Surrogacy has become one of the most important family-building options for individuals and couples who cannot carry a pregnancy on their own. Whether due to infertility, health concerns, or family circumstances, intended parents around the world increasingly turn to surrogacy as a safe and effective path to parenthood.
Although widely practiced, surrogacy can seem complex at first. The process involves medical treatments, legal protections, emotional considerations, and cultural differences depending on the country. This article provides a clear, step-by-step explanation of how surrogacy works internationally, so that intended parents and potential surrogates alike can understand the journey from first consultation to bringing a baby home.
1. What Is Surrogacy?
At its core, surrogacy is an arrangement in which a woman (the surrogate) carries and delivers a baby for intended parents. Modern surrogacy is almost always gestational, which means the surrogate has no genetic link to the child. Instead, embryos are created through in vitro fertilization (IVF) using the intended parents’ or donors’ eggs and sperm.
Two main types exist:
Gestational surrogacy: The surrogate carries an embryo created from the intended parents’ or donor gametes. She is not biologically related to the child.
Traditional surrogacy: The surrogate’s own egg is used, making her the genetic mother. This method is now rare and legally restricted in many countries.
Gestational surrogacy is considered the safest and most widely accepted model because it separates the biological and gestational roles, reducing legal and emotional complications.
2. Step One: Initial Consultation and Preparation
The surrogacy journey begins with research and consultation. Intended parents usually contact a fertility clinic or a surrogacy agency to discuss their options. During these first conversations, professionals explain the medical process, legal framework, financial considerations, and expected timeline.
Key aspects at this stage include:
Reviewing the intended parents’ medical history.
Determining whether donor eggs, donor sperm, or existing embryos will be used.
Clarifying eligibility for surrogacy in the parents’ country of residence and the surrogate’s country.
Outlining costs, insurance coverage, and payment structures.
This early step ensures that all parties enter the process with clear expectations and accurate information.
3. Step Two: Surrogate Screening and Matching
Not every woman can become a surrogate. To protect both the surrogate and the future child, strict criteria and screening are applied:
Medical screening: Evaluation of reproductive health, history of healthy pregnancies, absence of major complications, and overall physical wellness.
Psychological evaluation: Assessing emotional stability, motivations, and support networks.
Background checks: Ensuring a safe environment for pregnancy.
Lifestyle factors: Non-smoking, no substance abuse, stable living conditions.
Once approved, the matching process begins. Intended parents are paired with a surrogate based on shared values, communication preferences, and medical compatibility. The goal is to create a strong and respectful partnership.
4. Step Three: Legal Agreements
Surrogacy always involves comprehensive legal contracts to protect all parties. Each side has independent legal representation.
The contract usually covers:
Medical procedures and responsibilities.
Parental rights and intended parentage.
Financial compensation (where permitted).
Decision-making during pregnancy.
Plans for delivery and post-birth care.
The legal framework differs internationally. For example, in some U.S. states intended parents can obtain pre-birth parentage orders, while in countries like the UK or Canada parental rights are only transferred after birth. This step is crucial for ensuring security and clarity before medical procedures begin.
5. Step Four: IVF and Embryo Transfer
With legal agreements in place, the medical process begins. Most arrangements involve in vitro fertilization (IVF):
Eggs are retrieved from the intended mother or a donor.
Sperm is provided by the intended father or a donor.
Fertilization occurs in the laboratory, creating embryos.
One or more embryos are transferred to the surrogate’s uterus.
The surrogate takes hormonal medications to prepare her uterine lining, and doctors carefully monitor the process. A pregnancy is confirmed through blood tests and ultrasound.
6. Step Five: Pregnancy Management and Communication
Throughout the pregnancy, the surrogate receives regular prenatal care. Intended parents are often actively involved, attending medical appointments (in person or virtually), receiving updates, and celebrating milestones such as ultrasounds.
Many surrogacy programs emphasize open communication. Surrogates and intended parents often build strong bonds, sharing the excitement of the pregnancy together. Emotional support and counseling are available to ensure the well-being of everyone involved.
7. Step Six: Birth and Legal Parentage
The delivery is planned in advance, often with the intended parents present. Hospitals are informed about the surrogacy arrangement to ensure smooth coordination.
After birth, the baby is placed with the intended parents. The legal recognition of parentage depends on local laws:
In some jurisdictions: Intended parents’ names appear directly on the birth certificate.
In others: The surrogate is initially listed as the legal mother, and the intended parents must apply for a parental order or adoption.
Regardless of the pathway, professional guidance ensures that parental rights are secured.
8. Step Seven: Post-Birth Support
The journey does not end at birth. Post-birth steps include:
Recovery for the surrogate: Medical follow-up and emotional support.
Administrative steps: Citizenship and travel documents for the newborn in international cases.
Ongoing relationships: Some surrogates and families remain close, while others prefer formal closure.
The focus is always on ensuring a positive outcome for both the baby and all adults involved.
9. Emotional and Ethical Aspects
Surrogacy is not only medical—it is profoundly emotional. Surrogates often describe their role as an act of compassion, while intended parents experience deep gratitude and relief.
Ethical considerations include:
Ensuring surrogates participate freely and with full informed consent.
Avoiding exploitation, especially in international arrangements.
Providing fair compensation where legal.
Offering psychological support for both surrogates and intended parents.
When done responsibly, surrogacy reflects a partnership built on trust, respect, and shared goals.
10. International Perspectives
Surrogacy laws and practices vary globally:
United States: Legal in many states with well-defined frameworks; compensated surrogacy allowed.
Canada and UK: Only altruistic surrogacy permitted; parental rights confirmed after birth.
Ukraine, Georgia, and other countries: Historically popular for international surrogacy (with compensation), though regulations evolve.
Western Europe (France, Germany, etc.): Surrogacy banned entirely.
These differences mean intended parents must research carefully and work with experienced clinics or agencies to ensure compliance and protect all parties.
11. Voices from Surrogates and Parents
Hearing real experiences helps humanize the process:
Surrogates often say they felt “called” to help others after completing their own families.
Intended parents describe the first moments with their baby as “life-changing and overwhelming.”
Both sides frequently build lasting friendships, united by the journey they shared.
These stories remind us that surrogacy is not only about medical success but also about human connection.
Conclusion and Call to Action
Surrogacy is a carefully structured journey that combines science, law, and compassion. From the first consultation to the joy of holding a newborn, each step is designed to ensure safety, clarity, and emotional support.
For intended parents, understanding the process provides confidence and reassurance. For potential surrogates, it highlights the preparation and purpose behind such an extraordinary decision.
👉 If you are considering surrogacy—whether as intended parents or as a surrogate—contact our clinic today. Our experienced team is here to answer your questions, guide you through every step, and support you in building the family you dream of.