The Surrogacy Process for Intended Parents

by | Mar 22, 2023 | Donor

How the gestational carrier process works

We’ve written this article on the gestational carrier (sometimes referred to as surrogacy)  process for intended parents as a guide for what to expect. Gestational surrogacy is a beautiful path to parenthood that comes with its own unique considerations. If you’re planning to pursue surrogacy, here are the broad overall steps to the process.

What Is Gestational Surrogacy?

Pregnancies require an egg, sperm, and a uterus. For intended parents who are unable to carry a pregnancy themselves, a gestational carrier carries a child through pregnancy on behalf of an individual or couple.

There are two types of surrogacy: gestational surrogacy and traditional surrogacy. At Pacific NW Fertility, we provide support to intended parents and gestational carriers through gestational surrogacy, in which the person carrying the pregnancy does not share a genetic connection to the baby. In these cases, the embryo uses eggs and sperm from the intended parent(s) or a donor, and a separate person receives the embryo through in vitro fertilization (IVF). Medically, the person carrying the pregnancy is called a “gestational carrier.” However, as most patients are more familiar with the term “surrogate,” we will use that in this article. In fact, nearly all fertility clinics only work with gestational carriers, even though they may use the term “surrogate.” You can read more on the differences between gestational and traditional surrogacy here.

Decide On the Type of Surrogate

Broadly speaking, surrogates can either be someone you know (a friend or family member) or someone you find through a surrogacy agency. Each arrangement has its own pros and cons. Working with a friend or family member can provide closeness and access during the pregnancy. However, there are additional emotional and legal considerations with this kind of arrangement. In addition, each state (and country) has its own laws regarding surrogacy agreements, payments, and necessary legal steps. Regardless of your type of surrogacy, we strongly recommend working with a knowledgeable surrogacy expert to help navigate your journey. At PNWF, we have a dedicated team at our Center for Collaborative Reproduction that provides insight and care. We can also recommend surrogacy agencies and legal experts.

Matching & Medical Clearance

If you work with an agency, you will most likely go through a matching process where you meet with surrogate candidates to find a good fit. Surrogacy requires an open and communicative relationship between the intended parents and the surrogate, so it’s important that everyone feels on the same page about working together.

Once you have chosen a surrogate, whether previously known or through an agency, they will need to pass certain medical requirements to make sure they can safely experience surrogacy.

Sign Surrogacy Agreements

At PNWF, we require patients going through the surrogacy process to have a legal surrogacy agreement, written with legal representation, whether or not your surrogate is a friend or family member. The agreement should cover compensation, any additional benefits provided (such as a stipend for maternity clothes or child care), details about communication and requests during the pregnancy, what to do in case of unexpected complications, and more. This contract covers parental rights, protects everyone involved, and allows for easier communication and flexibility during the pregnancy.

Embryo Development & Transfer

Once you complete all the medical and legal logistics, it’s time for the surrogate to become pregnant. Your fertility clinic will develop embryos using eggs and sperm from the intended parents and/or donors. The surrogate then goes through a minor procedure called an embryo transfer, in which a fertility doctor typically transfers one mature embryo into the surrogate’s uterus. The clinic will confirm if the embryo implants and develops into pregnancy with a blood test two weeks after the transfer.


Pregnancy is an exciting time! Depending on your surrogacy agreement, you may attend some or all prenatal appointments with your surrogate, such as to hear the fetal heartbeat or see the first ultrasound. Some intended parents find other ways to be involved with the pregnancy. One idea involves providing a recording of you speaking, singing, or reading a book for the surrogate to play for the developing baby, so they can hear their parents’ voices. This is also a great time to make sure your home is all ready to welcome a baby into your lives.

Labor & Delivery

Surrogates choose the hospital where they will give birth (although you may be a part of this decision). This ensures that they have a hospital near them for quick and easy access. If the surrogate agrees, many intended parents choose to attend their child’s birth and share in the joyful experience. You or your agency should provide the hospital with a birthing plan, designed and agreed on by you and your surrogate, with legal input. Depending on your state’s laws, you may need to receive an additional birth or parental order before or immediately after the baby’s birth to receive full legal parental rights. Becoming new parents is exciting – and as with all new parents, your medical team will provide next steps from what to expect, discharging from the hospital, and beyond.

PNWF Offers Expert Surrogacy Services

Surrogacy offers some couples a unique and meaningful path to parenthood. The surrogacy process can take a long time, but the outcome is well worth it. For more information about becoming a parent through surrogacy, contact us today.