How Does Surrogacy Work? Explaining the Gestational Surrogacy Process

Surrogacy works by having a gestational carrier (the surrogate) safely carry and deliver a baby for intended parents through a carefully structured medical and legal process. Today, surrogacy is more transparent, regulated, and medically advanced than ever before, but it's still normal to have questions about what to expect. 

In this guide, we'll walk you through the gestational surrogacy process from start to finish, including how matching works, what is involved medically, how legal and financial protections come into play, and how agencies support the emotional side of the experience. By the end, you'll have a clear, step-by-step understanding of how surrogacy turns the dream of parenthood into reality.

What Is Surrogacy? 

Surrogacy is a form of assisted reproduction in which a woman, called a gestational surrogate, bears a child for another person or couple, referred to as the intended parents. The gestational surrogacy process, the most common type of surrogacy today, involves the surrogate becoming pregnant via in vitro fertilization (IVF) using an embryo created by the intended parents and/or donors’ sperm and egg. The surrogate is not genetically related to the baby she carries since her eggs are not used in the process.

The Gestational Surrogacy Journey

Surrogacy is a complex, yet deeply meaningful and life-changing experience. While some intended parents and surrogates might pursue the process independently, a full-service agency like Circle offers invaluable support, knowledge, resources, and guidance along the way.

Getting Started With an Agency

For intended parents wanting to grow their family through surrogacy, they will typically begin by choosing an agency. If you choose Circle, you will meet with our team, sign our service agreement, and join an introductory call. 

We'll help you choose or connect with an IVF clinic and guide you through finding an egg donor if needed. We will also be here to support you during the creation of your embryos. Once you enroll, one of our Matching Specialists will work closely with you to prepare you for the surrogate-matching stage.

For women interested in becoming a surrogate, you’ll begin the surrogacy process by choosing an agency and completing an application. At Circle, once we have reviewed a surrogate's application and determined that they are a good candidate, we will grant them access to our Surrogate Portal, connect them with a dedicated Surrogate Advisor, and have their medical records and background checks completed. Throughout the prescreening process, one of our advisors will educate you on what to expect and prepare you for matching with intended parents. 

This initial prescreening process is immediately followed by a surrogacy consultation and more screenings. Our surrogates complete psychological testing, connect the Circle team with their primary support person, and complete a 3-step screening process to make sure surrogacy is the right fit for them. 

Matching 

This exciting stage connects intended parents with a carefully vetted surrogate through our thoughtful MatchMade™ process, which has yielded thousands of successful matches. Once you have successfully matched, our dedicated team helps both parties understand the process and supports each person throughout the surrogacy process.

Medical and Legal 

Following the match, the surrogate will undergo medical screening at the intended parents' IVF clinic with their doctor. This trip and its expenses are covered by the intended parents.

The legalities of the surrogacy process will also be finalized during this time. The surrogate will work closely with their legal counsel and finalize the Carrier Agreement (contract), which will be completed with the intended parents' lawyer. This contract outlines the surrogacy journey, including the number of transfers, compensation, parental rights, and more. 

Embryo Transfer 

After the contracts are complete, the surrogate will begin medications to prepare her body for the embryo transfer. She will attend monitoring appointments, which consist of bloodwork and ultrasounds, at her local clinic or physician's office. When the doctor has determined her body is ready, she will travel to the intended parents' IVF clinic to undergo the embryo transfer. This is usually a 4 to 7-day trip.

Intended parents may attend this milestone in person and spend meaningful time with their surrogate and her support person. After the transfer, the surrogate will return home for local beta hCG tests until her pregnancy is confirmed (about 10 to 14 days). Around 6 weeks after the transfer, she will have an ultrasound to confirm the heartbeat and will be released to the care of her OB/GYN at around 10 weeks to continue care until delivery.

Pregnancy

Pregnancy is an exciting time for both the gestational surrogate and the intended parents, and this is a great time for you to deepen your relationship through weekly updates and shared photos and videos.

Intended parents can support their surrogate by joining her for medical appointments and ultrasounds or creating a birth plan together. The pregnancy is also a nice time for intended parents to prepare their baby's nursery.  

Post-birth and Parenthood

After she delivers the baby, the surrogate will witness the beautiful moment her intended parents meet their child for the first time. She has now entered the final stage of the gestational surrogacy journey: post-birth. Surrogates should embrace the fourth trimester with care, taking time for their bodies to heal, reconnecting with family, and adjusting to daily life while reflecting on the incredible gift they've given. 

After an emotional journey, intended parents get to hold their baby for the first time. We advise all new parents to really soak up every moment. When the baby is discharged from the hospital's care, it's time for the intended parents to take their baby home. Your Circle support team will be there to guide you through these early days, remind you of any tasks to be completed, and answer any questions you may have. 

It can be difficult for the intended parents and their surrogate to say goodbye to one another, but this doesn't have to be a forever goodbye! In fact, many of our surrogates and parents continue their friendship beyond the birth of the baby. Each set of intended parents and their surrogate will find the right level of relationship that works for them. There is no one correct answer. 

Why Choose Surrogacy at Circle?

Circle Surrogacy is the only true full-service surrogacy agency. We have an internal team of finance, legal, mental health, and insurance specialists that provide coordinated and comprehensive support without the risk of low-quality, third-party services. 

Since 1995, Circle has helped bring over 4,000 babies into the world, growing more than 3,400 families across the world. Our team deeply understands your journey since many of us have been in your shoes! In fact, nearly 50% of Circle's staff are experienced surrogates, egg donors, or parents through surrogacy, IVF, or adoption. 

We are committed to each and every gestational surrogate and intended parent, supporting everyone from start to finish. Mental health professionals are assigned to every case, and we offer support groups customized to all types of families. 

We are always available to speak with you about our experiences, surrogacy options, and programs or just to answer questions. Contact Circle today to get started—we're happy to help!