How is gestational surrogacy defined?
Gestational surrogacy is an arrangement in which a woman carries and delivers a child for intended parents, using an embryo created by in vitro fertilization (IVF). The egg comes from the intended mother or an egg donor. The sperm comes from the intended father or a sperm donor. The woman who carries the pregnancy is called the gestational surrogate, or in medical settings the gestational carrier.
The defining fact is genetic. The surrogate's own egg is never used, so she has no genetic relationship to the child. She provides the pregnancy: her uterus, her care, nine months of her time. The child's genetics come from the people whose egg and sperm made the embryo.
Three terms you will see used for the same person:
- Gestational surrogate. The common term, and the one Private Label Surrogacy (PLS) uses with families.
- Gestational carrier (GC). The term clinics, ASRM guidance and most contracts use.
- Surrogate. The everyday shorthand.
The contract between the two sides is called the gestational carrier agreement. The people who will raise the child are the intended parents.
Gestational vs traditional surrogacy: what is the difference?
In traditional surrogacy, the surrogate's own egg is fertilized, usually by insemination with the intended father's or a donor's sperm. She is the genetic mother of the child she carries. In gestational surrogacy, she is not.
That single difference changes the legal, medical and emotional picture. When the surrogate is the genetic mother, parentage is harder to settle, and the arrangement carries more risk for everyone. For that reason most US agencies and clinics no longer offer traditional surrogacy. PLS arranges gestational surrogacy only.
| Gestational surrogacy | Traditional surrogacy | |
|---|---|---|
| Egg source | Intended mother or egg donor | The surrogate |
| Genetic link to the surrogate | None | She is the genetic mother |
| How pregnancy starts | Embryo transfer after IVF, at a fertility clinic | Usually insemination |
| Legal status in Illinois | Enforceable under the Illinois Gestational Surrogacy Act (2005) when its requirements are met | Not covered by the Act, so parentage is not automatic |
| Clinic acceptance | Standard at US fertility clinics | Most US agencies and clinics no longer offer it |
| Typical cost | Intended parents typically budget $150,000 to $200,000 for the whole journey | No PLS figure; PLS does not arrange it |
| PLS offers it | Yes | No |
If you have read about a surrogate "keeping the baby," the case almost always involved traditional surrogacy, where the surrogate was also the genetic mother. In a gestational journey with a compliant agreement, the intended parents are the legal parents.
Who uses gestational surrogacy and why?
Intended parents come to gestational surrogacy for medical reasons and for reasons of family structure. Common situations include:
- No uterus, or a uterus that cannot carry a pregnancy. For example after a hysterectomy, or with a congenital absence of the uterus, or with significant uterine scarring.
- A health condition that makes pregnancy dangerous. Some heart, kidney and autoimmune conditions, and some cancer treatments, fall in this group. The intended mother may still be able to provide eggs.
- Repeated IVF failure or recurrent pregnancy loss where the clinic suspects a uterine factor.
- Two fathers or a single father. Embryos are created with donor eggs and the father's or fathers' sperm.
- Parents with frozen embryos from earlier IVF who can no longer carry.
PLS serves intended parents across the United States and abroad, including single parents, married and unmarried couples, and LGBTQ+ parents. Your reproductive endocrinologist confirms the medical reason. PLS does not require one to start a consultation, but your clinic will document why a gestational carrier is needed.
Who is involved: parents, surrogate, clinic, attorneys, escrow, agency
Six parties take part in a gestational surrogacy journey. Each has a separate job.
- Intended parents. You set your criteria, choose your clinic and attorney, fund the journey and become the legal parents.
- The surrogate. A screened woman who has carried at least one healthy full-term pregnancy and is raising a child now. She is a partner in the journey. She has her own criteria, her own attorney and her own say in the decisions that affect her body.
- The fertility clinic. It creates and stores the embryos, screens the surrogate medically, manages her medications and performs the embryo transfer. PLS works with 14 partner fertility centers, including Kindbody, Shady Grove Fertility, Fertility Centers of Illinois and Oregon Reproductive Medicine. You can also use your own clinic.
- Two attorneys. One for you and one for the surrogate. They write the gestational carrier agreement and handle parentage.
- An escrow agent. An independent licensed escrow agent holds the journey's money and pays the surrogate and third parties under the agreement.
- The agency. PLS recruits and screens surrogates, runs matching, and coordinates everyone through birth.
PLS does not employ in-house attorneys, psychologists or escrow staff. It refers you to independent licensed professionals on purpose, so that each one works for the person they were hired to protect. You fund an independent escrow account with $10,000 at match and the balance before medications start, and you may choose your own escrow company. Read how independent escrow protects both sides.
For how these parties work together stage by stage, see how the surrogacy process works.
Is gestational surrogacy legal in the United States?
There is no single federal surrogacy law. Each state sets its own rules, and they differ. Some states have statutes that make compensated gestational surrogacy agreements enforceable and allow parentage to be established before birth. Others handle it through court decisions, and a few restrict it.
Illinois is one of the clearest states. Under the Illinois Gestational Surrogacy Act (2005), compensated gestational surrogacy agreements are enforceable and intended parents can be named as legal parents before birth, when the Act's requirements are met. The Equality for Every Family Act, signed December 2025, removed the requirement that at least one intended parent be genetically related to the child and requires independent counsel for both sides. Statute citation and details reviewed by counsel.
Michigan legalized compensated surrogacy in April 2025. New York licenses surrogacy agencies; PLS is applying. Reviewed by counsel.
PLS recruits surrogates in surrogacy-friendly US states. The law of the state where the surrogate lives and delivers generally governs the journey, so your attorney works in her state.
International parents face one more layer: the baby's travel documents and home-country citizenship. A federal executive order dated August 6, 2026, on citizenship for children born through compensated surrogacy to two non-citizen parents is under litigation. Status as of [date], reviewed by counsel.
What does a gestational surrogate have to qualify for?
At PLS a surrogate must be:
- 21 to 43 years old
- A US citizen or permanent resident
- At a BMI under 33
- A mother who has had at least one healthy full-term pregnancy and is parenting now
- A non-smoker
- Not receiving government assistance
- Living in a stable home
- Not currently taking antidepressants
Meeting the criteria is the start. Screening has seven steps: application, interview, a records review by Mark Silverberg, DDS, MD, a background check, an insurance review, a psychological evaluation by an independent licensed professional, and the fertility clinic's own medical screening after match.
Dr. Silverberg reads every candidate's prenatal and delivery records and writes a physician medical summary that goes to the intended parents' fertility clinic. The agency agreement defines this as review by a board-certified physician. The clinic's screening follows ASRM guidance for gestational carriers. See how a surrogate is medically screened.
What does gestational surrogacy cost?
Intended parents typically budget $150,000 to $200,000 for the whole journey. The money goes to several parties:
- The PLS program fee. $35,000 on the current schedule; $42,000 proposed for new agreements. Program fee: confirm current schedule.
- The surrogate's compensation package. A typical total package of roughly $68,000 to $78,000, including base compensation of $60,000 for a first-time surrogate (proposed, up from $55,000) or $65,000 to $70,000 for an experienced surrogate, plus allowances and milestone payments. Figures confirm with Nancy.
- Third-party costs. $15,300 to $29,000 for attorneys, escrow, the psychological evaluation, background checks, insurance review, travel and local monitoring.
- Surrogate health insurance, if her plan excludes surrogacy. $5,000 to $40,000.
- IVF and clinic fees, paid directly to your clinic.
Before clinic fees and any new insurance policy, the itemized total is about $112,000 to $127,000. Surrogate compensation and third-party costs are paid through independent escrow, so you can see every payment.
Sources
- ASRM (American Society for Reproductive Medicine), guidance on gestational carriers. https://www.asrm.org
- Illinois Gestational Surrogacy Act (2005), Illinois General Assembly. Pending review by counsel.
- Equality for Every Family Act, signed December 2025, Illinois General Assembly. Pending review by counsel.
- SEEDS, Society for Ethics in Egg Donation and Surrogacy, of which Nancy Block, RN, is a former President.