Surrogacy in the USA: What UK & European Intended Parents Need to Know

US surrogacy follows a predictable rhythm, even though each family’s timeline will have its own shape. Most international intended parents spend 14–30 months from their first consultation to travelling home with their baby. [5,6,7,8,9]

Here’s how the process typically unfolds:

Phase 1: Agency selection and initial screening

Time estimate: 1–3 months

You’ll meet agencies, compare models, speak with surrogacy lawyers, and review clinic options. This is when you confirm whether you will create new embryos or ship existing ones to the US, and start to understand which US states and clinics best fit your needs as an international intended parent. For UK-based parents, this is also the point where you should take independent legal advice in both the UK and the US, particularly if you’re considering international surrogacy and will need to secure a parental order and bring your baby back to the UK.

Phase 2: Matching with a surrogate

Time estimate: 3–9 months

Matching is thoughtful and carefully managed. You’ll review surrogate profiles, discuss expectations around communication and decision-making, and meet potential matches virtually before anyone commits. Most agencies quote a matching window of roughly 3–9 months, depending on your preferences, your chosen state, whether you need donor eggs, and your requirements around issues like views on selective reduction or termination. This stage is also when many parents start counselling or emotional support, as recommended in UK guidance for those pursuing surrogacy, because the hopes and stakes feel understandably high. [10]

Phase 3: Medical screening for your surrogate

Time estimate: 4–8 weeks

Once matched, your surrogate will attend detailed medical and psychological screening with your chosen clinic. This typically includes review of her previous pregnancy history, blood tests, infectious disease screening, and assessment of her uterine health to confirm she can safely carry a pregnancy. Clinics usually follow similar principles to those set out in UK fertility and surrogacy guidance: informed consent, clear discussion of treatment risks, and counselling support where needed. [10]

Phase 4: Embryo creation or transport

Time estimate: 1–3 months

If you already have embryos in the UK or Europe, your clinic and a licensed medical courier will coordinate the export to your US clinic, following both local and destination regulations on embryo transport. If you’re creating embryos, this phase will include ovarian stimulation, egg retrieval, fertilisation, embryo culture and freezing, and possibly PGT testing, using your own or donor eggs and/or sperm. UK-based guidance stresses that people using donor eggs or sperm should have clear information on donor rights and legal parenthood before treatment; the same principle applies when planning embryo creation for surrogacy in the US, even if the treatment happens abroad. [10]

Phase 5: Legal contracts

Time estimate: 4–6 weeks

Contracts are drafted and reviewed by your surrogacy lawyers in the US, with input from your UK or European lawyer so the agreement works on both sides of the Atlantic. These documents set out expectations around compensation, medical decision-making, insurance, contact, what happens if the pregnancy does not progress, and how parentage will be established under the laws of the birth state. For UK residents, it’s important to remember that surrogacy agreements are not enforceable in UK law and you will still need a parental order once you are home, even if your US contract is fully enforceable in that state.

Phase 6: Embryo transfer

Time estimate: 6–8 weeks

Your surrogate will complete a medicated cycle to prepare her uterine lining for transfer, often including oestrogen and progesterone, with monitoring scans and blood tests. When the clinic is happy with the lining, one (occasionally two) embryos are transferred in a simple procedure similar to IVF treatments described by HFEA, followed by a two-week wait before pregnancy testing. If the test is positive, early pregnancy scans will be arranged; if not, your team will talk you through options for another cycle and any adjustments to protocol. [10]

Phase 7: Pregnancy

Time estimate: 37–40 weeks

Once pregnancy is confirmed, care transitions into routine obstetric follow-up in the US, with additional monitoring if there are complicating factors such as twins, pre-existing health conditions or previous pregnancy complications. You’ll usually have regular updates from your surrogate and clinic, virtual attendance at key appointments where possible, and ongoing contact with your agency and legal team to make sure parentage orders and insurance are on track before birth. UK guidance highlights that surrogacy arrangements can be emotionally demanding for everyone involved, so accessing counselling or support for you and your surrogate throughout pregnancy can be protective for mental health and for ongoing relationships. [10]

Phase 8: Post-birth steps and returning home

Time estimate: 2–6 weeks depending on documentation and processing times

After birth, the US court will issue your parentage documents in line with state law, and your baby’s US birth certificate will be produced naming you as parents. You’ll usually apply first for a US passport so your baby can travel, then work with a UK or European lawyer to confirm your child’s nationality position and next steps for a UK/EU passport or entry clearance, following the Home Office’s nationality and overseas surrogacy guidance. Once you’re back in the UK, you will still need to apply for a parental order within six months of birth so that legal parenthood is transferred from your surrogate to you under UK law. The UK government is clear that at least one intended parent must be domiciled in the UK, Channel Islands or Isle of Man, the child must live with you in the UK, and at least one of you must have a genetic link to the child for a parental order to be granted.