Key Aspects of Surrogacy in the USA

1. Is Surrogacy Legal in the USA?
2. Cost of Surrogacy in the USA
3. The Surrogacy Process in the USA
4. States With Surrogacy-Friendly Legal Frameworks
5. Surrogacy Laws in the United States
6. The Role of Surrogacy Agencies
7. Requirements for a Gestational Carrier

States such as California, Massachusetts, and Delaware are generally considered surrogacy-friendly jurisdictions, while states such as Louisiana and Nebraska have more restrictive rules. Eligibility may also vary depending on factors such as marital status, residency, and the circumstances of single intended parents.

The total cost of a surrogacy program in the United States can be substantial and, depending on the state, clinic, agency, insurance coverage, and services included, may exceed $200,000.

The United States has one of the most developed medical, legal, and administrative systems for organizing surrogacy programs. However, there is one important distinction: there is no single nationwide surrogacy law. Instead, surrogacy is regulated primarily at the state level.

Below, we explain how surrogacy is regulated in the United States, which states generally provide favorable legal frameworks, what a program may cost, how the process works, and what criteria are typically applied when screening gestational carriers.

In the United States, specialized agencies, fertility clinics, and attorneys have worked together for decades to organize and support surrogacy programs.

In gestational surrogacy, the gestational carrier does not provide her own egg and therefore has no genetic relationship with the child. The embryo is created using gametes from the intended parents or, where necessary, donor eggs or sperm.

Is Surrogacy Legal in the USA?

The legal status of surrogacy depends on the state. There is no single federal law that permits, prohibits, or regulates surrogacy uniformly throughout the United States. Some states have specific statutes governing gestational surrogacy, while in others the legal framework may depend partly on case law or include significant restrictions.

The legal landscape has also changed considerably in recent years. Michigan, for example, enacted legislation in 2024 that replaced its previous restrictive approach to surrogacy agreements, with the new framework taking effect in 2025. New York has regulated gestational surrogacy under the Child-Parent Security Act since 2021.

States With Surrogacy-Friendly Legal Frameworks

States generally considered to have favorable legal frameworks for gestational surrogacy include:

• California;
• Colorado;
• Connecticut;
• Delaware;
• Maine;
• Massachusetts;
• Michigan;
• Nevada;
• New Hampshire;
• New Jersey;
• New York;
• Rhode Island;
• Vermont;
• Washington;
• the District of Columbia.

Other states apply different or more restrictive rules.

Louisiana, for example, permits gestational surrogacy only under specific conditions and has more limited eligibility requirements. In Nebraska, surrogacy agreements may not be legally enforceable. Other states may also impose specific restrictions or procedural requirements.

For this reason, the legal framework should always be reviewed specifically for the state in which the program will take place.

Feskov Human Reproduction Group offers consultations with professionals experienced in international reproductive law to help intended parents understand which jurisdictions may be appropriate for their individual circumstances.

The services, conditions, and terms of fixed-price programs are defined in the relevant contract.

The state in which the gestational carrier resides and the state in which the child is expected to be born are important considerations, as they can affect the applicable parentage rules and the legal procedures required.

Surrogacy Laws in the United States

Depending on the state, surrogacy laws may determine:

• whether compensation for the gestational carrier is permitted or only certain expenses may be reimbursed;
• how legal parentage can be established for the intended parents;
• whether a court order establishing parentage, such as a pre-birth order, may be available before the child is born;
• whether eligibility depends on residency, marital status, or other personal or legal circumstances.

In states with specific gestational surrogacy legislation, contracts and parentage procedures may be regulated in considerable detail.

However, the exact requirements always depend on state law, the circumstances of the intended parents, and the structure of the particular surrogacy arrangement.

Cost of Surrogacy in the USA

The total cost of a surrogacy program in the United States may include several components:

• compensation and/or permitted expense reimbursement for the gestational carrier;
• medical procedures, including embryo creation, IVF, and embryo transfer;
• pregnancy monitoring;
• childbirth and related medical expenses;
• agency services;
• donor eggs or sperm, when required;
• legal fees;
• insurance and related expenses.

In many programs, the intended parents and the gestational carrier are represented by separate attorneys so that each party receives independent legal advice.

The United States is among the more expensive destinations for surrogacy. Total costs depend on factors such as the state, fertility clinic, agency, insurance arrangements, gestational carrier compensation, the number of medical procedures required, and any pregnancy-related complications.

In some cases, the overall cost may reach or exceed $150,000–$200,000.

Before beginning a program, intended parents should therefore understand exactly which services are included in the quoted price and which expenses may arise separately.

Feskov Human Reproduction Group offers programs in which the included services and financial terms are defined contractually, allowing intended parents to understand what is covered under the selected program.

The Surrogacy Process in the USA

A surrogacy program may begin with the selection of a surrogacy agency, fertility clinic, and attorneys experienced in reproductive and surrogacy law.

The agency may assist intended parents with finding and screening a gestational carrier and, when necessary, an egg or sperm donor.

During this stage, the legal and organizational aspects of the arrangement are also prepared. Contracts are drafted, and each party may receive independent legal advice. The gestational carrier then undergoes the medical screening and psychological evaluation required by the program.

If the intended parents’ own gametes will be used, they undergo the necessary medical testing and procedures to obtain eggs or sperm. If donor gametes are used, donors are selected and screened according to the clinic’s protocols and applicable requirements.

In states where the procedure is available, attorneys may also begin the process of obtaining a pre-birth order or another court order related to establishing parentage.

Embryos are created through IVF. When medically indicated, preimplantation genetic testing (PGT) may be performed to assess certain chromosomal or genetic conditions. The reproductive medicine specialist then determines the appropriate timing for embryo transfer to the gestational carrier.

After the transfer, appropriate testing is carried out to determine whether pregnancy has occurred. If pregnancy is not achieved, the medical team evaluates the next steps and whether another embryo transfer should be performed.

Once pregnancy is confirmed, the gestational carrier receives medical care and monitoring throughout the pregnancy until delivery.

Under the current constitutional framework, a child born in the United States generally acquires U.S. citizenship at birth. After the birth, the necessary procedures are completed for the birth certificate, Social Security Number, and U.S. passport. How the intended parents are recorded on the birth certificate and whether a court order is required depend on the state where the child is born and the legal structure of the surrogacy arrangement.

For international intended parents, additional procedures may then be required to have the child’s parentage and documents recognized in their country of nationality or residence. These legal steps should therefore be planned before the child is born rather than addressed only after delivery.

The Role of Surrogacy Agencies

A surrogacy agency may coordinate the different participants involved in the program.

Depending on the services provided, an agency may:

• identify and screen a gestational carrier;
• coordinate the selection of an egg or sperm donor when necessary;
• manage communication with the fertility clinic;
• work with legal professionals on contracts and related documentation;
• coordinate the organizational aspects of the program.

Professional coordination can help reduce the risk of misunderstandings and administrative or organizational difficulties.

Medical decisions, however, remain the responsibility of qualified healthcare professionals, while legal matters should be handled by attorneys qualified in the relevant jurisdiction.

Requirements for a Gestational Carrier

Requirements for gestational carriers in the United States may vary depending on the state, fertility clinic, and surrogacy agency.

The ASRM recommendations provide medical and psychosocial criteria for evaluating potential gestational carriers.

In general, a candidate should:

• be within an age range considered medically appropriate;
• have previously completed at least one pregnancy;
• have an obstetric history compatible with another pregnancy;
• be in good overall health;
• be medically suitable to carry a pregnancy;
• undergo psychological evaluation;
• have an appropriate and stable social support system.

The screening process is intended to protect the health and well-being of the gestational carrier and future child and to ensure that the candidate understands the medical, psychological, and legal implications of the arrangement.

The United States can provide a highly structured legal environment for gestational surrogacy, but choosing the right state is essential.

Rules may differ significantly between jurisdictions, including neighboring states.

Before beginning a program, intended parents should consult professionals familiar with the laws of the specific state in which the arrangement will take place and where the child is expected to be born.

Feskov Human Reproduction Group offers consultations on programs involving birth in the United States to assess the options available based on the intended parents’ individual circumstances.