Types of Surrogacy & Your Choices: A Quick Guide

Surrogacy is more than just a medical process—it’s a personal journey, a legal agreement, and a deeply human collaboration. But if you’re just getting started, all the terms, categories, and pathways can be a little overwhelming.

This guide is designed to give you a clear, honest overview of the different types of surrogacy available in the United States, what they mean, and which might be the right choice for your unique situation.

What Is Surrogacy?

Surrogacy is a reproductive arrangement in which a woman (the surrogate) agrees to carry a pregnancy for another person or couple (the intended parents). The goal is to help individuals or families who cannot carry a pregnancy themselves—whether due to infertility, medical risk, or family structure.

Surrogacy is built on legal contracts, medical science, and a lot of trust. In the U.S., surrogacy is legal in many states and supported by an evolving network of clinics, lawyers, and agencies.

What Are the Types of Surrogacy?

There are several layers to surrogacy. The first major distinction is biological: whether the surrogate is genetically related to the child. The second layer is financial: whether the surrogate is compensated. And finally, there's the process management: whether you go through an agency or independently.

Let’s break down the options.

Gestational Surrogacy

This is the most common form of surrogacy in the U.S. In gestational surrogacy, the surrogate has no genetic connection to the baby. An embryo created via IVF (using the intended mother’s or donor’s egg and the intended father’s or donor’s sperm) is transferred to the surrogate’s uterus.

Because there’s no biological tie, legal parentage is usually more straightforward. Most surrogacy agencies and fertility clinics exclusively offer gestational surrogacy due to its legal and emotional clarity.

Traditional Surrogacy

In traditional surrogacy, the surrogate uses her own egg, making her the child’s biological mother. This method is rare and carries more complex emotional and legal considerations. In most U.S. states and agencies, it’s either discouraged or not supported at all.

Compensated vs. Altruistic Surrogacy

Compensated Surrogacy

In a compensated arrangement, the surrogate receives payment for her time, effort, and the risks involved in carrying a pregnancy. This is the norm in most U.S. states and often includes a base compensation package, plus additional payments for milestones (embryo transfer, carrying multiples, C-section, etc.).

Altruistic Surrogacy

In altruistic surrogacy, the surrogate does not receive compensation beyond reimbursement for medical and pregnancy-related expenses. This is more common in family arrangements—such as when a sister or close friend volunteers to carry a pregnancy.

Surrogate Compensation

Compensation varies widely based on experience, location, and the type of arrangement. On average, U.S. surrogates receive between $40,000 and $70,000, with experienced or repeat surrogates earning more.

Additional compensation may include:

• Monthly allowances
• Maternity clothing stipends
• Lost wages
• Travel reimbursement
• Childcare support

A surrogacy agency will usually handle these payments and ensure transparency and fairness. Surrogates should always be represented by their own legal counsel to review contracts and protect their rights.

To understand how surrogate compensation intersects with tax or benefit policies, you can visit https://www.irs.gov

Independent vs. Agency Surrogacy

Independent Surrogacy

In an independent journey, the intended parents and surrogate find each other without using a surrogacy agency. They coordinate legal, medical, and logistical tasks on their own or with the help of professionals like lawyers and IVF clinics.

While this can reduce costs, it increases the complexity and emotional weight on both sides. It’s crucial to have strong communication, airtight contracts, and clear expectations.

Agency Surrogacy

Most people choose to work with a surrogacy agency, which manages everything from screening to matching to post-birth logistics. An agency ensures the surrogate is qualified, the legal team is involved early, and that everyone receives consistent communication and support.

Agencies often have counseling services, legal partnerships, and medical coordination built into their programs.

You can check licensed healthcare providers and related services through https://www.cms.gov

What a Surrogacy Agency Can Do for You

A reputable agency acts as a guide and safety net through every step of the surrogacy journey.

Services typically include:

• Surrogate and egg donor matching
• Background checks and medical screenings
• Contract coordination with reproductive lawyers
• Psychological evaluations
• Travel planning for appointments
• Fertility clinic referrals
• Birth coordination and postpartum support

Who Can Benefit From Surrogacy?

Surrogacy is a path to parenthood for many individuals and families who can’t carry a pregnancy on their own. This includes:

• Couples facing infertility
• LGBTQ+ individuals and couples
• Single intended parents
• People with medical conditions that prevent pregnancy
• Families who have experienced multiple pregnancy losses

The journey to parenthood is personal. Surrogacy offers an inclusive option for building families in a way that respects individual circumstances.

For broader reproductive health education, visit https://www.nichd.nih.gov

Surrogacy Pregnancy

Once the surrogate becomes pregnant, her prenatal care is usually managed by a standard OB/GYN, just like in any other pregnancy. However, she may also see a maternal-fetal medicine specialist if the IVF clinic or agency requires it.

Agencies help coordinate:

• Health insurance coverage
• Regular medical updates to the intended parents
• Travel for appointments (if needed)
• Birth planning and hospital policies

What Happens to Any Remaining Frozen Embryos?

Frozen embryos are often created during the IVF process, and not all are used during a single surrogacy journey. The intended parents have legal control over what happens to the unused embryos.

Common options include:

• Saving them for future family-building
• Donating to another couple
• Donating for medical research
• Choosing to discard them (according to clinic protocol)

Where Is Surrogacy Legal?

Surrogacy laws in the U.S. vary by state, not at the federal level. Some states are surrogacy-friendly with clear legal protections. Others have restrictions or require court approval before or after birth.

Here’s a simplified breakdown:

• Surrogacy-Friendly States: California, Nevada, Connecticut, New Jersey, Illinois, and more.
• Restricted States: Michigan, Nebraska, Louisiana (traditional surrogacy banned or heavily limited).
• Case-by-Case States: Laws vary by judge or county; requires specialized legal guidance.

Conclusion

Surrogacy is not one-size-fits-all. Whether you’re considering gestational or traditional, compensated or altruistic, agency-managed or independent—the most important thing is making informed, thoughtful decisions that fit your needs and values.

Take time to understand the options. Ask questions. Build a team you trust. And know that whatever path you choose, you’re part of something extraordinary: bringing life and love into the world.