The Surrogacy Medical Process: Step-by-Step Guide for Intended Parents

If you’re considering surrogacy, the medical process can feel overwhelming at first. There are screenings, appointments, medications, legal steps and a lot of new terminology.

At its core, though, the surrogacy medical process follows a clear path. Each step is designed to protect everyone involved while giving you the best possible chance of a healthy pregnancy.

In this guide, we’ll break down the medical process into clear steps, explain what risks you should be aware of and cover the overall timeline. If you have questions, you can fill out our short contact form for more information.

What Is the Surrogacy Medical Process?

The medical process for surrogacy is the series of steps that lead to your surrogate becoming pregnant and carrying your baby.

In gestational surrogacy, the embryo is created through in vitro fertilization and then transferred to your surrogate’s uterus. She is not genetically related to the baby.

The process typically unfolds in five main stages:

Step 1. Comprehensive Medical Screening for the Surrogate

Before a match is finalized, a potential carrier must undergo surrogate medical screening. This step is designed to ensure her safety and give you the best chance of a successful pregnancy.

First, your fertility clinic will review her previous pregnancy and delivery records to ensure she has a history of healthy, uncomplicated births.

Next, she will visit your fertility clinic for an in-person medical clearance appointment. The medical tests that surrogates have to pass include a saline infusion sonohysterography or hysteroscopy to ensure the uterus is free of scarring, as well as hormone testing and infectious disease screening.

It’s better to find any issues now than to risk an unsuccessful transfer later. This process protects your embryos and your emotional investment.

What “Pre-Screened Surrogates” Really Means

Many intended parents assume screening only begins after a match. In reality, reputable surrogacy agencies like American Surrogacy conduct rigorous pre-screening before introducing you to a potential surrogate.

Pre-screening typically involves early background checks, psychological evaluations and medical record reviews. This helps identify candidates who are most likely to receive final clinic clearance.

Step 2. Preparing the Surrogate for Embryo Transfer

Once cleared, the focus shifts to the embryo transfer for surrogacy. The surrogate’s natural cycle is often suppressed so the clinic can control her hormone levels and time the implantation window.

This preparation involves two key medications:

• Estrogen: Administered via pills, patches or injections to thicken the uterine lining
• Progesterone: Usually started a few days before transfer (often via intramuscular injection) to support the early pregnancy

Throughout this stage, the surrogate attends monitoring appointments for bloodwork and ultrasounds to check the lining. Your agency will coordinate communication between you, your fertility clinic and your surrogate so everyone is on the same page. The best agencies also offer financial protection for canceled or delayed cycles.

Step 3. Embryo Transfer and the Two-Week Wait

The embryo transfer is a quick, non-surgical procedure where the doctor uses a thin catheter to place the embryo into the surrogate’s uterus. Most surrogates describe the sensation as similar to a pap smear: uncomfortable but not painful.

Following the transfer is the two-week wait. This is the period before a blood pregnancy test (beta hCG) can confirm the pregnancy. If the test is positive, the surrogate will have early ultrasounds at the fertility clinic to confirm a fetal heartbeat.

You may feel anxious waiting for the results. If you work with an agency, you’ll have an experienced professional by your side to provide emotional support and guide you through each step of the surrogacy medical process.

What Happens if Embryo Transfer Fails?

If the embryo transfer fails, your medical team will review the cycle to see if adjustments to the medication protocol are needed for the next attempt.

During this time, your surrogacy agency’s support can make a difference. If a transfer doesn’t work, they can help you understand your next steps, whether that’s trying again or considering a rematch.

Step 4. Pregnancy Confirmation and Early Monitoring

Once the surrogate pregnancy is stable, the surrogate will “graduate” from the fertility clinic to her local OB-GYN. From this point on, what happens during a surrogate pregnancy is very similar to a traditional pregnancy.

How involved are intended parents in the medical process? Even if you’re far away, you’re still very much involved. You’ll receive regular updates from the clinic, and most intended parents attend major appointments either in person or by video.

Behind the scenes, your surrogacy agency helps coordinate communication, insurance and other logistics so you don’t have to manage every detail yourself.

Step 5. Surrogate Labor and Delivery

As the due date approaches, you’ll create a surrogacy birth plan with your surrogate. This document outlines who will be in the delivery room, who will hold the baby first and how the hospital staff should handle the birth.

Knowing what to expect at the hospital when your surrogate gives birth can alleviate day-of stress. Your agency will share this plan with the hospital’s social work and labor departments in advance. The staff will know that you are the child’s parents when you arrive.

What Medical Risks Should Intended Parents Be Aware Of?

As with any pregnancy, there are potential medical risks. For instance, a transfer may not result in pregnancy, or the surrogate may experience complications like gestational diabetes or preeclampsia.

However, these risks are reduced through careful medical screening. Surrogates are thoroughly evaluated by fertility clinics before being granted medical clearance, and they follow strict reproductive medicine standards throughout the process.

Surrogacy agencies also plan ahead. Contracts and escrow arrangements typically outline what happens if another transfer is needed or if a complication arises. Having a clear plan in place can help you feel more confident.

How Long Does the Surrogacy Medical Process Take?

Here’s a general breakdown of the timeline for the medical process for surrogacy:

Some variability is normal. Delays can happen due to insurance approvals, the need for more than one transfer attempt or the timing of the surrogate’s natural cycle.

Why Medical Coordination Is Easier With an Experienced Surrogacy Agency

Managing the medical, financial and emotional details of surrogacy on your own can quickly become overwhelming.

Experienced surrogacy agencies like American Surrogacy help streamline the process and reduce unnecessary stress by offering:

• Pre-screening to ensure your surrogate has the highest chance of passing your clinic’s medical clearance
• Established fertility clinic relationships, helping you find a provider that fits your needs
• Financial protection if a screening fails or a miscarriage occurs
• Escrow oversight, paying medical bills and surrogate reimbursements on time

Having an expert advocate by your side throughout the surrogacy medical process ensures that you’re never navigating things alone. If you have questions or want to connect with a reputable surrogacy agency, fill out our form today.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice, diagnosis or treatment. Always seek the advice of a licensed healthcare provider with any questions you may have regarding a medical condition or procedure.