For two men who want to have a biological child, gestational surrogacy is the primary path. The process requires three key components: sperm from one or both fathers, eggs from a donor, and a gestational carrier (the surrogate) who carries the pregnancy. From start to finish, the journey typically takes 18 months to two years and costs roughly $150,000 or more in the United States.
The Three People Involved
Gestational surrogacy for male couples involves distinct roles that are important to understand upfront. The egg donor provides the eggs used to create embryos. The gestational carrier is the woman who carries the pregnancy and delivers the baby. These are almost always two different people. The older model, sometimes called “traditional surrogacy,” where the surrogate also provides the egg, is discouraged by the American Society for Reproductive Medicine and rarely used today. Keeping the roles separate simplifies legal parentage and reduces emotional complications.
The intended fathers provide sperm. One or both partners can be the biological father, depending on the couple’s preference and the approach they choose during the IVF process.
How Embryos Are Created
Once an egg donor is selected, she undergoes a hormone stimulation cycle to produce multiple eggs, which are retrieved in a short outpatient procedure. Those eggs then go to an IVF laboratory, where they’re fertilized with sperm from one of the fathers.
Many couples opt for what’s called a “split cycle.” The retrieved eggs are divided into two groups, and each group is fertilized with sperm from a different partner. This creates two sets of embryos, each genetically related to one father. The couple can then decide which embryo or embryos to transfer first, and freeze the rest for future use. Some couples transfer one embryo from each father during separate cycles, so each partner has a biological child.
Before transfer, embryos can undergo preimplantation genetic testing to screen for chromosomal abnormalities and genetic disorders. This step improves the odds of a healthy pregnancy and gives the couple more information when choosing which embryo to transfer.
What Happens During the Pregnancy
A selected embryo is transferred into the gestational carrier’s uterus. If the pregnancy test comes back positive, the carrier continues on estrogen and progesterone support for about eight weeks. Around weeks eight to ten, her care transitions to a local obstetrician, and the pregnancy proceeds like any other from that point forward.
Success rates for gestational surrogacy with donor eggs are strong. Using eggs from donors under 35, the live birth rate is around 50% per transfer cycle. That rate drops with older donors, falling to roughly 30% when donors are over 42. Most couples using young, healthy egg donors can expect good odds, though some need more than one transfer cycle to achieve a successful pregnancy.
Choosing an Egg Donor and Surrogate
Egg donors are typically found through agencies or fertility clinic databases. Compensation for a donor generally starts around $10,000, though donors with specific traits or credentials (Ivy League education, particular physical characteristics) can command significantly more. You’ll review profiles that include medical history, education, photos, and sometimes personality questionnaires.
Finding the right gestational carrier takes longer. Matching with a surrogate typically takes six months to over a year. Agencies screen candidates for physical health, psychological readiness, and prior pregnancy history. Most reputable agencies require that carriers have already had at least one successful pregnancy. During the matching process, you’ll typically meet or video-call with potential carriers to make sure the relationship feels right for both sides, since you’ll be in close contact for the better part of a year.
The Legal Side
Legal protections are one of the most critical parts of the process, and they vary dramatically depending on where you live. The strongest tool available is a pre-birth parentage order, a court ruling issued before the baby is born that declares both intended fathers as the legal parents. This means your names go directly on the original birth certificate at the hospital, you have immediate access to the baby and decision-making authority over medical care, and insurance coverage under your policy is more straightforward.
Not every state or jurisdiction allows pre-birth orders, though. In some places, only the biological father is listed on the birth certificate initially, and the non-biological father must go through a second-parent adoption after birth. This adds time, cost, and procedural steps like home studies. The legal landscape for surrogacy in the U.S. is a patchwork. California, Connecticut, and several other states have clear, protective surrogacy laws. Others are ambiguous or restrictive. Working with a reproductive attorney early in the process is essential for navigating this correctly.
Legal contracts between the intended parents, the gestational carrier, and sometimes the egg donor are drafted before any medical procedures begin. These agreements cover compensation, expectations during pregnancy, decision-making authority, and what happens in various contingencies.
What It Costs
Surrogacy for male couples is expensive because it involves multiple professionals, medical procedures, and legal processes. A reasonable estimate for the total cost in the United States is $150,000 or more. Here’s where that money goes:
- Surrogate compensation: Often $42,000 or higher, plus maternity clothes, lost wages, and travel expenses
- Egg donor fees: Starting around $10,000 and rising from there
- IVF and medical costs: Egg retrieval, embryo creation, genetic testing, embryo transfer, and fertility medications
- Agency fees: For matching and coordinating with both the surrogate and egg donor
- Legal fees: Contracts, parentage orders, and any adoption proceedings
- Insurance: Often a significant added cost, since many health plans exclude surrogacy coverage
These figures have risen since 2017, when $150,000 was already a common benchmark. Today, total costs in high-demand states like California can exceed $200,000.
Insurance Gaps to Plan For
Insurance is one of the trickiest financial pieces. Most insurance companies treat surrogacy as elective rather than medically necessary, which means the intended parents’ health insurance generally does not cover the surrogate’s pregnancy care or childbirth. The embryo transfer procedure itself is typically excluded, and so are costs related to egg donation.
If your surrogate has a “surrogate-friendly” health plan, one that doesn’t specifically exclude surrogacy pregnancies, her existing policy may cover pregnancy and delivery. This is relatively uncommon, though. More often, intended parents need to purchase a separate maternity insurance policy for the carrier, which adds several thousand dollars to the overall cost. Some employers now offer fertility benefits through companies like Progyny or Carrot, which may partially offset surrogacy-related expenses.
Where Surrogacy Is Legal for Gay Couples
Within the United States, the most welcoming states for same-sex surrogacy include California, which has the most established legal framework, along with Connecticut, Nevada, Maine, and others with explicitly supportive statutes. Some states have no surrogacy law at all, creating legal uncertainty. A few, like Michigan, still have laws that technically criminalize surrogacy contracts, though enforcement is rare.
Internationally, options for gay male couples are limited and have narrowed in recent years. India banned same-sex surrogacy in 2012 and later restricted all surrogacy to Indian nationals. Thailand, Cambodia, Nepal, and Mexico have all closed their doors to foreign surrogacy. Ukraine and Georgia allow surrogacy but restrict it to heterosexual married couples. The United Kingdom permits only altruistic surrogacy (no compensation beyond expenses), and the legal process for establishing parentage there is more complex.
Some couples look to countries with minimal regulation, like Laos, which currently has no surrogacy laws. But the absence of legal frameworks cuts both ways: there are no protections for intended parents if something goes wrong. For most gay male couples, pursuing surrogacy within the United States, in a state with clear legal protections, remains the safest and most predictable route despite the higher cost.