Surrogacy Frequently Asked Questions
What is surrogacy?
A surrogate is a woman who agrees to carry a pregnancy for another person or couple, called the intended parent(s). The current and more accurate term for surrogate is carrier. NAFG conducts gestational surrogacies, in which the carrier is implanted with an embryo created from either sperm and/or egg from the intended couple or a donor. The baby has no genetic relationship to the carrier, who is only responsible for gestating the baby until birth. Certain states have a legal structure for obtaining a pre-birth order, which allows the names of the intended parents to appear on the baby’s original birth certificate. In other cases, a step-parent adoption takes place. Either way, the intended parents take the baby home from the hospital.
Why would someone choose surrogacy over adoption?
Adoption is a wonderful choice for many people. However, surrogacy has a number of practical and medical advantages. When egg and/or sperm from the intended parents are used, there can be an actual genetic relationship to the child. In gestational surrogacies, embryos are created outside the womb through in vitro fertilization (IVF). Pre-implantation genetic diagnosis (PGD) is a critically valuable innovation practiced at the more sophisticated medical centers. Before implantation occurs, PGD can detect certain chromosomal abnormalities in the embryo typically discovered mid-pregnancy. Moreover, unlike in most adoptions, intended parents closely monitor the health and progress of the pregnancy and birth. The carrier’s obligations and compensation are governed by contract, which provides a distinct measure of security to all involved. In contrast with adoption, the carrier in a surrogacy has significantly diminished to non-existent parental rights once the baby is born.
How are surrogacies arranged?
A number of professionals work with the intended parents and carrier to create a successful outcome. Social workers, psychologists, physicians, and lawyers evaluate the carrier for suitability and make appropriate matches with intended parents. Counseling is provided throughout the process. Medical specialists are required for obtaining the eggs and sperm, implanting the embryo(s) in the carrier, monitoring the health of the pregnancy and delivering the baby. Lawyers are required to negotiate egg donation and surrogacy agreements and prepare other legal documents beginning from before conception and extending until after the birth (if post-birth procedures are necessary). Please see About NAFG to learn about our expert team.
Can the surrogate acquire legal custody to the child? What about the Baby M case?
If the intended parents fulfill their contractual obligations, it would be virtually impossible for a gestational carrier to acquire legal custody after the birth. The surrogate has no genetic relation to the child. In states where a pre-birth order can be obtained, the intended parents appear on the original birth certificate. At other times, a step-parent adoption takes place. NAFG conducts surrogacies only in states favorable to such arrangements, with most applicable legal agreements drafted and signed before fertilization and implantation takes place.
The Baby M case [109 N.J. 396, 537 A.2d 1227] (1988) was a traditional surrogacy, in which Mary Beth Whitehead used her own egg and was inseminated with the intended father’s sperm. Unlike in a gestational surrogacy, Whitehead was the genetic mother of the child. The final ruling granted custody to the intended parents with visitation rights for Whitehead, based on the best interests of the child. The court refused to enforce the terms of the original contract.
Occasionally, a family member may volunteer to serve as a traditional surrogate. The vast majority of NAFG’s cases, however, will involve gestational carriers.
See the How Surrogacy Works page for more specific information on how our surrogacy program works.
Is surrogacy legal everywhere?
Intended parents may live anywhere in the United States, and NAFG will work with intended parents from all US states and a number of countries overseas. However, since statutes and case law are different in every state, carriers must reside in states where commercial surrogacy is not prohibited. Massachusetts, where NAFG is based, has become increasingly favorable to surrogacies, and represents one of the best surrogacy options on the east coast. There are a number of other states within the US where carriers may live as well. NAFG presents intended parents with profiles of carriers from states where surrogate pregnancies and births may occur.
Why would a woman choose to be a carrier?
A carrier provides a very special gift to a couple or individual incapable of bearing children on their own. She is also compensated financially for her time and effort, yet her heartfelt commitment to help others is her primary motive. The ideal carrier is married (or in a committed relationship), is raising at least one child, and does not desire any more children of her own. Her family and friends are very supportive of her choice to be a carrier.
Candidates approach NAFG through mainstream media, word-of-mouth, and a variety of other sources. All candidates are rigorously screened medically and psychologically, and many aspects of their background are thoroughly investigated. Our clients choose compatible carriers from the profiles we provide. One of our social workers acts as liaison before, during, and after the pregnancy. The carrier and intended parents meet in person before the surrogacy proceeds. All parties must feel completely comfortable with the arrangement before any medical procedures take place.
Where can the medical procedures take place?
The participants decide, along with NAFG’s recommendations, on a reputable IVF clinic that is conveniently located to the intended parents, and/or donor and/or carrier. Travel may be required for some of the parties.
How long does the process take?
Because of the many variable components of the surrogacy arrangement, the duration of each one is different. Much depends on the availability of carriers, the success of the medical procedures, and a host of other factors. A general time frame of one to two years from the time you start with us to the time your baby is born would be an average.
How much does it cost?
The fee structure, like the time frame, varies for each case. For example, the use of donor egg will cost more than the use of the intended mother’s egg. Also, some carriers have greater expenses than others, and fees for IVF procedures vary among facilities. Depending on where the carrier lives, there may be travel costs to consider. An average total fee of $100,000 to $120,000 would be reasonable to factor for intended parents considering surrogacy.
The fee structure breaks down as follows (these are estimates and will vary with the scope of services you will require):
NAFG program fee: $25,500-$27,000
Carrier compensation: approx. $25,000
Egg donor compensation: typically $5,000-$8,000 (but no more than $10,000)
Egg donor facility fee: approx. $3,500 to $5,500
Surrogacy insurance premium (if necessary): $9,000
IVF costs: approx. $15,000 to $30,000 (depending on whether donor egg is used and other factors)
Surrogacy insurance deductible (if necessary): $15,000
Travel: approx. $5,000
Legal services (including independent counsel for carrier): approx. $7,500
*Many insurance policies carry surrogate / gestational carrier exclusions. In these cases, special surrogate maternity policies will be purchased. These policies have a $15,000 deductible for all related medical expenses within an 18-month period up to $500,000.
This general estimate comprises the complete set of fees including all expected components from start to finish. It is payable in stages over a 12 to 18 month period. Financing and credit alternatives are available, and may be discussed during your consultation.
Does insurance cover any costs?
In some cases, IVF procedures are covered. Separate medical insurance is often purchased for the carrier as part of the fee.
Can single people or gay and lesbian couples/individuals use gestational carriers?
Yes. NAFG supports the right of all people to have the families they desire, irrespective of marital status or sexual orientation. In fact, in many cases, surrogacy is the best option for single and gay people. The laws in some states, however, are more restrictive than with traditional married couples, so our team will take special care to devise a plan that is right for you.
