How Does Surrogacy Work? A Step-by-Step Guide

Sometimes the dream of becoming a parent does not follow a traditional path. Surrogacy offers another beautiful way forward, one made possible through compassion, collaboration, and the shared hope of creating a family.

Although the surrogacy process can feel complex at first, you do not have to navigate it alone. With the right information and an experienced support team beside you, each stage can become clearer and more manageable.

In this guide, we’ll explain what surrogacy is, how the process works, and how intended parents can find the right gestational surrogate for their journey.

What Is Surrogacy?

Surrogacy is a family-building process in which a woman, known as a gestational carrier or surrogate, carries and gives birth to a baby for another person or couple.

The person or couple who will become the child’s parent or parents are known as the intended parents (often referred to as IPs).

There are two primary types of surrogacy: gestational surrogacy and traditional surrogacy.

Gestational Surrogacy

Gestational surrogacy is the most common type of surrogacy today.

Through in vitro fertilization, or IVF, an embryo is created using an egg from an intended mother or egg donor and sperm from an intended father or sperm donor.

The embryo is then transferred to the gestational surrogate’s uterus.

Because the surrogate’s own eggs are not used, she has no genetic (biological) connection to the baby she carries (she does not share any DNA with the baby).

Traditional Surrogacy

In traditional surrogacy, the surrogate’s own egg is fertilized, typically through intrauterine insemination, or IUI.

This means the traditional surrogate is genetically related to the baby.

Traditional surrogacy is less common and may involve additional legal and emotional considerations.

For this reason, most professional surrogacy programs focus exclusively on gestational surrogacy.

Altruistic vs. Compensated Surrogacy

Gestational surrogacy arrangements may also be described as either compensated or altruistic.

Compensated Surrogacy

In a compensated surrogacy arrangement, the surrogate receives financial compensation in recognition of the time, commitment, physical demands, and responsibilities involved in the journey.

The intended parents also cover approved pregnancy-related expenses, medical costs, insurance, legal services, and other expenses outlined in the surrogacy agreement.

Most surrogacy journeys coordinated through Giving Tree Surrogacy are compensated arrangements.

Altruistic Surrogacy

In an altruistic surrogacy arrangement, the surrogate does not receive base compensation.

She may still be reimbursed for approved medical, legal, travel, and pregnancy-related expenses.

An altruistic surrogate is often a close friend or family member of the intended parents who has chosen to help them build their family.

Regardless of the arrangement, every surrogate should have independent legal representation, appropriate medical screening, and emotional support throughout the journey.

How Does the Surrogacy Process Work?

Surrogacy is a carefully coordinated journey that brings together medical care, legal protection, emotional support, and meaningful human connection.

While some intended parents consider navigating the process independently, working with a full-service surrogacy agency can provide greater clarity and peace of mind.

An experienced agency helps coordinate the many professionals involved, keeps important milestones on track, and ensures both intended parents and surrogates feel informed and supported.

Every journey is unique. Giving Tree Surrogacy currently advises intended parents that the process commonly takes approximately 18 to 24 months or longer, depending on factors such as embryo readiness, surrogate availability, medical circumstances, legal requirements, and personal preferences.

Here is a general look at the surrogacy process.

1. Choosing a Surrogacy Agency

Your journey begins by completing an intended parent application and speaking with a surrogacy professional about your goals, preferences, and family-building needs.

During your initial consultation, you can learn about available programs, estimated costs, the matching process, legal considerations, and the support you will receive.

Giving Tree offers complimentary, no-obligation consultations and can also assist intended parents who need an egg donor.

2. Selecting an IVF Clinic

Intended parents who have not already chosen a fertility clinic will select an IVF clinic and reproductive endocrinologist.

The clinic will guide the embryo-creation process, coordinate medical testing, screen the surrogate, prepare her for embryo transfer, and monitor the early stages of pregnancy.

3. Matching With a Surrogate

Finding the right surrogate is one of the most meaningful parts of the journey.

At Giving Tree Surrogacy, intended parents and surrogates are matched through the HEART Matching Process.

This structured approach considers alignment, expectations, communication preferences, values, and shared goals—not simply availability.

A thoughtful match helps create a strong foundation for a respectful and supportive relationship throughout the pregnancy and beyond.

4. Completing Medical and Legal Requirements

After both parties agree to move forward together, the surrogate completes medical screening through the intended parents’ fertility clinic.

The intended parents and surrogate will also work with separate attorneys who are experienced in assisted reproductive technology law.

These attorneys negotiate and finalize the gestational carrier agreement, which outlines everyone’s rights, responsibilities, expectations, compensation, and protections.

Depending on the circumstances and jurisdiction, the legal team will also complete the necessary steps to establish the intended parents’ parental rights.

5. Embryo Transfer and Pregnancy

Once medical and legal clearance have been completed, the fertility clinic prepares the surrogate for embryo transfer.

If the transfer results in a confirmed pregnancy, the surrogate will initially be monitored by the fertility clinic.

She will later transition to an obstetrician for routine prenatal care.

Throughout the pregnancy, intended parents may stay connected by attending appointments in person or virtually, joining ultrasound visits, discussing the birth plan, and preparing to welcome their baby.

Giving Tree believes that the relationship between intended parents and their surrogate is at the heart of the journey.

Open, respectful communication can help that relationship grow into a meaningful connection.

6. Preparing for Delivery

As the due date approaches, the intended parents, surrogate, agency, attorneys, and hospital will coordinate the details of the birth.

A thoughtful birth plan may address who will be present during delivery, how the intended parents will participate, hospital arrangements, communication preferences, and plans for the surrogate’s post-birth care.

Your agency team will help ensure that everyone understands what to expect.

7. Welcoming Your Baby Home

The moment you meet your baby is the beginning of an entirely new chapter.

After the birth, your legal and agency teams will help coordinate the remaining hospital, parentage, insurance, travel, and discharge arrangements.

Giving Tree continues supporting intended parents and surrogates as they transition into life after the journey.

How Do Intended Parents Find a Surrogate?

Intended parents generally have three ways to find a gestational surrogate:

1. A friend or family member offers to carry the pregnancy.

2. A surrogacy agency matches them with a qualified candidate.

3. They connect with a potential surrogate through an online forum, social group, or personal network.

   
   

Each option has different advantages and considerations. No matter how you meet your surrogate, professional medical, legal, psychological, insurance, and financial support remains essential.

Finding a Surrogate Through an Agency

A surrogacy agency does much more than introduce intended parents to available candidates.

Before matching, the agency helps evaluate whether a surrogate meets program requirements and appears medically, emotionally, and legally prepared for the process.

Intended parents may create a family profile that shares their story, values, personalities, hopes for the journey, and vision for their future family. Their program coordinator will also learn about their communication preferences, expectations, and priorities.

The agency then looks beyond basic compatibility to identify a surrogate whose goals and expectations align with theirs.

Giving Tree’s HEART Matching Process was created to support safe, compassionate, and lasting matches through a combination of personal care and professional expertise.

Working With a Surrogate You Already Know

Some intended parents begin their journey with a friend, relative, or independently identified surrogate.

Even when the match has already been made, professional support can help protect everyone involved and make the process easier to manage.

Giving Tree offers support for intended parents who have found their own gestational surrogate.

Depending on the program, this assistance may include journey coordination, surrogate screening, referrals to independent attorneys, escrow management, insurance guidance, medical billing coordination, and emotional support.

Having an agency oversee these moving parts allows the intended parents and surrogate to focus more fully on their relationship and the journey ahead.

Begin Your Journey With Giving Tree Surrogacy

Since 2015, Giving Tree Surrogacy has supported more than 1,000 families through surrogacy and egg donation.

Many members of our team have personal experience as surrogates, egg donors, or intended parents, giving us a firsthand understanding of the hope, uncertainty, courage, and joy that can accompany this path.

We believe family building should be guided by empathy, expertise, transparency, and care.

From your first conversation through matching, pregnancy, delivery, and the journey home, our team is here to help you move forward with confidence.

Your path to parenthood may be unique, but you will never have to walk it alone.

Contact Giving Tree Surrogacy to schedule a complimentary, no-obligation consultation. We would be honored to learn about your story, answer your questions, and help you explore the next step toward growing your family.