Step 1: Submit Information and Complete Document Review

Submit the information form, passport copy, and existing medical or embryo records. RSMC's case team completes the initial review within 1–2 business days.

✅ Success standard: Receive a confirmation email and enter the surrogate matching pool

⚠️ Common error: Incomplete documents cause review delays. Preparing in advance can save one week.

Step 2: Surrogate Matching and Video Communication

Receive and review surrogate candidate profiles, then participate in video conversations and mutual selection. RSMC's in-house surrogate pool ensures candidates have passed initial screening.

✅ Success standard: Both parties confirm their interest and sign a surrogate engagement letter

⚠️ Common error: Overly strict requirements for a surrogate may lengthen the matching process.

Step 3: Sign the Contract and Make the Initial Payment

After selecting a candidate, sign the engagement or fee documents, make the initial payment, and complete the background check and fund-management agreement. RSMC also provides clear pricing examples for U.S. IVF costs.

✅ Success standard: The contract takes effect and the escrow account is established

⚠️ Common error: Failing to carefully review contract terms. Ask an attorney to explain them line by line.

Step 4: Establish Project Communications and a Document Checklist

A bilingual case team creates the project's communication and document checklist. Bilingual coordination continues throughout the process to keep information flowing smoothly.

✅ Success standard: Project management documents are ready and responsibilities are clearly assigned

⚠️ Common error: Poor communication channels result in missed information.

Step 5: Medical Screening and Compliance Review

Arrange the surrogate's medical screening and complete psychological, insurance, and compliance reviews. RSMC's CAP+CLIA laboratory ensures top-tier screening standards.

✅ Success standard: The surrogate passes all medical and psychological evaluations

⚠️ Common error: A surrogate may need to be replaced if an issue is found during the examination. Allow time for contingencies.

Step 6: Sign the Legal Contract

The intended parents and surrogate each have independent attorneys review and sign the surrogacy agreement. California law provides clear protections for parentage in surrogacy. If same-sex partners are selecting eggs from an egg bank, the legality of the gamete source must also be confirmed.

✅ Success standard: Both attorneys confirm the agreement's compliance and parentage provisions are clear

⚠️ Common error: Overlooking exclusions and fine print in insurance provisions.

Step 7: Make Milestone Payments

Make the next milestone payment according to the contract and payment schedule. RSMC's sample fixed-expense plan totals approximately $145,000, including a $10,000 emergency reserve; the birth guarantee plan is approximately $202,000.

✅ Success standard: Payments are made on schedule and the process continues moving forward

⚠️ Common error: Failing to set aside emergency funds can leave you unprepared for unexpected costs.

Step 8: Surrogate Medication and Endometrial Preparation

After medical and legal clearance, the surrogate generally begins approximately 4–5 weeks of medication and endometrial preparation. The physician precisely adjusts the medication protocol according to the surrogate's hormone levels.

✅ Success standard: The endometrial lining reaches transfer requirements, typically ≥7 mm

⚠️ Common error: Failure to follow the medication protocol on schedule can delay the cycle.

Step 9: Embryo Transfer

The fertility clinic performs a single-embryo transfer. RSMC's laboratory supports embryo culture through day 7.5 and PGT-A/PGT-M screening to improve success rates.

✅ Success standard: The transfer is completed successfully and the embryo is properly positioned

⚠️ Common error: Excessive bed rest after transfer may hinder circulation.

Steps 10–11: HCG Testing and Ultrasound Confirmation

A blood HCG test is performed approximately 10 days after transfer, with a repeat test about two days later to confirm that levels are doubling. An ultrasound is performed 4–5 weeks after transfer to confirm cardiac activity.

✅ Success standard: HCG levels rise steadily and ultrasound detects cardiac activity

⚠️ Common error: Excessive anxiety can interfere with daily life. Try to maintain a calm mindset.

Steps 12–13: Final Payment and Transfer to Obstetric Care

Once the contractual milestone is reached, make the third payment and the agreed emergency reserve contribution. The fertility clinic monitors the pregnancy through weeks 11–12 before transferring care to an obstetrician.

✅ Success standard: The surrogate transitions smoothly to routine prenatal care

⚠️ Common error: Underestimating the impact of the obstetrician selection on the birth experience.

Steps 14–15: Parentage Order and Birth Plan

Attorneys prepare a Pre-Birth Order according to state law and the circumstances of the case. The team works with the surrogate, obstetrician, and hospital to develop a detailed birth plan.

✅ Success standard: The parentage order is approved and the birth plan is confirmed

⚠️ Common error: Differences in state law may lengthen the parentage-order process. Professional legal guidance is essential.

Steps 16–17: Travel to the U.S. and Post-Birth Documents

The intended parents travel to the U.S. as planned and coordinate with the hospital around the baby's birth. They complete post-birth documents, finalize the accounts, and receive any unused funds.

✅ Success standard: The baby is born safely and all legal documents are complete

⚠️ Common error: Failing to arrange return-home documents in advance can extend the stay.