What Happens If a Surrogate Miscarries?

Updated June 2026

QUICK ANSWER: A miscarriage during gestational surrogacy is medically and emotionally significant for both the intended parents and the surrogate. In most cases, the surrogate receives medical care, both parties are given time to grieve, and, when everyone is ready, another embryo transfer is attempted, typically beginning after the surrogate’s next menstrual cycle. The surrogacy agreement governs what happens to compensation and remaining embryos. Most intended parents who experience a surrogacy miscarriage ultimately continue their journey and go on to have a child.

If you are reading this after a loss: we are so sorry. Whatever brought you to this page, you deserve honest information and genuine care. 

How Common Are Miscarriages in Gestational Surrogacy?

Miscarriage during gestational surrogacy is more common than many intended parents expect, and less discussed than it should be.

In gestational surrogacy, pregnancy is established through IVF and embryo transfer. Miscarriage rates in IVF-conceived pregnancies range from approximately 15% to 25%, depending on the age of the egg source, embryo quality, and whether preimplantation genetic testing (PGT) was used. PGT-tested embryos have meaningfully lower miscarriage rates; some studies estimate 10% or below, which is one reason many reproductive endocrinologists recommend it (American Society for Reproductive Medicine, 2023).

It is important to understand that a surrogate’s miscarriage is not a failure of screening, character, or care. Surrogates undergo extensive medical evaluation before matching precisely because the process is rigorous, and a miscarriage can still occur in a fully healthy, fully screened surrogate. This is a biological reality of human reproduction, not a preventable error.

The Difference Between a Chemical Pregnancy and a Clinical Miscarriage

Not all early pregnancy losses are the same, and the terminology matters when you are trying to understand what happened.

A chemical pregnancy occurs when an embryo implants briefly and produces detectable levels of hCG (the hormone measured by a pregnancy test), but does not develop further. The loss typically occurs before an ultrasound can confirm the pregnancy visually, usually within the first few weeks after transfer. Chemical pregnancies are relatively common in IVF and are generally not indicative of anything.

A clinical miscarriage occurs after a heartbeat or gestational sac has been confirmed on ultrasound, typically after five to six weeks. This is a more developed pregnancy loss and often carries greater emotional weight for all involved.

Your reproductive endocrinologist and the surrogacy agency will communicate clearly about which type of loss has occurred and what it means medically for the next steps.

What Happens Medically After a Surrogate Miscarries

After a miscarriage is confirmed, the surrogate’s medical care comes first. Her reproductive endocrinologist will assess the situation and determine the appropriate course of treatment. In some cases, the body naturally completes the miscarriage; in others, medication or a minor procedure (a D&C) may be recommended to ensure the surrogate’s physical health and prepare her body for a potential future transfer.

The surrogate will be monitored by her medical team throughout this process. All medical costs associated with the miscarriage, including any treatment, are covered under the surrogacy arrangement, as they are considered part of the surrogacy medical process.

What the Surrogacy Contract Covers

This is one of the most important and least-discussed aspects of a surrogacy miscarriage: the gestational surrogacy agreement already addresses it.

Well-drafted surrogacy agreements include provisions that cover exactly this scenario. These typically address the surrogate’s compensation, what happens to any remaining embryos, the process for determining whether to attempt another transfer with the same surrogate, and the conditions under which the intended parents may request a new match.

If you are uncertain what your specific agreement covers, your reproductive attorney can clarify. This is precisely why having an attorney involved before the medical process begins matters: the contract provides a clear, agreed-upon framework for moments that are otherwise extremely difficult to navigate.

Grieving, for Both the Intended Parents and the Surrogate

A surrogacy miscarriage involves loss for both parties, and it is important that both receive space to grieve it.

Intended parents are often processing not just this loss but the weight of everything that came before it: fertility treatments, previous losses, the long road to finding a surrogate. A miscarriage during surrogacy can reactivate grief that had been set aside, and it can feel particularly isolating because it is a loss that most people around you have no framework to understand.

The surrogate carries a different kind of grief. She carried this pregnancy in her body; she was invested in the outcome, and she may feel guilt, even though she did nothing wrong, alongside her own physical recovery. Her emotional experience during this time is real and deserves acknowledgment from the intended parents and the agency.

Most surrogacy agencies provide access to mental health support for both parties after a loss. If you are working with Elevate Baby, our team will connect you with counseling resources and will not pressure either party to move forward before they are genuinely ready.

Your Options for Moving Forward

There is no timeline that is right for everyone. The following represents what most intended parents and surrogates experience when they decide to continue, but moving forward should only happen when both parties are medically cleared and emotionally ready.

The most common approach is to attempt another embryo transfer with the same surrogate. After a miscarriage, the surrogate’s body typically needs one to two full menstrual cycles before transfer medications can begin again. Her reproductive endocrinologist will confirm when she is ready. If remaining embryos are available, this can be a relatively straightforward next step.

In some cases, when the surrogate is not medically cleared to continue, or when either party decides they are not able to continue together, the intended parents may be rematched with a new gestational carrier. This does not mean the relationship with the previous surrogate ends; many intended parents and surrogates maintain meaningful connections even when their journeys separate.

If no viable embryos remain, the intended parents may need to return to an earlier step, like an egg retrieval cycle, or working with an egg donor. This is an additional step, and one where having the right agency and clinical team makes an enormous difference.

Frequently Asked Questions

You Don’t Have to Navigate This Alone

Whether you are preparing for the possibility of a loss or you are in the middle of one right now, Elevate Baby’s team is here. We’ve walked alongside families through every part of this journey, including the hardest parts.

Call us at (323) 933-8918 or contact us to talk to our team.