You will need to work with a surrogacy agency, and we strongly recommend you find one  with a long track record of success helping gay men become fathers. While it is possible to do a surrogacy journey on your own (which is called an "independent" surrogacy journey), a surrogacy agency will be there to guide you through every step of the experience — and be there when and if complications arise. (And as our GWK Partners to Parenthood will tell you, something always does!) Your surrogacy agency will assign you a case worker who is meant to help guide you through this all. Book a free consult with one of our GWK-approved surrogacy agencies here.

Egg Donor Agencies

You will also need to find an egg donor — and there are several different places you can do so. Some surrogacy agencies and fertility clinics have their own in-house egg donor directories. Fertility clinics generally work with a smaller group of donors they have already screened, and are less expensive for that reason, while agencies may have a wider selection, with slightly higher costs. You can also find an egg donor from an egg bank. In this case, an egg donor would have already donated her eggs, which have been frozen and stored. Lastly, you can work with a "known" egg donor — these are friends or family members willing to donate their eggs to you, often for free, and may play some role in your child's life. 

Legal Counsel

You will also need to work with an experienced assisted reproductive attorney, who will negotiate legal contracts with your surrogate and egg donor. Some surrogacy agencies have lawyers in-house and can help you navigate the legal aspects of the journey in addition to coordinating the overall journey. If your surrogacy agency does not have lawyers in-house, you will need to hire your own outside counsel. Your lawyer will help you navigate two critical issues: navigating surrogacy laws and establishing your legal parenting rights. 

Mental Health 

Next, you will need to work with an experienced mental health professional. The American Society for Reproductive Medicine (ASRM), which offers guidelines for the ethical practice of surrogacy, recommends you, your surrogate and your donor — and each of your partners, where relevant — undergo screening by a trained mental health professional early on in the process.

Insurance

You will also need the support of fertility insurance experts, who will help make sure both your surrogate and egg donor are properly covered. Your surrogacy agency should help facilitate that process. Even if the surrogate has her own health insurance that is approved to cover her maternity care during a pregnancy, parents should expect to compensate her for using that insurance, as well as paying her premiums and deductibles during the journey. You will also need a special form of insurance for your egg donor, as insurance companies do not cover the egg donation process.

Surrogate Screening

ASRM Guidelines:

The American Society for Reproductive Medicine (ASRM), which sets guidelines for the ethical practice of surrogacy in the United States, advises that surrogates be between the ages of 21-45 years old — most tend to fall somewhere in the age range of 25 to 35. All surrogates must have completed at least one previous full-term pregnancy without major complications, and can have had no more than three cesarean deliveries. Guidelines also stipulate that surrogates must independently have sufficient emotional and financial support throughout the process. These guidelines, however, typically are just the very beginning of the screening process.

Mental health screening:

Surrogates undergo comprehensive psychological testing prior to being approved. This evaluation will seek to identify her motivations for wanting to become a surrogate, whether or not she has adequate support, both financially and emotionally, in her network, and additional measures such as her particular style of communication. Surrogates are also given a mental health test to help identify any potential personality or mental disorders that may complicate her ability to serve as a surrogate. Her partner or husband will be screened along many of these lines as well. Physical health screening: Applicants will also undergo extensive medical screening to ensure she is a proper candidate to serve as a surrogate. Typically, this will include a thorough review of her medical history, pre-pregnancy planning, a physical exam, a pap smear, STI testing, drug testing, and a uterine cavity evaluation. Surrogates will also be screened for blood antibodies to maximize the chances for a healthy pregnancy. Finally, the levels of certain hormones, like thyroid hormone are also checked.

What to consider before matching with a surrogate

Legal fit:

Your lawyer will help with the legality of matches, and determine if the match between you and your surrogate is legally sound.

Timing fit:

Your agency will also want to ensure there is a proper fit with regards to timing and scheduling between you, as the intended parent, and your potential surrogate match.

Personality fit:

In some ways, the most important part of the matching process is whether the intended parents and surrogate are a good personality fit. Agencies will try to generate matches so that both share the same expectations, hopes, and dreams for their upcoming journey.

The 6 Phases of Gay IVF 

The IVF process is unique for every gay male surrogacy journey, but there are some predetermined steps that most have in common. Here are the 6 steps gay men can expect during the IVF process. 

1) Screening of sperm provider:  This includes an assessment of overall health, an examination of a sperm sample, and genetic testing to see if you are a carrier of certain recessive genetic diseases, such as cystic fibrosis. 

2) Find your egg donor: Next, you will need to find and select an egg donor, which you can do from any variety of sources (see below).  

3) Create embryos: Once you and your egg donor are screened and cleared, you will create embryos with the help of your fertility clinic. 

4) Match with a surrogate: Once you've created your embryos, you're ready to find and match with a surrogate mother.  

5) Transfer embryo: Once your surrogate is cleared by your IVF clinic, you're ready to conduct your first embryo transfer! 

6) Pregnancy and birth: A successful IVF transfer means your surrogate has achieved pregnancy. From here on out, your pregnancy will develop just like any other.

Where can I find an egg donor?

Before you begin IVF, you will also need to find an egg donor — who must meet certain requirements in order to donate eggs. There are several different places you can find one to work with:

• Fertility clinics: Many fertility clinics have egg donors exclusively available for their IVF patients. 
  
  
• Surrogacy agencies: In addition to matching you with a surrogate, some surrogacy agencies also have egg donor databases for you to choose from. 
  
  
• Egg donor agencies: These agencies focus solely on egg donors, and recruit from across the country. They often help intended parents find donors who meet specific or unusual donor requirements.
  
  
• Frozen donor egg banks: These facilities offer intended parents frozen eggs that were left over from another donor’s previous egg retrieval process.
  
  
• Known donors: Some gay couples may have a family member or friend willing to donate her eggs. 

Main Costs of a Gay Surrogacy Journey

Agency fees: $35,000 - $55,000

The agency fees refer to the professional costs associated with the coordination of your journey, legal work, social work screening, and the surrogate matching process. This includes all the associated services of the journey itself. Reputable agencies will ensure these costs are transparent and accessible — including a timeline of when certain expenses are expected to be paid.

IVF clinic: $25,000 - $50,000

The main fees incurred at your fertility clinic will be those associated with screening your egg donor, surrogate, and you — as well as those incurred during the embryo creation and transfer processes. There is a lot of variability in costs that can occur, however, depending on your unique set of circumstances. If you are partnered, and you both hope to contribute sperm, that will increase your costs since you will both need to undergo the screening and embryo creation process. With two sperm sources to consider, you may want to consider working with an experienced donor to help increase the odds that you will end up with a high number of quality eggs. Also, If you transfer more than one embryo, you will increase the likelihood of a twin pregnancy — which will also increase your costs.

Gestational carrier and egg donor: $60,000 to $80,000

These costs include the compensation to gestational carriers and egg donors, any needed travel costs, and any contingency fees that might arise — like bedrest or a c-section. Additional costs come from legal expenses, which are charged separately from the agency fee, and range from $8,000-$10,000 if all goes well. The location of your surrogate, donor and clinic will also impact your overall costs. Your surrogate and egg donor will go to your clinic at least twice — once for the medical screening, and again after the legal process is complete prior to transfer. Surrogates will typically need to stay in the same city as your clinic at least overnight, and maybe up to two or three days. Egg donors are typically required to stay nearby for five to 10 days, depending on how quickly their bodies mature eggs for retrieval. If your surrogate and donor don’t live nearby your clinic, you will need to cover their travel costs and hotel stays.

Insurance: $15,000 to $30,000:

You will also need to make sure both your surrogate and egg donor have insurance. Sometimes, a surrogate’s own insurance policy will cover her pregnancy, but increasingly they won’t. You will also need to pay for insurance for egg donors, who aren’t allowed to use their own insurance for any part of the egg donation process. International parents may have additional insurance costs to consider, because their baby will often not be covered under their own home insurance plan. That means they will have to buy insurance for their baby or babies.

How Can Gay Men Afford Surrogacy?

Break your journey into pieces: You don’t have to pay for your entire journey upfront, which allows you to approach and pay for your gay surrogacy process piece by piece.

Surrogacy loans: There are a couple of financing options in the field that provide parents loans between $20,000 and $65,000 that you can pay over the course of 3 to 6 years.

Employer assisted benefits: More and more employers are covering certain elements of a surrogacy journey for their employees. 

Altruistic surrogates and known egg donors: Some gay men may have friends or family members in their lives who are willing to serve as an "altruistic" surrogate or a known egg donor — meaning they will do so without compensation.

Yes, gay surrogacy is expensive — but planning ahead for your journey can help put this path to parenthood within your reach. For more information, visit our comprehensive guide to surrogacy costs — which includes breaks down ways to make your journey more affordable. 

How is U.S. Surrogacy Different for International Intended Parents?

Travel

It may be obvious — but if you are pursuing surrogacy in the United States from abroad, international travel will be a factor in your journey. You can conduct the bulk of your journey remotely — and will undergo all needed screenings including your semen analysis at a local IVF lab. But you may want to travel to the U.S. to meet your surrogate in person, for example, or to be present for specific doctor's appointments. You will also obviously want to be in the country for your baby's birth — and will need to be present to secure your parenting rights and obtain all needed legal documentation. 

Insurance

Many international intended parents are confused by the insurance system in the United States (and we don't blame them!) Like all intended dads, you will need to explore insurance options for your surrogate and egg donor. But international intended parents will also need to take out an insurance policy for your newborn baby. 

Obtaining documents

All children born in the United States are automatically U.S. citizens — including those born via surrogacy. You will likely need to expedite the processing of your baby's birth certificate, a process that can normally take several months. Once you have your birth certificate in hand, you can then petition for your baby's U.S. passport as well.

Your home country's laws

You will need to determine the laws in your country — and what you will need to do to safely return with your baby. You will need a home country lawyer (in addition to a U.S.-based attorney) who will help guide you through any legal considerations based on your home country's laws. 

What to Know About Surrogacy & HIV

Sperm washing

To conduct sperm washing, semen is first collected from the HIV positive partner. Through a separation process known as centrifugation, the sperm is removed from the seminal fluid. Since the HIV virus is carried in the seminal fluid, and not the sperm, this allows for a vastly decreased risk of HIV transmission to either the gestational carrier in a surrogacy arrangement, or the resulting child.

Fertility clinics

Your fertility clinic may conduct sperm washing in house — but many others will contract with an outside clinic that specializes in the procedure. One of the longest-established and most reputable programs is called the Special Program of Assisted Reproduction (SPAR) — a project of the Bedford Research Foundation Clinical Laboratory.

Transmission risks

While professionals will never tell you there is no risk, the research is pretty clear on the subject — there have been no documented cases of transmission when sperm washing has been conducted as a part of an IVF procedure. In fact, in 2016, Fertility and Sterility published a meta-analysis of 40 studies on the subject — and found zero transmissions of HIV following 11,585 sperm washing procedures with 4,000 women