If you have been working with a fertility clinic and are now considering surrogacy, you are entering a new stage of your family-building journey.
Your fertility team already knows your medical history, treatment history, and embryos. Now, the conversation shifts toward what is needed to move forward with a gestational carrier.
Your fertility clinic will play an important role throughout the medical portion of the surrogacy journey. The clinic typically reviews and medically screens your gestational carrier, prepares her for embryo transfer, performs the transfer, and monitors the early pregnancy.
Before you begin matching with a surrogate, it helps to understand your clinic’s specific requirements and process. These six questions can help you prepare for the next step.
Does your clinic work with gestational carriers?
Start by asking how often your fertility clinic works with gestational carriers.
Some clinics have dedicated third-party reproduction teams that regularly coordinate surrogacy cases. Others may handle them less often or have additional requirements before beginning the process.
Ask whether your clinic has a third-party reproduction coordinator and who will serve as your main point of contact once you begin a surrogacy journey.
It is also helpful to ask whether the clinic regularly works with surrogacy agencies. Surrogacy involves coordination between several professionals, so having clear communication between your fertility clinic and agency can make the process much easier.
What are your requirements for a gestational carrier?
Your surrogacy agency will have requirements that a woman must meet before becoming a gestational carrier. Your fertility clinic will also complete its own medical review before approving her for embryo transfer.
The American Society for Reproductive Medicine recommends that gestational carriers be at least 21 years old, healthy, and have previously experienced at least one uncomplicated pregnancy resulting in the birth of a healthy child. Clinics also review a potential carrier’s pregnancy history, medical history, medications, uterine health, and other factors.
Individual clinics may have additional requirements, including their own guidelines for BMI, previous C-sections, age, or certain medical conditions.
Ask your clinic about these requirements before matching. This helps your surrogacy agency identify candidates who are more likely to meet your clinic’s medical standards.
It is important to remember that agency screening and clinic medical clearance are two separate steps. A gestational carrier may meet an agency’s initial requirements but must still receive final medical approval from your fertility clinic before moving forward.
Are our embryos ready for a surrogacy journey?
Before matching, talk with your reproductive endocrinologist about your existing embryos and whether anything else should be completed before beginning a surrogacy journey.
Ask about the number and quality of embryos you currently have and whether your doctor recommends creating additional embryos before matching.
If your embryos have not undergone Preimplantation Genetic Testing for Aneuploidy, commonly called PGT-A, ask whether your doctor recommends it in your specific situation. PGT-A screens embryos for chromosome abnormalities, but it is not automatically recommended for every patient. ASRM notes that the benefits of PGT-A vary depending on the patient’s circumstances and that it has not been shown to improve pregnancy outcomes for everyone undergoing IVF.
Your clinic can help you understand whether testing makes sense based on factors such as your age when the embryos were created, embryo history, previous transfers, and overall treatment plan.
You should also ask whether any infectious disease testing or other medical documentation needs to be updated before your embryos can be transferred to a gestational carrier. FDA rules apply to certain donated reproductive tissues, while the exact requirements depend on how the embryos were created and whose eggs and sperm were used.
Having these conversations early can prevent unexpected delays once you have matched.
What will medical screening and embryo transfer look like?
Once you match with a gestational carrier, your fertility clinic will review her medical records and complete its own screening process.
The exact process varies by clinic, but it may include bloodwork, infectious disease testing, an examination, and an evaluation of the uterus.
Once your gestational carrier receives medical clearance, the legal agreement between you and your surrogate is typically completed before medications for the embryo transfer cycle begin.
Your fertility clinic will then create a medication and monitoring schedule designed to prepare the uterine lining for transfer. Depending on where your gestational carrier lives, some monitoring appointments may be completed near her home while the fertility clinic reviews the results.
Ask your clinic:
- How long does medical screening usually take?
- Which appointments must be completed at your clinic?
- Can monitoring be done closer to the gestational carrier’s home?
- Can intended parents attend the embryo transfer?
Understanding these logistics early can also help with travel planning and your overall surrogacy budget.
What happens if the first embryo transfer is not successful?
Everyone hopes for a successful first transfer, but IVF does not guarantee pregnancy.
Ask your fertility doctor what the next steps would be if an embryo does not implant or if an early pregnancy does not continue.
The answer will depend on your circumstances. Your doctor may recommend another transfer using the same protocol, adjusting medications, or completing additional testing before trying again.
It is also helpful to ask how much time your gestational carrier would need between transfer attempts and whether the clinic has a point at which it would recommend taking a closer look at the embryos, uterine environment, or treatment plan.
Knowing what a possible next step could look like does not mean expecting something to go wrong. It simply helps you understand the full process before beginning.
How will your fertility clinic work with our surrogacy agency?
Surrogacy works best when everyone involved understands their role.
Your fertility clinic manages the medical side of the journey. Your surrogacy agency helps coordinate the many other pieces, including matching, screening, communication, legal coordination, insurance review, travel planning, and ongoing support.
Ask your clinic how it communicates with surrogacy agencies and who will handle those conversations.
For example, you may want to know who sends medical clearance to the agency, when the clinic requires confirmation that legal contracts are complete, and who coordinates important dates surrounding medications and embryo transfer.
Clear communication between your fertility clinic, agency, attorneys, and gestational carrier can help prevent delays and keep everyone informed throughout the process.
What fertility clinic costs should we expect?
Surrogacy adds medical expenses beyond a typical IVF cycle, and clinic fees are usually separate from agency, legal, insurance, and gestational carrier costs.
Ask your clinic what is included in its surrogacy-related fees and what may be billed separately. This can include gestational carrier medical screening, monitoring appointments, IVF medications, embryo transfer fees, embryo storage, outside monitoring, and additional transfer attempts.
It is also helpful to ask what happens financially if a cycle is canceled or delayed.
Understanding these costs early can help you build a more realistic overall surrogacy budget and avoid surprises later.
When should you contact a surrogacy agency?
You do not have to wait until every medical detail is finalized before contacting a surrogacy agency.
If your fertility doctor has recommended surrogacy or you already know that carrying a pregnancy is not an option for you, you can begin exploring the process while continuing conversations with your clinic.
Starting early gives you time to understand gestational carrier requirements, the matching process, expected costs, legal steps, and your clinic’s medical requirements.
Your fertility clinic and surrogacy agency can then work together once you are ready to begin matching and move toward embryo transfer.
Questions to bring to your next fertility clinic appointment
If surrogacy is becoming your next step, start with these questions:
- Does our clinic regularly work with gestational carriers?
- What requirements must our gestational carrier meet?
- Are our embryos ready for a surrogacy journey?
- What will medical screening and embryo transfer involve?
- What happens if our first transfer is unsuccessful?
- What fertility clinic costs should we expect during the journey?
- How will your team communicate with our surrogacy agency?
You do not need to understand every detail before you begin. These questions simply give you a clearer picture of what your clinic will need and what comes next.
Taking the next step toward surrogacy
Moving from fertility treatment into surrogacy can feel like a major transition, especially after you have already invested so much time and energy into trying to build your family.
The good news is that you are not starting over.
Your fertility clinic already knows your medical history and embryos. A surrogacy agency can help you build the team and plan needed to move from fertility treatment into a gestational carrier journey.
If your fertility clinic has recommended surrogacy, or you are ready to explore it as your next step, Shining Light Baby can help you understand the process, find a gestational carrier, and coordinate with your existing fertility team throughout your journey.