Surrogate pregnancy gives hopeful parents the chance to build a family when carrying a child themselves isn’t possible. Through gestational surrogacy, a woman carries a baby created with IVF, using the intended parents’ or donors’ genetic material.
The surrogate has no genetic connection to the child but plays a vital role in making parenthood possible.
At Hatch, we guide surrogates and intended parents through every stage—from initial screenings and embryo transfer to pregnancy and delivery—so the experience is safe, transparent, and rewarding.
What Is Surrogate Pregnancy?
In a surrogate pregnancy, the surrogate carries a baby conceived through IVF. The embryo is created in a lab and then transferred to the surrogate’s uterus.
Unlike a typical pregnancy, the surrogate follows a carefully structured medical plan that begins with fertility medications, frequent monitoring, and a transfer procedure before pregnancy is confirmed.
Once the surrogate is pregnant, her medical care continues under close supervision. She transitions from IVF specialists to an OB at around 10 weeks, while the intended parents stay involved through appointments, screenings, and birth planning.
What makes surrogate pregnancy different from other paths to parenthood is that it involves three groups working together: the surrogate, the intended parents, and the medical and legal professionals guiding the process.
Each plays a role in ensuring the gestational surrogacy process is safe, legal, and supportive for everyone involved.
Who Chooses Surrogacy and Why?
Surrogate pregnancy is a collaborative process shaped by the needs of intended parents and the qualifications of surrogates.
- Intended parents: Surrogacy is often chosen when medical or biological factors prevent someone from carrying a pregnancy safely. This includes infertility, recurrent pregnancy loss, medical conditions that make pregnancy high-risk, or cases where pregnancy isn’t possible, such as for gay couples. Intended parents typically undergo medical and legal consultations before beginning the matching process with a surrogate.
- Surrogates: Women who become surrogates usually have had uncomplicated pregnancies of their own and are motivated by the desire to help another family. Before being approved, they go through extensive screenings—medical, psychological, and legal—to ensure they’re physically and emotionally prepared for the role. Once approved, they’re matched with intended parents and guided by medical teams and agency coordinators throughout the journey.
At Hatch, surrogacy is based on structured agreements and clear processes that protect the surrogate and the intended parents while keeping the health of the baby at the center.
The Surrogate Pregnancy Process
Surrogate pregnancy involves several stages:
1. Matching and legal agreements
The process begins with selecting a surrogate through a surrogacy agency.
Once a match is made, attorneys draft a legal contract that covers medical decisions, compensation, and parental rights.
This agreement must be finalized before any medical procedures begin.
2. Medical screenings and IVF
After signing the contracts, the surrogate undergoes medical testing to confirm she is healthy enough for pregnancy. Fertility medications are prescribed to prepare her uterus for embryo transfer.
The embryo, created using the intended parents’ or donors’ egg and sperm, is transferred via IVF.
Pregnancy is confirmed through blood tests and early ultrasounds.
The surrogate remains under the care of the IVF clinic until about 10 weeks, when she transitions to an OB for ongoing prenatal care.
3. Pregnancy journey by trimester
If you’re interested in becoming a surrogate, here’s what to expect during your pregnancy:
Your first trimester
Your pregnancy will be monitored through ultrasounds and blood tests by the IVF doctor either at your recipient parents’ office, or through a monitoring clinic closer to your home until about 10 weeks of pregnancy. Here’s what you can expect during your first trimester of the pregnancy:
- At four to six weeks of pregnancy, you’ll have an ultrasound to check for a gestational sac in the uterus.
- At six to eight weeks, you’ll have an ultrasound to check for fetal heartbeat.
- At 10 weeks of pregnancy, you’ll have one to two more visits before graduating from IVF care to OB care.
- At around 10 weeks of pregnancy, they’ll provide instructions for gradually tapering off the IVF medications. The clinical coordinator responsible for your care at the IVF clinic will inform you how your doctor is adjusting your medications after each appointment.
Your second and third trimester
Once your pregnancy has been confirmed by fetal heartbeat ultrasound, your surrogate coordinator will help you transition to OB care. We’ll check what OB/hospital options are in-network with the surrogacy insurance plan, and you and your intended parent(s) will decide on the best option for this as a team.
Your IVF doctor will inform you of the time frame for setting up your first OB appointment. Before your first OB appointment, your Surrogate Match Coordinator will make sure your OB has all of the relevant information from your IVF cycle and pregnancy thus far, a copy of your insurance card, and a copy of the medical records from the IVF clinic.
Screening tests during your second trimester
Most intended parents wish to do the non-invasive pregnancy screening tests, such as the Nuchal Translucency ultrasound, at around 12 weeks, state first and second trimester blood tests, and/or the NIPT blood test. You can coordinate this through your OB, or we can provide a referral within L.A. if you’re able to travel for these tests.
Some intended parents opt to do invasive testing, such as an amniocentesis or Chorionic Villus Sampling (CVS), if there are concerns resulting from the non-invasive testing. If your intended parents choose to pursue this, you’ll be compensated for the inconvenience associated with these tests.
Legal processes
At around 16 weeks of pregnancy, the legal parentage process will be initiated with the same attorneys who assisted with the initial contract. Depending on the state laws where you reside, both you and your spouse (if applicable) will sign documents to confirm that the intended parents are the legal parents of their baby in advance of the birth.
In some states, there are steps to complete post-birth. Because of this, it’s possible that you’ll attend a court date to solidify legal parentage.
Ultrasounds and monitoring before birth
Around 20 weeks of pregnancy, you’ll have a 20-week fetal anatomy ultrasound and possibly a fetal echocardiogram, which is the ultrasound of the baby’s heart. In many cases, the intended parents like to come out for this appointment. At this appointment, you can also tour the delivery hospital together. We can assist with finding a point of contact at your delivery hospital to coordinate this.
Most intended parents will plan to be in town two weeks before the due date (barring any indicators of an earlier birth) so that they don’t miss this special experience. It’s typical for the intended parents to be present for the birth, as long as the surrogate is comfortable with this.
If you have a scheduled C-section or induction, please make sure to let both your intended parents and us know in advance. When labor begins, please let your OB, your intended parents, and us know right away. Even if your water breaks in the middle of the night, please let us know by calling us and the intended parents. You’re never bothering anyone, and we’re all here to support you!
After giving birth, please stay in touch with us and your intended parents in case of any postpartum medical appointments. We’d all love to know how you’re recovering from birth and provide support (and gratitude) whenever we can.
What Are the Medical Risks and Considerations?
While surrogate pregnancies are carefully monitored, they carry the same risks as any other pregnancy, along with some unique considerations:
- IVF-related risks: The fertility medications used before embryo transfer may cause side effects such as bloating, headaches, or mood changes.
- Multiple pregnancy: IVF can increase the chances of twins or triplets, which raises the risk of complications.
- Pregnancy complications: Like any pregnancy, a surrogate may face gestational diabetes, high blood pressure, preterm labor, or C-section delivery.
- Emotional impact: Surrogates undergo psychological screenings before approval, but ongoing support is key to a healthy experience for the surrogate and intended parents.
Close medical supervision, combined with open communication between the surrogate, intended parents, and agency coordinators, helps manage these risks.
Experience the Rewarding Journey of Surrogacy
At Hatch, we're proud to be one of the most established surrogacy agencies in the world, with the top 5% of candidates and top compensation. We greatly appreciate and cherish your contribution as a surrogate, and we'll do everything in our power to make sure that this is the life-affirming journey it's meant to be.
If you have any questions or concerns, contact us and we'll get back to you as soon as possible. Make sure to learn about Surrogacy Success Rates, Surrogate Compensation, and the Surrogate Matching Process.
