Using a surrogate—someone who carries and delivers your child—can be a beautiful and fulfilling experience, albeit a complicated one with many steps. In addition to finding someone willing to serve as the gestational carrier, the surrogacy process also involves screening carriers for physical and mental benchmarks, drawing up legal papers for establishing parentage rights, meeting financial arrangements and managing all the necessary medical procedures, including embryo transfers. It can all feel rather daunting.

Many intended parents choose to use an agency that, for a fee, unlocks a network of professionals to help every step along the way. Other families decide to pursue surrogacy independently, relying on family, friends and their own doctors for advice and support. Both options have their own respective benefits and drawbacks. It’s important to know what to expect, whichever route you choose. Ready to weigh your options? Read on for a comparison of agency surrogacy vs. independent surrogacy.

What Is an Agency Surrogacy?

Also called matching agencies, a surrogacy agency is essentially a one-stop shop for intended parents who have decided to use a gestational carrier to expand their family. Agencies provide a range of services for families and surrogates, including:

Matching intended parents with gestational carriers
Medical screening and numerous background checks for surrogates
Establishing legal agreements—parental rights—between the parties
Referrals to mental health professionals, medical experts and fertility clinics
Fostering the relationship between both parties, from before conception to just after birth

“As a full-service agency, we recruit, screen and educate surrogates,” said Casey DiPaola, director of intended parent services for New York Surrogacy Center. “We educate them so that they fully understand what to expect—all the travel they might have to do, all the time away from their family and jobs and all the potential bumps along the way.”

DiPaola says that after a potential intended parent-surrogate match has been made, she likes to set up a Zoom meeting where they can ask each other questions. “With independent surrogacies, they don’t always get the in-depth conversations about all the different things that can come up,” DiPaola said. Topics discussed may include everyone’s thoughts on termination of the pregnancy, COVID and flu shots, the surrogate’s eating and drinking habits and traveling during the third trimester of pregnancy, she says.

Pros of agency surrogacy

The biggest benefit of going with an agency surrogacy is probably its matching service for intended parents who haven’t yet found their gestational carrier. “It’s not just locating a person who wants to do it. A matching program will likely be working with someone who has past clearance, past mental health evaluations, someone who’s had financial background checks, etc.,” says Rachel Loftspring, a partner at Essig & Evans LLP, a boutique family and fertility law firm in Cincinnati. Agencies are in charge of making sure that surrogates are medically and mentally prepared to carry your baby, and that they’re motivated for reasons other than money.

An agency also provides access or referrals to any professionals you’ll need along the way, including:

Mental health professionals
Fertility doctors and clinics
Lawyers specializing in fertility law
Insurance, financial and escrow experts

One big plus to using an agency is the legal expertise they facilitate. Surrogacy and parentage laws differ in almost every state, notes Loftspring, so enforcing a contract between intended parents and a gestational carrier can be tricky when they live in different places. Many agencies have experience dealing with both parties living in separate states and know how to foster legal counsel for everyone. “Most intended parents have never been here before, so it can be helpful to have that guidance from someone who does it every day,” adds Loftspring.

Cons of agency surrogacy

For some families, the biggest barrier to signing on with an agency is cost. Some agencies estimate that the low end of the range starts around $90,000. However, given the array of fees, that varies from case to case—health screening costs, legal fees, insurance premiums and payments for other things like c-sections, child care for the gestational carrier, etc.—intended parents may end up paying upwards of $140,000. “We typically tell people anywhere from $95,000 to $145,000, which doesn’t include the fees for the fertility clinic,” says DiPaola.

Fertility clinics differ substantially in how they charge, and some intended parents come to a surrogacy agency already having embryos created, so their fees are less, explains DiPaola. Other parents-to-be may need to find egg donors or have genetic testing done, which ups the price tag. Most surrogacy programs will work with intended parents at any point in their surrogacy journey and may offer a reduced agency fee if families come to them already having their own gestational carrier, notes DiPaola.

What Is an Independent Surrogacy?

Intended parents who decide not to use a surrogacy agency manage everything themselves, including finding their gestational carrier and IVF clinic, working directly with their own fertility lawyer and helping the surrogate through the course of the pregnancy process. Also called private surrogacy, going the independent route means parents have more control over the decisions and people involved along the way. Typically, notes Loftspring, intended parents who opt not to use an agency already have a surrogate in mind and feel comfortable vetting the person on their own.

Pros of independent surrogacy

Choosing the independent option usually means saving some money. Intended parents avoid the surrogacy agency fees, which at New York Surrogacy Center run $25,000 for parents needing a surrogate match and $10,000 for families who come to the agency with their own gestational carrier.

Parents who don’t employ an agency also have more control over the service professionals they hire to facilitate their surrogacy journey. It’s not terribly difficult to locate a fertility attorney on your own; fertility clinics frequently refer patients to lawyers, notes Loftspring. Especially if they’ve been through the process before, intended parents may not need all the extra support and services referrals that agencies offer.

Cons of independent surrogacy

Without access to the depth of resources that agencies provide—most importantly the thorough screening of gestational carriers and mental health counseling—it’s not uncommon for things to go awry with surrogacies formed between intended parents and carriers whom they’ve met on their own. It can be problematic if all the appropriate medical tests haven’t been performed, or if all the necessary legal conversations haven’t been locked down before embryos get transferred to the gestational carrier’s womb. “They’ve made this emotional connection with each other before they’ve checked all the boxes, and they’re more likely to overlook things they shouldn’t have,” said DiPaola.

Unlike with an independent surrogacy, many agencies don’t have the two parties meet until everything with the carrier and parent shores up medically, mentally and financially, which lessens the chance of things falling apart later during or after pregnancy, notes DiPaola. “You find a match, but then you need to be cautiously optimistic until you make sure everything else passes muster,” says Loftspring.

Whether you choose to move forward with surrogacy via an agency or independently, there’s a lot to consider. An agency can certainly help streamline the process, but it comes at a price—literally; it can also mean losing some level of autonomy. That said, independent surrogacy puts more work on your already-full plate. Unfortunately, neither option will be completely stress-free, and there will probably be at least a few hiccups along the way. Choosing surrogacy is a big and exciting step, so take the time to think through what works for you and your growing family.

About the experts:

Rachel Loftspring is a partner at Essig & Evans LLP, a boutique family and fertility law firm in Cincinnati. She practices fertility law exclusively, counseling clients from the United States and around the world on family-building through surrogacy as well as egg, sperm and embryo donation. She is licensed in Ohio and Illinois. She earned her law degree from the University of Pennsylvania Law School.

Casey DiPaolais the director of intended parent services at New York Surrogacy Center.

Plus, more from The Bump:

How to Navigate the Intended Parent-Surrogate Relationship

The Best Children's Books About Adoption and Surrogacy

IVF: What to Know About in Vitro Fertilization

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