Surrogacy is an arrangement in which a person carries a pregnancy for intended parent(s). In gestational surrogacy, the embryo is created through IVF using eggs and sperm from the intended parent(s) and/or donors; the gestational carrier does not provide the egg and has no genetic connection to the embryo. The exact process, eligibility and legal requirements vary by clinic and jurisdiction, so early medical and independent legal advice are important.
Who may consider gestational surrogacy?
A fertility team may discuss a gestational carrier when carrying a pregnancy is medically impossible or could pose a serious health risk, or after certain reproductive experiences. The decision should follow an individual assessment. Surrogacy is not a single treatment that suits every person, and alternatives such as other fertility treatments, donor eggs or embryos, adoption, or choosing not to pursue treatment may also be discussed.
Key stages in the process
1. Medical and fertility assessment
The intended parent(s) and prospective carrier undergo medical review and relevant fertility testing. The team discusses the source of eggs and sperm, IVF planning, pregnancy risks, screening, and whether a gestational carrier is medically appropriate. A carrier’s prior pregnancy history and overall health are considered under the clinic’s protocol.
2. Counselling and legal planning
All parties should have time to understand the medical, emotional and practical implications. Independent counselling can help clarify expectations and boundaries. Each party should obtain independent legal advice before treatment begins. Agreements should address decision-making, expenses, communication, pregnancy care, multiple pregnancy risks, unexpected medical events, and arrangements after birth. Legal parentage, enforceability and permitted payments differ across jurisdictions; a general article cannot determine what applies to a particular family.
3. IVF and embryo creation
Depending on the plan, the intended egg provider or an egg donor may use medicines to stimulate the ovaries. Eggs are collected and fertilised with sperm in a laboratory. Embryos may be cultured and frozen. Genetic testing is considered only when there is a clinical reason and after counselling; it is not a required step in every surrogacy cycle.
4. Preparing the carrier and embryo transfer
The carrier’s uterus is prepared for transfer using a natural or medicated cycle, depending on her clinical circumstances. A selected embryo is transferred into the uterus. The number of embryos transferred is discussed carefully because multiple pregnancy increases health risks for both the carrier and babies. A pregnancy test follows at the time advised by the clinic.
5. Pregnancy, birth and postnatal support
If pregnancy occurs, the carrier receives antenatal care, with the intended parent(s) involved as agreed. The care team monitors the pregnancy and supports communication and decision-making. Birth planning, hospital arrangements and legal steps after delivery should be discussed well in advance. Emotional support may be useful during treatment, pregnancy and after birth for everyone involved.
Questions to ask before proceeding
Ask the clinic how candidates are assessed, what counselling and screening are offered, what happens if an embryo transfer does not lead to pregnancy, how many transfers are included in the plan, and what costs may arise beyond treatment fees. Confirm who coordinates care and how urgent medical decisions are handled. Ask a lawyer with relevant local experience to explain parentage, documentation, citizenship or travel issues where applicable, and the rules on expenses or compensation.
Read Nordica’s surrogacy service information, Dr Abayomi Ajayi’s guide to surrogacy in infertility treatment, ASRM’s patient information on a gestational carrier, and the HFEA guide to surrogacy. These international resources describe their own systems; local legal advice remains essential.
