7 Reasons People Choose Surrogacy and Surrogate Mothers
For many people, starting a family is one of life’s most profound decisions. When pregnancy isn’t possible — due to a medical condition, a uterine factor, age, or personal circumstance — gestational surrogacy opens a path that biological limitations can’t close. If you’re weighing the reasons to use a surrogate, understanding what that journey looks like — medically, emotionally, and practically — changes everything.
Surrogacy sits at the intersection of modern medicine and profound human generosity. And the agency you choose to guide you through it shapes every aspect of the outcome.
Key Takeaways
Surrogacy by the Numbers
What Is Gestational Surrogacy?
There are two types of surrogacy: traditional and gestational. Traditional surrogacy uses the surrogate’s own egg — meaning she is the biological mother of the child. Gestational surrogacy is different.
In gestational surrogacy, an embryo is created through in vitro fertilization (IVF) using eggs and sperm from the intended parents — or donors — and then transferred to the surrogate’s uterus. The surrogate carries no genetic connection to the baby. This distinction matters enormously to many intended parents, both emotionally and legally.
Gestational surrogacy is the most widely used form today, and Physician’s Surrogacy specializes exclusively in this model.
The Top Reasons Intended Parents Choose Surrogacy
The reasons to use a surrogate vary by person — but the most common share a theme: pregnancy either isn’t possible, isn’t safe, or isn’t the right path. Here are the medical and personal circumstances that lead intended parents to surrogacy.
1. Absence of a Uterus
Some women are born without a uterus or have had one removed due to illness or injury. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome — a rare congenital condition — results in an underdeveloped or absent uterus and vagina.
Women with MRKH typically have functional ovaries, which means their eggs can be retrieved, fertilized through IVF, and carried to term by a gestational surrogate. Their child is biologically theirs in every meaningful sense.
2. Uterine Structural Conditions
Not every uterine condition results in complete infertility. Some conditions — including fibroids, uterine septum, or Asherman’s syndrome — affect the uterine environment in ways that make carrying a pregnancy to term difficult or unlikely.
In these cases, eggs and sperm function normally. The issue lies specifically with implantation and gestation. Gestational surrogacy allows the intended mother’s embryo to be carried in a surrogate’s healthy uterus.
3. Repeated Pregnancy Loss or IVF Failure
For many intended parents, surrogacy comes after a long and painful fertility journey. Multiple failed IVF cycles or recurrent pregnancy loss can point to an implantation issue — where embryos are healthy but the uterine environment prevents successful pregnancy.
A gestational surrogate with a proven obstetric history offers a different environment — one that has demonstrated its capacity to carry a healthy pregnancy. Our guide on how surrogacy works walks through this transition step by step.
4. Medical Conditions That Make Pregnancy Dangerous
Certain systemic health conditions — including heart disease, severe diabetes, kidney disease, and autoimmune disorders — can make pregnancy life-threatening for the mother and for the baby.
In these situations, surrogacy isn’t a preference. It’s a medical recommendation. A woman in this position still has the right to build a biological family — and gestational surrogacy makes that possible without putting her health at risk.
Our article on emotional and medical risks covers how physician oversight reduces these risks for everyone involved.
5. Age-Related Fertility Decline
Female fertility declines with age — measurably and predictably. By the late 30s, egg quality and quantity have dropped significantly. Pregnancies in the 40s carry higher rates of chromosomal abnormalities and maternal complications.
Some intended parents choose to use their own eggs — retrieved at a younger age or through IVF — and have them carried by a surrogate. Others work with donor eggs. Either way, surrogacy removes the uterine aging variable from the equation.
6. Same-Sex Male Couples and Single Intended Fathers
For gay male couples and single men, gestational surrogacy is one of the only paths to a biologically related child. One or both partners can contribute sperm for fertilization. A donor egg is used, and the resulting embryo is transferred to a gestational surrogate.
At Physician’s Surrogacy, we proudly serve LGBTQ+ intended parents. Our article on LGBTQ+ surrogacy covers legal considerations, emotional preparation, and what to expect throughout the journey.
7. Personal and Social Choice
Surrogacy is not always medically mandated. Some individuals choose it for personal reasons — a solo parent by choice, a professional athlete managing physical demands, or someone whose life circumstances make carrying a pregnancy impractical.
Reproductive autonomy matters. Physician’s Surrogacy believes everyone deserves access to the family-building path that works for them — without judgment or gatekeeping.
Many of the families we work with come to us after years of fertility treatments, pregnancy losses, or diagnoses that closed the door on a conventional pregnancy. The decision to pursue surrogacy is rarely easy — but for most, it’s the first time they’ve felt real hope.
Why Physician-Led Care Changes the Outcome
The agency you choose doesn’t just manage logistics. It determines the quality of medical oversight your surrogate receives — and the safety of your child throughout the pregnancy.
Most surrogacy agencies are run by non-medical staff: business operators, former surrogates, or coordinators with no clinical authority. When a complication arises, they relay information. They don’t intervene.
Physician’s Surrogacy is different in one defining way: we are the only surrogacy agency in the United States managed by practicing OB/GYNs.
Our in-house physicians design the surrogate screening protocol, monitor clinical communications after every appointment, and can consult directly with a surrogate’s managing OB if complications arise. That peer-to-peer physician contact — between our doctors and hers — is not something a standard agency can offer.
The result is measurable. Our preterm delivery rate sits 50% below the national average — a direct outcome of physician-designed screening and continuous clinical oversight.
Our average journey from match to live birth takes 12–14 months — with a match confirmed in as little as one week. Most agencies take 6–12 months just to find a surrogate. We skip that wait entirely.
What the Surrogacy Process Looks Like with Us
For intended parents, the journey begins with a consultation — not a waitlist. We want to understand your history, your goals, and what you need from an agency before we talk numbers.
From there, our physician-designed screening process ensures that every surrogate you could be matched with has already passed rigorous medical and psychological evaluation. Only about 8% of surrogate candidates pass our protocol. You never see an unscreened profile.
1. Free Consultation
Schedule a consultation with our team. We review your history and answer your questions — at no cost and with no commitment required.
2. Surrogate Matching
We draw from the largest active pre-screened surrogate pool in the U.S. Most intended parents receive a match within one week of beginning the process.
3. Legal & Medical Coordination
Our team coordinates with your fertility clinic, handles legal contract support, and monitors all clinical communications throughout the pregnancy.
4. Delivery & Beyond
We support your surrogate through the birth — and for 3–6 months afterward. You receive clinical updates after every appointment from match to delivery.
Understanding the Cost of Surrogacy
One of the most common questions intended parents ask is a simple one: what does this actually cost? Surrogacy is a major financial investment — and hidden fees mid-journey add real emotional and financial strain.
At Physician’s Surrogacy, our Flat-Rate Surrogacy program starts at $140,000–$170,000+. That is a fixed, all-inclusive price. You pay zero agency fees until your match is confirmed. We also partner with fertility financing providers to help intended parents plan for the journey.
Ask any agency for a complete itemized cost breakdown before signing. With a flat-rate model, every fee is disclosed upfront — so you can plan without worrying about surprise charges mid-journey. Our guide on how to prepare financially covers what to ask and what to watch for.
Is Surrogacy the Right Path for You?
Surrogacy is one of the most medically sophisticated ways a family can be built — and one of the most human. The right agency makes that journey safer, faster, and more transparent. And the reasons to use a surrogate are as individual as the families who pursue it.
If you’ve been through fertility treatments that haven’t worked, if pregnancy poses a medical risk, or if biological parenthood through a surrogate is the path you’re exploring — we’re here to help you take the next step with confidence.
Learn more about agency vs. independent surrogacy, or read our top questions from intended parents to get oriented before your consultation.
Schedule A ConsultationFrequently Asked Questions
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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.
