Agency surrogacy or independent surrogacy: what is the difference?

What does an agency do that you would otherwise do yourself?

In agency surrogacy, the agency recruits and screens the surrogate, runs matching, and coordinates everyone else involved through the birth. In independent surrogacy, you do those jobs yourself, or hire each professional one by one.

Here is the work, in the order it happens:

1. Finding a surrogate. An agency recruits candidates. Independently, you find someone yourself: a friend, a relative, or someone you meet online.
2. Screening. An agency checks eligibility, collects and reviews medical records, runs background checks, reviews her insurance and arranges the psychological evaluation before you meet. Independently, you arrange each of these.
3. Matching. An agency introduces you to a surrogate whose expectations fit yours, on termination, selective reduction, number of embryos transferred, contact during and after the pregnancy. Independently, you have those conversations without a go-between.
4. Legal and escrow set-up. Both paths need two independent attorneys and an escrow account. An agency refers and coordinates; independently, you find and brief them.
5. Clinic coordination. Travel to your clinic, local monitoring near the surrogate's home, the medication calendar, the transfer date.
6. Pregnancy and birth. Payments, insurance claims, the hospital plan, the parentage filing, and the calls that come at night.

At Private Label Surrogacy, that coordination is done by people with names: Nancy Block, RN, runs matching; two case managers, both former surrogates, carry the active matches; Jan Telman Berman, Global Surrogacy Coordinator, manages national and international cycles; and an after-hours team answers urgent calls.

What does independent surrogacy actually save?

The agency fee, and nothing else. Every other cost applies to both paths: the surrogate's compensation package, attorneys for both sides, escrow administration, the psychological evaluation, background checks, insurance review, travel, monitoring, a surrogate health policy if her plan excludes surrogacy, and IVF and clinic fees.

The agency fee is typically $25,000 to $60,000. At PLS, the program fee is $47,500. Third-party costs at PLS total $15,300 to $29,000, and a surrogate health policy, if needed, costs $5,000 to $40,000. Those last two you pay either way.

Independent surrogacy can also cost more than expected. If a surrogate you found yourself fails clinic screening after you have paid for legal work, travel and testing, those costs are spent and you start again. The agency's screening is, in part, insurance against that.

What are the risks of independent matching, and how often do they occur?

There is no published data on how often independent journeys run into trouble. What follows is what PLS sees in its own work, including the cycle management journeys described below. It is observation, not a statistic.

The problems that come up most often:

• A surrogate who fails clinic screening after money is spent. She seemed ready, but her medical history, her BMI, or a prior pregnancy complication rules her out once the clinic looks closely.
• Payment disputes without escrow. When compensation is paid directly, informally, or late, a good relationship can sour fast. Escrow with a written payment schedule prevents most of these.
• Mismatched expectations. Two people who like each other may never have discussed termination, reduction, or contact after birth until it matters.
• No one coordinating. The clinic, both attorneys, the escrow agent, the insurer and the hospital each handle their own piece. Without a coordinator, the gaps between them fall to you.
• Relationship strain with a friend or relative. Money and medical decisions change relationships. Independent counsel and a third party to carry the hard messages help.

None of these is inevitable. Each is avoidable with screening, escrow, counsel and someone whose job is coordination.

What stays the same in both paths: contracts, escrow, screening, clinic

The legal and medical requirements do not depend on whether an agency is involved.

• Contracts. You need a gestational carrier agreement drafted and negotiated by two independent attorneys, one for you and one for the surrogate. You pay for both. In Illinois, the Gestational Surrogacy Act requires independent counsel for both sides for the agreement to be enforceable.
• Escrow. Surrogate compensation and expenses should sit with an independent licensed escrow agent, not with you, the surrogate, or anyone else's account. At PLS, parents fund escrow with $10,000 at match and the balance before medications start. See how escrow works.
• Screening. Your clinic will screen the surrogate medically. A psychological evaluation by an independent licensed professional is standard practice. Background checks and an insurance review protect both of you.
• Clinic. IVF, embryo transfer and early pregnancy monitoring run the same way.

When does independent surrogacy make sense?

Independent surrogacy works best when:

• You already know your surrogate well, and she meets the medical criteria your clinic uses.
• She has carried a healthy full-term pregnancy and is currently raising a child.
• Both of you are prepared to have direct conversations about compensation, medical decisions and contact.
• You have time to coordinate attorneys, escrow, insurance, travel and the hospital yourself.
• You are comfortable being the person who handles problems when they come up.

If several of those are not true, independent surrogacy may cost you in time and stress what it saves in fees.

What is cycle management, and who is it for?

Cycle management is PLS's middle path. You bring your own surrogate. PLS screens her and coordinates the journey, so you keep the relationship you already have without doing the coordination alone.

What it includes:

• Screening through the same steps every PLS surrogate completes: application, interview, records review by Mark Silverberg, DDS, MD, background check, insurance review, psychological evaluation by an independent licensed professional, and clinic medical screening.
• Escrow and counsel set-up, with referrals to independent attorneys and an independent licensed escrow agent.
• Cycle coordination with your clinic, the surrogate's local monitoring and travel.
• Management through birth, including the hospital plan and support for the surrogate.

The cycle management fee is $15,000, or $12,500 for active-duty military. See cycle management with your own surrogate.

How do you decide?

Start with three questions:

1. Do you have a surrogate already? If not, you need someone to find one. That is agency surrogacy.
2. If you do, has she been screened? If not, screening comes before anything else, independent or not. A surrogate who does not pass screening is better found out early.
3. Who will coordinate? If you have the time, the experience and the stomach for it, you can. If not, cycle management gives you coordination without the full agency fee.

Whichever path you choose, insist on the parts that do not change: independent attorneys for each side, independent licensed escrow, a psychological evaluation by an independent professional, and a signed agreement before any medication starts.

If you are weighing agencies, see how to choose a surrogacy agency. If you have a surrogate and want to talk through cycle management, book a consultation with Jan.

Sources

• Illinois Gestational Surrogacy Act (2005), Illinois General Assembly. Pending review by counsel.
• SEEDS, Society for Ethics in Egg Donation and Surrogacy.
• Private Label Surrogacy fee schedule and screening process; PLS observation of independent and cycle management journeys.