Surrogacy agency vs a clinic-run surrogacy program

What does the clinic do and what does the agency do?

The fertility clinic performs the medicine. The surrogacy agency finds and prepares the people, and coordinates everything around the medicine. Independent professionals, two attorneys, a psychologist and an escrow agent, handle the parts that should not belong to either.

The clinic: medically screens the surrogate, creates embryos through IVF, prescribes and monitors medications, performs the embryo transfer, and follows the early pregnancy until it releases the surrogate to her own obstetrician. IVF and clinic fees are paid to the clinic, whichever model you use.

The agency: recruits and screens the surrogate, manages the match, coordinates legal, escrow, insurance and travel, and supports both sides for the 18 to 24 months a journey typically takes.

The two overlap most in the middle of the journey. After the match, legal and medical foundations take 1 to 2 months. The medical cycle takes 2 to 3 months, and the pregnancy test comes 9 to 11 days after transfer. The clinic runs the cycle; the agency keeps the contract, escrow, insurance and travel ready for it.

The table below shows who does each task. Clinic-run programs vary, so ask your clinic to fill in its own column.

Can a clinic match me with a surrogate?

Some can. A number of clinics run their own gestational carrier programs: they recruit candidates, screen them and introduce them to their patients. The advantages are real. Everything sits under one roof, and the program fee is usually lower than an agency fee.

Other clinics do not run a program. They expect you to arrive with a surrogate, found through an agency, a matching platform or your own circle.

If your clinic offers a program, ask:

1. How many screened surrogates are available today?
2. How are they recruited, and from which states?
3. Who handles the legal, escrow and insurance work after the match?
4. Who is my contact once the pregnancy is confirmed?

Pool size, wait time and screening depth at clinic programs

Pool size. Clinic programs tend to have small surrogate pools. A small pool can work well if your criteria are broad. If you need a surrogate in a particular state, or with particular views on medical decisions, a small pool can mean a long wait. Ask for the current number.

Wait time. At PLS, matching takes about 6 months. Measured from signing to surrogate introduction, the wait today is about 9 months, with a target of 6 or fewer. Ask a clinic program for its wait, measured the same way and dated.

Who manages your case. At many clinic programs, case management is done by clinical staff between patients. That is not a criticism of the staff. It is a question of time.

Screening depth. The clinic will medically screen any surrogate before transfer, in either model. Clinics screen gestational carriers to their own protocols, which generally follow American Society for Reproductive Medicine (ASRM) recommendations. Pending medical review. The difference is what happens before the clinic sees her.

At PLS, every candidate completes an application, interview, records review by Mark Silverberg, DDS, MD, background check, insurance review, psychological evaluation by an independent licensed professional, and clinic medical screening. Dr. Silverberg reads her prenatal and delivery records himself and writes a physician medical summary that goes to your clinic. Your clinic starts with a reviewed file, not a stack of records. PLS works with 14 partner fertility centers.

To apply, a PLS surrogate must be 21 to 43, a US citizen or permanent resident, with a BMI under 33, at least one healthy full-term pregnancy, and currently parenting. She must not smoke or receive government assistance, must not be taking antidepressants, and must have a stable home.

Who handles legal, escrow, insurance and travel in each model?

In a clinic-run program, the clinic usually handles the medicine and the match. The rest falls to you, working with the professionals you hire.

• Legal. You and the surrogate each need your own attorney to draft and negotiate the gestational carrier agreement. Illinois's Equality for Every Family Act, signed in December 2025, requires independent counsel for both sides, and the Illinois Gestational Surrogacy Act provides for pre-birth parentage. Statute details pending review by counsel.
• Escrow. Surrogate compensation and expenses should sit with an independent licensed escrow agent. At PLS, you fund escrow with $10,000 at match and the balance before medications start, and you may choose your own escrow company.
• Insurance. Someone has to read the surrogate's health plan to see whether it excludes surrogacy. If it does, a separate policy costs $5,000 to $40,000.
• Travel and monitoring. Trips to the clinic for screening and transfer, and local monitoring near the surrogate's home.

With an agency, the case manager coordinates each of these, and the attorneys, psychologist and escrow agent stay independent. PLS does not employ any of them, on purpose. For clinics in the state, see Illinois fertility clinics.

Cost comparison: agency fee vs clinic program fee

A clinic program fee is usually lower than an agency fee. Ask the clinic for its figure in writing, with what it includes.

Most of the cost of a journey is the same in either model:

• Surrogate compensation. At PLS, the typical total package is roughly $68,000 to $78,000, including first-time base compensation of $60,000 (proposed). Confirm with Nancy.
• Legal, escrow, psychological evaluation, background check, insurance review, travel and monitoring: $15,300 to $29,000 at PLS.
• A surrogate health policy, if needed: $5,000 to $40,000.
• IVF and clinic cycle fees, paid to the clinic.

The PLS program fee is $35,000, paid $15,000 at signing, $15,000 at surrogate acceptance and $5,000 at medical clearance. Program fee: confirm current schedule. A whole journey typically costs $150,000 to $200,000. For the itemized breakdown, see surrogacy cost.

When a clinic-run program is enough

A clinic program may be all you need if:

• The clinic has a screened surrogate available who fits your criteria.
• You are comfortable coordinating legal, escrow and insurance yourself, or through your attorney.
• You live near the clinic, or travel is simple for you and the surrogate.
• You want one medical team to run everything it can.

If those are true, the lower program fee is a fair trade.

When you need an agency, and what Cycle Management covers

You likely need an agency if you do not have a surrogate and your clinic cannot match you, if your criteria are narrow, or if you are coordinating from abroad. Jan Telman Berman, PLS's Global Surrogacy Coordinator, manages national and international cycles.

There is a middle path. If your clinic found you a surrogate, or you found one yourself, PLS's Cycle Management handles the agency work without the matching fee:

• Screening review, including records review by Dr. Silverberg.
• Contract coordination with independent attorneys for each side.
• Escrow setup with an independent licensed escrow agent.
• Insurance review.
• Journey management through birth.

The proposed Cycle Management fee is $15,000, or $12,500 for military families. Confirm pricing and scope with Nancy.

If you are also weighing an online matching service, read agency vs matching platform. To see which model fits your plans, plan my journey.

Sources

• American Society for Reproductive Medicine (ASRM), recommendations for gestational carrier evaluation.
• Illinois Gestational Surrogacy Act (2005) and Equality for Every Family Act (2025), Illinois General Assembly. Pending review by counsel.
• Private Label Surrogacy fee schedule, compensation schedule and screening process.