The Surrogacy Process

A Step by Step Guide – What to Expect

Contact Us

Whether just beginning to research, to being a step away from starting your journey, we are happy to  address all of your questions about surrogacy by phone or email before applying!

Whether you found us through social media, a friend, or found us on the internet, the first step is to make sure you understand surrogacy.  We understand that there is a lot to consider, which is why we understand that additional information may be needed before committing to the process.  You will never feel pressured to begin until every question has been answered and you are sure you are ready.  Reach out to us through our Surrogate Inquiry Form, social media, phone or email and we would be happy to chat!

Getting to

Know You

Completing Your Application

Once you are ready to apply to Family Makers, it’s time to sit down and complete an application.  It takes about 15-20 minutes to answer a variety of questions pertaining to medical and social history, and provides us with preliminary information needed to determine if you are an appropriate candidate for Surrogacy

Interviews & Creating a Profile

One of the most important roles an agency has is finding an ideal match for Intended Parents and Surrogates.  Each agency has it’s own process of doing this, and our approach is based on getting to know you as much as possible.

In addition to several interviews and calls with you, we give you the opportunity to be involved with creating a beautiful profile that allow Intended Parents to get to know important information about you.  ​Once we have everything we need, we provide you with a final draft for approval before it is shared with any possible matches.

Background Checks & Medical History

At the same time as we are working on your profile, we will be conducting background checks conducted by a licensed investigator to ensure there is no history of criminal activity or legal concerns we should be aware of that could affect your journey.  Background checks go back 7-10 years, and are performed on you, anyone you are in a committed relationship with, and anyone over 18 in your household.  A video tour of your home via video chat and/or an in-person home visit will also be required.

Meeting Your



Choosing Your Match

Unlike some agencies, we do not match Surrogates based on who has been waiting the longest.  Instead, much consideration goes into presenting a profile based on what you’ve told us you would like in a match.  In fact, more than 95% of Intended Parents and Surrogates who work with Family Makers agree to the first match they are presented with.  We do everything possible to get it right the first time.

Meeting Your Prospective Intended Parents

Many Surrogates have described meeting their a prospective Intended Parents to be very much like a first date.  You have seen one another’s profile and like what you see.  Still, it can be a little nerve wracking when meeting someone for the first time and trying to create a conversation out of thin air.  The great news is, we will prepare you so that you know exactly what to discuss, and a member of our staff will help guide the conversation to ensure that all major topics are covered.  If you forget to ask a question, or you think of one after your call, no worries!  We can clarify anything you need to know before making the decision to match.

It’s a Match!

At Family Makers, our matching process means that both the Intended Parents and Surrogate agrees to the match and general terms that both parties have agreed upon. We believe that communication is the foundation for a healthy journey, and so we encourage you to begin building your relationship with your Intended Parents immediately.  Once a match is official, we will provide email and phone contact information so that you can begin getting to know one another!



Medical Record Review & Screening

When a prospective Surrogate applies to Family Makers, one of the first things we do is a thorough medical record review.  Records pertaining to previous obstetric and gynecological history, pregnancy and delivery of previous babies are reviewed for any issues that could cause possible issues for future pregnancies.  Once they have passed Family Makers’ approval process, they are then sent to your fertility specialist for final review and approval.  Intended Parents can choose to have records sent to their clinic prior to meeting their Surrogate, or after their first match meeting.

Medical and Psychological Screening

Once your fertility clinic has confirmed that your prospective Surrogate’s medical records are acceptable, a psychological evaluation is performed by a licensed mental health professional.  This lengthy interview is an opportunity for the psychologist or social worker to go over the risks and responsibilities of surrogacy, social history of the surrogate and her significant other, and to assess a number of things to determine if your prospective surrogate is an appropriate candidate.  This evaluation also typically includes a group consultation with the Intended Parents review and clarify sensitive and important topics known to come up in surrogacy arrangements as a group.  Lastly, your match may be required to complete a standardized personality assessment called a MMPI-2 or PAI, an additional tool used to assist the mental health professional in the overall evaluation.

Psychological assessment may be completed prior to or during her physical medical screening at your fertility clinic.  This one to two day appointment with your RE will include an interview, pelvic exam, ultrasound and blood work.  Additional tests may be performed at your physician’s discretion.

In addition to a mental health evaluation, your Surrogate will be required to travel to your fertility clinic for a day of testing and appointments.  There will be extensive blood tests taken from her and her partner to look for infectious diseases, common health problems, and drug use.  An ultrasound will be performed to evaluate her uterus for any scar tissue, fibroids, polyps or anatomical malformations that could interfere with becoming a Surrogate.

Once the medical approval process is complete, she will return home.  She should receive final confirmation of approval in 1-2 weeks once blood tests and the psychological evaluation have been reported.

Legal –


Legal Process – Choosing Your Attorney​

Once clear blood results and psychological reports have been received in 8-10 days after her visit to the fertility clinic, your prospective Surrogate is then be officially “approved” by your clinic.  All that’s left before you can begin your journey is contracts

One of the most important steps you can do to protect yourself and your Surrogate is to select a qualified attorney experienced in surrogacy.  Family Makers is privileged to partner with legal experts throughout the United States and abroad who will prepare and negotiate your surrogacy agreement.  In most cases, you will use this same legal expert once your Surrogate becomes pregnant to ensure you are acknowledged as the baby’s legal parents by obtaining a Pre-Birth Order.


Contracts can be a bit stressful, even for matches who believe they are on the same page about everything.  As part of preparing for this stage of the process, Family Makers supplies a detailed list of match terms outlining all of the things you and your Surrogate have already agreed on, including compensation and delivery location.  Surrogacy contracts, some as lengthy as forty pages, cover anything and everything that could arise during your journey and can provide you with piece of mind that both parties are as protected as possible throughout the process.  Once contracts have been approved by you and by your Surrogate, you will visit a notary to sign.  It’s now official and now the exciting part begins!



Preparing for Embryo Transfer

Once your attorney has provided a legal clearance letter to your clinic stating that contracts have been finalized and executed, a number of things start happening!  n addition to the administrative side of things that we will be handling for you, such as setting up your escrow account and activating any required insurance policies, your Surrogate will finally begin preparing her body for embryo transfer.  During this time, your clinic will also create a medication calendar and protocol for your Surrogate to follow.  Your Surrogate’s Case Manager will review her shipment of medications and instructions just to confirm that there are no outstanding questions or concerns she should address with the clinic before beginning.

Many Surrogates do not live physically close to their Intended Parents’ fertility clinic, which means that a clinic located near her home is utilized.  This is what we call a “monitoring clinic,” and is the place she will be receiving 2-3 ultrasounds and blood work in preparation for transfer.

Transfer Day!

This is a big day, and one you’ve been waiting for!  Some Intended Parents and their Surrogates come dressed in matching pineapple socks, transfer shirts, lucky green polish, or other ways symbolizing the day.  Just as common are those that are more reserved and do not do anything.  Whatever your preference, many Intended Parents are present for embryo transfer and are allowed in the procedure room to witness the big moment.  Most procedures occur mid-day, so your Surrogate will usually be asked to arrive the day before or the morning of the transfer.  The procedure itself lasts a few moments, and then the 10-day countdown begins to find out if your Surrogate is pregnant.



Positive Pregnancy Test!

Ten days after transfer, a blood test is performed to determine if there is a specific hormone present to indicate pregnancy.  This is commonly called “beta,” and should increase steadily over time.  Your fertility specialist will order a second, and sometimes third, blood text to ensure that these levels are rising appropriately…indicating a viable pregnancy.

Approximately 3 weeks after your Surrogate’s last blood test, she will be scheduled for her first ultrasound to look for baby’s heartbeat!  This appointment usually takes place at her monitoring clinic or OB’s office.

We Have a Heartbeat!  – First Trimester of Pregnancy

You’ve heard the most precious sound in the world – your baby’s heartbeat!  Because this is a surrogacy pregnancy created through IVF, this pregnancy will be treated a bit differently than others.  Instead of an OB appointment, your Surrogate will continue being monitored by your fertility specialist for another 4-6 weeks after heartbeat is confirmed to ensure there are no complications or concerns prior to being released to a general obstetrician or midwife.  Your Surrogate will also stay on hormonal medications to support the pregnancy for several more weeks.​

Once released out of the care of your fertility specialist between 9-12 weeks, your Surrogate will begin attending regular prenatal appointments at her own provider’s office that will be managing the remainder of the pregnancy.  Intended Parents are many times able to join one of these first appointments in person, over video call, or by phone to “meet” the staff or ask questions as a new Parent.

One of the first tests many Parents learn about during pregnancy is prenatal testing (also called NIPT), a simple blood test that can identify possible genetic abnormalities.  An ultrasound-guided test called a nuchal translucency test can also be performed to check for early signs of physical birth defects as well.  We encourage Parents and their Surrogates to discuss these optional tests with the provider during their first visit since it can only be done before 14 weeks gestation.  Billing, insurance, and HIPAA releases can also be addressed during one of these first trimester visits.



Second Trimester of Pregnancy

We hope that the second trimester of pregnancy is a relatively quiet and enjoyable time for both you and your Intended Parents.  At the 18-20 week mark, an anatomy scan will be performed to evaluate growth and to ensure everything is as it should be.  Many Intended Parents attend this milestone appointment for a chance to see their baby and visit with their Surrogate. If they have not already discovered their baby’s gender and want to, they can find out now.  Some Parents want to be the first to know and keep the secret to themselves, others like to plan a party and make an announcement.  It is important to discuss how and when they want to know so that you are all on the same page.

Establishing Your Parental Rights

Once you have reached the middle of pregnancy, we will initiate a vital part of the legal process in order to establish who the baby’s Parents are between 18-24 weeks of pregnancy.  A Pre-Birth Order (commonly referred to as the PBO) is used in all but a handful of states to assign parentage prior to the baby’s birth. Once the baby is born, the document goes into effect and protects the Intended Parents’ rights, while also stating that you have no financial or legal responsibility for the baby.  These rights allow Intended Parents to make medical decisions regarding care of their baby after delivery, ensures that their name goes on the baby’s birth certificate, can assist in resolving insurance claim issues, and allows the baby to be discharged home in its parents’ care.


for Birth

Setting Expectations for Delivery

During the third trimester, we recommend touring the delivery hospital with your Intended Parents if you haven’t already during a previous visit.  From assisting with travel for your Intended Parents who aren’t local to their Surrogate, to ensuring the hospital is provided with all the insurance and legal paperwork needed, Family Makers does everything needed for a positive experience during this exciting time.

Many Surrogates have questions about how exactly the delivery will go.  Will the Intended Parents be in the delivery room?  Will they get their own room after the baby is born?  What if they miss the birth due to travel delays?  What happens in case of a c-section or complications?  Can you provide breastmilk? What should you pack and bring with you to the hospital?

All of these questions, we can help answer to ensure you feel as prepared as possible when the big day arrives!

Delivery Day!

Whether delivery is planned, or you go into labor spontaneously, delivery day can be extremely stressful and exciting all at the same time.  Many of the women who have completed journeys with us say one of the most special moments of their entire experience is witnessing their Intended Parents meeting their baby for the first time.  In most cases, Parents are allowed to attend delivery, or shortly after if a cesarean is performed.  Once your baby has arrived, we will request that your Intended Parents are provided with their own private area or room in the hospital to bond and enjoy one-on-one time with their baby, while you can have some much deserved rest.


After delivery, you will be free to leave the hospital whenever your OB discharges you.  If your Intended Parents do not live close by, they may decide to stay in the area for a few days to several weeks before returning home with their baby.  If you are providing breastmilk to the baby, Family Makers can provide education and assistance in milk preparation and shipment.  We will also request any documentation required to process any remaining compensation and benefits due from delivery and postpartum recovery.  Your journey is officially over and you can now call yourself an “Experienced Surrogate!”