How to Choose a Surrogacy Agency: 15 Questions to Ask

Choosing a surrogacy agency is one of the biggest decisions you'll make on your journey. The right agency makes the process smoother, safer, and less stressful. The wrong one can cost you tens of thousands of dollars and months of delays.

There are over 100 surrogacy agencies in the United States, ranging from large national firms with dedicated legal teams to small boutique operations run by former gestational carriers. Prices range from $15,000 to $30,000+, and the quality of service varies dramatically.

Here are the 15 questions you should ask every agency — and what good answers sound like.

The Must-Ask Questions

1. How long have you been in business, and how many journeys have you completed?

Why it matters: Experience means they've seen complications, legal edge cases, and difficult situations. A newer agency isn't necessarily bad, but you want to know they have a plan for when things don't go as expected.

Green flag: "We've completed 200+ journeys over 8 years." Red flag: Vague answers, or they can't give you a number.

2. How do you screen your gestational carriers?

Why it matters: Thorough screening protects everyone — you, the carrier, and the baby.

What good screening includes:

• Medical records review (OB history, all prior pregnancies)
• Psychological evaluation by a licensed professional
• Background check (criminal + financial)
• Home study or home visit
• Interview with partner/spouse (if applicable)
• Drug screening
• Verification that she has at least one prior successful pregnancy

Red flag: "We accept self-reported medical history" or "We don't require a psychological evaluation."

3. What's your matching process, and how long does it take?

Why it matters: Matching is where it all starts. You want an agency that matches based on compatibility — not just availability.

Good answers include:

• They learn about your preferences (location, communication style, values, birth plan preferences)
• They present profiles with detailed information
• They facilitate a "getting to know you" call before you commit
• Typical timeline: 1–3 months

Red flag: "We'll have you matched within 2 weeks." Speed usually means they're not being selective.

4. What happens if a match falls through?

Why it matters: Matches do fall through — medical screening fails, someone changes their mind, or it's just not a good fit. You need to know the financial and timeline implications.

Green flag: "We re-match you at no additional cost. Your agency fee covers the matching process, not a single match attempt." Red flag: "There's a $5,000 re-matching fee."

5. Which attorneys do you work with, and can I choose my own?

Why it matters: Some agencies have in-house counsel or require you to use specific attorneys. You should always have the option to use an independent reproductive law attorney.

Green flag: "We have attorneys we recommend, but you're welcome to use your own. The gestational carrier always gets independent counsel." Red flag: "Our attorney represents both parties." (This is a conflict of interest and illegal in many states.)

6. How do you handle escrow?

Why it matters: Your money should be held by a bonded, independent escrow company — not by the agency. If an agency holds your funds directly, you have no protection if they go out of business.

Green flag: "We use [specific bonded escrow company]. All funds are held independently." Red flag: "We manage the funds in-house." Walk away.

7. What's included in your fee, and what costs extra?

Why it matters: Some agencies quote a low base fee but then charge separately for matching, screening, coordination, and support. Get the full picture.

Ask for a complete fee schedule in writing. Typical add-ons to watch for:

• Re-matching fees
• International IP surcharges
• Travel coordination fees
• Post-birth support fees
• "Case management" fees beyond the agency fee

8. What support do you provide to the gestational carrier?

Why it matters: A happy, well-supported carrier means a smoother journey for everyone. If the agency treats carriers poorly, it reflects on the entire experience.

Green flag: "Our carriers have a dedicated case manager, 24/7 support, peer mentoring from experienced carriers, and we cover counseling sessions throughout the journey." Red flag: "We handle the business side. The carrier's emotional support is her own responsibility."

9. What support do you provide to intended parents?

Why it matters: You're going through something emotionally intense. The agency should be more than a transaction coordinator.

Good support includes:

• Dedicated case manager / coordinator
• Regular check-ins (not just when there's a problem)
• Referrals to surrogacy-experienced therapists
• Help with travel logistics for the birth
• Post-birth support and guidance

10. Do you work with LGBTQ+ intended parents and single parents?

Why it matters: Not just about whether they "accept" you — but whether they have experience and systems designed for non-traditional family structures.

Green flag: "Absolutely. X% of our intended parents are LGBTQ+ couples or single parents. Our contracts, processes, and team training reflect that." Red flag: "We work with everyone" without specifics. Or: "We require intended parents to be married."

11. Do you work with international intended parents?

Why it matters: International journeys involve additional legal complexity — citizenship, passports, embassy requirements, and immigration law. You want an agency that has navigated this before.

Green flag: "Yes, we work with IPs from [list of countries]. We have relationships with immigration attorneys and can guide you through the embassy process." Red flag: "We've never done an international journey, but we're open to it." That means you're their guinea pig.

12. What's your policy on selective reduction and termination?

Why it matters: This is a sensitive topic, but it must be discussed and agreed upon before the journey begins. It should be addressed in the gestational carrier agreement.

What to look for: The agency should facilitate an honest conversation between you and the carrier about scenarios involving medical complications, genetic abnormalities, or multiples — and ensure alignment before matching.

13. Can I speak with former intended parents?

Why it matters: References tell you what the agency is actually like, not just what they say they're like.

Green flag: "Absolutely. Here are three families who've completed journeys with us. They've agreed to speak with prospective IPs." Red flag: "We can't share that due to privacy." (They can if the families consent.)

14. What happens if something goes wrong during the pregnancy?

Why it matters: Complications happen. Bed rest, hospitalization, preterm delivery, medical emergencies. You need to know the agency's role when things get difficult.

Ask specifically:

• Who coordinates between the medical team, the carrier, and you?
• What if the carrier needs bed rest — how are lost wages and childcare handled?
• What if there's a disagreement between you and the carrier about a medical decision?

15. What are your success rates and typical timelines?

Why it matters: Transparency about outcomes and realistic timelines means the agency isn't overselling.

Green flag: "Our average journey from signing to delivery is 14–18 months. Our transfer success rate mirrors national IVF averages — about 60–65% per transfer." Red flag: "We guarantee a baby." No one can guarantee that.

Beyond the Questions

Trust your instincts

After speaking with 2–3 agencies, you'll feel a difference. The right agency makes you feel supported, informed, and respected. The wrong one makes you feel like a transaction.

Check for complaints

• Search the agency name + "complaints" or "reviews"
• Check the Better Business Bureau
• Ask in surrogacy Facebook groups — the community is small and honest
• Look for any legal actions or state regulatory issues

Don't rush

The matching process takes time regardless. Spending an extra 2–3 weeks choosing the right agency is worth it — this relationship will last 12–18 months.

Get everything in writing

Before you sign, you should have a clear written agreement with the agency that specifies: their fee, what's included, what costs extra, refund policy, re-matching policy, and their obligations to you.

The Right Agency Makes All the Difference

A great agency doesn't just find you a gestational carrier. They guide you through the most complex, emotional, and rewarding experience of your life with expertise, empathy, and transparency.

Take your time. Ask hard questions. And trust the agency that gives you honest answers — even when the answers aren't what you want to hear.