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How to Choose a Surrogacy Agency: Helpful Tips for Intended Parents

A surrogacy expert shares what to look for in a surrogacy agency to ensure the smoothest journey to parenthood.

December 27th, 2023 | 9 min. read

By Dr. Mark P. Leondires

As you embark on your journey to parenthood, it's easy to feel overwhelmed or confused. This can be especially true for intended parents pursuing surrogacy. Here are the most important things to look for as you evaluate your surrogacy agency options.

In this article:

Surrogacy Agency vs Fertility Clinic

Let's start at the very beginning, with a question you may be asking right now: do I need to work with both a fertility clinic and a surrogacy agency? The short answer is yes.

Here's why: While a fertility clinic takes care of the medical aspects of your surrogacy journey (including egg retrieval, IVF, screening, and embryo transfer), they can’t connect you with a gestational carrier (surrogate).

That’s where the surrogacy agency comes in. These organizations are responsible for finding qualified candidates, matching you with a gestational carrier, taking care of her (and your) emotional health, and coordinating medical processes and services with your fertility agency.

They’re also responsible for guiding you through all the legal jargon associated with surrogacy - which can be incredibly complicated to navigate without expert support.

Note: We will use the terms gestational carrier (GC) and surrogate interchangeably throughout this article - however, both refer to gestational surrogacy (where the surrogate is not biologically related to the intended parents' future child). 

How do I choose a surrogacy agency?

Once you and your fertility doctor have determined that your family-building journey will include working with a surrogate, the next step is choosing a surrogacy agency.

With so many agencies on the market, determining which one is right for you can be daunting.

From how to determine each agency's reputation to which questions to ask their staff and former surrogates, the following guide will walk you through everything you need to know. Here are some of the most important aspects to consider on your search:

1. Reputation

The agency should have good existing relationships with fertility clinics, and they should offer psychological screening and counseling support for both you and your surrogate. 

Pro tip: Learn various ways to determine a surrogacy agency's reputation below.

2. Client Experience 

In addition to offering high-quality matching services and guiding you through mountains of legal paperwork, a good surrogacy agency should make the entire process feel both professional and seamless. Their staff should also be kind and understanding, as you will rely on them for support throughout this very personal journey.

3. Cost Structure

An agency's costs should be transparent and competitive when it comes to both fees and surrogate compensation. This is a big financial and physical investment for the intended parent(s) and surrogate, and you should feel confident that your surrogate is well cared for. 

4. Management

For intended parents, the smoothest path to parenthood involves working with a surrogacy agency that is a one-stop-shop for all your needs. From screening gestational carriers to connecting you with an experienced lawyer, the agency should take care of organizing and facilitating the majority of the surrogacy process. 

5. Included Services

When considering each prospective option, it’s important to determine which services are included by the agency. If they don’t provide certain services (i.e. a legal team), the agency staff should at least be able to refer you to well-qualified experts they know and trust.

Questions to Ask Surrogacy Agencies

Prepare a list of questions and refer back to it as you assess your agency options. Here are a few essential things to take into consideration:

  • How much are the surrogacy agency fees and what do they include?
  • Does the agency have legal services in house?
  • Does the agency have someone to help deal with escrow management?
  • Will they help connect you with a lawyer or escrow specialist if they don’t offer these services on site?
  • How many years has the agency been in business?
  • What is the screening process for an egg donor and/or surrogate?
  • Will the agency help you choose an insurance plan for your surrogate?
  • Can they provide reviews from former clients and surrogates?
  • What does your fertility specialist think about the agency?

Surrogacy Agency Success Rates

A surrogacy agency’s overall success may be measured differently depending on who you ask. While the number one marker of success is (of course) a healthy baby, a surrogacy agency may also take into account other aspects of the journey when determining successful outcomes.

Here are a couple of examples:

  • How many surrogates have a successful pregnancy after the first embryo transfer versus the third embryo transfer?
  • How compatible are initial agency matches between surrogates and intended parents?

Pro tip: Ask each prospective surrogacy agency how they determine success and have them outline their overall success rates. 

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How much does a surrogacy agency cost?

Like most things in life, you get what you pay for at a surrogacy agency. At agencies with lower fees and minimal "up front" costs, you may have to wait longer for everything from administrative answers and emails to matching with the right gestational carrier.

While we’re not suggesting you need to cough up hundreds of thousands to the most expensive surrogacy agency on the market, it is important to balance your expectations for these services with your budget.

FYI: Agency fees can range from $22,000 to $50,000, not including egg donor and surrogate compensation. Legal fees and IVF costs are also not included, so you can expect additional costs on top of that.

Here are some questions to ask a surrogacy agency about costs:

  • What is included in your agency fees?
  • Are there any hidden costs?
  • Is the pricing structure easy to understand?
  • What types of payment schedules are offered?
  • Will I be required to pay a lump sum up front? If so, how much?

How to Determine An Agency's Reputation

Just as you wouldn’t purchase a car without reading lots of reviews and taking it out for a test drive, you should never blindly jump into a relationship with a surrogacy agency without first carefully assessing its reputation.

Pro tip: Talking to your fertility clinic about which agencies they recommend is the best way to start your search, as agencies and clinics work together on a regular basis to help LGBTQ+ parents pursuing surrogacy.

Here are a few critical questions to consider asking your fertility clinic's staff, as well as any prospective surrogacy agency:

Does the agency fully screen its surrogates (both physically and emotionally)?

A comprehensive mental and physical screening process ensures that your surrogate has been chosen for the right reasons, and that she’s both mentally and medically fit to carry your child.

Does the agency adequately compensate its surrogates?

The better the agency treats its surrogates, the more likely you are to have a happy and healthy gestational carrier. They should be treated with the utmost respect and compassion, in addition to being well compensated.

The best way to learn the truth is to talk to one of their surrogates. See if the agency can put you in touch with a former surrogate, or if their website or social media has video testimonials.

What is the agency’s match history?

Has the agency completed many successful matches, or have there been issues in the past?

What is the agency’s typical match time?

No one wants to wait years for a baby, especially considering the amount of time you’ve already invested in your fertility journey. That said, you want to be sure your agency is making a good match for your family, and these things do take time to come together.

Does your fertility clinic enjoy working with the agency?

Poor communication, slow response times, and disorganization can not only affect your personal level of satisfaction (or frustration), but it can wreak havoc on your clinic’s ability to work effectively with the agency.

Extra points if your clinic has used the agency before, although this isn’t necessary.

Is the agency too big or too small?

Just as you don’t want to go for the cheapest surrogacy agency, nor do you want to choose the largest. As a general rule, the bigger the organization, the slower the response times.

Sometimes, though, the opposite is true. A larger agency will boast more staff, meaning you’ll have greater resources for care when you need it most (i.e. during a crisis or when you have a time-sensitive question).

Next Steps: Matching with a Surrogate

Once you’ve chosen the right surrogacy agency for you and your needs, the next big step is to find a surrogate match. This person will be an integral part of your child's origin story, and will often be someone who remains in your family's circle for many years to come. Finding the right match is key to ensuring your experience is as smooth, stress-free, and joyous as possible.

The team at your surrogacy agency will help guide you through a pool of gestational carrier candidates that align with any specific criteria you're looking for in a surrogate.

As you navigate your path to parenthood, don't ever hesitate to reach out to both your fertility clinic and surrogacy agency for support and information - they are there to help you!

Remember: We all want you to succeed and end up with the family you dream of. 

Dr. Mark P. Leondires

Dr. Mark P. Leondires is the Founder and Medical Director of Illume Fertility, an inclusive, award-winning fertility clinic with five locations in Connecticut and New York. Dr. Leondires is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. Dr. Leondires is also the Founder of Gay Parents To Be, a leading family-building resource for the LGBTQ+ community - a passion project created after undergoing his own journey to parenthood as a gay dad.

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