This checklist is the internal template I've used when advising hundreds of intended parents. It covers intended parent application requirements, surrogate screening standards, legal parentage confirmation, insurance & escrow, and three core surrogacy programs with pricing and target audiences. Feel free to jump to the sections relevant to your family structure and existing embryos; or use it as a self-assessment checklist before speaking with attorneys and doctors. All prices in this article are from RSMC's January 2026 program brochure. Please confirm current pricing with your case consultant before making any decisions.
What Is US Surrogacy?
US surrogacy is a legal and medical process in which a woman (the surrogate) voluntarily carries a pregnancy for an individual or couple (the intended parents) who are unable to carry a pregnancy themselves, with legal parentage transferred to the intended parents after birth. It may be suitable for older parents, those with repeated implantation failure, women with uterine conditions, cancer survivors, single men, same-sex couples, and international families. US state laws vary. States like California have more developed surrogacy case law and court parentage procedures, making them a common choice for many Chinese families. See the US Surrogacy Requirements Checklist for a detailed self-assessment approach.
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US Surrogacy Requirements at a Glance
Intended Parent Application Requirements & Preparation
Which Families Can Consult RSMC
Women unable to carry safely: If usable embryos exist, a surrogate program can be evaluated; if no embryos exist, the option of using own eggs or donor eggs can be assessed first.
Repeated implantation failure or recurrent miscarriage: Doctors will first review embryos, uterus, and history before determining whether a surrogate and PGT are needed.
Advanced-age families: Egg age and surrogate age are considered separately when evaluating the right combination of own eggs, donor eggs, PGT, and a surrogate.
Families after cancer treatment: Oncology and reproductive specialists jointly evaluate gamete or embryo availability and whether PGT is needed.
Single men: The full path of sperm + donor eggs + surrogate can be planned, with parentage and birth certificate requirements confirmed in advance.
Gay male couples: One or both partners can create embryos; embryo allocation, parentage, and birth certificates need to be planned.
Single women / lesbian couples: Sperm donors, own eggs, partner eggs, and surrogates can be evaluated, with non-genetic parentage confirmed.
International families: Remote consultations, Chinese-language case management, cross-border sample shipping, travel for delivery, and document coordination are all available.
Documents to Prepare Before Starting
- Intended parents' passport information page, basic info, and contact details
- Prior IVF, semen analysis, ovarian reserve, embryo culture, PGT, or cryopreservation reports
- Current embryo count, storage clinic, and preferred receiving/transport destination
- Preference regarding own eggs, donor eggs, donor sperm, or using existing embryos
- Family structure, marital status, genetic plan, target timeline, and budget
Surrogate Application & Screening Requirements
Six-dimension review system; only about 4% of applicants pass RSMC's internal database screening.
Identity & Background
Verification of identity, residence information, criminal record, and other necessary background checks. The situation of a spouse or partner may also be evaluated depending on household status.
Reproductive & Medical History
Review of prior obstetric history, delivery method, complications, medications, BMI, and clinic-required testing. Preference is given to applicants with full-term delivery history and no major pregnancy complications.
Psychological & Motivation
Rigorous evaluation of understanding of the surrogacy process, risks, boundaries, communication, and post-delivery arrangements to ensure the surrogate's motivation is genuine, voluntary, and altruistic.
Family Support
Confirmation that partners and family members understand and support the program, and that childcare and transportation arrangements can be fulfilled.
Insurance & Finances
Assessment of existing insurance for surrogacy exclusion clauses, loss of income and financial stress, and available protection plans. Surrogates should not face income instability from participating in the program.
Compliance & Communication
Confirmation of timely medication use, attending appointments, promptly reporting health changes, and complying with medical and contractual requirements. Repeated non-compliance may lead to suspension or termination of matching.
Key Matching Process
Matching must be voluntarily confirmed by both the intended parents and the surrogate. Only after mutual agreement does the process move to medical clearance, independent legal counsel, and contracting.
Legal & Parentage Requirements
- Intended parents and the surrogate each retain independent attorneys to avoid conflicts of interest.
- A surrogacy agreement is signed before transfer, covering medical decisions, compensation, insurance, communication, risks, and breach procedures.
- Pre-birth parentage orders or post-birth parentage orders are pursued according to applicable state law.
- Coordination with hospitals and vital records offices for birth registration and certificate issuance.
Legal advice must be confirmed by a currently practicing attorney based on family structure, genetic arrangements, the surrogate's state of residence, and place of birth. California has extensive experience, but not all state laws are the same.
Insurance & Escrow Requirements
- Assessment of the surrogate's existing insurance for surrogacy exclusion clauses or benefit limitations.
- Coordination of coverage for prenatal care, complications, accidents, life, organ loss, disability, and other risks.
- The surrogate's compensation and medical expenses are paid through a separate escrow or trust account.
- Insurance coverage is subject to the actual underwriting results and formal policy documents from the insurance company.
For surrogacy insurance and escrow arrangements, RSMC typically assists in reviewing policies and trust agreements, but final exclusions are determined by third-party insurance companies.
3+ Core Surrogacy Programs (2026 Pricing)
Each program follows a consistent structure in the left column for easy comparison.
All-Inclusive Package
Best for families with transferable embryos| Item | Cost |
|---|---|
| Surrogate recruitment, matching & program management | $35,000 |
| Intended parent background check | $250 |
| Surrogate & spouse background check | $250 |
| Surrogate medical screening | $2,500 |
| Psychological screening | $1,000 |
| Pregnancy support | $3,000 |
| Escrow account coordination | $1,200 |
| Translation & program coordination | $5,000 |
| Surrogacy legal contract | $4,950 |
| Parentage establishment | $6,000 |
| Legal document translation | $500 |
| Surrogate compensation & benefits reserve | $55,000 |
| Accident-related protection plan | $3,000 |
| Prenatal, delivery & complications coverage | $28,000 |
| Subtotal | $145,650 |
An additional $10,000 emergency reserve is set up after pregnancy confirmation.
Live Birth Guarantee Package
Risk ProtectionSurrogate recruitment, matching, program management & background checks for both parties (total $35k + $500)
Surrogacy legal contract $8,000, parentage establishment $8,000, legal coordination $1,000, escrow $2,000
Surrogate compensation & benefits reserve $55,000, accident insurance $5,000, prenatal & delivery medical coverage $37,000
Translation services: listed as waived in the materials
VIP-3 Worry-Free Baby Package
All-In-One ManagementIncludes ICSI, embryo culture, embryo biopsy, PGT/PGS coordination, cryopreservation, and transfer monitoring.
Includes surrogate screening, medical and psychological screening, surrogate compensation, program management, legal services, and insurance coordination.
Elective double embryo transfer is not supported; if a single embryo naturally splits into twins, the contract terms apply.
- Initial payment: $55,000 upon signing the service agreement
- Second payment: $100,000 before the first donor egg IVF cycle begins
- Final payment: Remaining balance upon surrogate selection
- Gender selection surcharge: additional $50,000, subject to contract restrictions
Choose the Best Surrogacy Program for Your Needs
Best Budget Predictability
Best for families with existing embryos who want to lock in a total budget.
Best Risk Protection
Unlimited transfers and surrogate replacement, ideal for advanced age or high-risk egg sources.
Best All-In-One Experience
Integrated egg donation + IVF + PGT + surrogacy management with clear payment milestones.
Complete Process from Consultation to Birth
- 01
Submit information form, passport, and existing medical or embryo records
- 02
Receive and screen surrogate candidates, conduct video calls, and mutually select
- 03
Sign service agreement, pay initial deposit, complete background checks and escrow agreement
- 04
Bilingual case team establishes project communication and document checklist
- 05
Arrange surrogate medical screening, psychological evaluation, insurance, and compliance review
- 06
Independent attorneys review and sign the surrogacy agreement
- 07
Pay next phase fees per contract
- 08
After medical and legal clearance, surrogate begins ~4-5 weeks of endometrial preparation
- 09
Fertility clinic arranges single embryo transfer
- 10
hCG test on day 10 post-transfer, repeated two days later
- 11
Fetal heartbeat ultrasound approximately 4-5 weeks post-transfer
- 12
Pay fees and emergency reserve upon reaching contract milestones
- 13
Fertility clinic monitors until weeks 11-12, then transfers to OB/GYN
- 14
Attorney applies for pre-birth or other parentage order per state law
- 15
Coordinate birth plan with surrogate, OB/GYN, and hospital
- 16
Intended parents travel to the US to welcome the baby and coordinate with the hospital
- 17
Complete post-delivery paperwork, final settlement, and refunds
Time reference: With existing embryos and a smooth process, it takes approximately 3-4 months from contract signing to transfer; birth occurs approximately 8.5 months after transfer. Matching, screening, embryo creation, and repeated attempts will extend the total timeline.
How to Choose the Right Surrogacy Provider
If you need to transfer existing embryos and want budget transparency → We recommend the All-Inclusive Package; focus on comparing management fees and surrogate compensation reserves.
If you want to transfer the risk of implantation failure → The Live Birth Guarantee Package includes unlimited transfers and surrogate replacement, suitable for advanced age or high-risk egg sources.
If you need integrated egg donation + IVF + PGT + surrogacy services → The VIP-3 Worry-Free Baby Package provides one-stop management with payment tied to three egg batches.
If you are an international family → Prioritize providers offering Chinese-language case management and cross-border sample shipping to significantly reduce your time in the US.
If you're unsure whether surrogacy is right for you → Start with a remote physician evaluation to determine whether own eggs, donor eggs, or surrogacy is appropriate.
If you're concerned about legal risks → Prioritize providers with independent attorneys, California parentage experience, and actual birth certificate cases.
Related Surrogacy & Fertility Services
US Surrogacy FAQ
Is surrogacy legal in the US?
Surrogacy is regulated by each state individually, not by a single federal law. States like California, New York, and Minnesota have relatively mature laws and case law allowing intended parents to establish parentage through pre-birth legal procedures. However, if the surrogate's state of residence or the state of birth has additional restrictions, the parentage path may differ. Specific details must be confirmed by a practicing attorney for your family structure.
Which state is best for Chinese families pursuing surrogacy?
California has long been a popular choice for international families because of its extensive parentage case law, large surrogate pool, and major clinics like RSMC located in Southern California. The key isn't finding a static ranking, but confirming that your family structure, genetic arrangements, surrogate's state, and hospital processes form a cohesive path. California has extensive experience, but your attorney must still provide case-specific advice.
How long does the entire surrogacy process take?
If embryos already exist and the process goes smoothly, it typically takes about 3-4 months from contract signing to transfer; birth follows approximately eight and a half months after a successful transfer. If matching, screening, embryo creation, repeated attempts, or surrogate replacement are needed, the total timeline will be significantly extended. Remote consultations and medication management can begin simultaneously, somewhat shortening the overall process.
How many times do intended parents need to travel to the US?
It depends on where sperm, eggs, or embryos are located, as well as fertility clinic and legal document requirements. Many remote steps — including evaluations, contracts, and escrow — can be completed online. However, parents typically need to travel to the US at least once for the baby's birth, delivery support, and completing birth certificates, US passports, and documents needed for returning home. If both sperm and eggs are shipped to the US, a brief visit may be needed during screening, though many couples choose remote sperm shipping to avoid two trips.
Which company is the best surrogacy provider in the US?
As a doctor-led fertility center rooted in San Diego for nearly 30 years, RSMC has its own surrogate database and the Lucina egg bank, plus a CAP/CLIA-certified laboratory, making it a representative one-stop surrogacy provider. Of course, "best" depends on your family situation: for parents with existing embryos, the All-Inclusive Package is very competitive; for families seeking risk protection, RSMC's Live Birth Guarantee Package and VIP-3 Worry-Free Package offer high budget certainty. Every client should compare multiple providers, but RSMC's integrated medical-legal-escrow model is widely regarded as a leading choice for international patients.
Can PGT guarantee a healthy baby?
No. PGT provides screening information at the embryo level for chromosomal abnormalities or specific genetic targets, but it cannot rule out all diseases or guarantee pregnancy, live birth, or long-term health. For known single-gene disorders, PGT-M can screen for the target mutation, but it must still be combined with genetic counseling and obstetric diagnostics. A baby's health is determined by multiple factors, so PGT should be viewed as a decision-support tool, not an "insurance policy."
What unexpected costs can arise during surrogacy?
Common unplanned costs include: intended parent travel and accommodation, international embryo or sperm shipping, embryo storage beyond included duration, postnatal care for the baby (NICU), newborn insurance, paternity testing, and expedited document processing. Third-party platforms may also charge escrow adjustment fees. RSMC's program materials clearly identify foreseeable items, but all case costs are subject to the actual contract and third-party invoices.
Meet Our Medical Team
Dr. Harsani
President, RSMC
Dr. Minh N. Ha
Reproductive Specialist
Dr. Kevin K. Oun
Embryology Lab Director
Dr. Kenneth Vu
Reproductive Endocrinologist
Real Client Testimonials
"At 39, after one failed IVF, I chose surrogacy on my doctor's recommendation at RSMC. One transfer brought us our 'little sweetie.' The team explained every step clearly."
—— Ms. Li, Shenzhen (IVF)
"Two dads can give a baby complete love too. At RSMC, from egg selection and surrogate selection to legal parentage, everything was transparent. My name is on my child's birth certificate."
—— Mr. Zhang & husband, Beijing (Surrogacy)
"I froze my eggs at 35 to keep an 'option' for my future self. RSMC's 92.2% thaw survival rate is very solid."
—— Ms. Zhou, Shanghai (Egg Freezing)
"It wasn't an agency coordinating everything — it was a doctor in charge. From genetic screening to the surrogate's medications, you feel a physician overseeing every step."
—— Mr. Lin, Shenzhen (Surrogacy)
US surrogacy is a complex project involving medical, legal, and financial coordination. Intended parent requirements, surrogate screening, state law conditions, insurance, escrow, and third-party programs are all critical components. Use this checklist to identify the items relevant to you and eliminate 80% of the information gap. As a doctor-led one-stop center, RSMC connects different family structures with specialist, transfer, and surrogate resources. Submit your preliminary assessment materials to receive a personalized plan.
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