Becoming a surrogate follows a clear path: confirm you meet the requirements, apply and complete medical and psychological screening, match with intended parents, sign contracts with separate lawyers, go through IVF and the embryo transfer, carry the pregnancy, and hand the baby to its parents at birth.
I carried twice, and the honest version is that the medical side is the part people over-worry about and the emotional and logistical side is the part they under-prepare for. Below is what each stage actually involves, including the things no one told me going in.
The two types of surrogacy
Before anything else, it helps to know which kind of surrogacy you would be doing, because it changes the medical process and the legal picture. What are the main types of surrogacy? In gestational surrogacy, you carry an embryo made through IVF from the intended parents' or donors' eggs and sperm, so you have no genetic connection to the baby. In traditional surrogacy, you would use your own egg, making you the biological mother.
Almost every arrangement today is gestational, and that is what most of this guide describes. The lack of a genetic tie keeps the emotional and legal boundaries clear, which is why most clinics and nearly all surrogates prefer it. For a fuller explainer, see gestational surrogacy.
Do you qualify to be a surrogate?
Not everyone can be a surrogate, and knowing the criteria up front saves you months. In broad terms, you need to be:
- 21 to 43 years old
- Have had at least one healthy full-term pregnancy
- Be raising at least one child of your own now
- Have a BMI in the healthy range (typically 18 to 33)
- Be a non-smoker
- Be financially stable rather than relying on the pay to cover basics
Those are the headline requirements; the full medical, lifestyle, and legal criteria are in our guide to surrogate qualifications. If a specific condition or history has you worried, disqualifications for surrogacy covers what tends to rule someone out and why.
The steps in the surrogacy process
The process moves through the same stages whether you go through an agency or independently. Here is the sequence and roughly how long each stage takes.
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11–3 months
Research and decision
Learning the process, talking it through with your family.
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21–2 months
Application and screening
Medical exam, fertility check, psychological evaluation.
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31–6 months
Matching
Meeting intended parents and finding the right fit.
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43–6 weeks
Legal contracts
Separate attorneys draft and negotiate the agreement.
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52–3 weeks
Medical protocol
Medications to prepare your body for transfer.
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61 day
Embryo transfer
The procedure, then a pregnancy test 10 to 12 days later.
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7~9 months
Pregnancy
Carrying the baby, routine prenatal care.
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81–2 days plus recovery
Birth
Delivery and transferring care to the parents.
The stage that surprised me most was matching, because its timing swings the most. One of my journeys matched in a few weeks; the other took months. There is no "right" speed, and waiting for parents whose communication style fits yours is worth it.
What the IVF and embryo transfer are like
The medical part is more manageable than most people expect, so it helps to know what actually happens. What happens during the medical process for gestational surrogacy? In gestational surrogacy, after screening you take medications, usually a short course to sync your cycle, then estrogen to build your uterine lining and progesterone to support early pregnancy. You will have three to five monitoring appointments with bloodwork and ultrasounds.
The transfer itself is a short outpatient procedure, about 10 to 15 minutes, with no anesthesia. Most surrogates describe it as similar to a pap smear, briefly uncomfortable, not painful. A blood pregnancy test follows about 10 to 14 days later. National fertility data put live-birth rates for gestational carriers at roughly 45% to 55% per transfer, and higher across more than one, partly because surrogates are carefully screened before they are approved; the CDC's national ART success-rates data is the primary US source for these figures.
What surrogates get paid
Compensation is real, and it is fair to want to understand it before committing. In the US, a typical surrogate package runs about $65,000 to $95,000, with base pay of $37,000 to $75,000 depending on your state and the rest covering allowances, expenses, and situation-based extras. In Canada, surrogates are reimbursed for expenses but not paid a fee.
I have kept the detail light here on purpose, because the numbers deserve a full breakdown, state by state, experience level, and when each payment lands. That is all in how much do surrogates get paid. Whether you can be paid at all depends on your state, covered in paid surrogacy laws by state.
Insurance during a surrogate pregnancy
Insurance is the piece that trips people up, so settle it before the transfer. Your own health plan may or may not cover a surrogate pregnancy, many policies exclude it specifically, so the intended parents often buy a separate policy for you.
You should never pay out of pocket for pregnancy-related care. Before you sign, get clear answers on whether your policy excludes surrogacy, who covers deductibles and co-pays, what happens if you need bed rest or time off work, and how the baby's care is covered if a NICU stay is needed. All of it should be spelled out in your contract.
How to find intended parents
Once you qualify, you have three main routes to a match: work with an agency, match independently through platforms and communities, or connect through a fertility clinic. Each suits a different kind of surrogate, and I cover how to choose, what to ask parents, and the red flags to watch for in how to find intended parents, where you can also browse profiles directly.
What to do next
If this still feels right after reading it, three practical steps come first: confirm you meet the requirements, talk it through honestly with your family, and start gathering your pregnancy medical records so screening moves faster. For support and community, RESOLVE: The National Infertility Association has resources specific to surrogacy.
Frequently asked questions
How long does it take to become a surrogate?
Typically 12 to 18 months from application to birth, covering screening, matching, contracts, medical preparation, and about nine months of pregnancy. Independent arrangements can move faster because there's no agency waitlist.
Can I become a surrogate if I have never had a baby?
Generally no. Most clinics and agencies require at least one previous healthy, full-term pregnancy.
Can I be a surrogate for a friend or family member?
Yes. This is called identified surrogacy. It still requires full medical and psychological screening, separate attorneys, and a formal contract.
Can I become a surrogate if I had my tubes tied?
Yes. The embryo is placed directly into the uterus, so the fallopian tubes aren't involved.
What should a first-time surrogate expect that's different from later journeys?
Eligibility and screening are identical either way. Age, prior pregnancy, health, and the psychological evaluation all apply the same regardless of experience. The real difference shows up in pacing: a first journey has no track record for a clinic or agency to draw on, so the psychological evaluation in particular often takes longer than it would for someone who's already been through one.
What happens right after you're matched as a surrogate?
After matching, you move into legal contract review and medical clearance for transfer, coordinated with the intended parents' fertility clinic. This stage typically takes several weeks before an embryo transfer actually happens.