Surrogacy Process:  The Surrogate



If the surrogate is using an agency to match her with the intended parents, then the surrogate must get approved by the agency and fill out an in-depth questionnaire and application before the initial process can begin.

Medical Screening

Prior to being approved by an agency, the surrogate must undergo a series of medical assessments and tests. Each clinic and agency will vary in what they require from their surrogates.


The potential surrogate must pass a basic physical prior to moving forward through the approval process. Again every clinic and agency will vary in specific requirements for passing through their surrogacy program however a general physical typically includes:  Brief overview of history, vital signs, review general appearance, heart exam, lung exam, head/neck exam, abdominal exam, neurological exam, dermatological exam and an extremities exam. There are typically no standard lab tests but one could expect a complete blood count, chemistry panel, urinalysis and potentially a lipid panel.

Pap smear and Fertility Evaluation

The surrogate will have to have a standard pelvic exam along with a culture and breast exam. Basically, they must submit an up to date OBYN annual exam.  Most clinics/agency’s will require one within 6 months of the scheduled transfer.  Some clinics will also order Vaginal Ultrasounds, Hydrosonogram or a Hysteroscopy to determine if the uterus is in prime condition to sustain a pregnancy.

STD panel including: HIV, HTLV-1 & 2, Hepatitis B & C, and vaginal cultures are also standard in this process especially considering biological matter is being exchanged under a lab setting. The agency and or clinic will also request  blood work screening such as RH factor, Blood type, analysis and coagulation test, FSH, LG, prolactin, testosterone, cortisone, progesterone, T3, T4, TSH, somatotropin. Some of these STD and blood work tests will additionally be requested on the surrogate’s significant other if applicable.

Psychological Evaluation

All parties involved, surrogate, her spouse and both IPs will have to undergo a psychological evaluation. The counselor will make sure that all parties have worked through all possible scenarios and that everyone is on the same page mentally and emotionally.


Typically the agency or clinic will arrange this process between both parties. This is the general setting where the surrogate will meet the matched IPs. This meeting helps determine whether if the party’s interests and personalities match. They will be working closely together for the next year so it best make sure everyone is getting along nicely.

Contractual Process

An attorney is retained to help make sure all state and federal laws are under compliance and that the contract is completed to appease both the surrogate and the IPs. Some surrogacy lawyers maybe appointed through the agency/clinics where others are hired outside by the IPs to handle the specifics of the contract. At this point of the process is where every detail of both parties is painstakingly encoded in the legal confusing language of “legalease.” From basics such as the surrogate’s fee and payment schedule to detailed requests such as the birth plan and diet, this is the point where everything is mapped out and put into writing.

IVF Procedure

If it is a traditional surrogacy, then the Res (Reproductive Endocrinologist) will use the surrogate’s eggs during an IVF (In Vitro Fertilization) retrieval and fertilize with the male IPs sperm and transfer it back. In few cases or otherwise known as a “partial” surrogacy, the sperm is injected by way of IUI (Intrauterine insemination) Gestational surrogacy is when both the IPs contributes their egg and sperm by way of IVF and transfer the fertilized embryo to the surrogate. In this case the surrogate has no biological tie and is the carrier.


The surrogate will keep in contact with the IPs throughout the gestational process; attend all requested prenatal care and recommendations of the selected OBGYN until birth.