How to get started with surrogacy

Medical Necessity

As an individual or couple who has struggled with infertility or need an alternative solution to build your family, there are requirements as to who can use a surrogate or why.  Most commonly individuals and couples are approved for surrogacy through their reproductive endocrinologist for one of the following reasons:

  • For Same Sex Couples, an egg donor and a surrogate are often times their only options to create a family.

  • Loss of reproductive organs due to cancer, hysterectomy after delivery, or other medical conditions.

  • A couple who has experienced recurrent miscarriages, stillbirths, or had multiple unsuccessful attempts with IVF.

  • Many medical conditions make pregnancy unsafe for both the mother and the fetus.  Some of these conditions include diabetes, epilepsy, multiple sclerosis, kidney disease, organ transplants, or even a complicated past pregnancy.  Additionally some medications are unsafe for the fetus and therefore these couples choose surrogacy as an option to grow their family.

Create Embryos

Depending where you are at in the process, you may need to create embryos, or you may already have some frozen and tested.  

If you do not have embryos created,  you will need to engage a reproductive endocrinologist to create embryos. is a wonderful resource that provides statistical information on the success rate of clinics.  This may help you in choosing a Reproductive Endocrinologist to work with on your journey.

A reproductive endocrinologist will determine if using your own ova and sperm will be the best route, or if they suggest an egg donor or embryo adoption.  Either way, there are many possibilities!

In addition to how your embryos are created, discuss testing options with your Fertility Clinic. You will also want to discuss ICSI and Assisted Hatching options for your embryos.  

Creating embryos prior to finding a surrogate will help to streamline the process in finding a surrogate as well as the testing and legal contracts.  However, it is not necessary that create embryos before finding a surrogate.

Find a Surrogate

Finding a surrogate is a very personal experience that should not be made out of desperation.   Finding the right person to carry your baby for the next 10 months is a very important job and you should take the time to find the right person.  You can be in the process of finding a surrogate while also creating embryos.

Surrogate Qualifications

Guided Surrogacy Solutions will never jeopardize your time by introducing you to a surrogate who has not passed all of our requirements.  We want the process to be as smooth and efficient as possible.

The prescreening of a surrogate includes the following criteria:

  • Medical History Review

  • Criminal Background Check for her and her Partner (State + Federal + Local), Sex Offender

  • Psychological Screening to ensure the Surrogate is prepared for the surrogacy journey

In addition to passing the requirements to become a surrogate, we also specifically match you with a surrogate who meets additional criteria that you identify is important.

Some of the additional criteria to consider:

  • Number of Embryos to Transfer (This should be discussed with your Fertility Clinic)

  • Selective Reduction

  • Vaccinations

  • Religious Beliefs

  • Location

  • Health Insurance

  • Compensation Requirements

Meeting Your Potential Surrogate

Guided Surrogacy Solutions takes the nerves and jitters out of meeting your surrogate for the first time and conducts an introductory call where each of you an get to know one another better.  You won’t have to worry about awkward silence or uncomfortable small talk. We will help to facilitate the call and make sure that both parties feel comfortable and that each of you have the opportunity to get to know one another better to understand if you would like to proceed forward.  If after the call both parties feel that they would like to continue to get to know one another, Guided Surrogacy Solutions coordinates an in person meeting.

Fertility Clinic Screening

Fertility Clinic screenings can differ, but most often times include:

  • Medical Records Review

  • Physical/Pap Smear

  • Routine Lab Work

  • FDA Lab Work (HIV/Hepatitis)

  • Sonohysterogram (Procedure that evaluates the uterus of the surrogate to ensure it is suitable for an embryo transfer and pregnancy)

  • Meeting with Social Work or Psych for MMPI test

Drafting Legal Contracts

Once the surrogate has been approved by the Fertility Clinic to proceed forward, Intended Parents and Surrogate can begin drafting the legal contracts.  The Intended Parents should have their own ASRM Attorney, as well as the Surrogate should have her own ASRM attorney that the Intended Parents pay for. Guided Surrogacy Solutions connects you with experienced ASRM attorneys in your state to complete this step.

The legal contracts are extremely important and help set forth the agreements of the journey.  The legal contract will be used extensively throughout the surrogacy journey and therefore using an experienced ASRM attorney is very important.  

Embryo Transfer

After the legal contracts are reviewed and approved, you will work with your fertility clinic to determine a date that the surrogate will start medications and set the embryo transfer date.  

Confirmation of Pregnancy

The Fertility clinic will closely monitor the Surrogate after embryo transfer with multiple blood tests and ultrasounds.  If the surrogate is confirmed to be pregnant, the Fertility Clinic will continue to monitor both her and the baby’s progress up to about 12 weeks prior to releasing to her OGBYN.  

PreBirth Order

Depending on where you and your surrogate live, your attorney will present in court for a prebirth order that provides legal documentation that the both you and your spouse’s name should display on the Birth Certificate.  In some states, the attorney will present in court after delivery to ensure that you and your spouses names display on the birth certificate. An ASRM attorney is experienced in these procedures and will work with you through this process.


Prior to the surrogate delivering your baby, Guided Surrogacy Solutions coordinates with the hospital to ensure everything is in place for the big day.  From prior authorizations, to insurance, admissions, to correctly differentiating you and your baby from your surrogate in their electronic medical records system, to ensuring that you have a place to stay in the hospital.


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