Frequently Asked Questions

Total costs typically range from $90,000 to $200,000. The major categories are surrogate base compensation ($30K–$60K), agency fees ($25K–$50K), IVF and medical costs ($15K–$30K), legal fees ($8K–$15K), surrogate health insurance ($5K–$30K), and surrogate expense allowances ($5K–$15K). California and major coastal markets tend toward the higher end. See our full cost breakdown for line-by-line estimates.
A typical journey takes 12–18 months from starting your agency search to birth: agency selection (1–2 months), matching (1–4 months), legal contracts (3–6 weeks), medical evaluation and embryo transfer (2–3 months), and the pregnancy (approximately 9 months). Build in a 3–6 month buffer for unexpected delays like a failed transfer or rematching.
In gestational surrogacy, the surrogate has no genetic connection to the baby. In states with surrogacy statutes and pre-birth orders, intended parents are established as legal parents before birth — the surrogate has no legal claim to the child. This scenario is extremely rare in properly structured gestational surrogacy with the right legal protections in place. It is one of the primary reasons to choose a surrogacy-friendly delivery state.
No — not in gestational surrogacy. The embryo is created using the intended parents' or donors' genetic material and transferred to the surrogate's uterus via IVF. The surrogate carries and delivers the baby but has no genetic relationship to the child. This distinguishes gestational surrogacy from traditional surrogacy, in which the surrogate is inseminated and is the genetic mother. Over 95% of US surrogacy arrangements today are gestational.
A pre-birth order is a court order issued during pregnancy — typically in the second trimester — that names intended parents as the legal parents of the expected child. It directs the hospital to list intended parents on the birth certificate at delivery, without the surrogate's name appearing. PBOs are available in most surrogacy-friendly states for all family types including same-sex couples and single parents. In states without PBOs, a post-birth parentage order is required instead.
A GCA is the comprehensive legal contract between intended parents and their gestational surrogate, covering compensation, expense reimbursements, medical decision-making authority, communication expectations, selective reduction and termination protocols, parental rights establishment, and all other terms of the arrangement. Both parties must sign the GCA with independent legal counsel before any fertility clinic will proceed with an embryo transfer. There is no legal pathway to proceed without a signed GCA.
Yes, absolutely. Your agency handles matching and case management — your attorney provides legal protection. Every intended parent must retain their own licensed reproductive attorney, and the surrogate must have completely separate, independent legal representation. The intended parents typically pay the surrogate's attorney fees. Agencies do not provide legal advice and cannot draft or negotiate the GCA.
A neutral third-party escrow company holds and manages all surrogacy funds — surrogate base compensation, expense reimbursements, medical bill coverage, and other GCA-directed payments — on behalf of intended parents. Funds are disbursed only according to the payment schedule in the GCA. Reputable agencies require escrow management by an independent company fully separate from the agency. An agency managing its own escrow is a significant red flag.
Yes. Same-sex male couples are one of the most common groups pursuing gestational surrogacy in the US. They need both an egg donor and a gestational surrogate. In surrogacy-friendly states, both partners can be named on the birth certificate via a pre-birth order regardless of which partner is the genetic father. See our guide for same-sex male couples.
Yes, if embryos undergo preimplantation genetic testing (PGT-A), the genetic sex of each embryo can be determined. Intended parents can then choose which embryos to transfer. Not all fertility clinics offer sex selection for non-medical reasons — ask your clinic about their policy during initial consultations.
Failed transfers are common and don't mean surrogacy isn't possible. If a transfer fails, your fertility clinic will evaluate the surrogate for any uterine factors and your embryos for quality. After medical clearance (typically one full cycle, around 4–6 weeks), another transfer can be attempted. The GCA specifies how many transfer attempts are included in the original arrangement and what happens financially if more are needed. Budget for at least two transfer attempts when planning.
A miscarriage is deeply painful for everyone involved. The surrogate typically receives a miscarriage fee specified in the GCA (usually $1,000–$2,500 depending on the stage of pregnancy). After medical clearance, if the surrogate is willing and medically able, another transfer can be attempted. The GCA specifies the terms for continuation after a miscarriage.
In most cases, yes — being present at the birth is one of the most significant moments for intended parents. Preferences should be discussed with your surrogate during the matching process and addressed in the GCA. Most surrogates welcome intended parents in the delivery room; others prefer them in a waiting area until after delivery. Coordinate with the hospital in advance by providing a copy of the pre-birth order to the labor and delivery unit.
With a pre-birth order in place, the surrogate has no legal parental relationship to the child after birth. What ongoing personal relationship, if any, you maintain with your surrogate is entirely up to both parties and what you've agreed to. Some intended parents and surrogates remain close friends; others prefer a quiet close after the journey. There is no right answer — what matters is that expectations are clear before the birth.
Surrogate base compensation is paid in monthly installments throughout the confirmed pregnancy, beginning after a confirmed heartbeat (usually 6–8 weeks). Additional milestone payments are made for events like embryo transfer, confirmation of pregnancy, and delivery. Expense reimbursements are paid as they occur. All payments are released from the independent escrow account according to the GCA schedule.
The state where your surrogate delivers determines your legal protections — what type of parentage order is available, how quickly it's processed, and whether LGBTQ+ families have explicit protections. Surrogacy-friendly states like California, Nevada, Illinois, New York, New Jersey, Washington, and Colorado offer the strongest and most predictable outcomes. If your surrogate is in a moderate-complexity state, your attorney may advise delivering at a hospital in a more favorable county or nearby friendly state. See our state-by-state guide.

Surrogacy Glossary

Beta-hCG Test

A blood test measuring the pregnancy hormone human chorionic gonadotropin (hCG), performed approximately 10–14 days after embryo transfer to confirm pregnancy. A second beta is drawn 2 days later to confirm the level is rising appropriately.

Egg Donor

A woman who provides eggs for IVF, used when the intended mother cannot or chooses not to use her own eggs. Required for same-sex male couples and single men. Egg donors can be found through the fertility clinic's donor database, a separate egg donor agency, or as a known donor.

Embryo Transfer (ET)

The procedure in which an embryo is placed into the surrogate's uterus via a thin catheter. Takes approximately 10 minutes and does not require anesthesia. Most transfers today use frozen embryos (FET — frozen embryo transfer).

Escrow

A neutral third-party account managed by an independent escrow company that holds and disburses all surrogacy-related funds according to the GCA payment schedule. Must be completely independent from the agency.

Frozen Embryo Transfer (FET)

An embryo transfer using a previously frozen embryo. The surrogate undergoes a preparation protocol to prime her uterine lining before transfer. Most surrogacy journeys today use FET rather than fresh transfers.

Gestational Carrier Agreement (GCA)

The comprehensive legal contract between intended parents and their gestational surrogate. Covers all financial, medical, and personal terms of the arrangement. Must be signed by both parties — each with independent legal counsel — before any medical procedures can begin.

Gestational Carrier / Gestational Surrogate

The woman who carries and delivers the baby for intended parents. In gestational surrogacy, she has no genetic connection to the child. The embryo was created using the intended parents' or donors' genetics and transferred to her uterus via IVF.

Intended Parents (IPs)

The person or people who will be the legal and social parents of the child born through surrogacy. May be a couple (different-sex or same-sex) or a single individual.

IVF (In Vitro Fertilization)

The process of fertilizing eggs with sperm outside the body in a laboratory to create embryos, which are then transferred to the surrogate's uterus. The foundation of gestational surrogacy.

Matching

The process by which an agency presents surrogate candidates to intended parents. Both parties review each other's profiles, meet (typically via video call), and either confirm or decline the match. Average matching time is 1–4 months.

Post-Birth Order (PBO — post-birth)

A court order obtained after the birth establishing intended parents as legal parents, used in states where pre-birth orders are not available. Takes several weeks to finalize. Intended parents should carry documentation of their legal status when traveling with the baby before the order is finalized.

Pre-Birth Order (PBO)

A court order issued during pregnancy naming intended parents as the legal parents of the expected child. Directs the hospital to list intended parents on the birth certificate at delivery. Available in surrogacy-friendly states; the strongest form of legal protection in a surrogacy journey.

Preimplantation Genetic Testing (PGT)

Genetic testing of embryos created via IVF prior to transfer. PGT-A screens for chromosomal abnormalities (aneuploidy), increasing transfer success rates and reducing miscarriage risk. PGT-M screens for specific single-gene diseases. PGT also reveals the genetic sex of each embryo.

Reproductive Endocrinologist (REI)

A physician specializing in fertility and reproductive hormones who manages the IVF process — including egg retrieval, embryo creation, and the surrogate's transfer cycle. Also called a fertility doctor or infertility specialist.

Surrogacy Agency

A company that recruits and screens surrogates, manages the matching process, coordinates case management throughout the journey, and maintains relationships with fertility clinics, attorneys, and escrow providers. Does not provide legal advice. Full-service agencies typically charge $25,000–$50,000.

Traditional Surrogacy

A surrogacy arrangement in which the surrogate is inseminated with the intended father's or donor sperm, making her the genetic mother of the child. Rarely practiced in the US today due to the significant legal and emotional risks. Nearly all US surrogacy arrangements are gestational.

Uterine Lining / Endometrium

The inner lining of the uterus that must be properly prepared before embryo transfer. The surrogate undergoes a medication protocol (typically estrogen and progesterone) to thicken the lining to the optimal thickness for implantation. Monitored via ultrasound before transfer.