The Complete Surrogacy Process: STEP-BY-STEP
Surrogacy is a major undertaking, and for most intended parents the biggest source of anxiety is simply not knowing what comes next. This guide lays out the surrogacy process step by step, from the first moment you consider surrogacy through to bringing your baby home, including how ADONIS Fertility Solutions supports intended parents at each point in the gestational surrogacy process step by step.
Contact us today to learn more about how we can help you build your family through surrogacy.
What Is the Surrogacy Process?
The surrogacy process refers to the full journey undertaken by intended parents to engage a gestational carrier to carry and deliver a child on their behalf. It involves selecting an agency, undergoing medical screening, embryo creation and transfer, navigating legal agreements, supporting a pregnancy through delivery, and finalizing legal parenthood. The process of surrogacy is a coordinated sequence of medical, legal, and emotional steps that typically unfolds over more than a year.
How Gestational Surrogacy Works
There are two types of surrogacy — traditional and gestational. In gestational surrogacy the carrier has no genetic connection to the baby. An embryo is created through IVF using the intended parents’ genetic material or donor eggs and sperm, then transferred to the carrier’s uterus. This model is widely considered to be safer and more legally protected, which is why ADONIS Fertility Solutions exclusively uses it.
Who Is Involved in the Process
A typical surrogacy journey involves several parties, including the intended parents, the gestational carrier, and the legal counsel for all parties. Intended parents are at the center of the process, which is designed to ensure the well-being of the child and the satisfaction of the parents. The pregnancy is carried by the gestational carrier. A fertility clinic manages the in vitro fertilization (IVF) and embryo transfer processes. A surrogacy agency coordinates matching. The agency also coordinates scheduling. The agency facilitates communication. The surrogacy agreement is legally binding and protects the rights of all parties involved. An egg or sperm donor is also part of the process where applicable.
How Long the Surrogacy Journey Takes
The typical complete surrogacy timeline takes 12 to 18 months from the initial consultation to welcoming the baby home, with variations depending on factors such as state or country laws, surrogate availability, and the presence of any complications. Every surrogacy journey is unique, but working with an experienced agency can help intended parents understand a realistic timeline from the beginning.
Step 1: Deciding if Surrogacy Is the Right Path
When Intended Parents Consider Surrogacy
The majority of people end up pursuing surrogacy after trying other options first. These options may include repeated unsuccessful in vitro fertilization (IVF) treatments, a medical diagnosis that makes pregnancy unsafe, the absence of a uterus, or the realization that pregnancy is not biologically feasible for their family structure. For many, surrogacy is not a backup plan; it is the only way to have a biological child. Understanding how to start surrogacy process begins with an honest look at why this path makes sense for your family.
Common Reasons for Choosing Surrogacy
The most common medical reasons for using gestational surrogacy include uterine factor infertility, recurrent pregnancy loss, repeated implantation failure, and health conditions that pose risks during pregnancy, such as certain heart or kidney conditions. Gestational surrogacy with egg donation is a method used by same-sex male couples and single intended fathers to have a genetically related child, in addition to medical reasons. When carrying a pregnancy is not medically advisable, single women and same-sex female couples may also pursue surrogacy.
Alternative Family-Building Options
Before committing to surrogacy, many intended parents also consider adoption, egg or embryo donation combined with their own pregnancy if possible, or fostering. Each option has its own timeline, cost, and legal framework. For those who want a genetic connection to their child and for whom pregnancy is not possible, gestational surrogacy remains the most direct family-building journey available.
Step 2: Choosing a Surrogacy Agency and Fertility Clinic
Agency Selection Criteria
Choosing the right agency is one of the most consequential surrogacy steps in the entire process. Look for a transparent track record, in-house legal support, a substantial database of pre-screened gestational carriers, and a dedicated coordinator model. Ask how long the agency has operated, how many completed journeys it has supported, and whether services are managed in-house or outsourced. These early steps to surrogacy and steps for surrogacy success map the surrogacy step by step process from day one.
Clinic Selection Factors
The fertility clinic handling the medical side should have its own embryology laboratory, experienced reproductive endocrinologists, and a track record with international patients if traveling abroad. Ask about laboratory accreditation, embryo transfer success rates, and how the clinic coordinates with the agency and legal team. A fertility clinic operating within the same organization as the agency reduces handoff risk.
ADONIS Fertility Solutions Is Ideal For
ADONIS Fertility Solutions is ideal for intended parents who want a single organization managing the entire journey — medical, legal, and coordination — rather than juggling providers. It suits international families from the US, Canada, the UK, and Australia who want fixed-price programs, in-house legal teams, and English-speaking coordinators. It also suits those who had a difficult experience with a previous agency.
Step 3: Surrogate Screening and Qualification
Medical Screening
Every gestational carrier candidate undergoes comprehensive medical screening before approval. This includes a full reproductive health assessment, screening for infectious diseases, evaluation of uterine health, and confirmation of at least one prior healthy pregnancy and delivery with no significant complications. Medical screening is one of the most rigorous parts of the surrogate mother process and is non-negotiable.
Psychological Evaluation
A licensed mental health professional evaluates each candidate’s emotional readiness, understanding of the arrangement, motivation, and support system. This helps ensure the gestational carrier fully understands what the journey involves, including the emotional aspects of carrying a pregnancy for someone else and relinquishing the baby at birth. Emotional support resources are typically available to surrogates throughout the program.
Background Checks
Background checks confirm the candidate’s identity, criminal history where applicable, and financial stability — checked partly to ensure the surrogate is not under financial pressure that could affect her decision-making. Reference checks with previous agencies, if applicable, are also part of a thorough screening process.
Insurance Review
Before matching, the program reviews what insurance coverage will apply to the surrogate’s pregnancy and delivery. In international programs such as those based in Ukraine, this typically means a dedicated surrogacy insurance product covering pregnancy-related medical expenses and complications, since standard health insurance policies are not designed for gestational surrogacy arrangements.
Step 4: Matching with a Surrogate
Matching Process
Once intended parents complete initial paperwork and medical clearance, the agency presents profiles of pre-screened, approved gestational carriers. Intended parents review medical history, psychological evaluation summaries, personal background, and photographs. This matching step is central to the surrogacy roadmap, since the relationship continues throughout the pregnancy.
Compatibility Factors
Matching preferences vary by family. Some prioritize the surrogate’s location relative to the clinic, others focus on communication style, openness to contact during pregnancy, or lifestyle factors. Compatibility is assessed on both sides — gestational carriers also review information about intended parents before confirming a match.
Expectations and Communication
Once matched, intended parents and the gestational carrier typically have an introductory conversation, often facilitated by the agency, covering communication during pregnancy, involvement in medical appointments, and other preferences. Clear expectations set early help prevent misunderstandings later.
Step 5: Legal Contracts and Parentage Planning
Surrogacy Agreement
The surrogacy agreement is the legal foundation of the arrangement. It outlines the rights and responsibilities of both sides, compensation structure, medical decision-making authority, and the process for establishing parentage after birth. It must be signed and, where required, notarized before any medical procedures begin.
Independent Legal Representation
Best practice — and often a legal requirement — is for the gestational carrier to have her own independent legal counsel, separate from the intended parents’ attorney. This protects the gestational carrier journey for everyone and reduces the risk of disputes later. At ADONIS, legal representation for all parties is coordinated in-house for efficiency.
State-Specific Requirements
For US-based programs, state surrogacy laws vary significantly. Some states have explicit statutes supporting surrogacy agreements and pre-birth parentage orders, while others restrict compensated surrogacy. For international programs, the relevant framework is that of the destination country — in Ukraine, the law explicitly recognizes intended parents as legal parents from birth for married couples with a documented medical indication.
Step 6: Embryo Creation
Embryo creation is the first medical milestone in the process of surrogacy pregnancy. If intended parents have their own viable eggs and sperm, an IVF cycle retrieves eggs, fertilizes them, and cultures the resulting embryos in the laboratory. If donor eggs or sperm are needed, that cycle is coordinated first. Embryos are graded for quality, and many programs run genetic testing before selecting the embryo for transfer. If intended parents already have frozen embryos from a previous cycle, this step may simply involve shipping those embryos to the clinic — the basis of frozen embryo transfer programs offered by clinics including ADONIS.
Step 7: Medical Preparation for Embryo Transfer
Before the embryo transfer, the gestational carrier undergoes hormonal preparation to optimize the uterine lining. This involves a medication protocol and monitoring through ultrasounds and bloodwork over several weeks. Timing is critical — the transfer is scheduled based on precise tracking of the carrier’s cycle. Meanwhile intended parents typically complete required medical examinations, which at ADONIS can be done in their home country or at the clinic in Ukraine.
Step 8: Embryo Transfer Procedure
The embryo transfer procedure itself is a brief, minimally invasive outpatient process — often the shortest step in the surrogacy full procedure despite being one of the most anticipated. A thin catheter places the embryo into the gestational carrier’s uterus, guided by ultrasound. No anesthesia is typically required, and the carrier can resume normal activities shortly after. About ten to fourteen days later, a blood test confirms whether the transfer resulted in pregnancy. If unsuccessful, the process may repeat with another embryo as part of the surrogacy full process.
Step 9: Pregnancy and Prenatal Care
Once pregnancy is confirmed, the surrogate motherhood process enters its longest phase. The gestational carrier begins a full schedule of prenatal care, including regular ultrasounds, bloodwork, and obstetric check-ins. The agency coordinates all appointments and sends intended parents regular updates, including images, scan results, and progress reports. Many programs allow ongoing contact with the gestational carrier if both sides wish, while the agency manages logistics and pre-birth legal processes in the background.
Step 10: Delivery and Birth Planning
As the due date approaches, the agency coordinates logistics so intended parents can be present for the birth, including travel arrangements, hospital registration, and a birth plan covering who is present in the delivery room and immediate post-birth procedures. At ADONIS, the intended parents’ stay at the maternity hospital during delivery is fully covered, allowing them to be fully present for this milestone.
Step 11: Establishing Legal Parenthood
Birth Certificate Process
Immediately following birth, the legal process to establish intended parents as the child’s legal parents begins. In jurisdictions with pre-birth orders, this paperwork may be largely complete before delivery. In Ukraine, intended parents who are married with a documented medical indication are named on the birth certificate from birth, without a separate court order — one of the most significant advantages of the country’s framework.
State Law Considerations
For US-based arrangements, establishing parenthood depends heavily on state surrogacy laws. Some states allow a pre-birth order before the baby is born, while others require post-birth adjudication. International intended parents must also navigate their own country’s requirements for recognizing the foreign birth certificate and obtaining travel documents and citizenship for the newborn.
Step 12: Postpartum Recovery and Journey Completion
Transition for Intended Parents
After birth, the gestational carrier receives postpartum medical care and any agreed-upon recovery support, while the final leg of the intended parent journey shifts toward documentation and travel. For intended parents, this stage involves final legal documentation, obtaining the birth certificate, and — internationally — applying for the newborn’s passport and citizenship through their embassy. Once complete, the full process of surrogacy is concluded, though many maintain a relationship afterward if both sides wish.
How Long Does the Surrogacy Process Take?
Timeline by Phase
Breaking the step-by-step surrogacy process into phases for a complete surrogacy timeline helps set realistic expectations. Initial consultation and agency agreement take a few weeks. Surrogate matching usually takes four to eight weeks. Legal contracts run in parallel and add a few more weeks. Embryo creation, if starting from scratch, adds several weeks to a few months depending on donor eggs. Medical preparation and the transfer cycle take roughly four to six weeks. The pregnancy accounts for the largest portion at approximately nine months. Post-birth documentation typically adds three to six weeks.
Common Delays
The most common sources of delay are an unsuccessful first embryo transfer requiring a repeat cycle, slower-than-expected matching due to specific preferences, additional medical testing, and post-birth documentation timelines that vary by country. International travel logistics and embassy processing times can also extend the final stage.
Ways to Shorten the Timeline
Intended parents can shorten the journey by arriving with frozen embryos already created, being flexible on matching preferences to widen the pool of carriers, completing medical examinations promptly, and choosing a program where medical, legal, and coordination functions are handled by a single organization.
How Much Does the Surrogacy Process Cost?
Surrogacy expenses vary depending on program structure and destination. In the US, a full domestic program typically costs between 100000 and 150000 dollars, covering surrogate compensation, agency fees, legal fees, and medical costs. International programs based in Ukraine through ADONIS offer significantly lower total costs at comparable medical standards — ranging from approximately 43840 dollars for intended parents with frozen embryos, up to 75430 dollars for programs with unlimited transfer attempts and live birth protection. Costs depend mainly on whether egg donation is needed, how many transfer attempts are included, and whether the program has a guarantee structure.
Risks and Challenges During the Surrogacy Process
Medical Risks
As with any pregnancy, medical risks exist for the gestational carrier, including the first transfer not resulting in pregnancy, pregnancy complications, premature birth, or an unplanned cesarean. Reputable programs mitigate these through thorough screening, continuous prenatal monitoring, and dedicated insurance for unexpected situations.
Legal Risks
Legal risks arise from inadequate surrogacy agreements, unclear or unfavorable state surrogacy laws, and international cases where recognition of the foreign birth certificate is not straightforward. These risks are significantly reduced by working with an agency that provides independent legal representation and has direct experience navigating local and international requirements.
Emotional Challenges
The surrogacy journey is emotionally demanding for both sides. Intended parents often experience anxiety around relinquishing control of the pregnancy, while the surrogate navigates the reality of carrying a pregnancy she will not raise. Emotional support — through psychological screening, ongoing check-ins during pregnancy, and clear communication agreements — is essential for everyone involved.
Financial Risks
Financial risk mainly relates to programs without fixed pricing, where additional transfer attempts or unexpected complications add unplanned costs. Programs with guarantee structures — covering additional cycles within a fixed fee until confirmed pregnancy or live birth — substantially reduce this risk.
How ADONIS Fertility Solutions Supports Intended Parents on Their Surrogacy Journey
ADONIS Fertility Solutions manages the surrogacy process step by step as a single, coordinated journey rather than handoffs between separate providers. It begins with a complimentary consultation with a program coordinator, who answers questions and builds a customized proposal. Once accepted, a program coordination agreement is finalized.
ADONIS then matches intended parents with a gestational carrier from its pre-screened database based on medical and psychological testing results, shared with intended parents for review before final approval. The surrogacy agreement is then drafted, reviewed, and finalized.
During the medical phase, ADONIS’s reproductive specialists create a personalized treatment plan, including examinations that can often be completed in the intended parents’ home country or at the ADONIS Medical Center in Ukraine. Intended parents may meet their gestational carrier before signing, and cryopreservation services are available for sperm storage where needed.
Once pregnancy is confirmed, ADONIS coordinates all medical appointments and provides regular updates, including ultrasound results, videos, and photos. ADONIS manages pre-birth legal processes and ensures intended parents’ presence at the maternity hospital for delivery, with the stay fully covered. After birth, ADONIS provides comprehensive support obtaining the birth certificate and completing the journey.
Adonis Fertility International became such a blessing to us. When they say they find the best and most affordable help for you, they mean it. Today, we are proud parents of a beautiful boy, who at the age of 4 is a complete copy of his dad. I cherish the bond they have together. I have my two most precious men in my life. My heart is full.”
I had many failed IVF attempts, I was struggling for a long time to have a baby. Adonis offered 2 candidates of surrogate mothers who were completely healthy women. It was difficult to choose between the two. And the medical and support teams were exceptional! So, finally, our baby was born and that’s wonderful! Now, our little Javi is 2 years old and is the greatest happiness of our life!
Adonis’ clear direct communication and thorough review of our situation helped us make some hard decisions. They are clearly at the top of their game and I trust them completely. I recommend this team to everyone I know!”
When we came to Kiev for the delivery of our daughter, we were blown away by the quality and the technology used at Adonis Medical Center. It is everything you would expect from the top-notch facilities with the most cutting edge technology working for us and the most brilliant doctors fighting the fight with us. We have two beautiful children now, thanks to Adonis Surrogacy Smart Program.
Our baby is our life. Our everything! I know you are juggling between many choices right now. All I could say, just speak to Adonis – include them in your possible options list. We did and never looked back. They have been a gift to us.
We were facing a choice between surrogacy or adoption. My husband and I had to be very open about the options. I am so grateful he was able to share his deep thoughts on how important it is for him to have a genetic connection to a child. I could have gotten mad at him – now that I am feeling so low, all you could think is your blood line?! But our trust and respect for each other, is what makes us strong. Adonis Fertility International became such a blessing to us. When they say they find the best and most affordable help for you, they mean it. Today, we are proud par-ents of a beautiful boy, who at the age of 4 is a complete copy of his dad. I cherish the bond they have together. I have my two most precious men in my life. My heart is full.
Surrogacy is such a vulnerable subject. When I came into the process, I felt so low of myself. My self-image just plummeted. My husband and I already have spent crazy amount of money on IVF and nothing was working. We did not know how much further can we go.I was lucky one of my friends told us about Adonis Fertility. I am so grateful to have found them. They delivered on every promise, managed every little detail for us, and we did not have to get a second mort-gage to reach our dream.
Infertility is emotional, painful, hard, and affects your relationship in so many ways. It tested me and my husband like we would never imagine. Adonis Fertility International has been incredible! They became a family to us. I hope they will for you as well.
Our surrogate mom was amazing! Although she was in Ukraine, she was big part of our life. It was so important for us to see her growth with our baby, to know how she is feeling, to under-stand her habits, routine, to be able to discuss her diet, exercises, and to see where she lives. Adonis Fertility International made the technology work for us and seem as we are right next to each other. She was the sweetest and most intelligent person ever. We can’t even begin to ex-press how happy we are.
I must be honest. We have not been outside of the United States ever. Going to Kiev, Ukraine for our surrogacy was a stretch big time. So many people around us said we are crazy. I am so glad we did not listen to any neigh-sayers. No problems legally or medically. Loved the hospitality, professionalism, open communication, honesty, transparency. We are lucky parents of Mia and Ethan.
The staff at Adonis are friendly and professional. They set up everything and walked us through every step. From receiving us at the airport, setting us up at an apartment, accompanying us for our first grocery shopping trip, to scheduling visits to the clinic and government departments, all were well planned. I simply cannot give higher praise to Adonis’ services.
We cannot say enough good things about Maria Feekes, the NA Executive Director, the company, and Adonis Medical Group in the Ukraine. In 38 years, we’ve tried, had 12 miscarriages, and spent all our money trying to have children. Maria worked with us and the clinic to make things affordable. She even came to the Ukraine with us to ensure everything ran smoothly, helped with documents, and helped to get our biological material shipped on time and without incident. She was amazing through all of it. I have not heard of anybody having the level of service we received from Adonis. We highly recommend them to to anybody hoping to achieve their dream of having a baby.”
We would not be able to afford surrogacy if it wasn’t for ADONIS. Both the United States and the Ukraine have phenomenal services, but in Ukraine, it is provided at a fraction of the cost. The first embryo implanted resulted in pregnancy, and now we have our beautiful 8-month-old daughter. ADONIS is a reputable company. The medical facilities and the doctors are on par with what you would expect in the US.
Our baby is our life. Our everything! I know you are juggling between many choices right now. All I can say is just speak to Adonis – include them in your possible options list. We did and never looked back. They have been a gift to us.
FAQ
How Long Does Surrogacy Take?
On average, the complete surrogacy process takes 12 to 18 months from first consultation to bringing the baby home — including surrogate matching, legal contracts, embryo creation if needed, the transfer cycle, the nine-month pregnancy, and post-birth documentation.
What Happens First in Surrogacy?
The first step is typically a consultation with a surrogacy agency to discuss the situation, review program options, and receive a customized proposal. Once intended parents decide to proceed, a program coordination agreement is signed before any matching or medical steps begin.
How Do Intended Parents Start Surrogacy Process?
For intended parents wondering how to start the surrogacy process, it begins with researching and selecting an agency and fertility clinic, completing an initial consultation, reviewing program options and costs, and signing a program coordination agreement. From there, the agency begins the matching process within the broader process of gestational surrogacy while intended parents complete any required medical evaluations.
How Do Surrogates Get Matched?
Gestational carriers are matched based on medical and psychological screening results, matching preferences such as location and communication style, and mutual profile review by both sides. Once both agree to the match, the surrogacy agreement is drafted and finalized.
What Are the Stages of Surrogacy?
The main stages of the surrogate process are deciding on surrogacy, choosing an agency and clinic, surrogate screening, matching, legal contracts, embryo creation, medical preparation, embryo transfer, pregnancy, delivery, legal parenthood, and postpartum completion — the full process of using a surrogate mother from start to finish.
What Happens After Matching?
After matching, the surrogacy agreement is drafted and finalized. Intended parents complete required medical examinations, and the medical team begins preparing for embryo creation or transfer depending on whether embryos already exist.
When Are Legal Contracts Signed?
The surrogacy agreement is signed after matching is confirmed and before any medical procedures begin, including the embryo transfer cycle. This ensures all parties’ rights and responsibilities are established prior to the medical phase.
How Does Embryo Transfer Work?
The embryo transfer procedure involves placing an embryo into the gestational carrier’s uterus using a thin catheter guided by ultrasound, after a period of hormonal preparation to optimize the uterine lining. Whether using a fresh embryo or a frozen embryo transfer, the procedure is brief and typically requires no anesthesia, with a pregnancy test performed about ten to fourteen days later — one of the most pivotal moments in the surrogate pregnancy process.
How Long Does Surrogate Screening Take?
Surrogate screening, including medical evaluation, psychological assessment, and background checks, typically takes several weeks. As part of the surrogacy medical process step by step, this timeline can run in parallel with intended parents’ own initial paperwork and medical evaluations, so it does not necessarily add extra time to the overall process if managed efficiently by the agency.
How Many Embryo Transfers Are Usually Needed?
Many gestational surrogacy journeys succeed on the first embryo transfer, but additional attempts are commonly needed. Programs with guarantee structures cover multiple attempts within a fixed fee, which is worth considering when evaluating surrogacy expenses across program types.
What Happens After the Baby Is Born?
After birth, the gestational carrier receives postpartum care, and the legal process to establish the intended parents as the child’s legal parents proceeds — in Ukraine this means the birth certificate names them from birth. International intended parents then complete passport and citizenship documentation through their embassy before traveling home.
Personalized Local Coordinators with Global Reach
At Adonis Fertility International Solutions, we prioritize exclusive personalized care, with our local coordinators who have a global reach and are dedicated to addressing your specific needs. Unlike many transnational fertility agencies, we don’t simply claim a location on a map that leads to a virtual address or P.O. Box in a country. We are physically present in your country, ensuring reliability, accountability, and a genuine connection with you.
What is the process of Surrogacy? How does the Surrogacy process work?
How long does the Surrogacy process take? How much is the Surrogacy process?
Still have questions? Do not hesitate to contact our professional managers to get more information about Surrogacy!
