So, you've built your first creative in Ad Designer. Nice! Now, you're going to want to export it so you can start trafficking it. Your shiny new creative needs to be exported through the Campaign Manager dashboard, where all publishing functionality is handled. So here's how to get your creative from Ad Designer, into Campaign Manager.

First, when once your creative is ready for prime-time, you need to export it from Ad Designer.
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To export a creative in Ad Designer, find the creative in the My Creatives view of Ad Designer and click the “Export” button. In the Export panel, click on the “Export” button again. This exports a duplicate of your creative in its current state. You can preview the duplicate or continue to share it to the person that can publish it in Campaign Manager.

Next, you'll probably want to give someone else on your team access to the creative ("teamwork makes the dream work" and all that).

All you need to do is type in their name or email when exporting the creative and that person will be able to access the creative in Campaign Manager.
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Finally, in order to start trafficking your Ad Designer creative, you'll need to add it to a campaign.

Pick the campaign you want to add it to (or create a new one if needed), and click "Choose layout". When the layout gallery opens, click on "Creative library" in the header. Find the creative you want, and click "Use".

Now you can go ahead and publish your campaign through Campaign Manager.