Understanding what Gestational Surrogacy Is for Surrogates & Intended Parents

Understanding what Gestational Surrogacy Is for Surrogates & Intended Parents

Gestational surrogacy is the most common form of surrogacy used in the United States today. In this arrangement, a Surrogate carries a pregnancy created through IVF using an embryo that is not genetically related to her. Intended Parents may use their own eggs and sperm, donor gametes, or a combination.

This guide explains what gestational surrogacy is, how it differs from traditional surrogacy, who may pursue it, what the process typically involves, and the legal and practical points families and Surrogates should understand before starting.

What is Gestational Surrogacy?

Gestational surrogacy is an arrangement in which a Surrogate carries a pregnancy created through in vitro fertilization (IVF). The embryo is made from the egg and sperm of the Intended Parents, donors, or a combination. The Surrogate has no genetic connection to the child she carries.

This is different from traditional surrogacy, where the Surrogate’s own egg is used, so she is genetically related to the child. Most modern U.S. agency programs and fertility clinics work with gestational surrogacy because the legal path to parentage is typically clearer when there is no genetic link between the Surrogate and the baby.

There are two main types of surrogacy:

Gestational surrogacy: An embryo is created through IVF using the Intended Parents’ or donors’ gametes and transferred to the Surrogate’s uterus. The Surrogate is not genetically related to the child.

Traditional surrogacy: The Surrogate’s own egg is used, usually through insemination. She is the genetic parent, which can make legal parentage more complex.

Why Might Someone Need a Gestational Surrogate?

There are various reasons people may need the help of a Gestational Surrogate. Some mothers are unable to carry a pregnancy due to medical reasons or past health reasons. Same-sex couples may choose gestational surrogacy as a way to build their family, and single men who would like to become fathers may also use this option. In some cases, a woman may physically be able to carry, but the risks of doing so make surrogacy a safer choice.

The Emotions of Surrogacy

From both sides, as the surrogate or as the intended parent, going on this journey will bring out some of life’s deepest emotions. Intended parents have often struggled with infertility for many years, pregnancy loss, or challenging medical conditions. Deciding to use a surrogate can bring on emotions of hope and appreciation. It can also bring on stress and anxiety, knowing that there can be a loss and that they have no control during the pregnancy.

For surrogates, completing a surrogacy journey is often rewarding and inspiring, but not without a mix of other emotions. To be able to carry a child for someone else and be able to part after delivery requires a mentally-strong and emotionally-resilient person. During the journey there is usually a bond formed between the surrogate and the intended parents; a relationship like no other. For both the intended parents and the surrogate, having emotional support is a must! Spouses, family or friends are great people to provide in-person support during the whole process. Counseling may be needed for one party or the other, it’s always good to talk to a professional. Making sure both parties agree on what is expected during the journey and are on the same page can help everyone to prepare for the ups and downs of the emotions that may come up during a surrogacy journey.

Money Matters

Surrogacy is a beautiful thing, but for the intended parents, it can be quite expensive.

The intended parents need to cover many costs such as:

• Agency fees
• Legal fees (for their own attorney and one provided for the surrogate)
• Surrogacy Compensation
• Medical and IVF costs
• Prenatal care and delivery
• Health insurance/Life insurance
• Travel expenses

For the surrogate, compensation does vary but will usually include:

• A base fee ( dependent on location, previous surrogacy experience, multiples)
• Pregnancy allowances
• Maternity clothing
• Travel costs (flights/hotel/food)
• Childcare/housekeeping
• Lost wages for the surrogate and her spouse/support person
• Life Insurance coverage

Both parties want to be sure that everything is clear and agreed upon before starting the journey. These things will be put into your legal contracts that all will sign off on. A surrogate can use her compensation for whatever she sees fit: possibly a down payment on a house or a college fund for her kids. Some may just want to save it for the future. There is no wrong way to spend the compensation you get for doing such an amazing thing for someone else.

Health Screening and Medical Requirements for Gestational Surrogacy

Each surrogate will go through an extensive screening process to make sure they are physically and emotionally ready to embark on this journey.

This will include:

• Multiple phone/video calls
• A full medical history review
• Background checks (surrogate/partner/any adults over 18 in the home)
• A uterine lining check
• Psychological evaluation

All to make sure you’re in optimal shape to have a safe and smooth IVF cycle and pregnancy.

The intended parents will also go through screening steps including:

• Psychological screening
• Multiple phone/video calls
• Background checks
• Medical screening if utilizing their own eggs/sperm to create their embryos

All aimed at ensuring you are delivering the baby into a safe and loving home.

Once a surrogate has completed and passed these steps, she will be matched with her intended parents and they will all sign off on the legal contract with support from their own individual expert attorneys.

The next step is starting the IVF treatments, working with whichever IVF clinic the intended parents utilized to create and store their embryos. They will have tested embryos frozen and ready to go. The surrogate will take medications to prepare her uterine lining for 3-6 weeks. The embryo will be transferred to the surrogate's uterus by the IVF Doctor. The pregnancy will be confirmed by a blood test 10-14 days later.. They will do an ultrasound to confirm heartbeat around 6 weeks of pregnancy, which is such an amazing moment. The pregnancy will be closely monitored and after about 10-11 weeks of pregnancy most women will be released to their own OB and deliver at their local hospital with a NICU on site. The surrogate and intended parents will keep in contact about updates for the pregnancy and appointments.

How the Gestational Surrogacy Process Typically Works

After screening and matching, most journeys follow a similar sequence:

1. Legal contracts: The Surrogate and Intended Parents each work with independent reproductive attorneys. The agreement is signed before medical procedures beyond eligibility screening begin.
2. Medical preparation: The Surrogate takes medications to prepare the uterine lining, usually over several weeks.
3. Embryo transfer: The fertility clinic transfers the embryo into the Surrogate’s uterus.
4. Pregnancy confirmation: A blood test is typically done about 10–14 days after transfer. An ultrasound around six weeks confirms a heartbeat when the pregnancy is progressing.
5. Ongoing prenatal care: Early monitoring is often managed with the IVF clinic; many Surrogates later transition to their own OB for the remainder of the pregnancy.
6. Parentage and delivery planning: Legal parentage steps follow state law and may include pre-birth orders or other filings. The hospital plan and communication expectations are coordinated before delivery.

Timelines vary based on matching, screening, embryo availability, and medical factors.

The Legal Part of Gestational Surrogacy

There are several legal considerations when doing a surrogacy journey. You want to make sure the intended parents/parent is the legal parent and has all rights to the child. It is important to make sure the surrogate is fairly compensated and this is all transparent and correct in the contract. When doing your legal contracts for a surrogacy journey, you should ensure it is clear on:

• Parental rights (the baby belongs to the intended parents)
• Surrogates responsibilities through the journey (what she can and cannot do)
• What is expected in case there are any medical complications
• Surrogate compensation and reimbursements

It is best to have two separate 3rd party attorneys: one for the surrogate and one for the intended parents/parent, and these attorneys must be familiar with surrogacy. Surrogacy laws differ from state to state, so it is very important to follow each state's laws for surrogacy.

Final Thoughts

Gestational surrogacy is a structured medical, legal, and personal process. Understanding the difference from traditional surrogacy, the screening and matching steps, the costs involved, and the legal requirements helps both Surrogates and Intended Parents make informed decisions.

Hatch has supported family building through surrogacy since 1991. If you are considering becoming a Surrogate or pursuing gestational surrogacy as an Intended Parent, our team can help you understand the next steps and whether this path fits your goals.