Becoming a gestational surrogate, also known as a gestational carrier or surrogate mother, is a life-changing decision. You are choosing to play a crucial role in helping someone experience the joy of parenthood. But before starting, it’s essential to understand how surrogacy works and what to expect throughout the gestational surrogacy process.
This guide is written for women who are curious about surrogate motherhood, wondering about the medical, legal, and emotional steps involved. We’ll walk through every part of the journey, including in vitro fertilization, fertility treatments, the surrogacy agreement, the legal process, and how to prepare for a healthy and safe experience. surrogate and biological mother, assisted reproduction, legal agreements, birth mother, child’s genetic parents, surrogacy services, and the important role of the infertility specialist who guides the medical process.
Whether you’re exploring this for the first time or ready to take the next step, this resource will help you understand what it truly means to become a gestational surrogate and how parent child relationships are carefully considered throughout the journey.
What Is Gestational Surrogacy
Gestational surrogacy is a type of surrogacy in which a woman carries and delivers a child who is not genetically related to her. In this process, an embryo is created through in vitro fertilization using donor sperm, eggs from another source, or both. That embryo is then transferred into the surrogate uterus.
Gestational surrogacy separates the biological and gestational roles. Surrogate mothers in gestational arrangements have no biological link to the baby. At Made in the USA Surrogacy, we exclusively support gestational surrogacy and do not participate in traditional surrogacy. Our focus is on safe, ethical, and structured surrogacy practices, always backed by professional guidance, medical care, and legal protection.
How Surrogacy Works — Step by Step
Step 1 | Application and Screening
To begin your journey, you will submit an application through our agency. This starts the surrogacy process and includes several important steps to ensure your health and readiness. As a prospective gestational carrier, you’ll go through comprehensive screening including:
- Physical exams and health evaluations
- Review of past pregnancies to confirm a healthy pregnancy history
- Screening for medical complications or risk factors
- Emotional and psychological assessments
- Background checks
- A review of your lifestyle, marital status, and personal goals
All of this ensures a safe and rewarding experience. The screening phase is also when you’ll learn about fertility treatments, medical procedures, and what to expect during the surrogate pregnancy.
Step 2 | Surrogacy Matching and Education
Once approved, you’ll begin working with your coordinator to prepare for your match. You’ll receive educational resources and emotional support to guide you through the surrogacy arrangements process.
This includes reviewing the type of surrogacy you’re participating in, understanding the roles and expectations defined in a surrogacy contract, and preparing for medical and legal steps ahead. The importance of a clear, legally binding first surrogacy contract is emphasized to protect all parties.
Step 3 | Medical Preparation and Fertility Treatments
Next, you’ll begin the medical phase of your journey under the supervision of an infertility specialist. This includes:
- Coordinating with a fertility clinic or IVF clinic
- Taking prescribed hormones to prepare the uterus
- Undergoing medical testing to confirm readiness
- Learning how assisted reproductive technology supports a successful gestational surrogate pregnancy
During this time, an embryo will be created using in vitro fertilization. This process involves egg retrieval and fertilization using sperm from the sperm donor. Once ready, the embryo is transferred into your uterus during an embryo transfer procedure.
You’ll be fully supported by the surrogacy agency and medical team through each step of the medical process.
Step 4 | Embryo Transfer
The embryo transfer is one of the most exciting parts of the journey. It’s a short, painless procedure performed at a fertility clinic where the embryo is placed directly into your uterus. You’ll then rest and follow any recommended protocols to support implantation.
In many cases, pregnancy is achieved on the first transfer, but if not, multiple attempts may be made, depending on your surrogacy agreement. All medical expenses associated with this process are covered.
Step 5 | Pregnancy Monitoring and Support
Once the embryo implants successfully, you’ll begin the surrogate pregnancy. You’ll continue to receive care and oversight from a qualified OB/GYN and your surrogacy team.
This part of the gestational surrogacy process is similar to a standard pregnancy but includes extra attention to ensure safety for everyone involved. Your health is monitored closely, and the surrogacy agency offers emotional support, logistical assistance, and regular check-ins.
You’ll also have access to professionals familiar with the psychological aspects of surrogacy arrangements, ensuring you feel respected and supported during each trimester.
Step 6 | Delivery and Transition
As you approach delivery, detailed planning takes place to ensure a smooth and respectful birth experience. The legal contract you signed early in the process will include details about the birth plan, legal custody, and your role as the gestational carrier.
Your team will coordinate with the hospital, handle all necessary paperwork, and ensure that the surrogacy agreement is honored. All legal aspects, including finalizing parental rights, will already have been addressed to protect you.
After delivery, your journey concludes with rest, recovery, and postnatal support.
How Long Does the Surrogacy Process Take
The full surrogacy process typically lasts between 12 and 24 months. This includes:
- 1 to 3 months for screening and approval
- 1 to 3 months for legal and medical preparation
- 9 months for pregnancy
- Additional time if multiple embryo transfers are required
Each journey is unique, and your surrogacy agency will ensure everything progresses at a safe and steady pace tailored to you.
Is Surrogacy Safe for the Surrogate
Yes, when managed professionally, gestational surrogacy is considered safe. All medical procedures are done under the supervision of licensed clinics and follow guidelines set by the Society for Reproductive Medicine and the American Society for Reproductive Medicine.
Risks are similar to those in any typical pregnancy and include:
- Mild to moderate health risks from hormone medications
- Standard medical risks related to pregnancy and delivery
- Emotional or psychological challenges, especially postpartum
Your safety and emotional health are priorities. The surrogacy agency provides referrals, resources, and support to navigate these aspects confidently.
Compensation for Surrogates
Surrogacy is not just a gift, it’s also a significant commitment. As a gestational carrier, you will receive financial compensation for your time, energy, and generosity.
In 2025, base compensation typically ranges from $50,000 to $70,000 for first-time surrogate mothers, with experienced surrogates earning more. Additional payments may include:
- Medical expenses
- Maternity clothing allowance
- Monthly wellness stipends
- Childcare or travel reimbursement
- Lost wages for time off work
All of this is defined clearly in your surrogacy contract, and the surrogacy agency ensures all terms are honored fully.
Legal Protections for Surrogates
A strong legal foundation is essential in any surrogacy agreement. Before the medical treatment phase begins, you’ll receive legal counsel to help negotiate and understand a custom legal contract.
This contract includes:
- Your compensation and reimbursement terms
- Guidelines for medical care and lifestyle during pregnancy
- Boundaries for communication and support
- Roles and responsibilities for all parties
- How legal custody is handled after birth
The legal process varies by state, but your agency and legal team will handle filings, court documents, and any necessary hearings. The result is a secure and respectful arrangement that protects your rights and your well-being throughout the journey.
Why Work with a Surrogacy Agency
Choosing to work with a professional surrogacy agency makes the entire experience smoother, safer, and more supported. Agencies handle the logistics, including:
- Screening and education
- Medical coordination with fertility clinics
- Organizing legal representation and covering legal fees
- Navigating surrogacy laws
- Providing guidance during every phase of the journey
Whether you are considering altruistic surrogacy, commercial surrogacy, or exploring how surrogacy varies across states and even transnational surrogacy arrangements, the agency ensures you receive high-quality care.
Most importantly, a trusted agency ensures your experience is structured, compassionate, and always in your best interest.
Frequently Asked How Surrogacy Works Questions
What is the difference between gestational surrogacy and traditional surrogacy
Gestational surrogacy uses IVF and involves no genetic link between the surrogate and baby. For a traditional surrogate, the surrogate provides her own egg, making her the biological mother. Made in the USA Surrogacy does not support traditional surrogacy.
Can I be a surrogate if I have never been pregnant
No. To qualify as a gestational surrogate, you must have previously carried at least one child to term. This ensures you are prepared both physically and emotionally for the journey.
Will I be responsible for any costs
No. All medical expenses, legal fees, travel costs, and lost wages are covered. You are never expected to pay out of pocket.
What if the embryo transfer fails
It’s common for the first embryo transfer not to result in pregnancy. If that happens, the medical team will evaluate next steps, which may include another cycle. Your surrogacy contract outlines this possibility clearly.
What if I change my mind after starting
Before moving forward, you’ll sign a binding legal contract. This agreement ensures that everyone’s responsibilities and expectations are understood. We take time to make sure you are fully informed and emotionally ready before reaching that stage.
Ready to Begin Your Journey
Becoming a gestational surrogate is one of the most impactful, compassionate acts a woman can offer. Whether you’re just exploring or ready to begin the process, we’re here to walk with you.
To learn more about how surrogacy works, what’s included in the surrogacy agreement, and how to take your first step toward surrogate motherhood, we invite you to explore our resources or connect with our team today.
