Peer Advice on Working with Surrogacy Agencies

This document was created by a group member in 2008, and was edited and updated by several of the group facilitators.

Basic Role of Surrogacy Agencies:

  1. Agency will find and screen a gestational carrier (surrogate) for you.
  2. Agency will link you and the carrier with an outside IVF clinic (or you can start with a clinic and it may recommend an agency for you).
  3. Agency will often have a list of donor eggs to choose from; IVF clinic may have a separate list.
  4. While the egg donor is donating her eggs, eggs are inseminated, and embryos are placed into the gestational carrier, your main contact will be with the IVF clinic.
  5. As soon an ultrasound shows a developing embryo at about 10 weeks, the gestational carrier will be sent to the care of her personal obstetrician. The IVF clinic contact ends at that point, and you work directly with the gestational carrier and her OB.
  6. Just before the baby is born, the Surrogacy Agency starts the legal processes for correct names to be on the birth certificate and later, if necessary, coordinates the second-parent adoption process in your state if that is possible there.
  7. Everything generally takes about 18 months from start to finish.

Pros of Using a Surrogacy Agency

  • Agencies are experts in surrogacy laws and medical standards, many of which change state to state.
  • Agencies have long experience working with gestational carriers.
  • Agencies find gestational carriers and manage all the required psychological and medical screening to find a good match for you.

Cons of Using a Surrogacy Agency

  • Agencies can be expensive, with total costs for agency, legal, gestational carrier, donor and IVF clinic well above $100,000 (less if you have eggs donated by a family member or use an egg bank).
  • Agencies do not coordinate everything; you still have to be a very active participant.

If you use a Surrogacy Agency, be sure to:

  1. Ask for a detailed financial assessment, prior to signing a contract, to consider options based upon your specific goals and financial constraints (eg, twins, family donated eggs, insurance choices, IVF clinic choices, etc.). The estimates listed in Agency literature generally are the most minimal possible, often with asterisks qualifying many lines. If you are determined to keep your expenses at the levels listed, ask how to do so. Inquire how the Agency came to a specific cost—line by line. Create a personal Excel table to estimate how optional costs may add up.
  2. Stay very active in all aspects of the planning. Do not depend exclusively on the Agency to make sure everything is done right. Constantly ask questions so you are clear at every step. Don’t assume that everything will happen on schedule without your attention. Know all the medical milestones of IVF and pregnancy to be sure everything occurs on time. Many agencies seem overloaded with clients—you may get lost if you do not advocate for yourself constantly. Ask for a monthly accounting to follow your costs.
  3. Work with the Agency to minimize costs. Ask which IVF clinics are more affordable (but make sure to compare all costs, as many clinics tend to only quote part of the process and omit genetic tests, cost of egg donation components, etc.). Try to find a local donor, and if you are willing to wait an extra few months, ask for a gestational carrier who lives within driving distance so visits are less expensive. Ask for a carrier who has her own health insurance although this is becoming rarer. Surrogacy insurance can cost up to $20,000 or more —mandatory if the carrier doesn’t have her own insurance that covers surrogacy. Also inquire about special egg donation arrangements like egg sharing or using an egg bank.
  4. Consider the donors offered by your clinic or bringing egg donors from other Agencies if your Agency does not have specifically what you want.
  5. Compare several Agencies until you are satisfied with the price, people, and procedures.
  6. Find other people who have used or are using surrogacy to exchange experiences. Some places to find them include the Community Center in NYC (attend the monthly group for men who are planning biological parenthood) and social networks like Facebook.