Choosing a fertility clinic is a major decision in a gestational surrogacy journey. The clinic will assess medical suitability, manage embryos and medication, coordinate infectious-disease testing and perform the embryo transfer. Its policies can affect the surrogate, intended parents, donors and the wider professional team.
The short answer: Ask how much surrogacy experience the clinic has, who makes medical-clearance decisions, which tests are required, how embryo transfer is managed, how success rates are calculated, what every stage costs and how the clinic coordinates with your agency, lawyers and mental-health professionals.
Do not rely on a single headline success rate or a polished consultation. Ask for clear, written answers and compare more than one clinic where possible. The most suitable clinic is one that can safely manage your particular journey and communicate respectfully with everyone involved.
Start with the clinic’s surrogacy experience
Not every fertility clinic regularly manages gestational-carrier cycles. General IVF experience is important, but surrogacy introduces additional screening, consent, communication and legal-coordination requirements.
Ask:
- How many gestational-carrier journeys does the clinic manage each year?
- Is there a dedicated third-party reproduction or surrogacy coordinator?
- Has the clinic worked with patients in our circumstances and jurisdictions?
- Does the clinic accept independently matched surrogates as well as agency matches?
- Which agencies, lawyers, counsellors and laboratories does it commonly work with?
- Can we choose our own qualified professionals?
Ask who will be your main contact and who covers when that person is unavailable. A clinic may be clinically experienced but still difficult to work with if responsibilities and communication channels are unclear.
Questions about medical screening
The clinic—not the matching platform or agency—should decide whether a prospective surrogate is medically suitable for treatment. Agency pre-screening can save time, but it does not equal full medical clearance.
Ask the clinic:
- Which pregnancy and delivery records must the prospective surrogate provide?
- Which previous pregnancy complications require further review?
- Which physical examinations, imaging and laboratory tests are required?
- Which infectious-disease tests apply to the surrogate, her partner and genetic contributors?
- Are age, body-mass index, previous caesarean deliveries or medication use considered?
- How recent must screening results be before embryo transfer?
- Who reviews the records and makes the final medical-clearance decision?
- Will the clinic explain a refusal or request for more information?
Our guides to surrogacy screening and medical tests for prospective surrogates explain the broader process.
Questions about psychological support and consent
Medical treatment should be supported by appropriate psychological evaluation and implications counselling. This gives the surrogate and intended parents space to explore expectations, boundaries, communication, difficult pregnancy decisions and the relationship after birth.
Ask:
- Does the clinic require separate and joint psychological consultations?
- What qualifications and surrogacy experience must the counsellor have?
- Is ongoing counselling available after clearance?
- How are language or accessibility needs accommodated?
- Who explains the medical consent forms to the surrogate and intended parents?
- How does the clinic confirm that consent is informed and freely given?
The surrogate retains authority over her own medical care. A clinic should explain how it protects informed consent and handles situations in which the parties have different preferences.
Questions about embryos and transfer policy
Embryo-transfer policy affects the health of the surrogate and any resulting child. The American Society for Reproductive Medicine strongly recommends single-embryo transfer in gestational-carrier cycles because multiple pregnancy increases risk.
Ask:
- Does the clinic normally transfer one embryo in gestational-carrier cycles?
- Under which exceptional circumstances would it consider transferring more than one?
- How are embryos assessed and selected for transfer?
- Does the clinic recommend preimplantation genetic testing in our circumstances, and what are its limitations?
- Can existing embryos be shipped to the clinic, and which laboratory requirements apply?
- How does the clinic identify, store, transport and witness embryos?
- What happens if an embryo does not survive thawing?
- Which decisions must be documented before treatment begins?
Ask the clinician to explain recommendations for your actual embryos and medical history rather than presenting optional testing as automatically necessary.
Questions about medication and embryo transfer
The prospective surrogate should receive her own explanation of the treatment plan, medication, possible side effects and warning signs. She should also know whom to contact outside normal hours.
Useful questions include:
- Will the cycle be medicated or based on natural ovulation?
- Which medicines are used, for how long and by which route?
- Who teaches medication administration?
- Where can monitoring be completed if the surrogate lives far away?
- How many visits are usually required before transfer?
- Does the clinic require travel or bed rest after transfer?
- Which symptoms require urgent medical advice?
- When is the pregnancy test, and when is the first ultrasound?
Read what happens during an embryo transfer to a surrogate for a step-by-step overview.
Questions about success rates
Success statistics can be useful, but they are easy to misunderstand. The US Centers for Disease Control and Prevention notes that clinic rates vary because clinics treat different patient populations and use different methods. Small numbers can also produce extreme percentages. The UK Human Fertilisation and Embryology Authority advises considering factors such as cost, location and patient experience rather than choosing on success rates alone.
Ask:
- Which outcome is being reported: positive test, clinical pregnancy or live birth?
- Is the rate calculated per cycle started, egg retrieval or embryo transfer?
- Does the figure specifically cover gestational-carrier cycles?
- Does it separate embryos made with intended-parent eggs from donor eggs?
- How many cycles are included in the figure?
- Which year or reporting period does the data cover?
- Is the result independently reported to a regulator or national registry?
- What is the clinic’s multiple-pregnancy rate?
- What factors are most likely to affect our individual chance of success?
In the United States, compare clinic-reported information with the CDC ART Success Rates service. In the UK, use the HFEA Choose a Fertility Clinic service for verified clinic data and inspection information.
Questions about costs and refunds
Request a written, itemised estimate based on a surrogacy cycle—not a standard IVF headline price. Ask which charges are fixed, which depend on treatment and which are paid to outside providers.
Check whether the estimate includes:
- consultations and medical-record review;
- surrogate and genetic-contributor testing;
- monitoring, medication and laboratory work;
- embryo thawing and transfer;
- embryo storage or transport;
- pregnancy testing and early scans;
- cancelled-cycle or repeat-transfer charges;
- donor treatment or genetic testing, where relevant;
- administrative or third-party reproduction fees.
Ask when each payment is due and which fees are refundable if medical clearance is not granted, a cycle is cancelled or an embryo cannot be transferred. Clinic treatment is only one part of the overall budget described in our guide to surrogacy costs.
Questions about legal coordination
The clinic should not replace independent lawyers, but it should know which legal documents it needs before treatment. Ask:
- Does the clinic require written legal clearance before medication or embryo transfer?
- Must the surrogate and intended parents use separate lawyers?
- Which jurisdictions must the lawyers be qualified to advise on?
- How are parentage, consent and embryo-disposition documents recorded?
- What additional requirements apply to international patients?
- Can the clinic coordinate with lawyers chosen independently by each party?
Surrogacy and parentage laws vary widely. A clinic being willing to provide treatment does not by itself confirm that an arrangement is legally secure.
Questions about communication and privacy
A surrogacy journey involves information belonging to different people. Ask how the clinic handles communication without confusing who the patient is or sharing confidential information improperly.
- Who receives test results and treatment updates?
- Which information requires the surrogate’s permission before it is shared?
- Can intended parents attend appointments in person or remotely?
- How quickly are routine questions answered?
- Who handles urgent medical questions after hours?
- How does the clinic communicate with outside monitoring providers?
- Which secure portal or communication system is used?
- How are language, disability and accessibility needs supported?
Questions about pregnancy handover and complications
Fertility-clinic care generally ends after early pregnancy monitoring, after which obstetric care takes over. Ask when this handover normally happens, which records are transferred and who remains available if the obstetric team has questions.
Also ask how the clinic manages pregnancy loss, failed transfer, ectopic pregnancy, medication reactions and other complications. Participants should know who provides clinical care and emotional support at each stage.
Warning signs when comparing clinics
Be cautious if a clinic guarantees success, presents pregnancy rates as though they were live-birth rates, will not explain the denominator behind a percentage or pressures you to purchase optional add-ons without discussing evidence and limitations.
Other concerns include unclear fees, poor privacy practices, difficulty obtaining written policies, pressure to transfer multiple embryos, dismissive communication with the surrogate or reluctance to coordinate with independent lawyers and counsellors.
Preparing for the first consultation
Before the appointment, gather a short summary of reproductive history, information about any existing embryos, the locations of the intended parents and prospective surrogate, and the details of professionals already involved. Bring a written question list and take notes.
Afterwards, ask for the proposed treatment pathway, estimated timetable and itemised costs in writing. Compare the answers with another qualified clinic before deciding. You can also browse fertility clinics listed on SurrogateFinder and review our guide to the role of a surrogacy agency.
Frequently asked questions
Does every fertility clinic offer surrogacy treatment?
No. Some clinics do not provide gestational-carrier treatment, while others have dedicated third-party reproduction teams. Confirm the clinic’s current services, eligibility rules and geographical restrictions before arranging a consultation.
Should I choose a fertility clinic based on success rates?
Success data are useful but should not be the only factor. Compare the outcome measured, patient population, cycle type and number of cases, then consider experience, safety, communication, location, regulation and cost.
Who medically clears a surrogate?
The fertility clinic and appropriately qualified clinicians should review records, conduct the required assessment and decide whether the prospective surrogate is medically suitable. Agency pre-screening is not full medical clearance.
How many embryos should be transferred to a surrogate?
ASRM strongly recommends single-embryo transfer in gestational-carrier cycles because multiple pregnancy increases health risks. Individual decisions should be made by the treating clinician with informed consent and reference to current professional guidance.
Should the surrogate speak directly with the fertility clinic?
Yes. The surrogate is the patient for medication and embryo transfer and should receive information directly, provide her own informed consent and have access to the clinical team for questions and urgent concerns.
Sources and further guidance
- American Society for Reproductive Medicine: recommendations for practices using gestational carriers
- US Centers for Disease Control and Prevention: interpreting ART success rates
- Human Fertilisation and Embryology Authority: finding the best fertility clinic for you
- Human Fertilisation and Embryology Authority: preparing for a clinic appointment
Important: This article provides general information, not medical or legal advice. Treatment, screening, consent and legal requirements differ between clinics and jurisdictions. Obtain advice from qualified professionals familiar with your circumstances before proceeding.