Surrogacy Process for Intended Parents and Surrogates: A Step-by-Step Guide

If you're researching surrogacy, chances are you didn't arrive here casually.

For intended parents, this journey often begins long before you ever speak with an agency. It may begin with years of infertility, a medical diagnosis that changed your plans, or the realization that surrogacy is the path that can finally help you build the family you've dreamed of. By the time most intended parents start researching agencies, they are carrying equal parts hope, fear, grief, and determination.

For surrogates, the journey often begins with something less tangible but equally powerful: a feeling. A recognition that while most people see another family's longing and feel sympathy, you feel called to help. The women drawn to surrogacy are often the same women who have always shown up for others—the caregivers, the nurturers, the steady hands. Somewhere inside them is the realization that someone else's dream of becoming a parent may depend on the generosity of a woman willing to help.

Once you've decided this path is right for you, the process itself follows a series of important steps. Intended parents begin by selecting the right agency, preparing embryos, and building a financial plan. Surrogates move through education, screening, and qualification. Together, both parties progress through matching, legal agreements, escrow, embryo transfer, pregnancy, birth, and postpartum support.

At Roots, we believe this journey is one of the most meaningful decisions a person can make, which is why we intentionally bring together exceptional intended parents and extraordinary women whose compassion, character, and emotional intelligence are what we refer to as “the best of the extraordinary.”

What does a good surrogacy process look like?

A good process is not fast at every step. It is thorough in the right places.

That means:

• medical record review before match
• psychosocial screening before match
• clear insurance review before legal
• independent attorneys for both sides
• independent escrow, not agency-held funds
• a case manager who leads communication
• parentage planning before delivery

ASRM guidance supports structured medical, psychological, and legal screening before treatment moves forward (Fertil Steril® 2022;118:65–74. ©2022 by American Society for Reproductive Medicine).

The surrogacy process for intended parents and surrogates, step by step

1. Start with readiness

If you are an intended parent:
Choose your agency, confirm embryo plans, and understand total cost.

If you are a surrogate:
Learn the process, review requirements, and decide if the timing is right for your life.

2. Screening begins

If you are an intended parent:
Complete onboarding and share your preferences, goals, and clinic details.

If you are a surrogate:
Complete records review, background checks, labs, and psychological evaluation.

3. Matching

If you are an intended parent:
Review one thoughtful profile at a time. Look for values and communication fit.

If you are a surrogate:
Review one intended parent profile at a time. You should never feel pressured.

4. Clinic approval

If you are an intended parent:
Your IVF clinic reviews the carrier's records and completes medical screening.

If you are a surrogate:
Attend screening at the IVF clinic. Expect labs, ultrasound, and a full review.

5. Legal contracts

If you are an intended parent:
Your attorney drafts the Gestational Carrier Agreement.

If you are a surrogate:
Your independent attorney reviews every term with you before you sign.

6. Escrow and insurance

If you are an intended parent:
Fund independent escrow and finalize insurance planning.

If you are a surrogate:
Confirm payment terms, benefits, and medical coverage before medications start.

7. Embryo transfer and pregnancy

If you are an intended parent:
Your clinic directs transfer timing. After a positive beta, pregnancy care usually shifts from IVF to OB near the end of the first trimester.

If you are a surrogate:
Take transfer medications, attend appointments, and then move into routine prenatal care after IVF discharge.

8. Parentage, birth, and beyond

If you are an intended parent:
Your legal team secures parentage in the birth state, and you travel for delivery.

If you are a surrogate:
You deliver near home, recover, and should receive real postpartum support.

That is the clean version. Real life has more texture.

Here is what good looks like inside each phase.

1. Agency selection should feel clear, not salesy

Once you've decided surrogacy is the right path, one of the most important decisions you'll make is choosing the agency that will guide your journey.

Many agencies focus on moving people through a process. At Roots, we believe this journey is too meaningful to be treated like a process alone.

For intended parents, that means feeling deeply understood, emotionally protected, and thoughtfully guided through one of the most vulnerable seasons of your life. For surrogates, it means being recognized for the extraordinary compassion, generosity, and commitment this path requires.

Roots was never built for volume. We intentionally remain highly selective so every surrogate, intended parent, and match receives extraordinary care, personal attention, and meaningful support from beginning to end.

2. Screening should protect the journey

One of the clearest indicators of an agency's standards is when screening occurs.

At Roots, screening happens before matching because we believe intended parents deserve more than availability. They deserve confidence.

The women who become Roots surrogates are not selected solely because they meet medical requirements. They are chosen because they demonstrate the character, emotional maturity, resilience, and generosity that help create exceptional journeys.

We accept fewer than 1% of surrogate applicants—not to create exclusivity, but to protect the integrity of the community and the quality of every match we facilitate.

3. Matching should be mutual

A surrogacy match is not a transaction. It is the beginning of a relationship that will become part of your family's story forever.

At Roots, intended parents do not browse hundreds of profiles, and surrogates do not shop through databases. Instead, we carefully consider values, personalities, communication styles, expectations, and emotional alignment before making introductions.

Our philosophy is rooted in a simple belief: extraordinary journeys are built by extraordinary people.

The intended parents and surrogates that become members of the Roots community are not selected because they check boxes, but because of who they are—their character, emotional intelligence, trustworthiness, and humanity.

When the stakes are this meaningful, the quality of the people involved matters enormously.

4. Legal and escrow should stay independent

The strongest surrogacy journeys are built on trust, transparency, and clear boundaries.

Every surrogate and intended parent should have independent legal representation. Separate attorneys ensure that everyone understands their rights, responsibilities, and expectations before agreements are signed.

And agencies should never hold or control client funds. Never. At Roots, all funds are managed through independent licensed escrow partners, including SeedTrust and Clarity, providing protection and transparency for everyone involved.

We also work exclusively in surrogacy-friendly states that support pre-birth parentage orders whenever available, helping create clarity and peace of mind long before delivery day.

5. Insurance should be reviewed early

Do not treat insurance as a last-minute checkbox.

Some health plans exclude surrogate pregnancies or have unclear language around maternity claims. That review should happen before legal is finalized and before medications begin (ART Risk Solutions, accessed 2026; International Fertility Insurance, accessed 2026).

If you are an intended parent, ask who reviews the policy and what happens if the plan excludes coverage.

If you are a surrogate, ask how out-of-pocket costs, deductibles, lost wages, and complications are handled in contract language.

6. Pregnancy support should not disappear after transfer

A positive pregnancy test is not the finish line. In many ways, it is the beginning of a new phase of the journey.

Surrogacy is emotional, complex, and deeply personal. It requires ongoing communication, coordination, and support.

At Roots, every active journey receives consistent attention throughout pregnancy. We work closely with fertility clinics, attorneys, obstetric providers, hospitals, surrogates, and intended parents to ensure everyone feels informed, supported, and cared for.

And our support does not end at delivery. We continue supporting surrogates through the fourth trimester because the women who help create families deserve care long after the baby is born.

When a journey ends, the belonging does not. Many Roots surrogates choose to remain part of the community long after their journey is complete. Through alumni programs, events, and ongoing connections with fellow surrogates, they stay involved because Roots was never intended to be just a service provider. It was built to be a community of extraordinary women who share a profound commitment to helping others build their families.

How long does the surrogacy process take?

The honest answer is that every journey is different.

Timelines depend on embryo readiness, matching, medical screening, legal work, clinic schedules, and transfer success. Some journeys move quickly. Others require patience.

At Roots, intended parents can choose from programs with timelines ranging from just a few weeks to approximately twelve months, depending on the level of flexibility, support, and matching options they select.

While every journey follows a similar path, no two journeys are exactly alike—which is why having the right people beside you matters so much.

Eight questions both sides should ask before saying yes

1. Have the surrogate and IPs been fully screened before match?
   If the answer is no, you are taking an avoidable risk.
2. Will we each have our own attorney?
   The answer should always be yes.
3. Who holds escrow?
   A licensed third-party escrow company is the safest answer.
4. When is insurance reviewed?
   Before legal, not after contracts are signed.
5. How many profiles will we see?
   A thoughtful process is usually slower and more intentional.
6. What happens if a transfer fails?
   You need the policy, the cost impact, and the communication plan in writing.
7. Who coordinates the clinic, attorneys, and hospital?
   You want one case manager leading the process.
8. What support exists after birth?
   Surrogates need postpartum care. Intended parents often need travel and parentage support.

Red flags to watch for

Some warnings are easy to miss when you are excited. Slow down and look for these.

• A large profile database with little screening detail.
• Vague answers about total cost.
• No written explanation of who pays what, and when.
• The agency holds escrow funds itself.
• The same attorney represents both sides.
• Insurance review happens after the match or after legal.
• You do not know who your case manager is.
• Communication feels reactive, not proactive.

If you see two or three of these, keep looking.

Why the process order matters so much

The right order protects everyone.

You do not want to fall in love with a match before the screening is complete. You do not want to sign a contract before insurance is reviewed. You do not want to discover legal problems in the third trimester.

ASRM guidance exists for a reason. So do insurance reviews and parentage planning (ASRM, accessed 2026; ART Risk Solutions, accessed 2026).

At Roots, we use a Seed, Water, Grow approach.

• Seed: onboarding, readiness, plan selection
• Water: screening, matching, clinic approval, legal, escrow
• Grow: transfer, pregnancy, parentage, birth, and post-birth support

That sequence keeps the journey grounded.

A final word for intended parents and surrogates

If you are an intended parent, you are not just hiring an agency. You are choosing the people who will manage one of the most meaningful phases of your life. You want to feel proud of the people walking beside you in this journey. Most agencies position surrogacy as process management: profiles, databases, timelines, and coordination, which causes intended parents to feel like they are being pushed through a system during one of the most emotionally vulnerable periods of their lives.

At Roots, we understand that many IP’s struggle quietly with a deeper fear: “How do I know this woman will truly care?” Not simply care about compensation or completing a process, but care about the emotional magnitude of helping create my family.

We know you’re not simply “looking to match,” but that you are searching for emotional safety, discernment, and the best of the extraordinary humans to work with on this journey.

If you are a surrogate, you are not just filling out an application. You are deciding who will protect your health, your time, your family, and your heart. And it’s deeper than generosity. You are a person of emotional abundance. Capacity. Nurturing instinct. The ability to hold fear and love simultaneously and still move toward sacrifice for a stranger. You should feel informed, not sold.

That is what good looks like.

• Book a call with Brooke!
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Sources

• American Society for Reproductive Medicine. Surrogacy guidance and patient resources. ASRM. Accessed 2026.
• Cleveland Clinic. Gestational Surrogacy. Accessed 2026.
• PubMed Central. Surrogacy article and ethics overview. PMC6262674. 2018.
• ART Risk Solutions. Gestational carrier insurance guidance. Accessed 2026.
• International Fertility Insurance. Gestational carrier insurance guidance. Accessed 2026.