Starting a surrogacy journey can feel overwhelming at first. There are different paths, different terms, and a lot of information to take in.
Knowing the different types of Surrogacy is one of the most important steps to begin your journey. Each type comes with its own medical implications, legal considerations and emotional dynamics.
This comprehensive guide breaks down every type clearly so that you can make informed confident decisions about your path.
Surrogacy types: what to choose from?
At the core, surrogacy is divided into two main types:
- Gestational surrogacy
- Traditional surrogacy
The key difference for these two main types is genetics: in gestational surrogacy, the surrogate is not biologically related to the baby. In traditional surrogacy, she is.
Surrogacy can also be classified according to the following:
According to Surrogate Compensation:
- Compensated surrogacy
- Altruistic surrogacy
According to Location of Intended Parents:
- Domestic surrogacy
- International surrogacy
According to Journey Support:
- Independent Surrogacy
- Agency-led Surrogacy
Then, there is IVF surrogacy which is often confused with IVF treatment.
If you want more of a general context of what surrogacy is before learning about the types, check out our guide.
Gestational vs Traditional Surrogacy Explained
Traditional surrogacy was the only way to complete a surrogacy throughout most of history. Over the past 30 years however, Gestational surrogacy has become more recognized as a way to start building a family, due to improved medical success rates and clearer legal frameworks on how it is established who the parents are.
| Gestational Surrogacy | Traditional Surrogacy | |
|---|---|---|
| Medical procedures involved | IVF, where the intended parents’ embryo is created and transferred to the surrogate | IUI, also called sperm injection, or natural conception |
| Is the surrogate genetically linked to the baby? | No | Yes |
| Is this type of surrogacy legal? | Many states have clear legal frameworks and established processes in place. | Only a few states explicitly allow it or ban it. |
| Who is this type of surrogacy for? | Individuals with infertility, LGBTQ+ couples, single parents by choice, or anyone unable to safely carry a pregnancy | Not encouraged due to legal and emotional complexity |
| Does SurrogateFirst offer services? | Yes | No |
Gestational Surrogacy: Definition
When you opt for gestational surrogacy, the surrogate acts more like a nurturing vessel to carry your child to term. She will not use her own egg; the embryo is created through in vitro fertilization using the egg from the intended parent or donor, and then transferred to the surrogate’s uterus. This means that the child won’t have any of the surrogate’s genetic profile, which is the exact opposite of traditional surrogacy.
Gestational surrogacy entails a lengthy screening process to find out whether the surrogate is healthy enough physically, emotionally, and mentally to have a successful pregnancy. At SurrogateFirst, we’ve seen that the most successful journeys often begin with this kind of careful and rigorous screening process.
The surrogate process – when it comes to gestational surrogacy – follows the same surrogacy program in all states:
Is gestational surrogacy legal?
Gestational surrogacy laws can vary from state to state, but many areas in the United States are supportive of this path and have clear guidelines in place. States like California and New York are considered one of the most surrogacy friendly, because of their established framework that help protect both intended parents and surrogates.
If you are considering this path, we encourage you to find out if gestational surrogacy is legal in your state.
Who is gestational surrogacy for?
- Individuals with infertility
- LGBTQ+ couples
- Single parents by choice
- Anyone unable to safely carry a pregnancy
- It provides hope for many who’ve struggled with other paths to parenthood.
Traditional Surrogacy Definition
Traditional surrogacy is the process where the surrogate uses her own egg, which means she is biologically and genetically related to the baby she carries. There are different ways this can happen, though nowadays it is most commonly done through a procedure called intrauterine insemination (IUI) which is a fertility treatment that involves placing sperm (the IP’s or a sperm donor’s) inside a woman’s uterus to facilitate fertilization
Is traditional surrogacy legal?
Only a few states explicitly allow it or ban it.
Traditional surrogacy is legally possible in some U.S. states, but it is much less common because the legal process can be less predictable than gestational surrogacy.
In traditional surrogacy, the surrogate uses her own egg, which means she is also the child’s genetic mother. That can make parentage more complex. In many cases, intended parents cannot rely on the same clear pre-birth legal protections that are often available in gestational surrogacy. Depending on the state, parentage may need to be confirmed after birth through a court order, consent process, or adoption-related steps.
What does that mean in practice?
- legal recognition of the intended parents may take longer
- the process may depend more on state law, local court practice, and timing
- the surrogate’s legal rights and responsibilities towards the baby may remain more significant until parentage is formally transferred
- if something changes during pregnancy or after birth, resolving disagreements can be more complicated
Who is Traditional surrogacy for?
Traditional surrogacy has become very niche in the US. In those instances, it is mostly used by:
- Single men who want a genetic connection with the child (simple medical path, emotionally can be complicated for the surrogate)
- People without access to viable eggs (unavailability of own eggs, save cost in buying egg)
- Those avoiding IVF (looking to lower cost or invasiveness)
- Deeply Trusted (Pre-existing) personal arrangements (for e.g. a family member, a close friend, or someone deeply trusted may offer to help)
- Very specific cultural or personal preferences (“natural” process, backgrounds where certain family structures and reproductive choices are viewed differently)
Even in these cases, traditional surrogacy is used cautiously and far less often than gestational surrogacy not because it cannot work but because many families find greater clarity and protection in gestational surrogacy.
Why it’s not common anymore
Major medical organizations explicitly state that traditional surrogacy is now uncommon and discouraged:
- The American College of Obstetricians and Gynecologists notes: “Although traditional surrogacy can be less expensive… it is more legally and ethically complex… For this reason, many surrogacy programs no longer offer traditional surrogacy arrangements.”
While the American Society for Reproductive Medicine states: “Traditional surrogacy is “rarely offered by most programs and is more ethically and legally complex.”
Amongst the emotional reasons that make the traditional surrogacy process harder to managed by Intended Parents and Surrogates, often get quoted:
- Stronger internal conflict around “role” – the surrogate may at times feel both like the carrier and a form of mother, which can create identity tension during or after pregnancy.
- More complex attachment processing – emotional attachment can feel harder to contextualize or “place,” because it isn’t only about carrying the pregnancy.
- Greater sensitivity to language and recognition – terms like “mother,” “parent,” or even how others refer to the pregnancy can feel more loaded or uncomfortable.
- Heightened emotional impact at handover – the transition after birth can feel less clearly defined emotionally, even when fully agreed upon.
- Long-term emotional ambiguity – questions around connection to the child (even if not acted on) can remain more present over time.
Commercial vs Altruistic surrogacy explained
In the U.S., altruistic surrogacy is relatively uncommon, unless the intended parents already know someone willing to carry for them. Even in these cases, while there is no base compensation, costs still apply—including medical expenses, legal contracts, and ongoing support. Because of the legal and logistical complexity of the process, it’s strongly recommended to work with experienced professionals. Agencies like SurrogateFirst can step in to support specific parts of the process, depending on what you need managed.
Alternatively, intended parents who prefer an altruistic model may look to countries where only altruistic surrogacy is permitted, though this often comes with longer timelines and additional legal steps.
By contrast, compensated surrogacy is the most common model in the U.S. It offers a more structured and predictable framework, with clear agreements and defined expectations for all parties.
| Commercial Surrogacy | Altruistic Surrogacy | |
|---|---|---|
| Medical procedures involved | Typically involves IVF (gestational surrogacy) | Depends on the arrangement |
| Is the surrogate genetically linked to the baby? | No | It depends |
| Is this type of surrogacy legal? | Yes, but depends on the state or location | Yes, but depends on the state or location |
| What are the costs? | Base compensation plus reimbursement and support | Reimbursement only (no base compensation) |
| Who is this type of surrogacy for? | Families without a known surrogate or those who prefer a structured journey | Families with a relative or close friend willing to help |
| Does SurrogateFirst offer services? | Yes, full service | Yes, to help manage the process |
Commercial Surrogacy: Definition
Compensated surrogacy or commercial surrogacy involves reimbursements for the surrogate’s medical care, pregnancy-related expenses, and circumstantial needs such as lost wages, along with a base compensation for her time and commitment.
With commercial surrogacy, it is important to have a detailed contract in place that helps outline expectations, roles, and responsibilities so that everyone involved in the journey feels informed, protected and supported throughout the process.
Is Commercial Surrogacy Legal?
Surrogacy laws vary by state, but overall, the United States are generally supportive of commercial surrogacy. Many states allow and regulate these arrangements, providing legal frameworks that protect both surrogates and intended parents. Some states have restrictions or less clear guidelines, but very few prohibit being compensated for surrogacy altogether. States like California and New York are known to be more surrogacy-friendly, with established legal processes.
To understand what applies to you and your journey, it is important to check if commercial surrogacy is legal in your state.
Who is commercial surrogacy for?
- Surrogates: Women who want to help build families while receiving financial support for the time, effort, and physical commitment involved.
- Intended parents seeking clarity: Those who prefer a structured, transparent process with defined compensation and expectations.
- People without close surrogate options: Intended parents who don’t have/don’t want to call on a friend or family member able to carry for them.
- Time-sensitive journeys: Those who want a more efficient matching process through agencies and established frameworks.
- International intended parents: Often rely on compensated surrogacy in the U.S. due to clearer legal structure and availability.
Pros of Commercial Surrogacy
- Balanced relationship: The surrogate is fairly compensated for the significant physical, emotional, and time commitment involved.
- Comprehensive support available: usually supported by an agency, Surrogates are financially covered for medical, logistical, and related needs throughout the journey.
- Faster timelines: A larger pool of available, pre-screened surrogates makes matching more efficient.
- Clear structure: Defined compensation and contracts help set expectations and reduce uncertainty.
Altruistic Surrogacy Definition
Altruistic surrogacy is when the surrogate agrees to carry a child to term without monetary compensation.
In some countries, for instance in Canada, surrogates cannot receive compensation beyond pregnancy-related expenses making it de facto altruistic. To be noted: though there is no base compensation in those cases, there are still many expenses related to surrogacy that may need to be reimbursed to the surrogate, as it is only fair that the surrogate doesn’t have to cover them out of pocket.
Is Altruistic Surrogacy Legal?
Similar to other types, surrogacy laws in the US vary from state to state though altruistic is not usually singled out.
Most surrogacy-friendly states are California and New York, because of these states having an already established legal processes around surrogacy.
Find out if surrogacy is legal in your state.
Who is altruistic surrogacy for?
- Close relationships: Intended parents who have a friend or family member willing to carry without financial compensation.
- Countries with restrictions: Those in places where only altruistic surrogacy is legal (e.g., UK, Canada, Australia).
- Values-driven journeys: People who prefer a non-commercial, relationship-based approach to surrogacy.
- Surrogates who want their journey to be solely about purpose and compassion: Women primarily driven by the desire to help someone they know build a family or who do no need the extra compensation.
- Flexible timelines: Intended parents open to longer timelines, as matching depends on personal connections rather than agencies.
International vs Domestic Surrogacy Explained
Domestic surrogacy is when both the intended parents and the surrogate are based in the same country, operating under one legal and medical system. International surrogacy involves intended parents and a surrogate based in different countries, requiring cross-border coordination of legal processes, medical care, travel, and parentage recognition.
Who is International surrogacy for?
- Countries with restrictions: Intended parents from countries where surrogacy is limited, altruistic-only, or prohibited.
- Seeking legal clarity: Those choosing destinations with clearer or more supportive surrogacy frameworks that the one available in their home country.
- Access to surrogates: Intended parents who cannot find a surrogate locally or face long wait times.
- Specific medical expertise: Those looking for established clinics and experience in certain destinations.
- LGBTQ+ or single parents: Individuals who may face restrictions in their home country and seek more inclusive options abroad.
Independent vs agency surrogacy explained
Independent surrogacy is when intended parents and a surrogate arrange the journey directly between themselves, managing matching, legal, medical, and coordination steps on their own or with selected professionals. Agency surrogacy involves a specialized agency that supports the process end-to-end, including matching, screening, coordination, and ongoing guidance.
Who is independent surrogacy for?
- Existing relationships: Intended parents who already have a trusted surrogate (friend or family member) they know they can work very smoothly with.
- Hands-on planners: Those comfortable managing legal, medical, and logistical steps themselves.
- Cost-conscious journeys: Intended parents looking to avoid agency fees.
Who is agency surrogacy for?
- First-time intended parents: Those who want to benefit from guidance through a complex process.
- No identified surrogate: Intended parents who need help with matching and screening.
- Structured support: Those who prefer coordination, oversight, and reduced administrative burden.
- Time-sensitive journeys: Intended parents looking for a more streamlined and efficient process.
IVF, Surrogacy and IVF Surrogacy: debunking misconception
IVF, Surrogacy, and IVF Surrogacy: What’s the Difference?
IVF and surrogacy are often mentioned together, but they are not the same.
IVF (in vitro fertilization) is a medical treatment where an egg is fertilized in a lab and the resulting embryo is transferred into a uterus.
That embryo can be transferred:
- to the intended mother, who carries the pregnancy herself, or
- to a surrogate, who carries the pregnancy for the intended parents.
To conclude, surrogacy is the broader family-building arrangement, while IVF is often the medical step used to create the pregnancy. In gestational surrogacy, IVF is one part of a much larger process that also involves matching, screening, legal agreements, and support throughout the journey.
How to choose my types of surrogacy?
Understanding the different types of surrogacy is essential, because each dimension—gestational vs traditional, compensated vs altruistic, domestic vs international, and independent vs agency-led—shapes the journey in very different ways. These are not standalone choices; they combine to create entirely different legal, emotional, and practical realities.
A domestic, gestational, compensated, agency-led journey in the U.S., for example, is typically the most structured and predictable, with clear legal frameworks, professional support, and defined timelines. By contrast, an international, gestational, compensated journey may offer access and availability, but requires navigating cross-border laws, travel, and parentage recognition.
An altruistic, domestic, independent journey—often involving a friend or family member—can feel more personal and values-driven, but may involve less formal structure and longer timelines depending on the country’s regulations. Meanwhile, a traditional, independent arrangement introduces additional legal complexity, as the surrogate is also the genetic mother, often requiring post-birth legal steps.
These combinations show that there is no single “surrogacy journey”—only a range of paths, each with its own implications. Being precise about the type of surrogacy you are considering helps you anticipate what the process will look like, what support you may need, and how to choose the option that best aligns with your situation, location, and priorities.
Need a hand talking though your options? Talk to us.
Types of Surrogacy FAQs
What is the most common type of surrogacy today?
Gestational surrogacy is the most common today. In this type, the surrogate has no genetic connection to the baby and an embryo created through IVF is transferred to her uterus.
What is the difference between international and domestic surrogacy?
Domestic surrogacy takes place within your home country, where laws and processes are more familiar. International surrogacy, on the other hand, involves working across borders, which can bring different legal requirements, medical systems, and travel considerations.
What is the difference between independent surrogacy and agency surrogacy?
In independent surrogacy, the intended parents and the surrogate arrange the journey on their own, while agency surrogacy involves a professional team who helps guide the process from matching to legal coordination and pregnancy support.
What is the difference between surrogacy, IVF, and IVF surrogacy?
Surrogacy is the overall journey of someone carrying a pregnancy for intended parents. IVF is the medical process used to create embryos. IVF surrogacy (gestational surrogacy) brings both together, where an embryo created through IVF is carried by a surrogate.
What are the main types of surrogacy available in the US?
Surrogacy laws vary by state, but gestational, compensated/commercial surrogacy is most widely practiced across the U.S. Because the process can be complex and energy consuming, most people choose to work with an agency to help manage each step.
Why SurrogateFirst?
At SurrogateFirst, we’re more than a matching agency—we’re your support system.
- Compassionate, personalized matching
- 24/7 access to dedicated case managers
- Legal and medical coordination
- Transparent pricing
- Emotional support for surrogates and for intended parents alike
