Overseas Assisted Reproduction Q&A

Surrogacy generally refers to a family-building arrangement in which a woman carries and gives birth to a child for intended parents, with medical, legal and professional support. Common forms include:

• Gestational surrogacy: an embryo created through assisted reproduction is transferred to the surrogate's uterus. The surrogate normally has no genetic link to the embryo.
• Traditional surrogacy: uses the surrogate's own eggs, so she is genetically related to the child. Because this raises more complex medical, ethical and parentage issues, most international programs today use gestational surrogacy.

Surrogacy is not purely a medical program. It can involve contracts, parentage confirmation, birth registration, nationality, travel documents, border crossing and household or status arrangements after returning home. Intended parents should obtain advice from lawyers both in the program's jurisdiction and in their place of long-term residence before starting.

Rules vary significantly between countries — and even between regions of the same country — and policies can change. Destinations most often discussed include:

• United States: rules are set state by state. Some states have clear law and court procedures, some are restrictive, and others lack complete written rules. Marital status, gender, genetic relationship and residence can all affect feasibility.
• Colombia: assisted reproduction and surrogacy practice exists, and the Constitutional Court has heard cases on children born through surrogacy, nationality, birth registration and family relationships. There is still no single dedicated law covering the whole process, so each program must be assessed case by case.
• Canada: operates an altruistic model. Purchasing surrogacy services or paying compensation is not allowed, though reasonable pregnancy-related expenses may be reimbursed where legal and documentation requirements are met.
• Other countries: some open only to people meeting specific marital, gender, nationality or medical conditions; others prohibit or strictly limit surrogacy. Geopolitics, visa policy and birth registration rules can all affect execution.

PuhuSpring never recommends a program simply because "country X allows surrogacy." We weigh marital and family circumstances; whether egg or sperm donation is needed; the genetic relationship to the child; budget and timeline; birth registration, nationality and travel document pathways; legal requirements both locally and back home; and tolerance for medical, insurance and unexpected risks.

Actual cost depends on the country, the medical protocol, whether donor eggs are used, the number of embryos and transfers, the surrogate's pregnancy, insurance, legal fees and newborn care. Typical items include:

• Initial medical examinations
• Sperm and egg retrieval and laboratory fees
• IVF, ICSI and embryo culture
• Embryo testing such as PGT
• Donor screening and related services
• Surrogate screening, testing and pregnancy support
• Embryo transfer and prenatal care
• Legal, notary and documentation fees
• Insurance or medical risk reserves
• Birth and newborn medical costs
• DNA testing, birth registration and travel documents
• Accommodation, transport, translation and infant care

Any program can incur unplanned costs from failed transfers, miscarriage, multiple pregnancy, premature birth, cesarean delivery, neonatal hospitalization or policy changes.

During consultation and planning, PuhuSpring helps distinguish: costs clearly included; costs that may arise but are not yet fixed; costs paid directly to third parties; and the risk budget we suggest holding in reserve. Final figures are always those in the formal documents from clinics, lawyers, insurers and other providers.

The first step is not signing or paying, but completing a preliminary feasibility assessment. This usually includes:

• Understanding family structure, health and reproductive goals
• Confirming existing sperm, eggs or embryos
• An initial view on suitable countries and program paths
• Assessing budget, timeline and key risks
• Consulting an independent local lawyer
• Undergoing medical assessment at a partner institution
• Deciding whether to proceed only after fully understanding the contract

PuhuSpring helps organize questions, compare plans and understand the process — but medical diagnosis comes from licensed physicians, and legal opinions from qualified lawyers in the relevant jurisdiction.