Surrogacy Process Overview
Surrogacy is a family-building arrangement where a woman (the surrogate) carries a pregnancy for intended parents who cannot carry a child themselves. Intended parents choose this path due to medical conditions, fertility challenges, or being in a same-sex relationship. The surrogacy process involves matching with a surrogate, medical procedures including IVF, legal agreements, pregnancy monitoring, and the joyful milestone of birth and transition to parenthood.
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Surrogacy Process by Country
The surrogacy process varies significantly worldwide. Laws range from fully supportive to prohibitive, with costs typically between €50,000-250,000 depending on location. When selecting a destination, consider legal frameworks protecting parental rights, surrogate availability, quality of medical care, the overall surrogacy infrastructure and total costs. Local regulations directly impact how smoothly your journey will progress and your legal recognition as parents.
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Surrogacy Process in the USA
The USA offers strong legal surrogate protections but with significant state-by-state variations. Costs are significantly higher than in all other countries, making it the most expensive option. The surrogacy process in the US involves working with established agencies that handle matching, screening, and coordination. Alternatively, some intended parents opt to proceed with an independent journey where they handle all the processes alone. Pre-birth orders in surrogate-friendly states ensure intended parents are named on the birth certificate immediately. The comprehensive support system and legal clarity make the USA very attractive despite higher costs.
Surrogacy Process in Colombia
Colombia has emerged as a popular destination with its progressive surrogacy framework. Costs are relatively affordable, much less than in the USA, offering good value while maintaining quality care. The surrogacy process requires at least one intended parent to have a genetic link to the child. After birth, the surrogate signs legal documents relinquishing parental rights, and DNA testing confirms the biological connection, allowing new birth certificates to be issued. Colombia welcomes international and same-sex intended parents, making it increasingly sought-after.
Surrogacy Process in Georgia
Georgia offers a structured surrogacy procedure for heterosexual married or cohabiting couples only. The process is competitively priced (on average slightly higher than in Ukraine) and provides strong legal protections with intended parents named directly on birth certificates. Georgian law clearly defines surrogates as having no parental rights, simplifying the legal process. Agencies coordinate the entire journey, from surrogate matching to birth. The combination of clear laws, direct birth certificate recognition, and reasonable costs makes Georgia attractive despite eligibility restrictions and recent shortages of local Georgian surrogates.
Surrogacy Process in the UK
The UK permits only altruistic surrogacy with reasonable expense reimbursement (which is notably less expensive than programs in many other countries, but additional expenses can set the price much higher). The surrogacy process involves surrogate-first birth certificate registration, with intended parents applying for a Parental Order after birth to become legal parents. No pre-birth contracts are enforceable, requiring mutual trust between parties. Most arrangements occur through non-profit organisations that facilitate matching and provide guidance, with surrogates retaining parental rights until the court process completes several months post-birth.
Surrogacy Process in Ukraine
Ukraine offers gestational surrogacy exclusively to married heterosexual couples with a medical need. Costs are relatively affordable, with clear legal frameworks allowing intended parents to be registered directly on birth certificates. The Ukrainian surrogacy procedure requires contracts between the surrogates and the intended parents to be signed before embryo transfer, with local agencies coordinating the entire process. Intended mothers must provide medical documentation proving inability to conceive or carry pregnancy. Both parents must travel to Ukraine for the birth registration.
Surrogacy Process in Mexico
Mexico's surrogacy process has gained popularity following the 2021 Supreme Court ruling protecting access to surrogacy regardless of nationality, sexual orientation, or marital status. Costs are moderately priced if we compare them to other countries. The legal surrogate framework requires one intended parent to have a genetic connection to the child. Post-birth legal processes allow intended parents to be named on the birth certificate after DNA testing confirms biological relationships. Conveniently, there is also an option of a pre-birth legal process ensuring that the names of both intended parents are listed on the original birth certificate. Local agencies facilitate the entire journey, from surrogate matching through birth and parentage establishment.
Stages of the Surrogacy Process
The surrogacy process realistically takes 18-20 months from start to finish. Each stage builds on the previous one, creating a path to parenthood that requires patience and preparation. Understanding what happens at each point helps intended parents plan properly and manage their expectations throughout this life-changing journey.
1. Initial Consultation & Agency Selection
Finding the right support team is crucial when starting your surrogacy journey. Research agencies in your chosen country by checking their track record, reading client reviews, and understanding their fees. Good agencies will openly share all costs without hiding any charges.
When you meet with agencies, ask about how they screen surrogates, their success rates, and how they handle problems if they come up. Don't be shy about asking for references from families who've completed the process.
Working with an independent consultant during this stage can be incredibly helpful. I provide unbiased advice about different agencies and explain what each package truly includes. This saves you from pressure tactics and helps you make decisions based on facts rather than emotions.
Start thinking about legal matters early. Each country has different rules about how you become the legal parents of your child. Understanding these requirements from the beginning prevents headaches later on.
Many intended parents tell me this research phase feels overwhelming at first, but having expert guidance makes it manageable. Take your time with this decision – the agency you choose will be your partner throughout this important journey.
2. Medical Process for Embryo Creation
The process of creating embryos in gestational surrogacy begins with the collection of genetic material from either the intended parents or donors. This typically involves in vitro fertilization (IVF), a sophisticated assisted reproductive technology. Here's how the medical process works:
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Egg Retrieval: The first step involves stimulating the intended mother's or the egg donor's ovaries to produce multiple eggs through hormonal injections. Once the eggs are mature, they are retrieved in a minor surgical procedure performed under sedation.
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Sperm Collection: The sperm used for fertilization is typically provided by the intended father or a sperm donor. Sperm is collected through masturbation, processed in a laboratory, and prepared for fertilization.
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Fertilization: The retrieved eggs are then fertilized in the laboratory using the sperm. The most common method of fertilization is conventional IVF, where sperm is placed directly with the egg. Alternatively, in cases of male infertility, intracytoplasmic sperm injection (ICSI) may be used, where a single sperm is injected directly into an egg.
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Embryo Development: The fertilized eggs (embryos) are monitored for several days, typically up to five, to assess their development. The embryos are graded based on their quality, and the best-quality embryos are selected for transfer.
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Genetic Screening: Genetic screening, such as Preimplantation Genetic Testing (PGT), may be performed on the embryos to check for chromosomal abnormalities (such as Down syndrome, Turner syndrome, etc.) and to determine whether the embryo is genetically normal. This screening can also reveal the embryo's gender. Only the embryos with the best genetic quality and chromosomal integrity are selected for transfer.
3. Matching with a Surrogate
Finding the right surrogate is perhaps the most personal part of the surrogacy process. Agencies will show you profiles of women who match your preferences and requirements. These profiles include health history, previous pregnancies, lifestyle information, and personal values.
The surrogate screening should be thorough and include:
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Full medical exams and fertility checks
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Psychological evaluations
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Criminal background checks
Beyond medical qualifications, a good match depends on compatible communication styles and similar expectations about involvement during pregnancy. Some intended parents want weekly updates, while others prefer more or less contact.
The matching process usually takes 2-4 months, though this varies depending on your specific needs and the availability of surrogates in your chosen location.
Once the agency identifies a potential match, you should request to arrange a meeting (often by video call) where both sides can ask questions and see if there's a natural connection. Many intended parents describe this meeting as a "first date" feeling - a bit nervous but exciting. Trust your instincts during this process; the right match often feels comfortable from the start.
4. Legal Preparation
On the legal side, contracts protect everyone's rights and spell out expectations clearly. These agreements cover:
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Payment schedules and financial arrangements
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Who makes medical decisions during pregnancy
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How much contact you'll have during and after pregnancy
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Birth plans and hospital arrangements
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How legal parenthood will be established
In some locations both you and your surrogate need separate lawyers during contract negotiations. Your legal team will explain what's required in your chosen location and make sure the contract follows local laws. Some places require court approval before medical procedures can begin, which adds time to the process.
This stage also involves setting up escrow accounts (for the US and Canada), finalizing insurance coverage, and preparing for unexpected expenses. Good agencies manage funds transparently, releasing payments at specific milestones. Understanding the complete financial picture helps avoid surprises later.
Many intended parents find this preparation phase requires patience, but it creates the secure foundation needed for a smooth journey ahead.
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5. Embryo Transfer & Pregnancy
The embryo transfer is a pivotal moment in your surrogacy process. Before the transfer, your surrogate receives hormone treatments to prepare her body for pregnancy.
During the actual transfer, the doctor places one or more embryos (make sure it is never more than two to avoid additional risks) in the surrogate's uterus in a quick, simple procedure. Then comes the "two-week wait" until a pregnancy test can confirm if it worked. Surrogacy success rates at good clinics range from 50-75% per transfer, though sometimes multiple attempts are needed.
After confirming pregnancy, your surrogate continues taking hormones for the first 8-12 weeks until the placenta fully develops. Early monitoring includes frequent ultrasounds and blood tests to check embryo development.
This phase brings mixed emotions for everyone. You might feel excited but anxious about being so physically removed from the pregnancy. Your surrogate is experiencing physical changes while carrying a child for someone else. Open communication through agreed channels helps build trust during this time.
6. Pregnancy Monitoring & Support
During pregnancy, your surrogate attends regular check-ups that track both her health and your baby's growth. I've found that clinics usually schedule more frequent visits for surrogacy pregnancies, especially in those first 12 weeks. After each appointment, you'll receive updates – intended parents love getting those ultrasound pictures!
While the pregnancy progresses, you'll be getting ready for your baby's arrival – setting up the nursery, buying those tiny clothes, and perhaps reading every parenting book you can find! For international arrangements, you'll also need to plan your travel for the birth and sort out how long you'll need to stay afterwards for paperwork.
I've watched many intended parents form genuine connections with their surrogates during pregnancy. There's something special about sharing this experience, even when you're miles apart. Some of my intended parents prefer to send their surrogate a small gift after each milestone appointment – little gestures that help build that relationship despite the distance.
7. Birth & Parental Transition
As you get closer to the due date, everyone finalises the birth plan – who'll be in the delivery room, what hospital you'll use, and how the first hours after birth will unfold. Your surrogacy team works with the hospital staff so everyone understands your unique situation.
Birth experiences vary hugely. I've had clients who were right there in the delivery room cutting the umbilical cord, while others first met their baby in the recovery room. It really depends on the hospital policies, your surrogate's preferences, and what feels right for you. That moment when you first hold your baby – after all the waiting, paperwork, and emotional ups and downs – is absolutely magical.
After birth, the focus shifts to securing your legal parenthood. This looks different depending on where your baby was born:
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In some places like Ukraine, you're immediately named on the birth certificate
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In countries like Colombia, the surrogate is initially listed, and you'll need DNA testing to amend it
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The UK requires a Parental Order process that takes several months after birth
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Some jurisdictions need court appearances before you can take your baby home
Your baby will have the usual newborn check-ups before leaving the hospital. Some surrogates want to spend time with the baby before saying goodbye, while others prefer a quicker transition. I always encourage respecting the surrogate's wishes here – she's just completed an incredible journey too.
The final hurdle for international arrangements is obtaining travel documents. You'll need birth certificates, possibly DNA test results, and sometimes court orders. This can take anywhere from a few days in well-established destinations to several weeks in countries with less streamlined processes. So get a Netflix subscription, download plenty of content, and be patient while you wait!
Bringing your baby home doesn't always mark the end of the surrogacy process. In some countries like the UK, Ireland, Germany, and others, the legal part will still need to be finalized. However, for many families, it's just the beginning of their family story. Many of my clients maintain relationships with their surrogates – sending photos, updates, and sometimes planning visits. One family I worked with celebrates their 'surrogiversary' each year by sending their surrogate a photo book showing how their child has grown.
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FAQ
From my experience working with over 250 families, most journeys take 18-20 months from first consultation to baby in arms. I had one couple complete everything in 12 months (they arrived at the clinic in December, created the embryos fast, matched with a surrogate quickly, their first transfer was successful and they welcomed twins in December of the following year), while another journey took nearly 4 years due to failed transfers and COVID travel restrictions. Every journey is unique!
Almost all modern arrangements use gestational surrogacy, where the surrogate has no genetic connection to your baby. The embryo comes from the intended parents' or donors' eggs and sperm. Traditional surrogacy (rarely used now) would use the surrogate's own eggs, creating both legal complications and emotional challenges for everyone involved.
The clinics I work with see success rates between 55-70% per embryo transfer, much better than standard IVF. One clinic in Albania has achieved 73% first-transfer success over the past two years. When considering multiple attempts, nearly all intended parents eventually succeed – I've only had two clients who didn't achieve pregnancy after five transfers.
Working in this field since 2019, I've rarely seen issues with surrogates not following guidelines. These women go through intense screening specifically designed to assess their commitment as well as access medical compatibility. In some countries, the contract spells out exactly what the surrogate can and cannot do during the pregnancy. Most surrogates are personally invested in delivering a healthy baby – after all, that’s why they became surrogates. Additionally, they are motivated by the financial compensation, which is often an important factor in their decision to participate in this process.
Adoption is generally a more financially accessible path to parenthood compared to surrogacy. While both journeys involve expenses, surrogacy typically requires a significantly greater financial investment. The difference in cost reflects the different processes and levels of control. With surrogacy, you're involved from conception and know exactly what prenatal care is provided. Adoption timelines can be unpredictable – I've had clients wait years for placement prior to turning to international surrogacy and their journey was much quicker.
Adoption and surrogacy are distinct paths to building a family. Surrogacy involves a direct connection from conception to pregnancy, while adoption involves welcoming a child into the family. Adoption timelines can be less predictable due to legal processes and matching with a child in need of a home. Surrogacy journeys, on the other hand, have a more defined and potentially quicker timeline from the start of the process to welcoming the child.
