Surrogacy is a path to parenthood where someone else carries and delivers a baby for you. It involves medical procedures, legal agreements, significant financial investment, and emotional preparation for everyone involved. The total cost in the U.S. ranges from $100,000 to $250,000 or more, and the full process from matching to delivery typically spans 18 months to two years. Here’s what you need to understand before starting.
Two Types of Surrogacy
Gestational surrogacy is by far the more common arrangement. The surrogate (often called a gestational carrier) has no genetic connection to the baby. An embryo is created in a lab using eggs and sperm from the intended parents or donors, then transferred to the carrier’s uterus. In one U.S. survey of surrogates, about 92% were gestational carriers.
Traditional surrogacy is the other option, where the surrogate uses her own egg and is genetically related to the baby. This is much less common today, partly because it raises more complex legal and emotional questions about parental rights. Traditional surrogates are typically inseminated rather than going through a full IVF cycle, and the process sometimes happens in a clinic or even at home rather than a fertility center.
How the Medical Process Works
Gestational surrogacy relies on IVF. The intended mother or an egg donor undergoes ovarian stimulation and egg retrieval. Those eggs are fertilized with sperm in a lab to create embryos, which can be frozen until the surrogate is ready.
Before the transfer, the surrogate takes medications to prepare her uterus. This usually starts with birth control pills or a drug that suppresses her natural ovulation cycle so doctors can control timing precisely. She then takes estrogen to thicken her uterine lining, followed by progesterone to support a potential pregnancy. Once her body is ready, a single embryo is transferred to her uterus. A blood test about 10 to 14 days later confirms whether the pregnancy has taken hold. Not every transfer succeeds on the first attempt, which is one reason costs can climb.
The Full Timeline
Matching with a surrogate alone can take six months to over a year, depending on whether you work with an agency or find someone independently. After matching, both parties go through medical screenings, psychological evaluations, and legal contract negotiations, which can take another two to three months. Then comes the medical preparation and embryo transfer, followed by a standard nine-month pregnancy. Start to finish, most families should plan for roughly 15 to 24 months.
What It Costs
The average cost of surrogacy in the U.S. in 2025 ranges from $100,000 to $140,000, though depending on the circumstances it can reach $250,000 or more. Here’s where that money goes:
- Agency fees: $35,000 to $55,000 for matching, coordination, and support services throughout the journey.
- Surrogate compensation and expenses: $35,000 to $60,000 in base pay, though total compensation including maternity clothes, lost wages, childcare, and other reimbursements can reach $65,000 to $95,000. First-time surrogates in 2025 typically earn $55,000 to $75,000 or more in base pay, while experienced surrogates start around $70,000 and can exceed $110,000.
- Legal fees: $10,000 to $25,000, covering contracts for both parties and parentage orders.
- IVF and medical costs: A single IVF cycle runs $25,000 to $35,000, including medication, monitoring, egg retrieval, and embryo transfer. If your insurance doesn’t cover any of it, the range is closer to $15,000 to $40,000.
- Prenatal care and delivery: An additional $10,000 or more depending on insurance coverage, with costs rising significantly if complications require specialized care.
Insurance Can Be Complicated
Standard health insurance doesn’t typically cover “surrogacy” as a single benefit. Some policies will cover the surrogate’s prenatal care and delivery as they would any pregnancy, but others contain surrogacy exclusions or “intent to parent” limitations that restrict maternity coverage when the pregnant person isn’t planning to raise the child. You need to review the surrogate’s existing policy carefully, line by line, before assuming it will apply.
When the surrogate’s policy excludes surrogacy pregnancies, intended parents often purchase a supplemental surrogacy-specific insurance plan. Many surrogacy agencies work with specialized insurance brokers who can help navigate these options. The cost of a supplemental policy varies, but it’s a significant budget line item worth planning for early.
Legal Considerations Vary Widely by State
Surrogacy law in the U.S. is a patchwork. Some states expressly permit compensated surrogacy and have clear processes for establishing the intended parents’ legal rights before birth. Others make surrogacy contracts unenforceable or impose restrictions based on the parents’ marital status or genetic connection to the child.
Arizona, for example, statutorily declares surrogacy contracts unenforceable, yet courts there have still granted pre-birth parentage orders when both intended parents are genetically related to the child. When neither parent has a genetic connection, an adoption after birth may be the only route. Alabama expressly permits surrogacy and specifically excludes surrogate payments from its adoption payment prohibitions, but unmarried couples can only get a pre-birth order for one parent. States without any surrogacy statute on the books, like Alaska, may still allow the practice but with less predictability about how courts will handle parentage.
The key legal document is a pre-birth parentage order, which establishes the intended parents as the child’s legal parents before delivery. Whether you can obtain one depends on your state, your marital status, and whether you have a genetic link to the child. Working with a reproductive attorney is not optional in this process. Both the intended parents and the surrogate should have separate legal representation.
Who Qualifies to Be a Surrogate
Surrogacy agencies and fertility clinics screen candidates thoroughly. Common requirements include a BMI between 18 and 35 (many clinics cap it at 32), no history of major psychiatric diagnoses like bipolar disorder or schizophrenia, and no current use of psychiatric medications. Candidates who previously had gestational diabetes may still qualify if they managed it through diet alone without medication.
Surrogates must have had at least one successful prior pregnancy and delivery, live in a surrogacy-friendly state, and demonstrate financial stability. Substance use rules are strict: typically at least one year smoke-free, three to six months without vaping nicotine, and no history of drug or alcohol abuse. Infrequent marijuana use when not pregnant is sometimes considered on a case-by-case basis depending on the clinic and the intended parents’ preferences.
Psychological Screening for Everyone
Mental health evaluation is a standard part of the surrogacy process for both the surrogate and the intended parents. The American Society for Reproductive Medicine recommends that surrogates undergo a full psychological assessment that includes a clinical interview, standardized psychological testing, and counseling about the emotional implications of carrying a child for someone else. A new evaluation is required each time a surrogate enters a new contract, and if a previous evaluation is more than a year old, it must be repeated.
Intended parents are also strongly encouraged to participate in psychosocial counseling. The process brings up complex emotions on all sides: anxiety about the pregnancy, navigating boundaries with the carrier, and adjusting expectations about bonding and birth. Many agencies require this counseling rather than simply recommending it, and the investment of time pays off in clearer communication and a smoother experience for everyone involved.