What defines a boutique agency?
A boutique surrogacy agency is a small agency, typically under 10 staff, with three features:
- A named senior person runs matching. Often the founder. You know who is reading your criteria and choosing which surrogate to present.
- Each case manager carries a capped number of journeys. The cap is a number, not a promise, and you can ask for it.
- One team, not departments. The person who did your intake still knows your file at delivery.
A large agency runs hundreds of journeys a year. It is organized by department: intake, matching, case management, finance, often in different offices. It has a larger pool of surrogates and may recruit across more states.
Neither model is better for every family. The choice is a trade-off between reach and attention. This page sets out what each does well, where size matters and where it does not, so you can decide which fits you.
| Boutique agency | Large agency | |
|---|---|---|
| Who matches you | A named senior person, often the founder | A matching department or coordinator |
| Case manager continuity | Usually one case manager from match to birth | Can change as staff and departments change |
| Caseload per manager | Capped, and disclosed if you ask | Often higher; ask for the number |
| Surrogate pool size | Smaller | Larger |
| Locations | Fewer surrogacy-friendly states | More states, sometimes more offices |
| After-hours access | Direct line to the team that knows your file | Varies; ask who answers and whether they know your file |
| Pricing | Fees overlap with large agencies | Fees overlap with boutique agencies |
| Escalation path | One or two steps to the founder | Several layers to a decision-maker |
What do large agencies do better?
Reach. Large agencies have advantages that come from scale, and they are worth naming plainly.
- A larger surrogate pool. More screened surrogates at any time means more possible matches for specific criteria, such as a particular state or a narrow window.
- More locations. Some recruit across many states and have staff in several regions.
- Depth in departments. A large agency may have dedicated staff for insurance, travel or international documents.
- Volume experience. An agency running hundreds of journeys a year has seen many unusual situations.
If your criteria are narrow, or you need a surrogate in one specific state, a larger pool can help.
What do boutique agencies do better?
Attention. The advantages come from fewer people doing more of the work for fewer families.
- Direct access to decision-makers. You can reach the person who matched you, and that person can make a decision.
- Consistency. One case manager carries your match from introduction to birth and knows your surrogate.
- Faster escalation. When something goes wrong at 11 p.m., the person who answers knows your file.
- Surrogates treated as partners. A small team gets to know each surrogate: her preferences, her family and her goals.
Boutique is not automatically cheaper. Fees overlap. The difference is in who does the work and how many families each person serves.
Does size affect wait time?
Sometimes, in both directions.
A larger pool can mean more profiles to choose from. It does not guarantee a faster match, because a large agency also has more families waiting. A boutique agency has a smaller pool and fewer families. If your criteria are flexible, the wait can be similar.
Private Label Surrogacy (PLS) publishes its numbers. Today it takes about 9 months from signing to surrogate introduction, with a target of 6 or fewer. Matching itself averages about 6 months. The whole journey typically runs 18 to 24 months.
Ask every agency the same question: how long from signing to introduction, measured over the past year? Compare like with like. See surrogacy agency wait times.
Does size affect safety? What the 2024 to 2026 failures showed
Not in the way you might expect. What protected families was where the money was held, not how big the agency was.
In late 2025 the Surro Connections agency collapsed. A federal indictment followed in August 2026. The SEAM escrow collapse involved more than $16 million. Both failures turned on the same question: who held the money, and whom did they answer to?
Agency size did not protect clients in these collapses. What does protect you, at any size:
- Independent licensed escrow. Your money is held by a licensed escrow agent, not by the agency. You may choose your own escrow company.
- Independent professionals. Attorneys, psychologists and escrow agents who answer to their own clients, not to the agency.
- Written, published standards you can read and hold the agency to.
PLS has always used independent licensed escrow. In 2025 and 2026 it took on three surrogates, pro bono, who were stranded when their agencies failed. See how escrow works.
The escrow and screening standards should be the same at any size. If an agency of any size cannot show you independent escrow, keep looking.
How does PLS operate as a boutique agency?
PLS is a small team in Northbrook, Illinois, serving intended parents across the US and abroad. The core team is six people. Confirm headcount.
- Matching. Nancy Block, RN, the founder, runs matching personally. She has made more than 2,500 matches across her career. See how matching works.
- Case management. Two case managers carry the active matches: Natalie Gaudio-Fricano and Jenni Symons. Both have carried as gestational surrogates themselves.
- Medical review. Mark Silverberg, DDS, MD, Executive Director, reads every surrogate candidate's prenatal and delivery records and writes a physician medical summary for your clinic.
- Coordination. Jan Telman Berman, Global Surrogacy Coordinator, manages national and international cycles. Jo Ann Levitan, Director of Operations, runs operations.
- Nutrition. Julie Bendix, MPH, RD, LD, CLC, a registered dietitian and lactation counselor, provides at least six nutrition consults per surrogate.
- A capped caseload. Each case manager carries no more than [CAP] active matches. Confirm the caseload cap figure.
- After hours. One night, the after-hours team rebooked a stranded surrogate's hotel, car and flight while another PLS surrogate delivered twins.
PLS does not employ in-house psychologists, attorneys or escrow. It refers to independent licensed professionals on purpose, to avoid conflicts of interest.
The trade-off applies here too. PLS has a smaller surrogate pool than a large agency. What you get in exchange is the founder choosing your match and a case manager who has been a surrogate herself. See why a nurse-led agency matters.
Questions that expose the difference in a consultation
Ask these of any agency, large or small. The answers tell you more than the website.
- Who will match us, by name? And how many matches has that person made?
- Who will be our case manager, and how many active journeys does she carry? Ask for a number.
- Will the same case manager stay with us from match to birth?
- Who answers the phone at night or on a weekend?
- Where is our money held? Ask for the escrow company's name and license.
- Who reads the surrogate's medical records? A coordinator, a nurse or a physician?
- Do you employ the attorneys or psychologists you refer us to? Do you take referral fees?
- How long from signing to introduction, measured over the past year?
- If something goes wrong, how many steps is it to the founder?
For a fuller list, see how to choose a surrogacy agency.
Sources
- SEEDS, Society for Ethics in Egg Donation and Surrogacy, of which Nancy Block, RN, is a former President.
- ASRM (American Society for Reproductive Medicine), guidance on gestational carriers. https://www.asrm.org