Surrogacy is one of the most beautiful yet complex paths a person or couple can take when growing their family. For many, this option comes after a long journey through infertility, health concerns, or the recognition that they need assistance to bring a child into the world. While surrogacy offers hope, it is also an intricate process involving medical, emotional, financial, and legal layers. It can feel overwhelming for intended parents, especially at the beginning, when there are so many unknowns.

That’s why today I want to take a step back and explain, in plain terms, how surrogacy works. This post is designed to set realistic expectations, help you understand the surrogacy process step by step, and offer insight into whether this path could be right for you.

How Does Surrogacy Work

What to Expect From This Post?

If you’re new to surrogacy, you may have a mix of excitement and anxiety. You may be wondering:

How do we start finding a surrogate?
What’s the difference between traditional surrogacy and gestational surrogacy?
How much will it cost?
How long will the process take before we can hold our baby?

This post will walk you through all of that and more. By the end, you’ll have a clear picture of what’s involved, who qualifies, and what milestones you can expect along the way. Surrogacy isn’t the right fit for everyone, but understanding the process will help you make the best decision for your family.

Who Is Eligible For Surrogacy

Not everyone can pursue surrogacy, but many people qualify. Here are some of the most common groups who turn to surrogacy as a way to grow their families:

Couples who have experienced infertility and cannot carry a pregnancy to full term
Women with medical conditions that make pregnancy dangerous or impossible
Same-sex couples, usually male partners, who need someone to carry and deliver the baby

How Surrogacy Works

The surrogacy process involves several important steps. Each stage has a purpose, and understanding them will help you feel more confident as you move forward.

Decide Between Traditional Surrogacy and Gestational Surrogacy

In traditional surrogacy, the surrogate provides her own egg, meaning she is biologically related to the baby. This type of surrogacy is far less common today because of the emotional and legal complexities.

In gestational surrogacy, an embryo is created through IVF using the intended parents’ or an egg or sperm donor’s egg and sperm. The embryo is then placed into a gestational surrogate, who carries and delivers the baby but has no genetic connection. The American Society for Reproductive Medicine recommends gestational surrogacy as the standard of practice, and most surrogacy agencies today exclusively work with this model.

Work With a Surrogacy Agency or Go Independent

Most people choose to work with a surrogacy agency because of the complexity of the process. An agency is responsible for recruiting or finding a surrogate, screening her medically and psychologically, and guiding both parties through the journey. Some families choose an independent route, but that can increase risks and require more work from intended parents.

Matching and Medical Screening

Before any agreements are signed, both the intended parents and the potential surrogate undergo medical and psychological evaluations. The surrogate is screened to ensure she is healthy enough to carry a pregnancy to full term, while the intended parents may undergo fertility assessments as well as a psychological consult.

Once a match is made, the two parties build a relationship, discuss expectations, and prepare for the next step.

Legal Agreements

Legal protection is one of the most important parts of surrogacy. Attorneys draft legal agreements that outline each party’s rights, responsibilities, and expectations. This ensures clarity on issues like parental rights, medical decisions, compensation, and what happens if complications arise. These contracts are crucial for protecting the surrogate, the intended parents, and—most importantly—the baby.

Embryo Transfer Through IVF

The medical process begins with in vitro fertilization (IVF). An embryo is created using the eggs and sperm of the intended parents or donors. This embryo is then placed into the gestational surrogate through a procedure called embryo transfer. With luck, the embryo implants, and the surrogate begins her pregnancy journey.

Pregnancy and Support

Throughout the pregnancy, the surrogate is supported by her medical team, the surrogacy agency, and often the intended parents themselves. Regular checkups, ultrasounds, and communication ensure everything is progressing as it should. This phase requires patience, trust, and care for everyone involved.

Delivery and Bringing Baby Home

At the end of the journey, the surrogate will deliver the baby. The intended parents are usually present at the birth, ready to hold their child for the first time. This is the culmination of months—often years—of planning, waiting, and hope.

How Long Does The Surrogacy Process Take

The timeline for surrogacy varies, but most intended parents can expect the process to take 15 to 24 months from the moment they sign with a surrogacy agency to the time they bring their baby home. Here’s a rough breakdown:

Matching with a surrogate: 1–6 months (sometimes longer depending on preferences and availability)
Medical and legal: 2–4 months
Embryo transfer and achieving pregnancy: 1–3 months (sometimes multiple attempts are needed)
Pregnancy itself: about 9 months to full term

Delays can occur due to failed transfers, medical clearances, or legal complexities, but many intended parents find that the time investment is worthwhile once they hold their baby in their arms.

Additional Considerations: Cost, Emotional Journey, and Resources

The cost of surrogacy can be significant, typically upwards of $150,000 in the United States. This includes medical expenses, surrogate compensation, agency fees, and legal costs. It’s an investment, but for many families, it’s the only way to realize their dream of parenthood.

Surrogacy is also an emotional journey. Both the surrogate and the intended parents must navigate expectations, hopes, and the realities of assisted reproduction. A strong relationship between all parties makes the process more fulfilling and less stressful.

If you’re looking to deepen your understanding, I recommend checking out this post on great books on surrogacy for stories and perspectives from families who have gone through the process.

Surrogacy is an extraordinary option for building a family. It brings together science, law, and deep human connection to make parenthood possible for people who otherwise might not have that opportunity. While it can be complicated, overwhelming, and costly, many intended parents describe it as the most rewarding journey of their lives.

By understanding how surrogacy works, who is eligible, the steps involved, and how long it takes, you can make a more informed decision about whether this path is right for you.

How Does Surrogacy Work?