Surrogacy: History, laws and costs in 2025
Surrogacy: what is surrogacy, how does it work and where is it legal?
1. Introduction to surrogacy
Surrogacy - also known as surrogate motherhood or, less precisely, "surrogate womb" - is no longer a medical oddity but a legitimate and regulated option to form a family. From its emergence in the legal arena in the 1980s to its current international expansion, this process has been chosen by people with infertility, LGBT+ couples, women with a medical contraindication to pregnancy, and even singles determined to take on parenthood alone.
In 2024, more than 25,000 children were born through surrogacy worldwide, according to the International Association for Assisted Reproduction, representing a global growth of about 12% per year. This phenomenon responds not only to scientific advances, but also to the legal and social recognition of family diversity.
This article is a comprehensive guide for those who are considering surrogacy: it addresses its historical bases, legal modalities, costs, clinical process, medical and psychological requirements, ethical aspects, real testimonies and future trends. It also includes practical resources and links to Gestlife Surrogacy Europe and USA, two of the leading agencies in safe, ethical and transparent processes.
2. Historical origins of surrogacy
Although the biblical stories of Sarah and Hagar can be considered a cultural antecedent of surrogacy, the modern practice was born in 1980, when a paid gestational surrogacy contract was signed in Michigan (USA). Thereafter, the development of In Vitro Fertilization (IVF) in the 1980s and the possibility of implanting an embryo without the genetic load of the gestational carrier in 1985 changed the paradigm.
During the 1990s, several American states, including California, Illinois and New Hampshire, regulated surrogacy, which offered legal certainty to intended parents. In 1994, the United Kingdom legalized altruistic surrogacy through the Human Fertilisation and Embryology Act.
The 2000s marked the international expansion of the business model. Georgia, Ukraine and Russia established themselves as emerging destinations. India, meanwhile, became a low-cost benchmark until 2015 when it banned the practice for foreigners after allegations of exploitation. This generated a migration of the map to Eastern Europe and Latin America.
The 2020 pandemic brought unprecedented challenges: closed borders, babies born without their parents being able to pick them up, and new security protocols. In response, the industry integrated digital contract signing, telemedicine medical consultations and remote manager services. Today, surrogacy is regulated in more than thirty jurisdictions, and continues its path toward stronger international harmonization.
3. Definition and essential terminology
Surrogacy is a legal-medical and emotional procedure by which a woman (surrogate) carries a pregnancy to term for another person or couple, called intended parents, who will assume legal filiation of the baby at birth.
3.1 Modalities
Traditional gestation: the gestational carrier provides her egg, and therefore has a genetic link to the baby. It is prohibited or severely restricted in most jurisdictions because of the risk of legal disputes.
Gestational gestation: the embryo is created with gametes from outside the gestational carrier, and is implanted by IVF. It is the current standard in regulated programs.
3.2 Glossary
Surrogate: a woman who carries a pregnancy for another person or couple.
Intended parents: those who desire and assume legal parenthood.
Pre-birth order: court ruling that assigns parentage before birth (common in the USA).
Live birth guarantee: clause that assures unlimited attempts until a live birth is achieved.
Blastocyst: five-day-old embryo, ideal for uterine transfer because of its development.
PGT-A: preimplantation genetic test to detect chromosomal abnormalities.
Matching: process of selection and compatibility between intended parents and gestational carrier.
4. Legal map 2025
The legality of surrogacy varies widely from country to country. Jurisdictions are divided into prohibitionist, permissive for altruistic purposes, and those that allow financial compensation or commercial programs.
4.1 Spain: reinforced prohibition
Law 14/2006 establishes that any surrogacy contract is null and void in Spain. The Instruction of the Directorate General of Legal Security and Public Faith (DGSJFP) of April 2025 tightens the requirements for the registration of children born by surrogacy abroad: full adoption or proof of proven biological link with one of the parents is now required.
4.2 Permissive jurisdictions (expanded table)
Note: Gestlife Surrogacy provides an updated legal map and interactive tools to check legal feasibility by country of residence.
5. Detailed costs
The surrogacy budget may seem high, but it is a complex and regulated process, involving dozens of professionals: doctors, embryologists, lawyers, translators, psychologists, visa managers, among others.
The typical distribution of the total cost is:
Clinical fees (IVF, laboratory, ultrasound, delivery): ≈ 40 %.
Compensation or reimbursement to the pregnant woman (depending on the model): ≈ 25 %.
Legal fees (contracts, judgments, apostilles): ≈ 10 %.
Obstetric and neonatal insurance: ≈ 15 %.
Logistics (travel, accommodation, translation, documentation): ≈ 10 %.
5.1 Financing and support.
Medical loans in the USA: CapexMD, Future Family.
Corporate coverage: companies such as Google, Meta or Pinterest cover up to 40 000 USD for employees using surrogacy.
Crowdfunding campaigns (GoFundMe, Generosity): not recommended for reasons of privacy and exposure of the minor.
Gestlife allows payment in up to 7 installments.
Financial entities do not put obstacles to finance a surrogacy process.
6. Health and psychological requirements
The success of a surrogacy process does not depend only on medical technology. It is essential that all persons involved - gestational carrier, intended parents and clinical team - meet physical and mental health requirements.
6.1 Surrogate
Age between 21 and 40 years.
Body Mass Index (BMI) less than 30.
At least one pregnancy and delivery without complications.
Medical tests: HIV, syphilis, hepatitis B and C, cytology, blood group, RH.
Independent professional psychological evaluation.
Motivational interview and socioeconomic verification.
6.2 Intended parents
Demonstrable financial solvency to cover the process and expenses of the minor.
Medical report of infertility (when required, in altruistic models).
Clean criminal record.
Mandatory participation in emotional counseling sessions (preparation for parenthood, reproductive grief if applicable, bonding with the surrogate).
7. Step-by-step medical itinerary
The medical itinerary of a surrogacy usually lasts between 15 and 18 months. Each step requires planning, expert professionals and personalized follow-up.
Selection of agency and clinic (2-4 weeks): initial legal advice, signing of pre-contract, verification of expectations.
Matching with the surrogate (1-3 months): video call interviews, compatibility of values, signing of contract.
Ovarian stimulation and follicular puncture (10-14 days): oocyte production and retrieval.
Fertilization and culture to blastocyst (5-6 days).
PGT-A (optional): genetic analysis to reduce risk of anomalies.
Embryo transfer: outpatient procedure, without anesthesia.
Pregnancy confirmation: β-hCG analysis at day 12; ultrasound at week 5.
Complete prenatal follow-up: minimum 8 medical controls according to WHO protocol.
Delivery: hospital with neonatology, shared birth plan.
Filiation and return: court sentence or civil registry, baby's passport, exit visa.
8. Insurance and medical guarantees
Specialized obstetric insurance is mandatory in most commercial or compensated programs. This insurance protects both the pregnant woman and the baby against complications such as preeclampsia, premature delivery or cesarean section.
Recommended coverage:
Pregnant: prenatal checkups, hospitalization, cesarean section, transfusions, optional life insurance.
Neonate: ICU admission, respiratory or cardiac complications, extended pediatric care.
Health visa: in some countries private medical insurance is required to obtain a visa for the child.
9. Documentary checklist
A common mistake is to underestimate the amount of legal and medical documents required for the process. The following checklist allows you to prepare everything in advance:
Valid passport (intended parents and future baby).
Apostilled and translated criminal certificates.
Infertility report (when required).
Bilingual and legalized surrogacy contract.
Informed consents from clinic and surrogate.
Medical policies (obstetric, neonatal, travel insurance).
Court sentence or registry of filiation with apostille.
Sworn translations of all documents (when required).
Gestlife offers a checklist for each country and a personal manager who reviews all the documentation step by step.