Many gay men from around the world come to the U.S. for their surrogacy journey to take advantage of the surrogacy-friendly laws in the U.S., and to work with the world’s top fertility clinics and agencies located here.
Read on for our comprehensive guide to all you need to know in order to pursue your own surrogacy journey in the United States from wherever you live, including Canada, the U.K. or elsewhere within the European Union, Israel, and Australasia.
The United States is one of the only countries in the world where compensated gestational surrogacy is both legal and highly regulated. This means you can expect your U.S.-based surrogacy journey will be highly ethical and safe for you, your surrogate and egg donor, and your baby.
While altruistic surrogacy (meaning no money changes hands) is legal in many countries across the world, the United States is one of the only countries in the world to allow for compensated gestational surrogacy. The practice is legal in nearly every state in the U.S. (other than Louisiana and Michigan). You may face legal risks if you attempt to enter into a compensated surrogacy arrangement in your home country.
Compensated gestational surrogacy and IVF have been practiced in the United States for several decades now — far longer than in other countries. This means the United States is home to the world's most experienced surrogacy and IVF professionals, and these experts have access to the cutting-edge in reproductive technologies.
The surrogacy industry in the United States is regulated by the American Society for Reproductive Medicine (ASRM) — which sets guidelines for the ethical practice of surrogacy in the United States — as well as guidelines set forth by the Food and Drug Administration (FDA.) Still, to maximize your chances for a successful and uncomplicated journey, you should partner with the best family-building partners, like the GWK vetted and approved Partners to Fatherhood.
Any child born in the United States is a U.S. citizen— even children born via a surrogate pregnancy to foreign dads. As a result, your baby will receive a U.S. birth certificate — and will be eligible for a U.S. passport.
Regardless of where you live, your surrogacy team will guide you through your journey from start to finish and much of this work can easily be accomplished remotely. Read on for an overview of your U.S.-based surrogacy journey.
As you start your surrogacy journey, the first step you need to take is to find the family-building partners that will support your entire journey. We encourage you to schedule introductory video calls with several IVF clinics and surrogacy / egg donor agencies. Try to meet with a mix of organizations, from small and boutique to some of the nation’s largest.
Truth is, today there is a huge number of agencies and clinics for you to choose from. We understand it can be overwhelming just to figure out which family-building partners to interview, let alone which to hire. That’s why we created our Partners to Fatherhood program -- to connect you with a small group of GWK vetted and approved providers that each enjoy a long and proven track record of success and passion for LGBTQ family building.
Once you have confirmed your family-building partners, you will be advised to select your egg donor, a woman who will provide the egg used to create your embryo. Your fertility clinic or surrogacy agency may have an in-house egg donor program, or you may have a friend or relative donating the eggs, or you can find your egg donor using a third-party agency.
At the same time, your U.S. fertility clinic will help you find a local clinic near your home that is pre-approved by the Federal Drug Administration (FDA) in the United States. This clinic will conduct a semen analysis and some basic lab work, and eventually they will also freeze or cryopreserve your specimen to be shipped to your U.S. clinic. (Without FDA approval, your specimen cannot be transferred to your surrogate.)
The work of matching you with a surrogate, or gestational carrier, is coordinated by your surrogacy agency. Reputable surrogacy agencies will thoroughly pre-screen their surrogates before matching them with intended parents, which hopefully increases the chances that each surrogate in their network is approved by your fertility clinic upon their own medical screening.
Your initial contact(s) with your surrogate will take place either on a phone or video call, so no travel is required by either of you. In order to confirm your match, you will both need to confirm your interest in being matched together.
After the match has been confirmed, your surrogate will visit your U.S. clinic to undergo her medical screening. Assuming she is approved by your doctor, either your surrogacy agency or, in some cases, outside counsel, will then draft the legal contracts you will both have to sign. Again, no travel required on your part yet.
Once she is ready, your surrogate will return to the fertility clinic for the embryo transfer. Again, you do not have to be present for this stage of the process. Presuming the transfer successfully resulted in a pregnancy, your carrier will be monitored by the IVF clinic for her first 6 weeks of pregnancy, and then she will be monitored by her own OBGYN for the duration.
While you may choose to travel and spend time with your surrogate before she delivers, it is not required. However, you should book your travel plans about a couple of weeks before her due date to make sure you do not miss the arrival of your baby(ies). Your surrogacy agency should help you book your travel and accommodations.
Following the birth, you will need to complete all the necessary legal work to obtain proper documentation for your newborn(s). Once again, your surrogacy agency will help guide you, but keep in mind that your individual circumstances will dictate how long you will need to stay in the U.S. and it could be a month or longer. could be a month or longer.
Many international intended parents are confused by the U.S. insurance system (don't worry — plenty of people inside the U.S. are just as confused!) But part of your surrogacy journey in the United States will require navigating this system to ensure all proper plans are in place.
Unlike most countries, most people in the United States obtain their health insurance through their employers. As an international intended dad, then, it will be extremely important for you to understanding what your surrogate's insurance policy does and does not cover — this will be an important part of the matching process that your surrogacy agency should help you to navigate. A surrogate’s own insurance policy may cover all aspects of your surrogate pregnancy, some of it, or none of it — this will be a huge variable in the overall costs of surrogacy you can expect from your journey. Your surrogacy agency will also inform you about optional but recommended insurance polices you can take out to cover the costs of rare events that may arise during your surrogate's pregnancy — such as bed rest, accidental death, hospital indemnities, or loss of her reproductive organs.
Unlike your surrogate, no current insurance policies in the United States will cover the medical costs for your egg donor. So you will need to make sure you have an egg donor insurance policy in place. This policy will cover any complications that might arise during the egg donation process — the most common being over-stimulation during fertility treatments, resulting in the hospitalization of your donor.
For international intended parents located outside of the United States, you will also need to secure insurance for your infant once born. (Intended parents located inside the United States can simply add their baby to their own insurance plans once born). Your legal team will ensure that you are the legal guardian of your child by the time your baby is born — meaning you will be responsible for all of your baby's medical costs.
There is no federal surrogacy law in the United States. Instead, the industry is governed by state laws. There are also some legal implications for international intended parents pursuing surrogacy in the United States that are important to be aware of — an experienced reproductive lawyer in the U.S. (and in your home country) will help guide you through these considerations.
Currently every state in the U.S. besides Louisiana and Michigan allow some form of compensated surrogacy — but laws governing surrogacy still differ vastly from state to state. Some states will be better for an international surrogacy journey than others. It's important to work with a U.S.-based attorney, who is well versed in these laws, prior to beginning your surrogacy journey. (Our Partner to Fatherhood can help advise you.)
In order to secure your parentage (and those of your partner, if applicable) you will need the aid of a U.S.-based attorney. Though the process varies state to state (and sometimes even county to county) generally you will pursue a court order to obtain these rights. Ideally, you will be working with a surrogate in a state that permits pre-birth parenting orders (meaning your rights are secure prior to the birth of your child.) In some states, you will need to pursue a post-birth order instead.
Your home country may also require you to navigate certain legal considerations. In some countries, for instance, you will need a birth certificate that lists your surrogate as a "parent" in order to register your child — it will be important for you to match with a surrogate in a U.S. state where this is allowed.
All children born in the United States automatically become U.S. citizens — including those born via surrogacy to international intended parents. Your U.S.-based surrogacy attorney will help you obtain this passport before you fly home.
The ultimate goal of the legal process for international intended parents is to ensure you become the legal parents of your child — and that you can return safely home with your baby. Though it may differ slightly depending on your home country, and the state where your surrogate lives and will deliver your baby, the process for meeting these goals generally unfolds as follows:
Much of the legal process will be dictated based on the laws in the state where your baby will be born (generally — where your surrogate lives.) There are several ways surrogacy laws differ state to state, the most important concerns establishing your parenting rights. Some states will allow you to obtain a pre-birth order before your baby is born, while others will require to wait until after the birth. Still others will require intended parents to be married. An experienced surrogacy lawyer will help you navigate these state-based laws.
All intended parents need to draft legal contracts with their surrogates and egg donors. The contract process usually lasts several weeks. Most of the time, these are fairly standard documents, with expectations, terms and fees all spelled out. The goal of these documents is to ensure you walk away from your journey as a legal parent, and your surrogate and egg donor have no legal ties.
As part of the legal process, you will need to list a guardian for your child in the event that something were to happen to you that left you (and your partner, if applicable) unable to assume legal parenting rights over your child. Your lawyer may also work with your surrogate to grant you a health care power of attorney — so that you have some legal standing with your obstetrician that grants you access to some medical knowledge with regards to your surrogate's pregnancy that would otherwise be kept confidential.
Establishing your legal parentage is the most important, and longest, phase of your legal surrogacy process — and it will generally start at the beginning of the second trimester of your surrogate's pregnancy. This process will ensure everyone involved agrees that you and your partner have full legal rights, while your surrogate and egg donor do not. Again, this process will vary state to state — and can either occur pre or post birth.
Following the birth of your baby, your lawyer will assist you in filling out all needed paperwork to secure the birth certificate and U.S. passport for your baby. For international intended parents, your lawyer can attempt to expedite these processes as much as possible — generally you can secure your baby's birth certificate within two weeks of birth. (For domestic parents, this process can take two to three months.) Once you've obtained the birth certificate, you can use this to petition for your baby's U.S. passport, a process which can take an additional three to five days.
Depending on where you live, you may need to visit your home country's consulate in the United States, where you will officially register the birth of your child. You may also need your consulate to help you obtain travel documents. Your home country attorney will help you navigate these steps of your legal process.