How to Approach the Surrogacy Process

Let me be real with you for a hot sec about surrogacy. It's absolutely incredible: this amazing process where someone carries a baby and gives birth for a couple or individual who can't do it themselves. The ULTIMATE out of body experience. But holy shit, can it seem overwhelming and complicated when you're staring down this path for the first time.

I've been there. Twice, actually. And after navigating two different (and semi-overlapping!) surrogacy journeys complete with miscarriages, NICU stays, and all the emotional rollercoaster rides you could imagine, I'm here to break down exactly how you can approach the surrogacy process without losing your mind in the process. Because trust me, there's already enough to stress about without feeling completely lost from day one.

How to Approach the Surrogacy Process

I get it: trying to understand how surrogacy actually works and what the process looks like can feel like trying to decode some secret medical language that no one bothered to teach you. But when you actually understand the steps involved and what to expect, you can approach this whole journey with way more confidence and a lot less panic.

In this post, I'm going to walk you through everything you need to know about the surrogacy process. I’ll be outlining what surrogacy actually means (spoiler alert: there are different types), how the whole thing works from start to finish, realistic timelines (because whoever told you this would be quick was lying), and my best tips for navigating it all without completely losing your shit. By the end of this, you'll have a clear roadmap instead of feeling like you're stumbling around in the dark.

What Is Surrogacy

Surrogacy is when another person (called a gestational surrogate or traditional surrogate, depending on the type) carries and delivers a baby for someone else: the intended parents. It's basically the ultimate act of generosity when you really think about it.

There are two main types of surrogacy, and this distinction is crucial because it affects everything from the medical procedures involved to the legal implications:

Gestational surrogacy is the most common type these days. This is where the surrogate carries an embryo that was created through IVF using the egg and sperm from the intended parents (or sometimes an egg and/or sperm donor if needed). The gestational surrogate has no genetic connection to the baby - she's essentially the world's most amazing babysitter for nine months. The embryo transfer happens at a fertility clinic, and from there, it's a regular pregnancy (well, as regular as any pregnancy involving multiple people, lawyers, and a shit ton of paperwork can be).

Traditional surrogacy is less common now, but it's when the surrogate's own egg is used, so she is biologically related to the baby. This obviously makes things more emotionally and legally complex, which is why most people go the gestational route.

The whole process involves way more people than just the intended parents and surrogates. You've got fertility clinics, surrogacy agencies (if you choose to work with one), lawyers, insurance companies, and mental health professionals all playing their part. It's like assembling the world's most expensive and emotionally invested team.

How Does The Surrogacy Process Work

Okay, let's break this down step by step because the surrogacy journey has more moving parts than a piece of IKEA furniture (and is infinitely more stressful):

Step 1: Finding a Surrogate

This is where the magic begins (and where you may choose to enlist my help!). Traditionally, you can work with surrogacy agencies (which I highly recommend as they handle so much of the logistical burden), find someone independently (surrogacy Facebook groups…IYKYK), or even work with someone you already know. As you think about where to find your surrogate, you’ll also want to start crafting a list of criteria for your search. You will want to look for someone who's had successful, uncomplicated pregnancies before, someone who is in overall good health, and honestly, someone you can genuinely connect with because you're about to go through something pretty intense together.

Step 2: Medical and Psychological Screening Process

Before anyone gets pregnant with anyone's baby, there's a thorough screening process for both intended parents and potential surrogates. The American Society for Reproductive Medicine has guidelines that most fertility clinics follow in terms of what is required for all parties. This includes medical exams, psychological evaluations, background checks, and more bloodwork than you ever thought possible. Everyone involved needs to be physically and emotionally ready for this journey.

Step 3: Legal Contracts and Agreements

Get a good lawyer. No, seriously. Get a REALLY good lawyer who specializes in Assisted Reproductive Technology Law. The contracts cover everything from medical decisions during the surrogate pregnancy to what happens if there are complications. Both the intended parent and the surrogate need separate legal representation. It's not romantic, but it's absolutely necessary.

Step 4: Medical Procedures and Embryo Transfer

If you're doing gestational surrogacy, this usually involves IVF. The intended mother (or egg donor) goes through ovarian stimulation and egg retrieval. The intended father provides sperm (or you use a sperm donor). The embryos are created in the lab, and then comes the embryo transfer to the surrogate. This part happens at fertility clinics with reproductive medicine specialists who know what they're doing.

Step 5: Pregnancy Management and Birth

Once the surrogate is pregnant (fingers crossed it works on the first try, but don't count on it), you're managing a pregnancy that's happening in someone else's body. Regular check-ups, communication about decisions, and preparing for the birth (including making sure the hospital knows the intended parents will be taking the baby home, not the surrogate) are all part of the process.

How Long Does The Surrogacy Process Take

Here's where I might burst your bubble a little bit. If someone told you surrogacy would be a quick solution after years of fertility struggles, they were either lying or had never actually been through it themselves.

Realistically, you're looking at 12-24 months from start to finish, and that's if everything goes smoothly (which, spoiler alert, it rarely does). Here's the breakdown:

Finding the right surrogate can take anywhere from 1-6 months if you're working with a concierge service or an agency with quick matching, or upwards of 12 months if you're stuck on waitlists at popular agencies that doctors typically recommend first. The legal process adds another 1-2 months. Medical procedures, including potential multiple embryo transfer attempts, can add several more months. And then, of course, there's the actual pregnancy - another 9 months if you're lucky enough to go full term.

But here's what no one tells you: the timeline isn't just about the medical stuff. It's about finding the right match, building trust, navigating the emotional complexity, and honestly, just getting all the logistics to align. Some intended parents I work with have been pleasantly surprised by shorter timelines, while others have faced delays they never saw coming.

The key is managing your expectations while also being strategic about how you approach the process. This isn't something you want to rush, but there are definitely ways to be smarter about it (more on that below).

How To Go About Surrogacy Process

Alright, here's where I'm going to share the strategies that can actually make a difference in your surrogacy journey:

Do Your Research Before You Do Anything Else

I cannot stress this enough: educate yourself about the entire process before you make any major decisions. Understand the difference between gestational surrogacy and traditional surrogacy. Learn about what the American Society for Reproductive Medicine recommends. Research different fertility clinics in your area and their success rates. Know what questions to ask surrogacy agencies before you sign any contracts. Talk. To. A. Lawyer. First.

The intended parents who struggle most are usually the ones who jump in without understanding what they are getting into. Don't be those people. Take the time to understand the medical aspects, legal implications, and financial commitments upfront.

Cast a Wide Net When Finding a Surrogate

Here's some insider knowledge: many agencies that fertility clinics initially recommend are wonderful, but they often have waitlists of 12-18 months. That's an eternity when you already feel behind in your family building goals.

Instead of putting all your eggs in one basket (pun intended), consider working with a concierge service or consultant who has access to surrogates at many agencies. I personally work with a network of agencies that I've vetted through my own experience and can help intended parents find matches much faster than traditional timelines.

Build Your Team Early

You're going to need more than just a surrogate and a fertility clinic. Start identifying and vetting your team early: reproductive lawyers, insurance specialists, mental health professionals who understand surrogacy, and yes, maybe even a concierge service (shameless plug, but seriously lmk if you wanna chat!). Having your team in place before you need them eliminates stress and delays later.

Prepare Financially (And I Mean Really Prepare)

Surrogacy is expensive. Like, really fucking expensive. We're talking upwards of $150,000+ expensive depending on your situation. But beyond the obvious costs, there are hidden expenses that can pop up: additional medical procedures, legal complications, insurance gaps, travel costs if your surrogate lives far away, and potential multiple attempts.

Have a clear financial plan and probably add a 20-30% buffer because something unexpected will come up. Consider talking to a financial advisor who understands fertility treatments and surrogacy costs.

Manage Your Expectations About Control

This is a hard one for type-A personalities like myself (hi, fellow control freaks!). You are not in control of this process in the way you might expect. Your surrogate is growing your baby, making daily decisions about what she eats and how she exercises, and ultimately, her body will dictate the timeline.

The intended parents who thrive are the ones who can balance being engaged and informed with trusting their surrogate and the process. Build a good relationship with your surrogate, communicate openly, but also accept that some things are simply out of your hands.

Don't Go It Alone

The isolation during fertility struggles is real, and surrogacy can amplify that feeling because it's less common and more complex than other treatments. Connect with other intended parents who have been through this. Join support groups. Work with professionals who understand the emotional complexity.

I've seen too many intended parents try to white-knuckle their way through this process alone, and it's so much harder than it needs to be. There are people who can help - use them.

Advocate for Yourself

Here's something I learned the hard way: not all fertility clinics, agencies, or professionals are created equal. Some have more experience with surrogacy than others. Some are more transparent about costs and timelines. Some are better at managing the emotional aspects of the journey.

Don't be afraid to ask tough questions, get second opinions, or even switch providers if something doesn't feel right. You're paying a lot of money for these services, and you deserve to work with people who are truly experts in surrogacy, not just fertility treatments in general.

The surrogacy process doesn't have to be as overwhelming as it initially seems, but it does require strategy, preparation, and the right support system. As someone who has been through this journey twice as an intended parent and now helps other families navigate it professionally, I can tell you that the difference between a nightmare experience and a manageable one often comes down to how you approach it from the beginning.

If you're considering surrogacy and want guidance from someone who has actually been there, I'd love to talk. My concierge service is designed to bridge the gaps in the surrogacy experience and help intended parents find their perfect surrogate match quickly, while providing the transparent, personalized support that's so desperately needed in this process.