International vs. Domestic Surrogacy for American Parents

When you decide to pursue surrogacy to build your family, you'll need to choose between international and domestic surrogacy. Here's what you need to know.

When American intended parents decide to pursue surrogacy, one of the first things they usually consider is whether to complete a surrogacy at home in the United States or abroad in a foreign country. There are a lot of considerations for each process, and it is easy to become overwhelmed with the different aspects of surrogacy — a process that can be complicated enough on its own without involving international laws and standards.

So, with all of this in mind, how do you make the decision that’s best for you?

To help you learn more, American Surrogacy has detailed the differences between the international and domestic surrogacy process. Our surrogacy specialists are also available to answer any more specific questions you may have.

Here’s what you should know before deciding between domestic and international surrogacy as American intended parents:

The Surrogacy Process

While the surrogacy process is generally the same no matter where you complete it, the level of detail and involvement that you have as intended parents can vary widely with an international surrogacy. Because surrogacy laws and standards vary from country to country, the safe process that you’ve come to know as you’ve been researching in the United States may not exist in another country.

For example, the process of finding a surrogate in the U.S. is a mutual one, while you have no guarantee that a surrogate in another country truly gets a say in which couple she works with. Medical processes may be less detailed, and your surrogacy professional may not provide the support you need. When you cannot be there in person for every step of the surrogacy, you just have to trust that your surrogacy professional is completing everything ethically and legally, which can be nerve-racking if you’re half a world away.

In addition, international surrogacy requires another complicated step — bringing your child back into the U.S. with the proper documentation. Depending on the laws of the country in which your child was born, this process can be easy or difficult. You’ll need to work closely with your surrogacy professional, your surrogacy lawyer and the U.S. Department of State to find out whether you can protect your rights and your child’s rights quickly and efficiently.


Many times, when American intended parents consider an international surrogacy, it’s because they are trying to save on the expenses of the surrogacy process. Surrogacy can be expensive process no matter where it’s completed but, generally, the cost may be less expensive when completed outside the United States.

However, when you pay less for surrogacy in another country, it’s usually because you’re receiving fewer services or the surrogate is not receiving the proper compensation she deserves. Because surrogacy is a complicated process, it’s not recommended that intended parents cut corners to save money — as this can result in danger for them, the surrogate and their unborn child.

An international surrogacy process may be cheaper because there are less-strict medical requirements and procedures, a surrogate does not receive base compensation or compensation for surrogacy-related expenses, or other risks are taken in the name of bringing the price down. As with many family-building options, the amount of money that you pay for surrogacy directly correlates with the services that are offered you — and, when your baby is being carried by a woman in a completely different country, you may not have the peace of mind that you would with an American agency. If you’re considering international surrogacy simply because of the cost, we encourage you to weigh the other pros and cons of the process, too.

Surrogacy in the U.S. can be expensive, but these professionals offer a level of services and reassurance that you cannot receive overseas. In addition, with proper foresight and financing, the cost of surrogacy is manageable for many intended parents.

Medical Standards

When you complete a surrogacy in the United States, you can always confirm that your surrogacy professional and fertility clinic meet the standards of the American Society for Reproductive Medicine. This organization sets requirements for all assisted reproductive technology professionals to make sure that medical processes are completed in a safe, ethical and effective manner. If your surrogacy professional meets these requirements, you can be confident that the medical process will protect your and your baby’s rights.

However, not all countries have an organization like the ASRM to regulate the medical process of surrogacy. Add that many other countries may not have the medical advances of the United States, and there is a degree of uncertainty involved with foreign medical practices, especially if you’ve never visited the facility before the surrogacy process begins. In addition, you’ll need to take certain steps to either travel to your surrogate’s country for the embryo transfer process or arrange for your already-completed embryos to be sent to that international fertility clinic. Like other parts of the surrogacy process, the distance and uncertainty involved in the medical process can be risky, especially for intended parents using their last viable embryos for this endeavor.

Completing the medical process in the United States, however, is a much safer and well-regulated process.


In addition to the uncertainties of the medical process in international surrogacy, there is also a degree of uncertainty when it comes to the health of the prospective surrogate and her background. Professionals like American Surrogacy take extensive steps to make sure that all surrogates have a clean bill of physical and mental health, no criminal background and no pressure from others to become a surrogate before they can begin the process. However, international surrogacy professionals may not complete as thorough of a screening process, especially if their fees are significantly lower than an agency in the United States.

Even if a surrogate passes a clean bill of health, there may be other factors that a surrogacy professional doesn’t consider, like her home environment and whether she is doing this of her own free will. Sometimes, poor women are forced into surrogacy as a quick way to make money for their family (an ethical dilemma we’ll discuss more below). But, when you work with a domestic agency like American Surrogacy, a prospective surrogate is extensively interviewed and even subject to a home visit to make sure this is something she really wants to do and that her home environment is conducive and healthy for a surrogate pregnancy.

A lack of surrogate screening in international surrogacy is not always of ill-will on the surrogacy professional’s part; many just don’t have the resources to complete a thorough screening that American professionals do. Still, trusting a woman who has only been lightly screened with your unborn baby can be risky.


Today, many surrogacies are long-distance, whether it’s in different states or different countries. The advance of technology makes communicating during these long-distance surrogacies easier than ever, giving intended parents and surrogates the ability to send messages and information back and forth quickly over phone and email.

However, the technology that is commonplace in the United States may not be in the country that you’re considering international surrogacy. While your surrogate may own a phone, she may not have reliable internet service. In addition, rather than the hours’ time-difference in the U.S., international surrogacies create much greater time differences, making communicating at the same time difficult. Intended parents that choose to complete an international surrogacy must be comfortable giving up this instant contact and knowledge, especially if something were to go wrong with the pregnancy or surrogacy process. While you can quickly fly to a different state if needed, flying to a different country on short notice is much more complicated.

In addition, there is the possibility of language barriers between you and your surrogate. International communication can be difficult enough and, while some agencies provide translators, others do not — leaving you to overcome a language barrier that can lead to possible miscommunications that can gravely impact your surrogacy process.

Surrogacy Laws

While surrogacy laws in the U.S. do vary by state, they are fairly well-regulated, and surrogacy professionals and lawyers are well-versed in how to manage surrogacies in the U.S. Most states allow for the surrogacy process and, even where there are no strict regulations, lawyers and professionals have created their own standards they hold themselves to when completing surrogacies.

However, the laws regarding international surrogacy are much stricter than they were years ago. As international surrogacy becomes a more popular option for American intended parents, foreign governments are either restricting or shutting down surrogacy for foreigners within their borders.

Even when surrogacy is not outlawed for Americans, other countries usually don’t regulate their surrogacy process as well, or they have regulations that make the process even more complicated or ethically questionable. For example, many countries do not allow compensated surrogacy, which means a surrogate cannot be paid for carrying your child. Other countries do not recognize LGBT marriage, which means that LGBT parents completing a surrogacy abroad cannot both establish parental rights until their child is back in the U.S. Some countries only allow Americans to complete a surrogacy if they have a prospective surrogate who is related to them within that country’s borders.

Because there is no global regulation on surrogacy, there’s also the possibility that a Hague-like set of regulations will be required at some point, shutting down international surrogacies (even those in process) until the new regulations are enacted. So, legally, international surrogacy is a huge risk for intended parents. For a safer legal process, intended parents should turn to domestic surrogacy instead.

Ethical Concerns

In addition to legal concerns over unregulated surrogacy processes abroad, there are also several ethical concerns to consider — primarily, the surrogate involved.

While international surrogacy can be cheaper for intended parents, the amount of compensation a surrogate gets paid (if allowed in her country) is usually a substantial amount compared to her average income. Therefore, it can be a tempting way to erase debt or keep her family afloat in hard financial times — even if it’s not a process that she is genuinely interested in. She may also be forced into the process by her husband or other family members in order to improve their financial standing.

That’s why many critics of international surrogacy argue that the process takes advantage of vulnerable women who may not be completely aware of what the process entails and what their legal rights are. Some surrogates cannot even receive compensation for their decision, which should give intended parents pause. Is it right for a complete stranger to carry your child and receive nothing in return?

In addition, for intended parents who don’t speak the language in the country they choose, miscommunication between them and their surrogacy professional (whether intended or not) can have dire consequences for all involved. If you choose to complete an international surrogacy, it’s important that you fully research the professional you’re working with and what the process will look like to avoid you or your surrogate being taken advantage of during the process.

Deciding What’s Right for You

Clearly, while surrogacy is always a complicated process, international surrogacy comes with many more risks and potential complications than a surrogacy completed in the United States. Unlike in a domestic surrogacy, there is always a degree of uncertainty abroad, whether that’s for the progression of your unborn child or the well-being of the surrogate that you haven’t gotten to know along the way. Before choosing an international surrogacy, it’s important to consider all of these aspects.

At American Surrogacy, we highly encourage all intended parents to complete a domestic surrogacy instead. We want every intended parent to achieve their family-building dream without compromising their safety or interests, and international surrogacy cannot guarantee that.

However, when you choose to complete a domestic surrogacy with our agency, we can guarantee that you will have a baby in a process that’s well-regulated, safe and protects the interests of all involved. Our domestic surrogacy program offers unparalleled support, matching and case management skills that you will rarely find abroad. To learn more about our program or to get started today, please call our surrogacy specialists at 1-800-875-2229.