Understanding the surrogacy process | Progyny

Updated by the Progyny Editorial Team — January 2026.

Surrogacy is one way to grow your family. You may consider surrogacy if you have experienced infertility, have a medical reason you cannot carry a pregnancy, are part of the LGBTQ+ community, or you are planning to have a child as a single parent. The process can feel complex, so this guide walks you through each step.

The surrogacy process

1. Create embryos through in vitro fertilization (IVF)

You will start at a fertility clinic to learn about IVF and begin the medical screening process. Tell your clinic that you plan to use a gestational carrier so they can complete the required testing.

Your Progyny Care Advocate (PCA) can answer questions about IVF and the screening process.

2. Choose a surrogacy agency or attorney

A surrogacy agency may manage matching, screening, counseling, case management, legal support, and referrals. Both you and the gestational carrier will complete psychological evaluations, and each party will have separate legal counsel.

Surrogacy laws differ by state. It's helpful to work with someone who understands the laws where you live and where the birth will take place. Your fertility clinic may offer referrals.

You may also work directly with a surrogacy attorney, who will handle the legal contract. An attorney may not provide the additional services an agency offers.

You can ask the agency:

• What do your fees include, and what is the payment timeline?
• What insurance coverage is available for the gestational carrier?
• How do you screen candidates, and who completes the evaluations?
• How many intended parents or carriers have you matched in the last year?
• What is your matching process like?

When speaking with an attorney, you can ask:

• How long have you worked in surrogacy and assisted reproductive technology?
• In which states are you licensed?
• If the surrogacy happens in another state, which state has legal jurisdiction?

3. Match with a carrier and complete legal requirements

Your agency can help you find a gestational carrier. Once matched, you will sign a legal agreement and complete any state-specific requirements.

You may want to ask the carrier:

• What were your previous pregnancies like?
• Are you open to carrying one or more embryos?
• What is your comfort level with selective reduction or ending a pregnancy if there are serious complications?
• How would you like to stay in touch during the pregnancy and after birth?

For a comprehensive list of questions, go to What to consider when choosing a surrogate

4. Embryo transfer and pregnancy

After the contract is complete, the gestational carrier will take medication to prepare for the transfer. The reproductive endocrinologist will transfer a frozen embryo into their uterus. The procedure is brief and typically does not require anesthesia.

After transfer, there is a two-week wait to confirm pregnancy. If the pregnancy test is negative, another embryo may be transferred. Many journeys include more than one attempt. If pregnant, the gestational carrier receives routine prenatal care.

Surrogacy includes many steps and decisions, and having the right support can help you navigate the process with confidence.

If you have questions, Progyny is here for you. Please contact your PCA for support.

Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.