To compare surrogacy agencies as a surrogate, look at five things: how thoroughly the agency screens, who supports you day to day, how clearly it puts every payment and fee in writing, how it handles escrow, and whether it respects your right to your own attorney. No agency is right for every surrogate. A good fit for you depends on how much contact you want, how much you are comfortable managing yourself, and how the agency behaves when something goes wrong. You can check every one of these before you sign anything.
You may be reading this privately, before you have told a partner or family. That is a sensible order to do things in. A surrogacy commitment usually runs a year or more from application to delivery, and the agency you choose shapes much of that year. This guide gives you criteria you can apply yourself rather than a ranking.
A note on how this site works. Surrogate Compass is an independent educational and matching platform. We help you understand your options and can connect you with agencies. We are not an agency: agencies screen, match, contract and pay. Surrogate Compass may be compensated by partner agencies when we connect a candidate with them. That is why this page offers a method, not a list of names.
What Surrogacy Agencies Actually Do, and What They Don't
Three separate organisations usually take part in a surrogacy, and first-time researchers often blur them together.
The agency coordinates. It screens surrogates, matches you with intended parents, manages the case, and keeps everyone on schedule. It does not perform medical procedures and it does not represent you legally.
The fertility clinic does the medical work: IVF, embryo transfer, and early pregnancy monitoring. The clinic runs its own medical evaluation of you, separate from the agency's.
The reproductive attorney handles the legal work: the surrogacy agreement and, in states that use them, the court orders establishing the intended parents' parentage.
An agency's job is to coordinate the work of three groups: you, the intended parents, and the medical and legal teams. Agency involvement typically runs from initial screening through delivery and the post-birth legal steps, but the scope varies by agency. Some stay closely involved after birth. Others close the file at delivery.
Different structures suit different situations. An agency that does a lot is not automatically better than one that does less, as long as you know exactly what you are getting.
The Main Agency Models: Full-Service, Boutique, and Matching-Only
Before you weigh any single agency, it helps to know which kind you are looking at. The labels are informal and agencies use them loosely, so ask what each one actually includes.
Full-service agencies handle screening, matching, case management, escrow coordination, and ongoing support through the pregnancy. You have one organisation coordinating most moving parts. These agencies are often larger, which can mean a larger pool of intended parents. Ask how many surrogates each case manager carries.
Boutique agencies run smaller caseloads and tend to offer more individual contact, often with a single case manager from start to finish. The usual tradeoff is a smaller pool of intended parents and, potentially, a longer wait to match.
Matching-only or low-service agencies introduce surrogates and intended parents but offer limited coordination afterwards. Their agency fees are typically lower, which is a cost on the intended parents' side, and you take on more of the logistics yourself: scheduling, chasing paperwork, keeping track of payments.
Independent or self-matched arrangements, with no agency at all, also exist. They carry a different risk profile and are outside the scope of this page. The broader guide to choosing a surrogacy agency covers how they compare.
Which model fits depends on you. A surrogate who wants one consistent contact may lean towards a boutique programme. One who values a larger matching pool may look at full-service agencies. One who is experienced and organised may be comfortable with less coordination.
Screening: What Agencies Check and How Thoroughly
Screening protects you as much as it protects the intended parents. An agency that screens carefully is also more likely to screen the intended parents carefully, and that affects the match you end up in.
Surrogate screening commonly includes:
- A medical history review
- A review of your OB and delivery records
- A psychological evaluation
- A background check, often covering adults in your household
- A home study or home visit
- A review of your financial stability
Standards differ. Some agencies align their screening with guidance from the American Society for Reproductive Medicine (ASRM), the professional body whose recommendations clinics use when evaluating gestational carriers. Others set their own criteria. Eligibility thresholds such as age, BMI and number of prior deliveries also vary by agency and clinic, and a physician reviewing your records makes the medical decision. A woman who misses one agency's cutoff may still meet another's.
Questions you can ask:
- Who conducts the psychological evaluation: an in-house counselor or an independent licensed professional?
- Which background check provider do you use?
- Is the home study conducted by a licensed social worker?
- How do you screen intended parents?
Passing agency screening is not medical clearance. The fertility clinic runs its own independent medical evaluation, and its physician decides whether you are cleared for transfer. If you have a history of complications, the page on pregnancy complications and surrogacy explains what clinics weigh.
Support Structure: Case Management, Counseling, and What Happens When Things Get Hard
This is often the part that matters most once you are pregnant, and it is the hardest to judge from a website. Every agency says it offers support. The useful question is what that support looks like in practice.
Case manager. Some agencies assign one dedicated case manager. Others use a rotating team. Ask whether the same person stays with you from match through delivery, and how many active cases that person carries.
Counseling. Ask whether psychological support is available throughout the pregnancy or only at screening, and whether it is included or billed separately.
Complications and loss. Ask whether the agency has written protocols for a medical complication, for intended parents who withdraw, and for a pregnancy loss. A written protocol tells you the agency has thought about these situations before they happen.
Communication. Ask about response time commitments and how you reach someone after hours in an urgent situation.
After birth. Some agencies offer counseling or check-ins after delivery. Others close the case at birth. Ask which.
No level of support is standard. The variation between agencies is wide, so the only reliable way to know is to ask directly and get the answer in writing.