Fertility Clinic vs. Surrogacy Agency: What's the Difference?

The process of expanding your family through surrogacy can be complex and overwhelming, with many layers of medical, legal, financial, and logistical challenges to navigate. Learn why it's so helpful to work with both a fertility clinic and a surrogacy agency, how they differ, and ways to find the perfect match of professionals for your personal journey.

In this article:

• Beginning Your Surrogacy Journey
• Fact: Surrogacy is An Expensive Process
• The Role of a Fertility Clinic
• The Role of a Surrogacy Agency
• Do I have to use a surrogacy agency?
• 4 Reasons to Work with Both a Fertility Clinic & Surrogacy Agency
• Give Yourself the Best Chances of Success

Beginning Your Surrogacy Journey

Choosing to become a parent through surrogacy is a profound and life-changing decision. As you begin to explore your options and construct a support team, you may feel confused about the specific roles that a fertility clinic or surrogacy agency play in the process. 

While it is true that a fertility clinic and a surrogacy agency each serve a distinct purpose, their combined expertise and support are crucial in navigating the complexities of surrogacy. From medical evaluations and embryo creation to finding the perfect gestational carrier and protecting your legal rights, understanding the collaboration between an agency and a clinic is key to a successful and fulfilling surrogacy journey.

Fact: Surrogacy is An Expensive Process

Understandably, one of the first questions that many intended parents ask is why they need both a fertility clinic and a surrogacy agency. With the cost of surrogacy ranging anywhere from $48,000 to $140,000 and above, it may seem that cutting out just one of these parties could save you valuable funds. 

However, IVF and surrogacy can both be quite complicated – and we want to help you build your family without any unnecessary roadblocks or speed bumps. In this guide, we will delve into the various reasons that prospective parents may choose to work with both a fertility clinic and a surrogacy agency. 

The Role of a Fertility Clinic

A fertility clinic is in charge of all of the clinical (medical) aspects of your journey to surrogacy – from the intended parents' genetic carrier screening all the way through embryo transfer and the first 8-10 weeks of pregnancy.

Services provided by a fertility clinic often include:

• Fertility testing for you and your partner (if applicable)
• Genetic carrier screening for the intended parent(s)
• Testing and screening for your chosen egg donor (if applicable)
• Completing an IVF cycle - including either a donor egg retrieval or a retrieval from one intended parent
• Preimplantation genetic testing (PGT) of your embryos (an optional test that can screen for chromosomal abnormalities, the sex of each embryo, and other information)
• Gestational carrier (surrogate) medical screening
• Embryo transfer to your gestational carrier
• Remote or in-house monitoring of your carrier up to 10 weeks of pregnancy

Fertility clinics may also offer the following services:

• Storage of eggs, sperm, or frozen embryos until ready to be used
• Support groups and mental health counseling
• Comprehensive genetic counseling services
• Screening services for all parties to ensure all are mentally, physically, and emotionally prepared for this life-changing process

Note: Often times, prospective parents will find a fertility clinic first, as baseline fertility testing can be an easier introduction into family building. However, you can also start your journey by finding a reputable surrogacy agency.

The Role of a Surrogacy Agency

The experts at a surrogacy agency help coordinate your entire surrogacy journey to make it as easy as possible for you to navigate. They will provide most (or all) of the services needed to complete the surrogacy part of your family-building journey.

Common services offered by surrogacy agencies:

• Counseling services
• Matching services to find your gestational carrier (surrogate)
• Screening to ensure both you and your surrogate are mentally, physically, and emotionally ready to begin the surrogacy process
• Legal guidance, including executing surrogacy contracts and protecting the rights of both the surrogate and the intended parent(s)
• Coordination of information and services between the fertility clinic and the agency to ensure all steps are properly completed
• Nurturing the relationship between you and your gestational carrier

How to find the right fit:

Learn what to look for in a surrogacy agency to ensure the smoothest journey to parenthood with this guide from surrogacy expert Dr. Mark Leondires.

Do I have to use a surrogacy agency?

While many agency tasks may appear to be more administrative, they play a crucial role in your overall success. 

The United States may be a surrogacy-friendly country, but there are still a few states where compensated surrogacy is not yet legal. Making sure that your rights, your gestational carrier's rights, and the rights of your future child are protected is the primary job of your surrogacy agency and their legal team.

The common goal shared by all involved is to help you complete your journey to parenthood as efficiently and securely as possible. There are so many moving parts to surrogacy, and you don’t want to miss any critical steps of the process because you declined the help of an agency or legal representation.

Note: Many clinics will simply not move forward with intended parents trying to pursue surrogacy without the aid of a reproductive attorney or a surrogacy agency.

4 Reasons to Work with Both a Fertility Clinic & Surrogacy Agency

Now that we've explored the two distinct roles of a fertility clinic and a surrogacy agency, let's break down a few specific reasons why working with both parties can be so helpful.

1. Surrogacy is a complicated legal process

It is the surrogacy agency's responsibility to help you not only match with your gestational carrier but to also help negotiate the terms of your contract together. Surrogacy contracts cover everything from medical procedures to surrogate compensation to her relationship with you and your child after birth.

Depending on your citizenship, residence location, and the location of your surrogate’s home, the legal work related to your surrogacy journey may include a pre-birth order, a voluntary acknowledgement of paternity, a custody order, or even an adoption.

Note: Some surrogacy agencies don’t have legal counsel on staff. It is helpful to choose a "full service" agency with a legal team to take care of all of these matters efficiently.

2. Comprehensive surrogate screening is a two-way street

The clinical team at your fertility clinic (which will most likely consist of your doctor, an assigned nurse, and a patient navigator – along with other support staff) has a few very important jobs.

Before you are officially matched with a gestational carrier, your clinic will medically screen each candidate, even if she has already been accepted by the surrogacy agency. It’s a good idea to have two separate groups of professionals reviewing a potential gestational carrier's records to ensure nothing is overlooked or forgotten. 

Note: It is rare that a fertility clinic would disqualify a surrogate who had passed agency screening, but certain factors (such as high-risk pregnancy history or number of births/C-sections) are thoroughly reviewed by your physician and fertility clinic's staff.

3. Your chances of success increase with a good fertility clinic

Whether you have existing embryos at another facility and need to transfer them to a clinic in a surrogacy-friendly state or you’re starting from square one, choosing a fertility clinic you can trust is crucial, and can even impact your overall success with surrogacy.

Note: Many clinics have success rates posted online. You can also visit the Society for Assisted Reproductive Technology (SART), a neutral resource that reports clinic data.

A single surrogacy journey can take anywhere from 15 months to two years or more. You want to ensure that the relationship with your doctor and fertility clinic team will be supportive and positive in the long term. Make sure that you feel comfortable asking questions, communicating concerns, and feel genuinely taken care of during each interaction.

Your IVF doctor will be helping you through the process of choosing an egg donor, their egg retrieval, fertilizing eggs in the lab, genetically testing your embryos (if desired), and ultimately, transferring an embryo to your surrogate’s uterus. In other words, they will be your primary guide throughout the entire IVF process.

Success rates matter.

Find out how to understand the data behind the science of IVF and how it all factors into your own journey.

4. What happens after embryo transfer is important

After an embryo transfer, most gestational carriers will return home within the next few days. Oftentimes, they don’t live locally to the clinic where transfer was completed - intended parents, their surrogate, and the fertility clinic can often be located in different states.

Note: Your fertility specialist will order bloodwork and ultrasounds in your surrogate's local area to continue critical monitoring throughout early pregnancy. Once your surrogate is 8-10 weeks pregnant, they will transition all care to a local OB.

Over the next few months, and until your due date, your surrogacy agency will be responsible for helping to nurture your relationship and helping to complete any outstanding paperwork before your baby arrives. They will also help you to create a birth plan that everyone is comfortable with.

Give Yourself the Best Chances of Success

Although a fertility clinic and a surrogacy agency have different responsibilities, we all share one common goal – to help you have a healthy, happy family. While surrogacy may feel like a long, winding road, having the guidance of both a fertility clinic and a surrogacy agency can make the journey less stressful, more enjoyable, and more efficient.

In short, if you want to maximize your chances of surrogacy success and a healthy baby, opting to work with both an agency and a clinic is a great place to start!