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.

Click here for our surrogacy application.

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 totalof $90,000 to $130,000 would be reasonable to project 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 to $30,000
Egg donor compensation: $10,000 for an NAFG donor (but no more than $10,000)*; compensation varies for donors from other programs
Egg donor agency fee: approx. $3,500 to $6,000
Surrogacy insurance premium (if necessary): approx. $12,000
IVF costs: approx. $15,000 to $30,000 (depending on whether donor egg is used and other factors)
Surrogacy insurance deductible (if necessary): approx. $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, a special surrogate maternity policy will be purchased. This policy has 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. 

NAFG Donor Egg Program Fees

NAFG Program Fee: $4,000 ($3,000 if part of NAFG’s Gestational Surrogacy program)
Administration Fee: $1,000
Egg Donor Fee: $10,000 (Under no circumstances are donors paid more than $10,000)*
Insurance: $180 - $400 premium (sometimes included in medical expenses)
Legal fees for donor and recipient: approx. $1,500
Expenses and travel: $0 - approx. $4,000 (depending on circumstance/amount of travel required)

NAFG’s program and administration fees include the costs for nationwide electronic and print donor marketing and outreach, non-medical screening (including background checks), trust account maintenance, scheduling and arranging appointments with medical and other professionals, making travel arrangements, and general support for both donors and recipients from our counseling staff. The fees are non-refundable and due with the service agreement at the time of your match.

The fees listed above do not include medical tests and procedures, which vary and are paid directly to the medical facilities involved. IVF costs (including medical procedures, medication, and lab fees) can range from $15,000 to $30,000.

*According to the American Society for Reproductive Medicine's Ethics Committee guidelines published in 2000 and restated in 2007, egg donor compensation exceeding $10,000 is inappropriate. NAFG shares this view. Under no circumstances are donors paid more than $10,000. Donors are compensated for the time and effort required for the process, not for their eggs. NAFG offers the highest amount allowed by the ASRM in order to attract motivated, qualified egg donor candidates from around the country.

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.

What is NAFG's policy on maintenance of records?
NAFG will endeavor to maintain, to the extent feasible, Donor/Carrier identifying information and Recipient Parent/Intended Parent identifying information for an indefinite period of time. When an Egg Donor Agreement or Gestational Surrogacy Agreement governs the relationship between the Parties, it customarily indicates instances when the identities of the participants may and/or must be revealed. NAFG will do its part to comply with the terms of these Agreements. The IVF clinics involved and individual attorneys involved should also be considered a resource when and if necessary.