Want to Become a Surrogate Mother? Here's How the Program Works

When considering surrogacy, it's worth finding out more than just the payment amount. Who will manage the pregnancy? Will you need to relocate? How are payments organized, and what does the contract cover? These terms will shape your everyday life throughout the program.

You can start with a consultation and by comparing offers. Below is an overview of the requirements for a surrogate mother, the medical stages, and the arrangements worth discussing before you start.

A surrogate mother carries and gives birth to a child for the intended parents. In a gestational program, she is implanted with an embryo created in a lab using the egg of the intended mother or of a donor. Her own eggs are not used for this.

In Ukraine, the terms for such programs are set out, among other things, in the Procedure for the Use of Assisted Reproductive Technologies, approved by Order No. 787 of the Ministry of Health. It requires medical indications for surrogacy and a genetic connection between the child and at least one of the intended parents.

It's also important to understand how long participation takes. It covers preparation, embryo transfer, pregnancy, birth, and postpartum recovery. A transfer doesn't guarantee pregnancy on the first attempt, so an exact end date for the program can't be set in advance.

Clause 6.4 of Order No. 787 sets out four main conditions: the woman must be an adult with full legal capacity, have a healthy child of her own, voluntarily submit a written statement, and have no medical contraindications.

At the same time, a specific program's requirements can be narrower. For example, ADONIS states an age range of 18–36 for its candidates, plus additional criteria on health and prior births. These are the clinic's own conditions — clause 6.4 of the Ministry of Health order doesn't set such an upper age limit.

Without a child of her own, a woman cannot participate under these requirements. Being married, however, isn't required. If a woman is married, her husband's consent is added to the documents for her participation.

A previous C-section doesn't always mean a rejection. For example, ADONIS will consider candidates after one C-section under conditions the clinic defines. But meeting that initial criterion doesn't by itself mean medical clearance for the program.

The full history of previous pregnancies and births matters for the assessment, not just how the child was delivered. International ASRM (American Society for Reproductive Medicine) guidelines call for a review of medical history, an exam, and an assessment of the uterine cavity.

Bring discharge records from the maternity hospital and documentation of any surgeries to the consultation. If you gave birth recently or are breastfeeding, discuss with your doctor when it makes sense to revisit participation. Don't adjust your own plans just to fit a timeline a coordinator suggests.

The first conversation lets you find out whether you meet the initial requirements and whether the organizational terms work for you. The doctor assesses the medical side after screening.

This includes a gynecological exam, a pelvic ultrasound, blood tests, testing for specific infections, and an assessment of overall health, among other things. The Ukrainian Procedure separately requires an examination by a psychiatrist. Get the full list and how long results remain valid from the clinic.

Psychological preparation is worth treating as separate from the mandatory medical screening. ASRM recommends discussing the candidate's expectations, support from loved ones, the effect of participation on her own family, and her feelings about ending the relationship after the child is born.

This kind of conversation is also there for your own questions — for example, how to explain the pregnancy to your own child, what boundaries to set for communication with the intended parents, and who to turn to if things get emotionally difficult.

Before medication preparation begins, it's worth agreeing on the main participation terms and getting independent legal advice. ASRM specifically emphasizes the importance of the surrogate having her own legal representative, who protects her interests specifically. This is an international recommendation, not a separate requirement under Ukrainian law.

To formalize a candidate's participation, you need a written statement, a copy of her passport, her own child's birth certificate, and documents on marital status where applicable. A married woman also needs her husband's consent.

When getting to know the intended parents, discuss how often you want to be in touch, who will receive updates on the pregnancy, and who to contact about everyday matters. It's better to identify differences in expectations up front than to try to sort them out during the pregnancy.

The doctor prepares the endometrium — the inner lining of the uterus — for transfer. Depending on the situation, this uses either a natural cycle or medication-based preparation, including estrogen and progesterone. The regimen and monitoring schedule are set individually.

This is not the same process as egg donation: a surrogate mother doesn't need to undergo egg retrieval for this program. Her medical preparation relates to the embryo transfer and supporting the pregnancy.

Before treatment begins, you need clear written prescriptions and a contact at the medical team. Organizational questions can go through a coordinator, but changes to medications and doses should be discussed with your doctor.

During the transfer, the doctor places the embryo into the uterine cavity through a thin, soft catheter, usually under ultrasound guidance. The procedure generally doesn't require sedation.

The number of embryos needs to be discussed in advance. ASRM strongly recommends transferring a single embryo in surrogacy programs to reduce the risks of a multiple pregnancy. Extra payment for twins shouldn't replace a conversation with your doctor about health.

After the procedure, the clinic schedules a pregnancy test date. A positive result is then confirmed with ultrasound — a single test isn't enough to assess the pregnancy's location and development.

If the transfer doesn't succeed, next steps are discussed with the doctor. The payment terms for that attempt, the possibility of trying again, and the limits on the program's total length should all be clear before it starts.

Find out in advance who will manage the pregnancy after the fertility clinic's involvement, where checkups will take place, and at which maternity hospital the birth is planned. It's also important to have a contact for medical concerns in the evenings and on weekends.

A previous uncomplicated pregnancy is no guarantee the next one will go the same way. Participation requires medical monitoring, and the doctor should discuss the possible risks of pregnancy and birth with you before the program begins.

After the child is born, registration follows a special procedure. Among the required documents is the woman's statement consenting to have the couple recorded as the child's parents, with her signature notarized. The registration process is worth reviewing with a lawyer in advance.

The end of the pregnancy doesn't mean the end of the need for support. Discuss postpartum checkups, recovery, lactation, and access to psychological support. ASRM recommends arranging support for the surrogate even after her participation ends, including covering treatment for any complications.

To compare financial terms, you need to separate the base fee, monthly payments, and expense coverage. An ad quoting a single total figure doesn't always explain what it's made up of.

For example, as of the time of checking, the agency Delivering Dreams states for its Ukraine program a base compensation of $20,000 for a singleton pregnancy plus $500 a month for everyday expenses. Per the agency's published terms, monthly payments start after a heartbeat is confirmed on ultrasound, and medical expenses are covered separately. This is one specific offer, not an average rate for Ukraine or a guarantee of payment in another program.

When comparing programs, look not only at the total amount but also at what the payments consist of and which expenses are covered separately. This lets you compare offers on the same terms.

First, clarify the surrogate's base fee: what amount will be fixed in the contract, when it will be paid, and under what circumstances it might change. Ask for an explanation not only of the amount, but of the terms for receiving it.

Discuss monthly payments separately. It matters to know from what point they start, what they're meant to cover, and whether they're included in the total figure quoted in the offer. That way it's clear which funds you can rely on during the program and which you'll receive after it ends.

Also find out who pays for testing, medication, travel, housing, the birth, and postpartum care. Ask for specifics on which expenses will be paid directly, which will be reimbursed to you, and whether any will have to be covered out of pocket.

Additional compensation is worth discussing in advance. What's provided for in case of a C-section, hospitalization, a repeat embryo transfer, or other changes to the program? It's important to understand which payments apply in each situation, when they're made, and who's responsible for them.

Separately, clarify the currency of payment, the rule for converting to hryvnias, and any possible tax withholding. You need not just the figure in the contract but an understanding of how much money you'll actually receive.

Payments to surrogates are worth weighing against the costs that remain on the participant herself. For example, will you need to pay for childcare for your own child during your appointments? Is extra accommodation reimbursed if your return home is delayed? All financial arrangements should be clear and set down in writing.

A relocation arrangement needs to be specific. Wording like "a late move" or "housing is provided" doesn't yet explain where, when, or under what conditions you'll be living.

If the program involves living in another city, find out the expected timing of the move and the circumstances under which it might change. Discuss whether you can bring your child, whether the housing will be separate, and who will pay for utilities and travel to appointments.

It's also worth planning for help at home — who will look after your child during checkups, the birth, or a hospital stay. You don't have to decide everything at once, but it's important to understand what support you'll need.

A separate question is a backup plan in case the security situation changes. Where could monitoring continue, who would arrange the move, and how would extra costs be paid? It's better to have these arrangements in place before they become urgent.

Payments, medical support, relocation, and support from loved ones — all of this matters when choosing a program. Give yourself time to compare offers and work out which terms suit you and your family. On Ovomama, you can create a surrogate mother profile, get to know intended parents and agencies, and discuss the details. Start with a conversation, and make your decision about participating once you have answers to your own questions.