For many intended parents, the decision to create embryos and start fertility treatments can feel daunting. You’ve researched surrogacy programs, weighed clinic options, and maybe even met your potential surrogate or donor. But once it’s time to actually begin, most parents discover there’s a steep learning curve ahead.
This stage can be a mix of science, logistics, and emotion, and it’s often where people start to feel out of their depth. Having guided hundreds of intended parents through this point in their journey, I’ve seen how much smoother things go when people know what to expect and how to prepare.
Here’s what intended parents should understand before starting fertility treatment.
1. Getting Ready for Embryo Creation
Embryo creation is a medical milestone that becomes the foundation of your family-building journey. Understanding what happens helps you make confident decisions and avoid common setbacks.
Clinics will begin by coordinating egg and sperm retrieval, which may come from you, your partner, or a donor. Once fertilisation occurs, embryos are grown for several days before being assessed for quality. Some will reach the blastocyst stage, others won’t, and that’s completely normal.
What can help:
- Make sure you’ve confirmed all documentation for your donor or sperm samples before your cycle begins. Administrative delays can easily set you back weeks.
- Ask your clinic when to expect updates and in what format. Knowing how and when results will be communicated helps prevent anxiety and misinterpretation.
- If you’re creating embryos overseas, clarify logistics early, such as shipping samples or synchronising donor and surrogate cycles to avoid complications later.
Many intended parents underestimate the amount of coordination involved at this point. If that already feels overwhelming, some agencies can help oversee communication between your clinic, donor, and legal team to keep everything aligned.
“There are so many moving parts early in the process. When an agency is proactive and organised, it can completely change the experience for intended parents. You shouldn’t have to chase updates or guess what’s happening, that’s what strong coordination is for.”
– Amanda Poston
Senior Director of Surrogacy Case Management
If your current agency isn’t equipped to provide that kind of hands-on coordination, it might be worth re-evaluating whether they’re the right fit. And if switching agencies isn’t an option, our Concierge Support service can step in to bridge those gaps, keeping things on track and helping you feel supported throughout the process.
“In my role as a concierge support manager, I work alongside agencies and clinics to keep everything coordinated, and one thing I’ve learned from years of experience is that not all agencies are equal! Some agencies are just easier to work with, so it’s important to find one that can really support you. It doesn’t remove the complexity, but it makes the process far more manageable and less stressful for intended parents.”
– Anita Fiorenza,
Concierge Support Manager
Growing Families
2. Understanding Screening
Once embryos are created, most US clinics recommend preimplantation genetic testing (PGT) to identify chromosomal abnormalities. This helps determine which embryos are most likely to result in a successful pregnancy.
But PGT is not a guarantee, and it’s important to interpret the results with perspective. A genetically “normal” embryo doesn’t always implant, and occasionally an “abnormal” one still can. What matters is how these results fit into your overall family goals, age, and medical background.
Don’t make decisions based on one number or label alone. Ask your clinic to explain what your results mean in plain terms. If something doesn’t make sense, press for clarity. The best decisions come when you fully understand the options, not when you’re simply told which one is “best.”
“There’s a deep emotional investment in every step. You can prepare yourself logically, but when you’ve pinned your hopes on a single result, disappointment hits hard. It’s why having a strong support system around you matters so much. You need space to process it all”
– Anita Fiorenza,
Concierge Support Manager
Growing Families
3. Surrogate Matching and Embryo Transfer
Once your embryos are ready, the next major step is finding the right surrogate. A good match can make the journey smoother, while a mismatch can introduce delays or additional stress. Factors like health history, availability, lifestyle, and communication preferences all play a role in how compatible a surrogate will be for your journey. Taking time to consider these factors upfront can save frustration later.
Embryo transfer is the medical milestone that follows matching. Coordinating timing between the surrogate’s cycle, the clinic, and any medications can be complex. A good agency can help ensure everyone is aligned, confirming appointments, reviewing protocols, and communicating updates promptly.
Even with careful planning, unforeseen changes can require rematching, which may involve extra coordination, legal steps, and potentially additional costs. Having clarity on how your agency handles rematching before it becomes necessary can help you anticipate potential expenses and minimize stress.
“A surrogate may need to withdraw for medical reasons, failed transfers, or scheduling conflicts. These things can happen in any journey. It’s important to work with agencies that have clear rematching policies, so intended parents aren’t hit with unexpected costs.”
– Amanda Poston
Senior Director of Surrogacy Case Management
4. Understanding Costs and Guarantees
Finances are one of the biggest unknowns when starting fertility treatment. Even when you’ve planned carefully, unexpected medical, travel, or legal costs can appear mid-process. What many intended parents don’t realise is that fertility costs aren’t always fixed, and how your clinic or agency structures their fees can dramatically affect your budget and peace of mind.
Some clinics and agencies now offer guaranteed birth or all-inclusive programs that cover most, if not all, medical and non-medical expenses under one set fee. These models are designed to remove financial uncertainty, a single cost that includes donor compensation, surrogate care, legal fees, and unlimited transfers until live birth.
For intended parents, these programs can offer stability in a process that often feels unpredictable. They’re not right for everyone, but for those who want a more controlled financial path, they can be worth exploring.
“Intended parents deserve to start this journey knowing exactly what to expect, medically, emotionally, and financially. Programs with guaranteed birth outcomes or fixed fees can give people the freedom to focus on the experience rather than worrying about what could go wrong along the way.”
– Greg Wiles
President of Hatch Fertility
and dad via surrogacy
5. Managing the Emotional Whirlwind
It’s perfectly normal to feel anxious, impatient, or even deflated during embryo creation. The constant waiting for fertilisation reports, for blastocyst updates and PGT results can be emotionally draining. Every message from your clinic feels monumental.
One of the most valuable things you can do is to build emotional structure around this waiting period. Take breaks from checking emails, plan activities that remind you of normal life, and allow space for both excitement and disappointment.
Many intended parents I’ve worked with found that journaling or connecting with others at a similar stage helped ease the mental strain. If you’re working with a counsellor, now is a good time to schedule regular check-ins.
6. Keeping Things on Track
Fertility treatment involves multiple professionals, often across different time zones and legal frameworks. It’s easy for small communication gaps to cause big frustrations.
Stay organised. Keep copies of all key documents and test results in one place. Maintain a simple spreadsheet of what’s been completed, what’s pending, and who’s responsible. When things start to feel chaotic, this helps you stay in control.
If you’d rather not manage every moving part yourself, there are options for more hands-on guidance. At Growing Families, our concierge support provides continuity, liaising with your clinic, ensuring forms and medical requirements are met, and helping you interpret each stage so you can make timely, informed decisions.
7. Stepping Back & Celebrating the Small Wins
It’s easy to feel like you should be doing more. But one of the hardest and most important lessons in this process is knowing when to pause.
Once you’ve completed your part in preparing embryos and coordinating with your agency and clinic, trust that the process will unfold as planned. Stepping back doesn’t mean you’re uninvolved; it means preserving your energy for the important steps ahead, like reviewing transfer updates, supporting your surrogate, and ultimately bringing your child home.
Along the way, take time to notice the small wins: a successful fertilisation, a healthy blastocyst, or a smooth transfer. Each milestone is a sign of progress, and celebrating them helps maintain perspective and hope throughout the journey.
Remember, surrogacy is a partnership with your surrogate, agency, clinic, and any support team you’ve engaged. Lean on them, and don’t hesitate to ask for guidance if the process starts to feel overwhelming. With the right preparation, organisation, and support, you can navigate each stage confidently, knowing every step is bringing you closer to your goal: a family of your own.
