What Happens After You Match in a Surrogacy Journey

Matching is one of the most exciting milestones in the surrogacy journey. It represents alignment, hope, and the beginning of a shared path between a surrogate and intended parents. Yet once the celebration settles, many people experience a familiar question: What happens next?

The post-match phase is where the journey becomes real. It is also where structure, guidance, and emotional support matter most. This stage is carefully designed to protect everyone involved while laying a strong foundation for a successful pregnancy and a healthy relationship.

Transitioning Into Case Management

After matching, both the surrogate and the intended parents are introduced to their case coordinator. This person becomes the central point of communication and guidance for the remainder of the journey. From this moment on, nothing happens in isolation.

One of the most important early steps is a face-to-face meeting with the case coordinator. This initial connection builds trust and clarity. The coordinator explains the overall roadmap, outlines upcoming milestones, and begins breaking the process into manageable, bite-sized steps. Surrogacy is often described as a cycle of “hurry up and wait,” and having a clear guide through that rhythm helps reduce overwhelm.

Rather than focusing on the entire journey at once, case managers encourage everyone to focus on the next milestone only. This approach keeps expectations grounded and emotions manageable.

Medical Screening: The First Major Milestone

The first milestone after matching is medical clearance. This phase centers primarily on the surrogate and ensures that her body is fully prepared for pregnancy.

Medical screening typically includes bloodwork, ultrasounds, and evaluations conducted at the fertility clinic. Intended parents are not required to attend these appointments, though some choose to if they are local. Many families decide it feels emotionally safer to wait for confirmed clearance before deepening the relationship further.

This stage can feel tense, particularly for intended parents who may carry past trauma from fertility struggles or pregnancy loss. The process is intentionally structured to allow emotional boundaries while ensuring all medical boxes are checked before moving forward.

Protecting the Relationship Early On

While excitement is high after matching, early restraint is encouraged. Case managers often advise intended parents and surrogates to allow medical screening and legal clearance to be completed before forming a deeply emotional bond. This helps safeguard both sides should unexpected delays or disqualifications arise.

At the same time, communication expectations should be discussed early. Everyone brings different emotional needs into the journey. Some intended parents may feel anxious and want frequent check-ins, while some surrogates may need space due to work and family responsibilities. Honest conversations about communication preferences prevent misunderstandings and allow the relationship to develop naturally over time.

Legal Clearance: Creating the Roadmap

Once medical screening is complete, the process moves into legal clearance. Each party is represented by their own attorney, and contracts are negotiated to protect everyone involved.

This phase can take anywhere from a few weeks to a few months, depending on schedules and the complexity of terms. It is common for drafts to go back and forth multiple times, and this is not a sign of conflict. It is simply part of building a clear, thorough agreement.

For surrogates especially, contracts can feel overwhelming. They include guidelines, expectations, and responsibilities. However, these agreements exist to remove guesswork and provide security. Compensation schedules, medical protocols, postpartum considerations, and hospital plans are all clearly outlined.

Case coordinators remain neutral during this phase and direct legal questions back to attorneys, while still supporting the overall timeline and keeping the process moving.

🎧 Want to dive deeper? Tune in to our podcast, where we discuss real stories, expert insights, and the heart behind every surrogacy journey.

Legal Clearance Changes Everything

Once legal clearance is granted, the tone of the journey shifts. This is often when surrogates and intended parents feel safe beginning to build their relationship more openly. The most technical and uncertain stages are behind them, and the focus turns toward preparing for embryo transfer.

At this point, fertility clinics determine the next steps based on their specific protocols. Some clinics require a mock cycle to test medication effectiveness before moving into an actual transfer cycle. Holidays, clinic schedules, and hormone responses can all influence timing.

Flexibility is essential. Even with projected calendars, dates often shift slightly to optimize success.

Preparing for Transfer

The transfer cycle typically begins with several weeks of medication and close monitoring. Surrogates attend frequent morning appointments for bloodwork and ultrasounds to track hormone levels and uterine lining development.

These appointments are short but frequent and require careful coordination with daily life. Case coordinators and fertility clinic teams help manage scheduling to reduce disruption as much as possible.

Travel for the embryo transfer is usually booked only once the clinic gives final approval, often just days before the procedure. While this can feel counterintuitive, it prevents costly changes and ensures optimal timing.

The Transfer Day

Embryo transfer itself is usually quick and surprisingly simple. Intended parents may attend, but they are not required to. Some choose not to in order to protect their own emotions or avoid placing pressure on the surrogate.

Surrogates are supported with medication to help them relax and are encouraged to rest afterward. This is a moment where the surrogate’s role shifts from intense preparation to quiet patience.

The Two-Week Wait and Early Pregnancy Milestones

After transfer comes the two-week wait, followed by blood tests to confirm pregnancy. Rising hormone levels bring cautious relief, especially for intended parents who may have experienced loss before.

A heartbeat ultrasound around six weeks marks another emotional milestone. Even with good news, mixed emotions are common. Excitement may coexist with fear, guilt, or guarded hope.

Case coordinators play a critical role during this time, helping both parties navigate communication and emotional differences with care.

Transition to OB Care

Once early pregnancy is confirmed, the surrogate graduates from the fertility clinic to her OB. This is often when the pregnancy begins to feel more familiar and routine.

Insurance coverage for pregnancy care begins at this stage, and case coordinators ensure providers are in-network and appropriately informed. Whenever possible, surrogates continue with their existing OBs.

Medications gradually taper off, and appointments become less frequent, offering a sense of normalcy after months of intensive oversight.

Ongoing Support Throughout Pregnancy

Throughout the pregnancy, communication remains essential. Surrogates are encouraged to seek medical care immediately if concerns arise and never hesitate to reach out to their case coordinator.

Support services, including counseling, are available to help navigate stress, uncertainty, and emotional shifts. No feeling is considered abnormal in this journey.

Preparing for Delivery

Delivery planning begins well before labor. Travel arrangements, housing for intended parents, hospital policies, visitation preferences, and birth plans are all discussed in advance.

These conversations prevent confusion and ensure everyone feels respected and prepared. Hospitals are well-versed in surrogacy arrangements, providing structure and security during delivery.

A Journey Meant to Be Shared

The post-match phase of surrogacy is complex, emotional, and deeply human. It requires patience, communication, flexibility, and trust. With the right guidance and support, it becomes not only manageable but meaningful.

Surrogacy is not meant to be navigated alone. With experienced case management, clear milestones, and compassionate support, this journey can be one of connection, growth, and extraordinary purpose—for everyone involved.

🎧 Want to dive deeper? Tune in to our podcast, where we discuss real stories, expert insights, and the heart behind every surrogacy journey.