Step 1: Initial Consultation

The process usually begins with a consultation with a qualified fertility specialist. The intended parent or parents can discuss their reproductive history, medical concerns, previous treatments and reasons for considering surrogacy.

The specialist may explain alternative family-building options, the possible role of IVF, expected stages of treatment and the uncertainties involved. Patients should be encouraged to ask questions and take time to consider the information.

Step 2: Medical Evaluation and Eligibility Review

Medical investigations help the clinical team understand the reproductive circumstances and whether surrogacy may be medically appropriate. In India, medical indication and statutory eligibility requirements must also be considered.

• Review relevant medical and reproductive history.
• Undertake investigations recommended by the treating specialist.
• Establish whether the circumstances meet the applicable legal criteria.
• Obtain the certificates and approvals required by current rules.

Medical eligibility and legal eligibility are separate questions. A person should not assume that a medical recommendation alone authorises surrogacy.

Step 3: Confirm Clinic Registration and Regulatory Requirements

Surrogacy services must be provided in accordance with the applicable regulatory framework. Intended parents should check the clinic’s registration and ask which procedures, documents and approvals apply to their case.

• Check the National ART & Surrogacy Registry.
• Ask for a written outline of the proposed treatment and administrative process.
• Clarify fees, insurance, permitted expenses and potential additional costs.
• Confirm the relevant State or District Appropriate Authority requirements.

Official information is available through the National ART & Surrogacy Portal.

Step 4: Carrier Assessment, Counselling and Consent

A prospective gestational carrier requires appropriate medical assessment and counselling. The clinical team should explain the procedure, possible risks, follow-up arrangements and the importance of voluntary, informed consent.

Discussions should respect the carrier’s privacy, dignity and autonomy. Any required consent forms, eligibility certificates, insurance and other documentation must follow the current law and rules.

In India, the Act sets specific criteria for a surrogate mother, including that she must not provide her own gametes. Confirm the current statutory requirements with qualified professionals.

Step 5: IVF and Embryo Creation

For gestational surrogacy, IVF is used to create an embryo outside the body. Depending on the treatment plan and applicable law, eggs and sperm may be obtained from the intended parent or parents or from donors in specifically permitted circumstances.

The treatment plan depends on clinical findings. Not every cycle produces an embryo suitable for transfer, and additional treatment may sometimes be discussed.

Step 6: Embryo Transfer

When an embryo is considered suitable and required legal and clinical conditions have been met, the fertility team may proceed with embryo transfer to the carrier’s uterus.

The procedure and preparation are explained by the clinical team. The carrier should receive clear information about the procedure, medication, follow-up and when to seek medical attention.

Embryo transfer does not guarantee implantation, pregnancy or live birth.

Step 7: Pregnancy Test and Follow-Up

A pregnancy test is arranged at the time recommended by the fertility team. If pregnancy is confirmed, follow-up may include ultrasound examinations, antenatal appointments and other investigations based on the carrier’s health and pregnancy progress.

• Attend scheduled fertility and obstetric appointments.
• Follow the prescribed medication and monitoring plan.
• Discuss symptoms or concerns promptly with the treating team.
• Plan appropriate maternity care and delivery arrangements.

Step 8: Delivery and Post-Birth Formalities

Delivery planning should involve the carrier and the relevant maternity team. The parties should understand the medical arrangements, communication preferences and procedures for birth registration and parentage documentation.

In India, the legal responsibilities of intended parents and the rights of the child are addressed by the statutory framework. Obtain case-specific legal advice and confirm the required documents and procedures with the relevant authorities.

How Long Does the Surrogacy Process Take?

There is no universal timeline. The duration depends on medical investigations, eligibility and approval procedures, clinic scheduling, IVF response, embryo availability, pregnancy progression and any additional treatment or administrative requirements.

Ask the clinic for a realistic, individualised timeline and clarify which stages may need to be repeated or delayed. Avoid relying on guarantees or fixed timelines advertised without reference to individual circumstances.

Costs and Financial Planning

The total financial commitment can depend on consultations, investigations, IVF procedures, medication, pregnancy care, delivery, insurance, legal advice and other permitted expenses. Obtain an itemised written estimate and ask which services are included or excluded.

India prohibits commercial surrogacy. Payments, expenses and insurance must be handled according to the applicable legal provisions. Do not rely on informal arrangements or assume that every payment described as an expense is automatically lawful.

Medical Risks and Emotional Support

IVF, embryo transfer, pregnancy and childbirth may involve risks. These can include medication effects, complications associated with fertility procedures, pregnancy-related conditions and delivery complications. Individual risks should be discussed with the treating clinicians.

Surrogacy can also involve emotional, relational and practical challenges. Counselling, clear communication, confidentiality and respect for the carrier’s healthcare decisions are important throughout the process.