Surrogacy in the US – absolutely everything there is to know

Jessie Day, in partnership with Pinnacle Surrogacy  |   8 Feb 2024

For US surrogacy experts Pinnacle Surrogacy, the direction is clear. Fulfilling dreams by building families, working with intended parents and gestational carriers to find a clear pathway. 

Surrogacy, in essence, is very simple. But anyone who’s walked this route knows that practically speaking, it can be anything but. We’ve teamed up with Pinnacle Surrogacy to deep-dive your most googled questions about surrogacy in the US, covering: 

  • how it works, step-by-step (with a handy video covering the process)
  • which states make it legal 
  • the IVF aspect
  • DNA questions
  • bonding and childhood
  • and, how to become a surrogate – if you’re here for that info 

Keen to connect with Pinnacle Surrogacy? Whether you’re looking to become a surrogate or find a surrogate, their expert team are on-hand to support your (incredible) journey, and get things moving. Every coordinator is a previous surrogate, so you’re in the most experienced and empathetic hands, at every stage. 

Back to your questions, here’s what people tend to want to know in the research phase, plus a section covering how to get started, if you’re looking to become a surrogate. 

Whichever group you fall into, just wow. You are amazing, and we’re so excited to be at the very beginning of your planning. 

Over to Amber Danley, Program Manager at Pinnacle Surrogacy.

Hi Amber, can you tell us about Pinnacle Surrogacy, and the work you do?

Absolutely. Pinnacle Surrogacy is a distinguished program offering expedited surrogate matching to Pinnacle network patients. We pride ourselves on working with high-quality surrogates and providing exceptional support services to both surrogates and intended parents.

All our surrogacy coordinators are previous surrogates, offering an unparalleled level of knowledge, expertise, and support to both our surrogates and intended parents, throughout their entire journey.


Can you help us with the definitions?

Yes – and there are quite a few, when we’re talking about different types of surrogacy! Here are a few of the most common, and the groups they fall into: 

Biological categorization

Gestational surrogacy – this is where the surrogate is not biologically related to the child she carries and delivers for another person or couple. In this case, you (as the intended parent) may be using your own eggs, or eggs from a different donor.

Traditional surrogacy – where the surrogate carries and delivers using her own eggs for another person or couple, making her biologically related.

Financial categorization

Altruistic surrogacy – where the surrogate doesn’t receive monetary compensation for her services, apart from (on a case-by-case basis) her medical expenses 

Commercial surrogacy – in this case, the surrogate is compensated for her services beyond reimbursement for her medical expenses 

How long does the surrogacy process take?

Typically in the US, a surrogacy journey – from agency research and matching with your surrogate to bringing your baby home – can take at least 18 to 36 months. The process will usually involve: 

  • researching and choosing which agency or professionals to work with on your journey 
  • surrogate matching 
  • creating your embryo(s)
  • medical and legal clearance
  • IVF and embryo transfer
  • a two week wait, and pregnancy confirmation
  • repeat embryo transfers (if necessary)
  • pregnancy itself
  • birth and delivery
  • hospital administration, plus sorting out birth certificate and passport 

That’s the ‘textbook’ list. With Pinnacle Surrogacy, however, you skip a lot of the initial to-and-fro, because we can match you as the intended parent(s) – IPs for short! – with a surrogate who has already completed the medical and psychological clearance process. 

Matching with a surrogate usually happens immediately, unless you’re looking for a very specific match point. 

If you’re a match, the surrogate is prepared to start as soon as you’re ready, reducing time, effort and risk of disappointment, if clearance stalls or falls through. And, we offer a world-class all-inclusive service – including IVF, egg donation and surrogacy – helping to streamline your journey. 

Are you looking to become a surrogate? The screening process for this typically takes around two months – touch base with our team for all the details on starting a surrogacy journey.

Whose egg is used in surrogacy?

In gestational surrogacy, the egg is either from: 

  • the intended parent (IP), or 
  • an egg donor

So, there’s no genetic connection, and we often refer to this type of surrogate as a ‘gestational carrier’. 

Keep in mind, Pinnacle Surrogacy – and the majority of surrogacy services in the US – only offer gestational surrogacy.

Does a surrogate share DNA with the baby? 

No, in gestational surrogacy (the most common type), the surrogate does not share DNA with the baby. The baby’s DNA is from the intended mother (IM) or an egg donor, and the baby’s father or a sperm donor.

How much does surrogacy cost?

The cost just for surrogacy (not including creating embryos or obtaining an egg donor) sits in the region of $150-200K, in 2024. 


Where is surrogacy legal in the US?

Currently, in all states except Michigan, Louisiana and Nebraska. 

At Pinnacle Surrogacy, whether you’re an IP or surrogate, you can choose to work with an agency within our network anywhere in the US – you’re not limited by location. The most important aspect is ensuring it’s the right fit for you. 

For more information on surrogacy state-by-state and location, take a look at our Laws and Guidelines hub.  

What should we know about the surrogacy legal process, state-by-state?

This depends on a multitude of factors – each state in the US has its own set of laws and determines what type of parents are able to match. 

We follow guidelines set by an expert legal team to ensure we understand what’s required legally, for each and every match. And, we never work in a state where a parent would need to adopt their child at the end of the process.

Our Laws and Guidelines hub provides lots of specifics on this, so head there for a full read-through and how the process works, in your state or chosen location. From Alabama to Wyoming, it’s all there – plus, we’re on hand to answer any specific questions you may have. 

From birth and into childhood, what support is available for me and my baby? 

So many parents ask us, as part of this process, how does surrogacy affect the child they’ll bring home, once the journey is complete. 

In almost every case, we see that families who are open with each other about the incredible process of surrogacy – and the journey they’ve all been on – thrive best, and are able to support a child born through surrogacy in building a strong sense of identity. The decision is, of course, yours to make as parent(s). 

To read up, the Centre for Family Research (University of Cambridge) provides world class research and innovation on this topic, focusing on our understanding of children, parents and family relationships. Search ‘surrogacy’, and read through their outstanding library. 

The team at Pinnacle Surrogacy are set up with expert resources, signposting and contacts, to support families and surrogates in whatever way they need, once the child is born. 

Most surrogates are open to contact with families well into childhood, if that’s something you’d like. And, many families we work with still contact us throughout the years, as their children grow.

How to become a surrogate

If you’re looking to become a surrogate – we’ll refer to ‘gestational carrier’, as that’s the type of surrogacy work we support with – you’re already one step into one of the most selfless decisions a woman can make. This really is an incredible journey, and if you’re keen to get started, we’re here to help at every step. 

Our Become a surrogate hub is packed with information. First things first, why not watch our video covering the process, and interview with Audra, a Pinnacle surrogate, talking through her real-life experiences? 

From there, here are a few of the core requirements you’ll need to meet, as a potential surrogate: 

  • age – you’ll need to be aged under 40
  • citizenship – you’ll need to be a US citizen or permanent resident 
  • state legality – surrogacy must be legal in the state you’re living in 
  • health – mental and physical, get ready for those screenings
  • birth history – you’ll need to have given birth to and raised at least one child

This is just a very initial outline – the application and process is much more involved! We are here to support, however, and are super-excited to meet you. 

On your to-do list

For intended parents, head to Pinnacle Surrogacy for an initial chat, and to get the ball rolling. There’s also a really handy online chat tool, for all your quick-fire questions, and a location tool to find a clinic and set-up which works for you. 

And, if you’re looking to become a surrogate, skip to Pinnacle Surrogacy’s support hub. You’ll find the application right up top, plus lots of information on the screening process, and more. 

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