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.
Types of Surrogacy: Gestational vs. Traditional
When people first hear the term “surrogate pregnancy,” they often don’t realize there are two types of surrogacy arrangements.
Understanding the difference is important because the medical process, genetic relationships, and legal considerations vary.
Gestational surrogacy is the most common path today — and the only one offered through Hatch. In gestational surrogacy, the surrogate (often called a gestational carrier) has no genetic link to the child.
Instead, the embryo is created through IVF using the intended parents’ or donors’ egg and sperm, and then transferred to the surrogate’s uterus. This is the safest and most widely accepted approach, both medically and legally.
Traditional surrogacy, by contrast, uses the surrogate’s own egg. This means the surrogate is both the genetic and birth mother, which can create complex legal and emotional challenges.
For this reason, traditional surrogacy is far less common and not supported by most agencies, including Hatch.
By focusing solely on gestational surrogacy, Hatch ensures a clear process that protects the rights of the intended parents, the surrogate, and the baby. You can read more about how we support surrogates throughout their journey on our surrogate compensation page.
How Much Does Surrogate Pregnancy Cost?
One of the first questions intended parents often ask is: how much does surrogacy cost? The overall investment is significant because the process involves medical treatment, legal protections, and surrogate compensation.
In the United States, the total cost of a surrogate pregnancy usually falls between $120,000 and $200,000, depending on individual circumstances and the payment model you choose.
Here’s what that typically includes:
- Agency fees: About $35,000–$55,000, which cover the support, coordination, and matching process between surrogates and intended parents.
- Surrogate compensation: On average $45,000–$60,000, plus allowances for living expenses, maternity clothing, and travel.
- Legal fees: Roughly $10,000–$20,000 for drafting contracts, securing parental rights, and navigating jurisdictional requirements.
- Insurance and medical costs: $7,000–$25,000 for health and life insurance, plus IVF and pregnancy-related care.
- Other expenses: Such as surrogate travel, outside monitoring, or lost wages if the surrogate must take time off work.
Because unexpected events like multiple embryo transfers or medical complications can affect costs, Hatch offers a fixed fee model to help intended parents avoid financial surprises. This bundled approach makes it easier to plan with confidence.
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.
Legal and Ethical Considerations
Surrogate pregnancy isn’t just a medical journey — it’s also a legal and ethical one. Because parentage laws vary widely between states and countries, it’s important for both intended parents and surrogates to work with experienced attorneys.
Clear contracts protect everyone’s rights and outline key details like compensation, decision-making, and parental rights.
In most cases, legal agreements are finalized before any medical procedures begin so that intended parents are recognized as the baby’s legal parents and that the surrogate is fully protected.
Depending on the state, parentage may be established through a pre-birth order or a post-birth court process.
Ethical considerations are also central to surrogacy. At Hatch, we prioritize the wellbeing of surrogates and intended parents by ensuring transparency, informed consent, and ongoing support. By focusing exclusively on gestational surrogacy (where the surrogate has no genetic link to the child), we help minimize potential legal and emotional complications.
For intended parents exploring surrogacy for the first time, having legal professionals guide you through these steps is essential and Hatch connects families with trusted legal partners to make the process as smooth and secure as possible.
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.
Frequently Asked Questions about Surrogate Pregnancy
Is the Surrogate Genetically Related to the Baby?
No. In gestational surrogacy — the only type offered at Hatch — the surrogate has no genetic link to the child. The embryo is created with the intended parents’ or donors’ egg and sperm, then transferred to the surrogate’s uterus.
Can a Friend or Family Member Be a Surrogate?
Yes, as long as they meet all medical and psychological screening requirements. Hatch provides the same thorough support and legal protections whether the surrogate is someone you know personally or someone matched through our program.
How Long Does the Surrogate Pregnancy Process Take?
From the first consultation to the baby’s birth, the process typically takes 12–18 months. This includes the time required for matching, legal contracts, IVF treatment, pregnancy, and delivery.
What Happens if the First Embryo Transfer Doesn’t Work?
It’s common for intended parents to need more than one embryo transfer. Hatch works closely with fertility clinics to plan for this possibility, and intended parents are guided through the next steps with ongoing medical and emotional support.
What Role Do Intended Parents Play During the Pregnancy?
Intended parents are encouraged to attend key appointments, stay in close communication with the surrogate, and participate in birth planning. Hatch helps coordinate these touchpoints so the journey feels collaborative and inclusive.
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