Process overview
The surrogacy process has 10 distinct phases. Most first-time surrogates take 18 months total. Here's the full sequence with realistic timelines for each step.
| Step | Phase | Timeline |
|---|---|---|
| 1 | Research and self-assessment | 1-4 weeks |
| 2 | Choose an agency | 2-4 weeks |
| 3 | Submit application | 2-6 weeks |
| 4 | Medical screening | 1-2 months |
| 5 | Psychological screening | 2-4 weeks |
| 6 | Matching with IPs | 1-6 months |
| 7 | Legal contracts | 2-6 weeks |
| 8 | Medical protocol + embryo transfer | 1-2 months |
| 9 | Pregnancy | ~9 months |
| 10 | Delivery and post-birth recovery | 4-8 weeks |
Step 1: Research and self-assessment (1-4 weeks)
Before contacting any agency, do the honest internal work. Can your body handle another pregnancy? Can your relationship handle an 18-month commitment? Is your motivation clear? If money is the only reason, will the hard parts be worth it?
This step is free. It's also the most important. Skipping it means you might realize 6 months in that this isn't actually right for you.
Step 2: Choose an agency (2-4 weeks)
Research 3-5 agencies. Check their SEEDS or ASRM membership, escrow practices, and reviews across multiple platforms. See our partner agency reviews for the four we work with, or our red flags guide for what to avoid.
Step 3: Submit your application (2-6 weeks)
The application is detailed. Expect questions about your full medical history, pregnancy records, current medications, photos, lifestyle details, criminal background, insurance, and motivations. Be honest — agencies verify everything.
Review typically takes 2-4 weeks. If approved, you move to medical screening.
Step 4: Medical screening (1-2 months)
Medical screening happens at the intended parents' fertility clinic, which may be in another state. You'll have bloodwork, a physical exam, uterine evaluation (sonohysterogram or hysteroscopy), pap smear, STI testing, drug screening, and a review of your pregnancy history.
The clinic — not the agency — makes the final medical clearance decision. You can pass agency screening and still be declined by the clinic. See our medical screening guide for details.
Step 5: Psychological screening (2-4 weeks)
Every surrogacy journey requires a psychological evaluation. You'll complete the MMPI-2 or PAI personality assessment (300+ questions), have a clinical interview with a licensed psychologist, and have your partner interviewed if applicable. About 10-15% of applicants don't clear this stage. See our psychological screening guide for more.
Step 6: Matching with intended parents (1-6 months)
This is the biggest variable. Once you clear screening, you enter the matching pool. Your flexibility on intended parent type, location, and contact level affects timing a lot. Matching can happen in 2 weeks or 6 months.
The match meeting is usually a video call. Both sides can decline. There's no pressure and there shouldn't be.
Step 7: Legal contracts (2-6 weeks)
Both sides hire attorneys. Yours is paid by the IPs but works for you alone. The contract covers compensation, medical decisions, communication expectations, miscarriage scenarios, insurance, and post-birth contact. Read every word. Don't let anyone rush this.
Step 8: Medical protocol and embryo transfer (1-2 months)
Your body is prepared with hormone injections (estrogen, then progesterone) for 2-4 weeks. Monitoring appointments confirm your uterine lining is developing properly. The embryo transfer is a short procedure at the fertility clinic — about 15 minutes.
After transfer, you wait 10-14 days for a blood test to confirm pregnancy. About 30-40% of first transfers don't result in pregnancy. If yours fails, you'll try again 1-2 months later.
Step 9: Pregnancy (~9 months)
Pregnancy itself is familiar (you've done it before) and different (you're carrying someone else's baby). Prenatal care, regular agency check-ins, continued hormone injections through the first trimester (10-12 weeks), communication with intended parents per your agreement.
If you're carrying multiples, you get extra compensation — typically $5,000-$10,000 for twins.
Step 10: Delivery and post-birth (4-8 weeks)
You deliver. In states with pre-birth orders (California, Illinois, and others), the intended parents are already the legal parents before the baby arrives. The hospital treats them as such from the moment of birth.
Final compensation is typically paid within 2-4 weeks. Your monthly allowance continues 1-2 months postpartum. Physical recovery is the same as any birth, longer for C-sections. Emotional processing is normal and expected.
Ready to start the process?
Our 2-minute quiz checks your eligibility and connects you with a partner agency. Step 1 takes less time than step 1 of anything else.
Take the quiz →Common process questions
Can I pause between steps?
Yes. You can pause at any point before signing the formal surrogacy contract with the intended parents. Some surrogates pause for a few months between screening and matching to handle life events. Most agencies are understanding about reasonable pauses.
What if I fail medical or psychological screening?
It depends on why. If you fail medical screening for a fixable issue (BMI, specific condition), you can address it and reapply later. If you fail psychological screening because of current high stress or unsupportive home environment, you can work on those and reapply. If the issue is a hard medical disqualifier (untreatable condition), that's typically permanent.
How does matching actually work?
Agencies typically send you a profile of one or more potential intended parents. You review their profile, family type, communication preferences, and personal story. If you're interested, the agency sets up a video call. Both sides then decide whether to move forward.
What if the first embryo transfer fails?
About 30-40% of first transfers don't result in pregnancy. If yours fails, you'll wait 1-2 months and try a second transfer with another embryo. Your contract should specify how many transfer attempts you've agreed to — typically 2-3.