Surrogacy

The surrogacy process generally runs: consultation and program selection; matching with a carrier; medical and psychological screening of the carrier; legal contract between the parties; embryo creation or transfer of an existing embryo; pregnancy and prenatal care; and finally the legal establishment of your parentage, which may happen before or after birth depending on your state.

The medical portion is the shortest part. Matching and legal work usually take longer than the pregnancy itself, which is the single most common surprise for people beginning this path.

ASRM's clinical guidance recommends that a carrier be of legal age and preferably between 21 and 45, that she have had at least one term, uncomplicated pregnancy before serving, and that she have had no more than five previous deliveries in total or three by cesarean section. It also recommends a stable family environment with adequate support, given the added stress a carrier pregnancy carries.

These are professional recommendations rather than law. Individual clinics and agencies often apply stricter criteria, and some states impose their own statutory requirements on top. ASRM's recommendations are more stringent than FDA minimums in some areas.

An agency handles matching, screening coordination, escrow, and case management, and charges for it. An independent arrangement — often with a carrier you already know — removes that fee but moves the coordination, vetting and administration onto you.

Independent arrangements are not simply the cheaper option. The agency fee buys screening infrastructure and a buffer between two parties who will be in a long, intimate, high-stakes relationship. Where an existing relationship is involved, several programs still recommend independent psychological screening for exactly that reason.

Surrogacy in the United States is governed entirely by state law. ASRM's policy analysis groups states into roughly three categories: those with statutes expressly recognizing and regulating gestational carrier arrangements; those with no statute or case law either permitting or prohibiting them; and those that void or restrict compensated agreements, or require additional adoption steps for a non-genetic parent.

Practice can vary by county even within states where the arrangement is permitted — which is why programs pay close attention to the specific court where a parentage order will be sought, not just the state.

This is not a settled area. Michigan's Family Protection Act, enacted in 2024, repealed that state's prior criminal ban on compensated surrogacy and replaced it with a regulated framework. Massachusetts' Parentage Act, also enacted in 2024, addressed assisted reproduction and gestational carrier arrangements directly and introduced pre-birth parentage routes.

Guidance more than a year or two old may describe a legal landscape that no longer exists in your state. Check the date on anything you read about surrogacy law, including this page.

A parentage order is the court judgment establishing you as your child's legal parent. Some states allow this to be obtained before birth, so your names go on the birth certificate directly. Others require a post-birth process, and some require a step-parent or second-parent adoption for a parent with no genetic connection to the child.

Which applies to you is the most consequential legal question in surrogacy, and it is determined by state law. Your state guide covers the position where PEONY has published one.

Intended parents and the carrier must each have their own attorney. This is not a formality — in some jurisdictions an agreement will not be enforced if the carrier was not independently advised, and clinics routinely require proof of separate representation before beginning a transfer.

Use an attorney who practices assisted reproduction law specifically. General family law experience is not the same thing, and the drafting here is specialised.

A surrogacy budget is not one number. It is: agency or program fees; carrier compensation; carrier medical care and any insurance policy purchased for her; IVF and embryo creation or transfer; separate legal fees for both parties; escrow administration; carrier life insurance; and a contingency for outcomes like a failed transfer, a cancelled cycle, multiples, bed rest, or a cesarean.

Totals in the United States commonly run well into six figures, and vary enormously by state, program, and whether embryos already exist. Treat any single quoted figure with suspicion until you have seen it broken into these components.

Published all-in program prices captured in August 2026 ranged from $145,000 to $255,000, with several agencies posting multiple tiers that differ by matching speed, number of transfers included, or whether a live-birth guarantee applies.

Those totals are not comparable to each other. Reviewing the published pages side by side, none disclosed its escrow administration fee, and at least one listed no escrow line at all. A program quoting $145,000 and one quoting $189,500 may be describing materially different scopes. Ask any program for a written breakdown against the component list above before comparing it to another.

Base compensation for a first-time gestational carrier is published by some agencies and not others, and the published figures do not agree. For a first-time carrier in Washington, posted base compensation in August 2026 ranged from roughly $45,000 to $70,000 depending on which agency was publishing.

Two agencies posted an explicit geographic premium and placed Washington differently: one grouped it with California, New York and New Jersey in a top compensation tier, while another placed California above a standard tier that included Washington. Base compensation is also only part of what a carrier receives. Monthly allowances, maternity clothing, milestone payments, lost wages, childcare and travel are typically listed separately.

The practical consequence is that a single compensation figure will be wrong for most readers. Treat any number you are given as that program's number on that date.

A carrier's existing health plan may or may not cover a surrogate pregnancy. Many policies contain express exclusions. Where it does not, intended parents typically purchase a separate policy for the pregnancy, and that cost belongs in the budget from the start rather than as a late surprise.

Whether your own insurance covers any part of the IVF portion is a separate question again, governed by your plan and any state coverage mandate that applies to it. Your state guide covers the mandate position where PEONY has published one.

Three of the largest line items in a surrogacy budget are almost never posted publicly. Escrow companies generally do not publish fee schedules. Assisted reproduction attorneys generally do not publish rates for carrier agreements or parentage filings. The specialist brokers who place carrier insurance policies route every enquiry to a consultation rather than posting premiums.

That is worth knowing before you start, because it means you cannot comparison shop these components the way you can shop a program fee. Expect to ask for written quotes, and expect the first number you are given to be the only one you have unless you ask for others.

The court filing itself is a minor line item next to the rest. Establishing parentage in Washington runs a filing fee in the low hundreds of dollars, and the same fee schedule applies across the counties PEONY has checked. California charges a general civil first-paper fee rather than a dedicated parentage fee.

Attorney time to prepare and file is the real cost here, not the filing fee. See your state guide for the figure where PEONY has published one.

Do not assume surrogacy expenses are deductible medical expenses. The deductibility of costs paid by intended parents for a carrier's care has been contested, and the IRS has generally taken a restrictive view of expenses incurred for someone who is not the taxpayer, their spouse or their dependent.

This is a question for a tax professional who has handled assisted reproduction, not a general preparer, and the answer may turn on facts specific to your situation. IRS Publication 502 sets out the general framework for medical expense deductions.

The federal Family and Medical Leave Act provides eligible employees up to 12 workweeks of job-protected leave for the birth or placement of a child and to bond with that child, taken within the 12 months following. Eligibility requires 12 months of employment, at least 1,250 hours of service in the preceding 12 months, and a worksite where the employer has at least 50 employees within 75 miles.

FMLA bonding leave turns on the parental relationship rather than on who was pregnant, so intended parents will often qualify. Because the analysis is fact-specific and employer policies differ widely, confirm your position with HR and, where the stakes are high, with an employment attorney before you rely on it.

Intermittent bonding leave — taking the 12 weeks in blocks rather than continuously — requires the employer's approval.

A leave request does not require you to explain how your child came to be. "I am becoming a parent in March and will be taking bonding leave" is a complete sentence.

Some employers have explicit surrogacy or family-building benefits and no easy way to find out about them; it is worth asking HR directly what exists rather than assuming from the handbook.

Several states run paid family leave programs that pay a portion of wages during bonding leave, with their own eligibility rules that are often broader than FMLA's — some have no employer-size or tenure threshold at all. These stack with, rather than replace, federal job protection.

What is available depends entirely on your state. See your state guide for the position where PEONY has published one.

Surrogacy asks two families to be closely involved with each other for well over a year, often across distance and difference. Expectations about contact during the pregnancy, presence at appointments and at the birth, and what the relationship looks like afterwards are worth discussing explicitly and early — including in the written agreement.

Mismatched expectations here are among the most common sources of strain, and they are almost entirely preventable by talking about them before matching is finalised rather than after.

Many people arrive at surrogacy after infertility, pregnancy loss, cancer treatment, or a hysterectomy. Beginning surrogacy does not resolve that history, and it is common for it to resurface at milestones — a transfer, a scan, someone else's pregnancy announcement.

A counselor experienced in reproductive loss and third-party reproduction is not a sign something has gone wrong. Most programs recommend one as standard, and psychological screening is a routine part of the process for both sides.

Current practice guidance and the donor-conception research that informs it both point the same way: early, age-appropriate openness is associated with better outcomes than disclosure later in life. Children told from the beginning tend to absorb it as simply part of their story.

Where an egg or sperm donor is also involved, that is a second layer of the same conversation. Our donor conception guide covers it in more depth.

There is no federal statute governing gestational carrier arrangements. What binds you is your state's parentage law, its position on compensated agreements, and the practice of the specific court that will issue your parentage order.

Several states have adopted versions of the Uniform Parentage Act, which provides a modern framework for assisted reproduction and gestational agreements. Adoption is uneven, and a state having adopted some version of it does not by itself tell you how surrogacy is treated there.

Surrogacy frequently involves more than one state — intended parents in one, carrier in another, clinic in a third. The state where the carrier gives birth generally governs the parentage process, which is why programs and attorneys care about where she lives, not only where you do.

If you are considering a carrier in a different state, that state's law becomes your law for this purpose. Raise it with your attorney before matching, not after.