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Surrogacy process: How it works step by step (2026 complete guide)

What is Surrogacy and How Does the Process Work?.

Surrogacy is an assisted reproduction method in which a woman — known as the surrogate or gestational carrier — agrees to carry a pregnancy for another person or couple who cannot or chooses not to carry a pregnancy themselves. This page covers what surrogacy is, how the process unfolds step by step, the types and compensation models, and the countries where it is legal.

Suscripciones
Couple and friend touching pregnant woman's belly
Definition

What is surrogacy and how does it work?

Surrogacy is a process in which a woman, known as the surrogate or gestational carrier, agrees to carry a pregnancy for another person or couple who cannot or decides not to carry a pregnancy themselves. In this model of assisted reproduction, although the surrogate could in theory use her own egg, in most cases this does not happen due to legal restrictions. The surrogate typically carries an embryo formed from the egg and sperm of the intended parents or donors.

A solution for those facing difficulties conceiving

This method offers a solution to people who face difficulties conceiving naturally. The reasons for choosing surrogacy vary and include fertility problems, medical complications that prevent a safe pregnancy, or personal situations that require this option.

Fertility Problems

Many intended parents face infertility, lack of uterus, or recurrent pregnancy loss.

Medical Safety

Some medical conditions make pregnancy risky for the mother or the baby.

Genetic Link

Gestational surrogacy allows at least one parent to be biologically related to the child.

All Family Models

Heterosexual, single, and same-sex couples can access the right destination for their case.
Key Takeaway
No Genetic Link Between Surrogate and Baby

In the most common model — gestational surrogacy — the surrogate has no genetic link to the child, which simplifies the legal and emotional process. This is the model used in the vast majority of modern programs worldwide.

  • Embryo created via IVF from intended parents’ gametes or donors.
  • Surrogate carries the embryo without any genetic relation.
  • Intended parents are listed on the birth certificate from the start.
  • Lower legal and emotional risk than traditional surrogacy.
Two smiling babies with teddy bears on couch
Types & Compensation

Gestational vs traditional surrogacy: the difference

There are different modalities of surrogacy, each with specific characteristics depending on the genetic relationship between the surrogate and the child, and the compensation model. Understanding these distinctions is essential before choosing a destination or program.

By Genetic Relationship
Now almost nonexistent

Traditional Surrogacy

The surrogate uses her own egg to conceive the child, making her the biological mother. This method is more complex emotionally and legally, as the genetic link can complicate the post-birth separation process.

Surrogate is the biological mother
More legal and emotional complexity
Less common in modern practice
Requires a clearer legal framework
Most common

Gestational Surrogacy

The egg is provided by the intended mother or a donor, fertilized in vitro, and implanted in the surrogate. The surrogate has no genetic link to the child, which facilitates the legal and emotional process and is the preferred model worldwide.

No genetic link between surrogate and baby
Minimizes legal and emotional risks
Used in the vast majority of programs
Intended parents on the birth certificate from day one
By Compensation Model
Expenses only covered

Altruistic Surrogacy

The surrogate receives no economic compensation beyond coverage of her medical expenses and other pregnancy-related costs. Based on solidarity, this model is permitted in countries like the UK, Canada, Australia, and Greece (for single women and heterosexual couples).

No salary paid to the surrogate
Medical and travel expenses covered
Based on a solidarity principle
Practiced in the UK, Canada, Greece, Australia
Paid surrogacy model

Commercial Surrogacy

The surrogate receives payment for her services in addition to expense coverage. Compensation includes a base salary, additional payments for unexpected costs or complications, and sometimes milestone bonuses during the process. This is the model used in our open destinations.

Base salary agreed between the parties
Additional payments for complications
Possible milestone bonuses
Practiced in Ukraine, Georgia, US, Colombia, Mexico
The Process

The 8 steps of the surrogacy process

Surrogacy is a complex, multi-stage path that demands legal, medical, and logistical coordination. Below is the standard 8-step process — from initial pre-counseling to post-birth documentation. Our team guides you at every stage.

12 to 24 months end-to-end
01

Pre-Counseling

We review your family profile, medical situation, and how a surrogacy program could work for you. Initial medical tests and psychological evaluation are performed as required by the destination country.
02

Agency Selection

Choose a surrogacy agency with experience, reputation, and full legal compliance. We research each destination and operate our own offices to ensure quality.
03

Surrogate Selection

The agency performs a thorough medical, legal, and psychological evaluation of surrogate candidates. In many cases, intended parents can accept the proposed surrogate or request a different one.
04

Legal Contract

The surrogacy contract establishes obligations, parental rights, compensation, and procedures in case of complications. Both parties receive independent legal counsel.
05

IVF & Embryo Transfer

Eggs are retrieved, fertilized in vitro with the intended father's sperm (or donor sperm), and the resulting embryos are cultured to the blastocyst stage. The best embryo is transferred to the surrogate's uterus.
06

Pregnancy Monitoring

Once pregnancy is confirmed, regular check-ups include blood tests, ultrasounds, prenatal screenings, and nutritional guidance. Intended parents are fully informed at every step.
07

Birth & Destination-Country Documents

The baby is born and the hospital issues a birth certificate with the intended parents' names. Civil registration, citizenship, and passport procedures are initiated in the destination country.
08

Return to Home Country

Back home, filiation procedures are completed. For Spanish parents: paternity filiation via DNA test, then maternal adoption. In more favorable jurisdictions, registration is automatic.
Legal Map

Where is surrogacy legal in 2026?

The legal framework for surrogacy varies significantly across regions. Some countries have well-established commercial frameworks, others allow only altruistic surrogacy, and a few have imposed recent restrictions. Below is a tiered overview of the global landscape.

Commercial Surrogacy · Open to Foreigners

These countries have established commercial frameworks accessible to foreign intended parents, with contracts, medical care, and legal pathways in place.

Colombia

Most flexible

Mexico

Cancún / CDMX - 2016 court rulings

Ukraine

Married couples

Georgia

Legal since 1997

Czech Republic

Cross-Border, EU birth

Kazakhstan

Commercial

Belarus

Commercial

United States

CA, IL & more

Altruistic Surrogacy · Reimbursement Only

These countries allow only altruistic surrogacy, where the surrogate is reimbursed for medical and pregnancy-related expenses but receives no salary. Wait times can be long.

Canada

Altruistic only

United Kingdom

Altruistic only

Australia

Varies by state

Greece

Single women too

Brazil

No detailed law

Uruguay

Medical reasons only

India

Restricted to locals

South Africa

Fully altruistic

Restricted or Recently Closed

These destinations have recently restricted or closed access for foreign intended parents. They are no longer recommended for international programs.

Russia

Citizens only since 2022

Tabasco (Mexico)

Closed to foreigners in 2016

India

Foreigners no longer accepted

Thailand

Limited to Thai couples
Ethics & Social Considerations

Ethical questions in surrogacy

Surrogacy and adoption are two distinct paths to building a family when natural conception is not possible or desired. Both have their own advantages, and the right choice depends on each family’s personal situation, legal context, and preferences.

Risk of Exploitation of the Surrogate

In countries where surrogacy is regulated, great emphasis has been placed on respectful treatment and care for surrogates, helping to minimize exploitation risks. Clinics and agencies implement rigorous selection and follow-up processes to ensure physical and emotional well-being.

Quality medical care and continuous psychological support throughout pregnancy and beyond.
Fair compensation covering physical effort and emotional impact.
Informed consent and freedom to withdraw before embryo implantation.
Strict legal safeguards protecting the surrogate's rights in well-regulated frameworks.

Rights of the Child and Legal Protection

Protecting the rights of children born through surrogacy is critical. Proper regulation ensures legal identity, access to records, and protection against conflicts between the surrogate and intended parents.

Legal identity — children must be recognized as children of the intended parents from birth.
Access to birth records — fundamental right to information about origin.
Protection in conflicts — clear protocols to resolve disputes between surrogate and intended parents.
Citizenship & travel documents — obtained in the destination country before returning home.
Surrogacy vs Adoption

Surrogacy vs. adoption: cost, timeline, and legal differences

Surrogacy raises important ethical and social questions that invite deep reflection. These issues range from the protection of surrogate mothers to the rights of children born through this method, as well as the inclusion of single parents and the LGBTIQ+ community.

Surrogacy

A woman gestates and gives birth to a baby for another person or couple, generally using the gametes of the intended parents or donors. Controversial and not allowed in many countries, including Spain.

Genetic link with at least one intended parent in most programs.
Experiencing gestation from the start with active involvement.
Option for medical reasons when pregnancy is impossible or unsafe.
Control over prenatal care and key decisions during pregnancy.

Adoption

A legal process by which a person who is not biologically related is welcomed as a child, establishing a permanent legal and emotional relationship. Widely accepted and regulated in most countries.

Legally accepted in the vast majority of countries.
Provides a home to children who already exist and need a family.
No medical risks for the adoptive parents.
Generally less expensive than surrogacy.
Resolves a social need by providing families to children without one.
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