Planning to build your family through surrogacy? This is where it starts.
Most chromosomal conditions arise from spontaneous errors during egg or sperm formation — not from anything the surrogate or intended parents did. Here’s what they are, and what they mean for your journey.
An extra copy of chromosome 21 causes lifelong intellectual disability and developmental delays of varying severity. Associated medical concerns include congenital heart defects, thyroid disorders, and gastrointestinal differences. Many individuals with Down syndrome live full, meaningful lives with the right support.
An extra chromosome 18 leads to severe developmental differences affecting multiple organ systems — heart, kidneys, and neurological function. Most cases result in stillbirth or loss within the first year of life. Prenatal screening can identify elevated risk early in the first trimester, giving families and their care team time to prepare.
An extra chromosome 13 causes severe structural differences including brain malformations, heart defects, and facial differences. Most affected pregnancies do not survive to term. Those born alive typically have very short life expectancy. Like Trisomy 18, it is detectable through first-trimester screening and NIPT.
Turner syndrome (45,X) affects females and Klinefelter syndrome (47,XXY) affects males — both involve variations in the number of sex chromosomes. Many individuals with these conditions live full lives, though hormonal and fertility considerations may arise. NIPT screens for both as part of a standard panel.
A neural tube defect that occurs when the spinal column fails to close properly during early fetal development. Severity ranges widely — from spina bifida occulta (often asymptomatic) to myelomeningocele, which involves spinal cord exposure and can affect mobility, bladder function, and neurological development. AFP Quad Screen and NT Sonogram can flag elevated risk.
Conditions like gastroschisis and omphalocele occur when abdominal organs develop outside the fetal body due to improper closure of the abdominal wall. The degree of impact depends on which organs are involved and whether other abnormalities are present. These are structural rather than chromosomal in origin, but fall within the same prenatal testing window.
Important: In gestational surrogacy, the embryo carries the chromosomal profile determined by the intended parents’ genetics (or donor genetics) at fertilization. A surrogate’s chromosomal makeup does not affect the baby. Her obstetric health affects the pregnancy — which is why physician-designed surrogate screening is built into every journey we manage.
Modern prenatal testing can identify chromosomal disorders in surrogacy pregnancies with high accuracy — often in the first trimester. There’s a key difference between screening (non-invasive, risk-based) and diagnostic testing (invasive, definitive).
Cell-free fetal DNA circulating in the surrogate's bloodstream is analyzed through a simple blood draw. It screens for Trisomies 21, 18, and 13, sex chromosome conditions, and select microdeletions. Sensitivity for Trisomy 21 exceeds 99%. Results typically arrive within 1–2 weeks, available as early as 10 weeks gestation.
ScreeningFluid at the back of the fetal neck is measured via ultrasound between weeks 11 and 14. Increased thickness is associated with chromosomal abnormalities and cardiac concerns. Often combined with first-trimester blood work. Our onsite physicians can order this directly as part of your care plan.
ScreeningFour maternal serum markers are measured through a second-trimester blood draw to screen for neural tube defects, Down syndrome, and Trisomy 18. Best used alongside first-trimester screening results, not as a standalone test. Our onsite physicians can coordinate this as part of an integrated testing plan.
ScreeningTrisomies 21, 18, and 13 are all frequently associated with structural cardiac differences that a standard anatomy scan may not fully characterize. The fetal echocardiogram — a specialized ultrasound of the heart — is the test that catches these. Our onsite physicians can order this as part of an integrated care plan.
ScreeningEmbryos are screened for chromosomal abnormalities at the IVF stage — before transfer occurs. Only chromosomally normal embryos are transferred. This reduces the likelihood of a chromosomally affected pregnancy reaching your surrogate. PGT-A is performed by your IVF clinic; Physician's Surrogacy coordinates with partner centers.
Pre-TransferScreening identifies risk. Only diagnostic testing confirms or rules out a chromosomal condition with certainty. Amniocentesis (second trimester) and CVS (first trimester) both carry a small procedural risk. Our Advisory Board includes a Maternal-Fetal Medicine specialist available for complex case consultation.
DiagnosticWe’re the only surrogacy agency in the U.S. managed by in-house, board-certified OB/GYNs. That clinical authority changes the medical equation at every stage of your California surrogacy journey.
When a prenatal test flags a concern, our onsite OB/GYNs are already part of your journey — not someone you wait to be referred to. They can consult directly with your surrogate's managing OB the same day a result arrives.
Our Advisory Board includes a Maternal-Fetal Medicine specialist — the same type of physician who manages high-risk pregnancies in clinical practice. They're available for consultation when screening results require specialist input.
Our preterm delivery rate is 50% below the national average — a direct result of the screening protocol our physicians designed. The surrogates who reach your match have already cleared a standard most agencies don't have.
NIPT, NT Sonogram, AFP Quad Screen, and Fetal Echocardiogram are available through our onsite physician oversight. Most agencies cannot order these tests at all. At Physician's Surrogacy, they're part of how every journey is managed.
You receive physician-monitored updates after every surrogate appointment. You know what was found, what it means, and what happens next — directly from the clinical team in charge of your case.
Only 8% of surrogate candidates pass our screening protocol. Obstetric history, prior complications, and medical factors that could affect a chromosomally complex pregnancy are assessed before any match is confirmed.
Surrogates in our Medically Cleared Program complete medical and psychological screening before matching — not after. You're matched with a surrogate who has already cleared our physician-designed protocol. No waiting on screening results after you've already fallen in love with a profile.
Every surrogacy journey follows six stages. Here’s what each one looks like — and where Physician’s Surrogacy compresses the timeline against the industry standard.
Bring your questions — including the hard ones about chromosomal disorders, prenatal testing, and what happens if something is found. We review your goals and medical concerns and give you a free personalized cost quote before you leave
Every surrogate you see has already passed our physician-designed pre-screening — OB medical history review, background checks, and diagnostic screenings. You're never matched with someone whose obstetric health is an unknown.
Your matched surrogate completes final medical and psychological screenings. Your surrogacy attorney drafts the gestational agreement — including any prenatal testing requirements you want documented before anything begins.
Your fertility clinic creates the embryo and transfers it to your surrogate. If you've chosen PGT-A testing, only chromosomally screened embryos move forward. Our physician-led team coordinates every step.
Our onsite OB/GYNs review clinical updates after every appointment. If a prenatal test flags a concern, they consult directly with your surrogate's managing OB the same day. You hear about it from the clinical team, not a coordinator relay.
A pre-birth parentage order means your names are on the birth certificate before delivery. Your baby comes home with you — no extra court steps required in most states.
Full step-by-step: Complete California Surrogacy Guide
Discover answers to common questions about your surrogacy journey.
No. In gestational surrogacy, the embryo is created from the intended parents' genetics (or donors'). Your surrogate carries the pregnancy but shares no biological connection with the child. Her chromosomes do not influence your baby's chromosomal profile — though her obstetric health affects the pregnancy overall, which is why our physician-designed surrogate screening goes beyond standard agency requirements.
Testing preferences are addressed during the legal contract phase. Many intended parents include prenatal testing requirements in their agreement. Your surrogacy attorney guides the language. At Physician's Surrogacy, our clinical team can handle ordering the approved tests — NIPT, NT Sonogram, AFP Quad Screen, and Fetal Echocardiogram — through onsite physician oversight.
PGT-A (Preimplantation Genetic Testing for Aneuploidy) screens embryos for chromosomal abnormalities at the IVF stage — before transfer occurs. Only chromosomally normal embryos are transferred. It reduces the likelihood of chromosomally affected pregnancies reaching your surrogate. PGT-A is performed by your IVF clinic; Physician's Surrogacy coordinates with partner centers and can support that conversation as part of your journey planning.
At Physician's Surrogacy, physician-monitored clinical reports are delivered to intended parents after every surrogate appointment. If a result requires immediate attention, our onsite physicians can communicate directly with the surrogate's managing OB the same day — and you receive that information promptly, not after it filters through a chain of coordinators.
No. NIPT is a screening test — it assesses risk, not certainty. A positive result indicates elevated probability and typically prompts consideration of diagnostic testing (amniocentesis or CVS) to confirm or rule out the finding. Our clinical team walks intended parents through what a result means and what options are available, so you're never interpreting results alone.
Our consultations are handled by the clinical team. Bring every question you have about genetic testing, what happens if a result comes back, or how our physician model protects your pregnancy. You’ll leave with real answers from the people who run this program.
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