The Role of a Surrogacy Agency

Last reviewed: August 2026. A surrogacy agency can coordinate many parts of a gestational-surrogacy journey, but it does not replace the fertility clinic, independent attorneys, mental-health professionals, insurance specialists or escrow provider. Services and fee structures vary significantly, so intended parents and prospective surrogates should confirm exactly what an agency does before signing.

What can a surrogacy agency do?

• Recruit and preliminarily screen prospective gestational carriers.
• Facilitate matching and match conversations.
• Coordinate records and communication among the parties and professionals.
• Refer clients to fertility clinics, reproductive-law attorneys, mental-health professionals, insurance specialists and escrow services.
• Help track milestones before transfer and during pregnancy.
• Provide practical and emotional support according to the agency's program.

Agency screening is not final medical clearance

An agency may review a candidate's application and pregnancy records, but the treating fertility clinic makes the medical-eligibility decision for embryo transfer. Psychological evaluation and legal review are also separate professional functions.

Insurance and financial coordination

An agency may coordinate an insurance review or refer the parties to a specialist, but coverage should be verified by qualified insurance professionals. Surrogacy exclusions, deductibles, maternity coverage and newborn coverage can create substantial costs. Compensation and expense funds should be handled according to the contract and applicable law, commonly through an independent escrow arrangement.

Does an agency provide legal advice?

The agency itself should not substitute for independent legal representation. Intended parents and the gestational carrier have different interests and should have their own qualified reproductive-law counsel where appropriate. Legal requirements vary by state.

Do you have to use an agency?

Not every journey uses a full-service agency. Independent surrogacy can be possible in some circumstances, including arrangements where the parties already know each other. But “independent” does not mean doing without medical screening, psychological support, independent legal counsel, insurance analysis, escrow and professional coordination.

Questions to ask before choosing an agency

• What exactly is included in the agency fee?
• When are fees earned, refundable or nonrefundable?
• What happens if a match fails medical screening?
• Are rematches included and under what conditions?
• How are intended parents and surrogates screened?
• Who performs insurance review?
• How are compensation and expenses held and paid?
• What support continues after contracts, transfer and delivery?
• What happens if the agency relationship ends before the journey is complete?

Bottom line

A strong agency can reduce the coordination burden and provide continuity throughout a complex journey, but its role has limits. Compare written services, fees, screening practices, rematch policies and support—and independently verify medical, legal, insurance and financial issues before committing.

This article provides general educational information and is not medical, legal, insurance or financial advice.