Time and Trials: Understanding the Phases and Delays in Surrogacy

The surrogacy journey is a life-changing decision for both intended parents and surrogates. One of the most common questions asked is, “How long does the surrogacy process take?” While a general estimate is 18-24 months, it’s crucial to recognize that numerous factors can influence this timeline, sometimes extending the process for several years.


The Phases of a Surrogacy Journey:

The surrogacy process involves a series of essential phases, each contributing to the overall timeframe. These include making embryos at the IVF clinic, surrogate screening, legal contracts, embryo transfer, pregnancy, delivery, and postpartum recovery for the surrogate. The 18-month estimate assumes successful embryo formation and a single embryo transfer resulting in pregnancy.

Factors Leading to Extended Timelines:

Challenges in Embryo Creation:

Poor Ovarian Reserve or Sperm Quality: Intended parents may face difficulties in creating sufficient embryos due to poor ovarian reserve or sperm quality. Multiple egg retrieval cycles may be necessary, elongating the timeline.Genetic Disease Screening: Screening embryos for genetic diseases may require discarding a significant number, necessitating additional egg retrieval cycles.

Egg Donor Considerations:

Prolonged Selection Process: Choosing an egg donor can be time-consuming, especially if intended parents are particular about their preferences. Delays may occur, such as waiting for the donor to complete other commitments.

Surrogate Screening Challenges:

Reproductive Endocrinologist’s Scrutiny: Additional screening by the reproductive endocrinologist may be required if questions arise from the standard screening or the surrogate’s obstetrical history. Ensuring the surrogate’s optimal health before embryo transfer is crucial. Medical Corrections: Unforeseen medical issues, like uterine polyps, may emerge during screening, necessitating correction before proceeding.

Medication Response Variability:

Unpredictable Medication Response: Surrogates’ bodies may not always respond as expected to medications, requiring adjustments and potentially prolonging the process. Failed Embryo Transfers: Repeated failed embryo transfers or miscarriages can extend the surrogacy journey, each cycle requiring several months.


Rematching and Insurance Considerations: 

Rematching Delays: If intended parents need to rematch with another surrogate, it can extend the timeline. Recommendations from the IVF doctor or previous surrogate experiences may influence this decision. Insurance Hurdles: Waiting for open enrollment to secure IVF-friendly health insurance or ACA marketplace plans for surrogates can contribute to delays.

External Factors:

Pandemic Impact: Unpredictable events, such as the COVID-19 pandemic, can disrupt surrogacy plans. Canceled cycles and clinic shutdowns during the pandemic exemplify external factors beyond anyone’s control.

Coping with Frustrations:

While the surrogacy journey is undoubtedly challenging, maintaining realistic expectations is crucial. Acknowledging potential delays and understanding the complexities of each phase can help intended parents and surrogates navigate this lengthy but ultimately rewarding process.


The surrogacy journey is a multifaceted process with numerous variables influencing the overall timeline. From challenges in embryo creation to unexpected medical issues and external factors like the COVID-19 pandemic, understanding these complexities is essential for all involved parties. By approaching the surrogacy journey with patience, realistic expectations, and open communication, intended parents and surrogates can navigate this transformative experience successfully.

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