Surrogacy

Welcome to our guide to surrogacy treatment: digestible, comprehensive and medically reviewed. Whether you’re brand new to fertility treatment or a pro already, this guide is for you to better understand the ins and outs of surrogacy treatment.

Reviewed by Hunter Stitzer, RN

Founder of Fertility Compass
Registered nurse and expert in reproductive medicine

A few quick facts

We have Latin to thank for the term “surrogate” — the original word, “surrogare,” means “to put in another’s place” or “to substitute”.

While surrogacy dates back to biblical times, the first legal surrogacy agreement was drafted in the U.S. in 1976.¹

Laws differ by state. Some states allow compensated surrogacy, where a surrogate is paid for carrying the pregnancy, and others only permit altruistic surrogacy, where a surrogate carries the pregnancy without compensation.² Check the footnotes below for an excellent map that breaks down state-by-state laws.

Fertility clinics can’t connect you with a surrogate, but there are lots of third party agencies and organizations willing to help.³

If you decide to use a surrogate, you can benefit from adoption leave and pay at work.⁴

What is surrogacy?

Surrogacy is when another person carries a pregnancy on behalf of another person, often called an “intended parent”. After the child is born, the intended parent becomes the legal guardian. A family member, friend, or a person recommended by a surrogacy organization can all be a surrogate. There’s paperwork to complete to ensure everyone consents to the arrangement, so it’s smart to consult a lawyer before beginning the surrogacy process.

How does surrogacy work?

In gestational surrogacy, there is no genetic connection between the child and the surrogate. This could mean having the surrogate implanted with an embryo made from you and your partner’s own eggs and sperm.

There are also two distinct arrangements to be aware of: compensated (also called “commercial”) and altruistic (also called “compassionate”) surrogacy.

In compensated surrogacy, you pay your surrogate a surrogate fee to carry the pregnancy. You’ll also pay for their healthcare premiums, travel costs, legal fees, and a stipend for reasonable expenses.

In an altruistic surrogacy, you don’t pay your surrogate a surrogate fee to carry the pregnancy. While you’re still expected to cover all of their expenses along the way, there’s no flat fee exchanged. These arrangements typically happen between friends or family members.

How successful is surrogacy?

There are a few important considerations: most importantly, the age of the surrogate, then the age of the eggs used, and the type of treatment. Other factors to consider include the quality of the sperm used, whether it’s from a donor or partner, and the surrogate’s ability to get pregnant.⁶

How much does surrogacy cost?

The frustrating answer is that it depends. Agencies and facilities in big cities will cost more than they will in other parts of the country, and some people even pay significant amounts of money for donor concierges that can expedite the process. In big cities, the cost for a commercial surrogate is often well over $100,000.

First things first: You’ll have to cover agency fees, IVF costs to create embryos (or donor eggs and sperm), legal fees, your surrogate’s treatment with the fertility clinic and care throughout the duration of the pregnancy, plus reasonable expenses like maternity clothing…as you can imagine, it adds up fast.

The numbers vary considerably depending on your state, whether you use an altruistic or commercial surrogacy agreement, the clinic your surrogate goes to, and whether you need donor eggs or sperm to create embryos. Altruistic surrogacy can start at $10,000⁷, and for commercial surrogacy, it’s significantly higher. Estimates range from $120,000 to $200,000⁸ when all is said and done, which includes the agency fee, compensation for the gestational carrier, legal fees, and all medical treatment costs.

Although that’s a huge amount of money to consider, it’s worth noting that intended parents don’t have to pay that amount all at once. If you’re considering surrogacy, your chosen agency will explain the timeline, checkpoints, and when payments are due.

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The bottom line

Surrogacy, or having someone else carry a pregnancy on someone else’s behalf, is an option for people who cannot, or don’t want to, carry on their own. It can be expensive and legally complicated and requires help from legal and medical professionals. A friend, family member, or someone connected via a surrogacy organization can also carry a child.

Common questions about surrogacy

Your fertility doctor will be able to answer your specific questions about your unique treatment plan, but there are a handful of questions that nearly every patient asks:

Is there a surrogacy age limit in the UK?

Generally, surrogates must be older than 21.⁹ While there isn’t a legal maximum age, each clinic has an age range in mind for the best chances of success. If you’re considering becoming a surrogate, ask a few clinics about their age limits to compare your options.

How long does the surrogacy process take?

From filling out an application to birth, it typically takes anywhere from 18-24 months, but it can be longer depending on many circumstances.⁸ It’s not a quick process, but that’s to make sure the intended parent, the surrogate, and the child are protected medically and legally.

Can you use your own eggs for surrogacy?

Yes, if you decide to do partial surrogacy, where the child is genetically related to you. If you choose this option, you’ll go through egg retrieval, and your eggs will be fertilised with your partner or a donor’s sperm in a lab before being implanted in the surrogate. You can read more about the egg retrieval process on our guide to IVF.

Do you have to do IVF for surrogacy?

Not necessarily. It depends on the type of surrogacy you choose.

If you’re using the surrogate’s eggs, the surrogate will likely go through intrauterine insemination (IUI) treatment. A doctor will wash a donor or the male partner’s sperm before injecting it into the surrogate’s womb in hopes of creating a viable pregnancy.

If you’re using your own eggs, you’ll go through egg retrieval, which is part of IVF treatment. On the same day as your egg retrieval, a doctor will wash a donor or the male partner’s sperm before fertilising your egg with it in a lab. After the embryo has grown for a few days, the doctor will implant it into the surrogate’s womb.

‍If you’re using a donor’s frozen eggs, the surrogate will go through IVF treatment. A doctor will wash sperm from a donor or the male partner before fertilising the donor egg with it in a lab. After the embryo has grown for a few days, the doctor will implant it into the surrogate’s womb.

Does surrogacy have both parents’ DNA?

It can, but it doesn’t have to.

Surrogacy can have both parents’ DNA if you decide to use your own eggs and your partner’s sperm.

Surrogacy doesn’t have to have both parents’ DNA if you use donor eggs or the surrogate’s eggs.

Am I a good candidate for surrogacy?

If you cannot, or don’t want to, carry a pregnancy, and you can afford to take care of a surrogate’s expenses, surrogacy can be a good option. If you want to use your own eggs or a partner’s sperm, your age and fertility history will be factors to consider. A fertility doctor can help you understand the options available for your specific situation and whether you need any diagnostic tests.

Unfortunately, we can’t currently support surrogacy in our Gaia Plans, but we’ll let the community know as soon as we change this.