What Is Surrogacy and How Does It Work?

Surrogacy is a method of Assisted Reproductive Technology (ART) in which a woman carries a pregnancy to term for another couple or individual to help them become parents and build their families. Surrogates give the gift of family to those unable to conceive.

If you’re wondering how surrogacy works—from the medical process to the legal logistics—this guide will walk you through every step.

What Is Surrogacy? 

Surrogacy is defined as the process or the arrangement of someone carrying a pregnancy to term and giving birth to a child for someone else. This form of assisted reproduction helps those who are unable to carry their own children into this world.

The couple or individuals using the support of a surrogate are known as Intended Parents (IPs). IPs can also be referred to as an Intended Mother (IM) and an Intended Father (IF).

This family-building process requires both exceptional legal and medical competencies, paired with experienced support. Similar to other technologies we see in the world, surrogacy has evolved over the years and is more accessible than ever before.

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How Does Surrogacy Work?

Many people have heard of surrogacy but aren’t exactly sure what the process looks like from start to finish. 

Whether you’re hoping to grow your family or thinking about becoming a surrogate, understanding how surrogacy works can help you take that next step with confidence.

Step 1: Consultation and Qualification

The first part of the journey is making an informed decision. Intended parents might turn to surrogacy for a variety of reasons: infertility, medical conditions, same-sex partnerships, or the desire to have a child biologically related to at least one parent. 

Meanwhile, women who become surrogates often feel called to help others experience the joy of parenthood.

This stage usually involves personal reflection, family conversations, and sometimes speaking with professionals—like fertility specialists or surrogacy agencies—to explore whether this is the right path forward.

Step 2: Choose a Surrogacy Agency or Go Independent

While some people go through the process independently, many choose to work with a surrogacy agency. 

An agency offers guidance, matches surrogates and intended parents, and helps manage the many moving pieces. This includes legal paperwork, medical coordination, screening, and more.

Choosing the right agency is a big decision. Look for experience, transparency, and success rates. 

A trusted agency will make sure everything is done legally and ethically, and also provide emotional support throughout the process.

Step 3: Matching with a Surrogate

The next big step is matching intended parents with a surrogate. 

This process is about finding the right fit. Both parties fill out detailed profiles outlining their preferences, values, and expectations for the journey.

When a potential match is found, a meeting (often virtual) is set up so everyone can get to know each other. If both sides feel it’s a good fit, the match moves forward.

Step 4: Legal Agreements

Before any medical procedures begin, you need to sign a legal contract. Each party has their own attorney to protect their interests. These agreements clearly outline each person’s rights, responsibilities, and expectations. The contract covers decisions around medical issues, financial compensation, parentage, and what happens if unexpected situations arise.

Step 5: Medical Screening and IVF Process

After you sign the contract, the surrogate undergoes a thorough medical evaluation, including physical exams, bloodwork, and sometimes psychological assessments. 

Once cleared, the IVF process begins.

In gestational surrogacy, embryos are created using the intended parents’ or donors’ egg and sperm. The embryos are then transferred to the surrogate’s uterus at a fertility clinic. With any luck, a pregnancy will be confirmed shortly after.

Step 6: Pregnancy and Monitoring

Once the surrogate is pregnant, she’ll receive regular medical care just like any other pregnancy. She’s supported by a whole team, including the agency, medical professionals, and the intended parents.

Some intended parents attend doctor’s appointments (virtually or in person), while others stay updated through the agency.

Step 7: Delivery and Legal Parenthood

When the surrogate gives birth, the baby is placed in the arms of the intended parents. Depending on the legal arrangements, the intended parents’ names are either already on the birth certificate or added shortly after through a pre-birth or post-birth order.

The Difference Between Traditional and Gestational Surrogacy

Gestational surrogacy has become the more common form of surrogacy today, especially for intended parents who are unable to conceive on their own. Its growing popularity is largely due to advancements in in-vitro fertilization, which make it possible for a surrogate to carry a baby without being genetically related to the child. Below, we’ll explore the key differences between traditional and gestational surrogacy.

What is Traditional Surrogacy?

Traditional surrogacy is called "traditional" in the sense that it is the old way of doing things. Traditional surrogacy refers to when a surrogate's biological eggs are used to get pregnant and deliver the baby to another couple or individual. In this scenario, the surrogate would be genetically related to the baby.

Before assisted reproductive technology developed IVF, traditional surrogacy was the only way to complete a surrogacy. In this process, the surrogate is artificially inseminated with the intended father’s sperm, and once pregnant, she then carries and delivers the baby. 

This type of surrogacy arrangement is most commonly discouraged because it has led to many legal and emotional struggles for surrogates when it came time to give up the baby to the intended parents. This type of surrogacy is much rarer now, and is, in fact, illegal in some states. 

What is Gestational Surrogacy?

Gestational surrogacy refers to when a surrogate has no genetic relation to the child and her uterus is used to carry the baby while in gestation. Gestational Surrogacy happens through IVF when embryos are cultured in a fertility clinic's lab using the IP's specimens or a donor's if needed (Sometimes, IPs will use their biological genetic egg or sperm). Once ready, the surrogate will undergo an embryo transfer, where one or two embryos are implanted and she will carry them to term.

Gestational surrogacy is often preferred and much more common within the fertility industry. At Hatch, we only service gestational surrogacy.

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Why Do Intended Parents Use Surrogacy?

Surrogacy allows an opportunity for individuals from all walks of life to pursue the path to parenthood and realize the joy of building a family of their own. At Hatch, we work with a variety of intended parents including:

• Couples who have been struggling with infertility, such as female infertility and male infertility
• Women who are not able to carry a successful pregnancy
• LGBTQ intended parents who desire a biological child
• Intended parents with hereditary genetic conditions
• Single parents by choice

We believe that anyone who wants to have a family should have that option. And we’re devoted to ensuring that intended parents, surrogates, and egg donors alike have the most rewarding experience possible throughout their journeys. Our motivation comes from helping intended parents bring newborns into the world, allowing donors and surrogates to contribute to a loving family, and making all participants’ dreams come true.

Surrogacy Success Rates ➜

How Much Does Surrogacy Cost?