How to Select the Best Surrogacy Clinic for You
Most intended parents spend weeks researching surrogacy costs and legal requirements — and almost no time researching what medical oversight actually looks like inside the agency they’re considering. When it comes to choosing a surrogacy agency, that’s the question that matters most.
That’s exactly where things go wrong.
Choosing a surrogacy agency isn’t like choosing a surrogacy clinic. Agencies don’t perform IVF — your fertility clinic handles that. What agencies control is everything around it: who screens your surrogate, how rigorously, who monitors the pregnancy, and who steps in if a complication arises. That distinction changes which questions you should be asking.
Key Takeaways
Why “Choosing a Surrogacy Clinic” Is the Wrong Frame
People search for “choosing a surrogacy clinic” because the two terms — clinic and agency — get used interchangeably. They shouldn’t be.
A fertility clinic performs the In Vitro Fertilization (IVF) procedure and the embryo transfer. Your reproductive endocrinologist (RE) at the clinic is the doctor managing conception.
A surrogacy agency does something different. It matches you with a surrogate, screens her, coordinates the legal process, manages escrow, monitors communications throughout the pregnancy, and supports both parties through delivery and beyond. No IVF. No deliveries. Coordination and oversight — for 12 to 18 months of one of the most medically complex experiences a family can go through.
The medical quality of that coordination is what separates a safe surrogacy journey from a risky one.
To understand how gestational surrogacy works end to end, it helps to read through the full process first. Then come back to this question: at every stage of that process, who is the medical authority?
The Medical Gap Most Agencies Leave Open
Here’s the uncomfortable truth about most surrogacy agencies: they are not medically managed.
The typical agency is run by coordinators, former surrogates, or business operators — people who know the process well but have no clinical authority. When a surrogate has elevated blood pressure at 28 weeks, the agency coordinator can’t evaluate that clinically. They relay information. They schedule calls. They wait for the surrogate’s OB to send a note.
Nobody at the agency is actually looking at the medical picture with trained clinical eyes.
This is the “medical black hole” — the gap between match and delivery where families assume someone medically qualified is watching, when in reality the agency has no physician on staff at all.
This gap is the most important thing to grasp when comparing agencies. It’s also what makes surrogacy agency red flags so easy to miss until it’s too late.
The Only Agency Managed by Practicing OB/GYNs
Physician’s Surrogacy was founded by board-certified OB/GYNs and is managed by an in-house medical team that includes maternal-fetal medicine specialists and neonatologists. No other surrogacy agency in the U.S. has practicing obstetricians running the agency itself.
Our preterm delivery rate is 50% below the national average.
That outcome is the direct result of physician-designed surrogate screening — not luck. See how our model works.
4 Medical Questions to Ask Any Surrogacy Agency
Before signing with any agency, ask these four questions. The answers will tell you more than any brochure.
What Physician-Led Screening Actually Means
The word “screening” gets used a lot in surrogacy marketing. What it means varies widely.
At a standard agency, screening usually means a background check, a basic health questionnaire, and a psychological evaluation from a contracted therapist. It’s not nothing — but it’s not a physician reviewing your surrogate’s complete obstetric history, evaluating her prior pregnancy outcomes, and stress-testing her profile against the criteria that actually predict complications.
Our surrogate screening process is proprietary and physician-designed. It exceeds ASRM guidelines. It includes medical history review, psychological evaluation, and IVF center compatibility checks — all evaluated by clinicians, not coordinators.
The result: only 8% of applicants pass. That selectivity is not about being exclusionary. It’s about only accepting surrogates who are genuinely prepared — medically and emotionally — for the journey ahead.
According to the CDC, preterm birth affects approximately 1 in 10 births in the United States. Our preterm delivery rate is 50% below that national average. The screening is why.
How This Compares to an Independent Surrogacy Arrangement
Some intended parents consider going independent — finding a surrogate without an agency, handling coordination themselves.
The cost savings are real. So are the risks. Independent surrogacy means no professional screening, no escrow protection, no legal coordination, and no medical oversight of any kind. You’re managing a 12-to-18-month medical process without any clinical infrastructure behind it.
That’s a real exposure — not just financially, but medically.
An agency with physician oversight closes that gap. It’s not just coordination — it’s clinical management from match to delivery, with a medical team that can intervene when it matters.
What to Look for in Agency-Fertility Clinic Relationships
Your fertility clinic and your surrogacy agency are two separate organizations. They need to work well together — but most agencies treat this as an afterthought.
The right agency actively maintains partnerships with leading fertility clinics, has established communication protocols, and supports smooth coordination between the surrogate’s medical team, the IVF center, and the intended parents. Gaps in that coordination — delayed records, missed appointments, unclear lines of responsibility — are where journeys stall or fail.
Our clinical partners include fertility clinics and hospitals across the United States. More importantly, our in-house physicians can communicate peer-to-peer with clinic staff when clinical questions arise — something no coordinator-led agency can offer.
For more context on how to evaluate the our agency evaluation guide, that guide covers the operational and logistical side in depth.
The Surrogacy Process: Where Medical Oversight Matters Most
It helps to map the gestational surrogacy process against the moments where physician involvement changes outcomes.
Before the Match
Physician oversight here means the difference between a surrogate who looks qualified on paper and one whose full obstetric history has been clinically evaluated. Most agencies complete this stage using coordinators and contracted therapists. We use our in-house physician team — and only 8% of applicants make it through.
Between Match and Embryo Transfer
This is where many agency journeys stall. Standard agencies run post-match medical screening that can take 3 to 5 weeks or more. Our Medically Cleared Program flips the order — surrogates complete medical and psychological clearance before matching, so they’re ready to proceed directly to legal and embryo transfer the moment a match is confirmed.
Transfer Through Delivery
This is the longest stretch — and the one where most agencies go quiet. We deliver physician-monitored clinical communications to intended parents after every appointment. If a complication arises, our physicians can consult directly with the surrogate’s managing OB. That clinical line of communication doesn’t exist at any other agency in the U.S.
Post-Delivery Surrogate Support
Most agencies consider the journey complete at delivery. We provide 3 to 6 months of continued support for surrogates after birth — including medical follow-ups and ongoing coordinator access. A surrogate who feels genuinely cared for after delivery is one who considers becoming a surrogate again. That matters for intended parents who need repeat journeys.
Questions to Ask When Choosing a Surrogacy Agency
Beyond the four medical questions above, these operational questions help round out your evaluation. Read our full surrogacy company questions guide for a deeper checklist.
- What is your average time from consultation to surrogate match? Industry average is 6 to 12 months. We match in an average of one week.
- What is your agency fee structure? We charge no agency fees until your surrogate match is confirmed.
- How many surrogates are currently in your active pool? Pool size directly affects how quickly you’ll be matched and how selective you can be.
- What happens if my first surrogate match doesn’t work out? Know the re-matching process before you need it.
- Do you have a flat-rate or itemized cost structure? Hidden costs are a common complaint about surrogacy agencies. Our Flat-Rate Surrogacy program means your total is your total.
One-Week Average Match — Backed by the Largest Pre-Screened Pool in the U.S.
Speed without quality is a risk, not a benefit. Our one-week average matching timeline is only possible because we screen 10,000+ surrogate candidates annually — and only 8% pass our physician-designed protocol. You’re matched quickly because the pool is large and every candidate in it has already been clinically evaluated.
The industry standard wait for a surrogate match is 6 to 12 months.
We match in an average of one week. See how we do it.
Frequently Asked Questions About Choosing a Surrogacy Agency
Is a surrogacy agency the same as a surrogacy clinic? +
Do all surrogacy agencies have physicians on staff? +
What does ASRM-compliant screening actually mean? +
How do I know if an agency’s screening is rigorous enough? +
What’s the difference between the standard journey and the Medically Cleared Program? +
Julianna Nikolic
Chief Strategy Officer Julianna Nikolic leads strategic initiatives, focusing on growth, innovation, and patient-centered solutions in the reproductive sciences sector. With 26+ years of management experience and a strong entrepreneurial background, she brings deep expertise to advancing reproductive healthcare.
