy Timeline

While every journey is unique, Surrogacy4All’s physician-led matching takes ~1 month, compared with the industry’s typical 6–18 months.

Application and screening

1–3 months

Matching with intended parents

~1 month

Medical preparation and embryo transfer

1–2 months

Pregnancy

9 months

Surrogacy4All Matching Timeline: ~1 Month

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.

Who Qualifies

To become a surrogate

To become an intended parent

Any relationship status, marital status, or sexual orientation — married couples, single parents by choice, and LGBTQ+ couples are equally served. The path in is either medical (a condition that prevents carrying a pregnancy) or personal circumstance (single parents, same-sex male couples, and others for whom gestational surrogacy is simply the route to a biological child).

Roles and Responsibilities

The surrogate's role

Follows the medical protocol for the transfer cycle, attends prenatal appointments, keeps the intended parents informed as agreed in the contract, and carries the pregnancy to term. She is not genetically related to the child in gestational surrogacy — the embryo comes from the intended parents or from donor egg and sperm.

The intended parents' role

Fund the process according to the payment schedule, participate in medical decisions as outlined in the contract, attend appointments and the birth to the extent agreed, and complete the legal steps (parentage order, birth certificate, and — for international parents — citizenship and travel documentation).

Why Choose Surrogacy4All

Families choose Surrogacy4All because it has:

This comprehensive process reduces stress, optimizes success, and reassures every future parent along the way.

Ready to Start the Journey?

If you are interested in learning whether you may qualify as a surrogate, the next step is simple.

Full program details

Surrogate qualifications

Compensation information

The application process

Visit the Surrogacy4All Become A Surrogate In US

You may qualify to earn $70,000–$105,000 helping a family welcome their baby.

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.

Patient 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.

Talk to a physician-led team

Free consultation with our medical and matching team. Call (212) 661-7673, email info@surrogacy4all.com, or request a call back.

     
    Written by Pooja Patel, MD — MBBS (Seth G.S. Medical College & K.E.M. Hospital), Fellowship in Embryology; Manager, Surrogacy4All. Dr. Patel manages surrogate screening, matching and journey coordination at Surrogacy4All’s New York program.
    Medically reviewed by Rashmi Gulati, MD — Board Certified, Internal Medicine, Medical Advisor, Surrogacy4All, privileges at Mount Sinai Hospital.
    Last updated: 27 August  2026

    Surrogacy4All · DGA, Inc. · 1148 5th Ave 1C, New York, NY 10128 · (212) 661-7673 · info@surrogacy4all.com · NYS Surrogacy Program License GSP220903 · NYS Tissue Bank License ID 1570 · FDA-registered (FEI 3021544308) · Clinics in New York, Toronto and Accra.

    FAQ’s

    An embryo created by IVF is transferred to a screened surrogate under a legal contract; she carries and delivers, and a court order names the intended parents as the legal parents.

    15–18 months from consultation to birth is typical, with a realistic range of 13–20 months.

    Industry-wide, 6–18 months; physician-led agencies with a larger pre-screened pool can match in as little as a month.

    No — gestational surrogacy uses the intended parents’ or a donor’s egg. The surrogate has no genetic relationship to the child.

    Yes, subject to hospital policy and whatever you and the surrogate agreed in the contract.

    A second transfer is typically scheduled 6–8 weeks later; escrow covers the surrogate’s transfer fee for the second attempt.

    No — it’s set state by state and controlled by the surrogate’s state of residence. See the state-by-state law guide for specifics.

    Yes — served on the same terms as married couples, subject to the state-by-state legal notes above.

    The timeline varies for each intended parent. With Surrogacy4All, our physician-led matching process takes ~1 month, compared with the industry’s typical 6–18 months. After matching, medical screening, legal agreements, IVF, embryo transfer, pregnancy, and delivery add additional time to the overall journey.

    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.