Surrogacy in the US 2026 is measured mainly through gestational carriers: CDC data show 8,862 embryo transfers to carriers in 2021, or 4.4% of all US embryo transfers, and a JAMA study of SART data found a 54.3% live birth rate per transfer with a carrier versus 43.6% without one. Industry sources put a typical US journey at $150,000 to $220,000, and compensated surrogacy is legal in most states, with Louisiana and Nebraska the most restrictive.
Surrogacy in America 2026 – Introduction
Surrogacy in the US 2026 is a small slice of fertility care that keeps changing. In 2021, the latest year with a full CDC national summary table, clinics performed 8,862 embryo transfers to gestational carriers, up from 3,202 in 2012. Carriers received 4.4% of all transfers. For scale, CDC counted 98,289 infants conceived with assisted reproductive technology in 2022, about 2.6% of US births, and a 2024 review found carrier pregnancies make up only 0.1% of all pregnancies.
Cost and law have moved at the same time. Industry sources put a full US journey at $150,000 to $220,000. Michigan’s surrogacy statute took effect on April 2, 2025, Hawaii’s Act 298 followed on January 1, 2026, and federal citizenship orders signed on August 6, 2026 added a new layer for international parents. This report covers volume, success rates, costs, state laws and safeguards. Figures run through October 2026.
Interesting Facts About Surrogacy in the US 2026
GESTATIONAL CARRIER EMBRYO TRANSFERS IN THE US (1 block = 250 transfers)
2012 | █████████████ 3,202
2019 | █████████████████████████████████████ 9,195
2021 | ███████████████████████████████████ 8,862
| Fact | Confirmed Data |
|---|---|
| Carrier embryo transfers, 2021 | 8,862 |
| Carrier embryo transfers, 2012 | 3,202 |
| Peak year | 2019 (9,195 transfers) |
| Carrier share of embryo transfers, 2021 | 4.4% |
| Live birth per transfer, with vs without a carrier (2014–2020) | 54.3% vs 43.6% |
| Typical total cost (industry-reported) | $150,000–$220,000 |
| Michigan statute effective | April 2, 2025 |
| Hawaii Act 298 effective | January 1, 2026 |
Source: CDC, 2021 Assisted Reproductive Technology Fertility Clinic and National Summary Report; JAMA, 2023 (SART data); Michigan Legislature; Egg Donor & Surrogacy Institute, 2026.
The chart shows a near tripling. Carrier transfers rose 177% from 3,202 in 2012 to 8,862 in 2021, with a peak of 9,195 in 2019. The table adds the outcome gap: transfers to a carrier produced a live birth 54.3% of the time in 2014–2020 SART data, against 43.6% for other transfers.
Two scale checks keep the numbers in proportion. Carriers account for 1.4% of all 413,776 ART cycles started in 2021 when egg and embryo banking cycles count, and 4.4% of embryo transfers. Applying the 54.3% live birth rate to 8,862 transfers gives roughly 4,800 deliveries, an estimate rather than an official count, because no federal agency publishes a surrogacy birth total.
Surrogacy Trends in the US 2026: How Carrier Use Grew Since 2012
CARRIER SHARE OF US EMBRYO TRANSFERS (1 block = 0.5%)
2012 | █████ 2.4%
2013 | █████ 2.6%
2014 | ██████ 2.9%
2015 | ███████ 3.3%
2016 | ███████ 3.6%
2017 | ████████ 4.2%
2018 | █████████ 4.7%
2019 | ███████████ 5.4%
2020 | █████████ 4.7%
2021 | █████████ 4.4%
| Year | Carrier Transfers | Share of Embryo Transfers |
|---|---|---|
| 2012 | 3,202 | 2.4% |
| 2019 | 9,195 | 5.4% |
| 2020 | Not itemized | 4.7% |
| 2021 | 8,862 | 4.4% |
Source: CDC, 2021 Assisted Reproductive Technology Fertility Clinic and National Summary Report, Figure 8.
Carrier use rose almost every year to a 5.4% share in 2019, then slipped to 4.7% in 2020 and 4.4% in 2021. Transfers fell 3.6% from the 2019 peak to 2021. SART data analyzed in JAMA show the same arc: 2.7% in 2014, 5.2% in 2019 and 4.6% in 2020. The pause overlaps the pandemic years, though the CDC report does not name a cause.
Age drives use. In 2021, carriers received 2.9% of transfers for patients under 35, 3.5% for ages 35–37, 4.1% for ages 38–40 and 9.0% for patients over 40. The oldest group used a carrier at 3.1 times the rate of the youngest. That pattern fits the main reasons people turn to surrogacy: age-related uterine and medical limits, and families who cannot carry a pregnancy at all.
Surrogacy Success Rates in the US 2026: Pregnancy and Live Birth Per Transfer
OUTCOMES PER EMBRYO TRANSFER, 2014-2020 (1 block = 2%)
Pregnancy, with carrier | ████████████████████████████████████▌ 73.0%
Pregnancy, without carrier | ████████████████████████████████ 63.4%
Live birth, with carrier | ███████████████████████████ 54.3%
Live birth, without carrier | ██████████████████████ 43.6%
| Measure (2014–2020) | With Carrier | Without Carrier |
|---|---|---|
| Pregnancy per transfer | 73.0% | 63.4% |
| Live birth per transfer | 54.3% | 43.6% |
| Transfers of two or more embryos | 27.6% | 36.0% |
| Live births that were twins or more | 14.8% | 12.6% |
Source: JAMA 2023;330(17):1691–1694, analysis of 1,008,205 transfers in SART data, of which 40,177 (4.0%) used a carrier.
Transfers to a carrier beat other transfers on every success measure. Pregnancy per transfer ran 9.6 points higher (73.0% vs 63.4%), and live birth ran 10.7 points higher (54.3% vs 43.6%). Screened carriers and younger donor eggs probably explain part of the gap.
Outcomes for babies also favored carriers on prematurity. After adjusting for plurality, the risk of preterm birth was 20% lower (adjusted relative risk 0.80) and very preterm birth 24% lower (0.76). Twins were the exception: 14.8% of carrier live births were multiples, against 12.6%. CDC’s 2021 donor-egg benchmarks, which carrier cycles often use, were 53.5% live birth for fresh embryos from fresh donor eggs and 46.3% for frozen embryos. Agency pages quote higher rates for tested embryos, but those are not national statistics and this report does not rely on them.
Single Embryo Transfer in Surrogacy 2026: Multiple Births Fall Sharply
CARRIER CYCLES, 2014 VS 2020 (1 block = 2%)
Multiple-embryo transfers, 2014 | ████████████████████████████ 56.6%
Multiple-embryo transfers, 2020 | ██████ 11.8%
Multiple births among live births, 2014 | █████████████ 25.5%
Multiple births among live births, 2020 | ████ 7.4%
| Metric | 2014 | 2020 |
|---|---|---|
| Multiple-embryo transfers | 56.6% | 11.8% |
| Multiple gestations among live births | 25.5% | 7.4% |
| Genetic testing in multiple-embryo cycles | 23.9% | 61.4% |
Source: American Journal of Obstetrics and Gynecology, 2024, SART data for 2014–2020; ASRM Scientific Congress abstract on carrier transfer trends.
Carrier clinics changed practice fast. The share of transfers using more than one embryo fell 79.2% between 2014 and 2020, and the share of multiple gestations among live births fell 71.0%. Over the full 2014–2020 period, 27.6% of carrier transfers still used two or more embryos, a figure pulled up by the early years.
ASRM and SART recommend single embryo transfer in carrier cycles because multiples raise health risks for the carrier. The national trend backs that advice: single embryo transfers across all US ART rose from 24.8% in 2012 to 82.9% in 2021, and the multiple-birth share of ART infants dropped from 42.2% to 10.7%. Carrier cycles started with a higher multiples rate than the national average and have closed most of the gap.
Surrogacy Cost in the US 2026: What a Full Journey Costs
TYPICAL COST COMPONENTS, RANGE MIDPOINTS (1 block = $5,000)
Surrogate compensation | █████████████████ ~$85,000
Agency and case mgmt | █████████ ~$45,000
IVF and clinic fees | ████████▌ ~$42,500
Insurance, screening | ████ ~$21,000
Legal and escrow | ███ ~$15,000
| Cost Category | Typical Range |
|---|---|
| Surrogate compensation and benefits | $60,000–$110,000+ |
| Agency fee and case management | $30,000–$60,000 |
| IVF, medications and clinical fees | $25,000–$60,000 |
| Legal fees and escrow coordination | $10,000–$20,000 |
| Insurance and screening | $12,000–$30,000 |
| Total journey | $150,000–$220,000 |
Source: Egg Donor & Surrogacy Institute, 2026 U.S. Surrogacy Cost Breakdown and Trends Report. Industry figures, not government data; other agencies quote $90,000 to $300,000.
Surrogate pay is the largest line. Established programs often start base compensation near $60,000, with totals of $80,000 to $110,000 or more once allowances and milestone payments count, while other agencies pay first-time surrogates $45,000 to $55,000. A surrogacy-only program that uses existing embryos typically costs $120,000 to $180,000, because it skips egg retrieval and embryo creation.
Insurance is the least predictable item. Many health plans exclude surrogate pregnancy, so agencies budget $10,000 to $30,000 for coverage review and screening. Escrow does not raise the total, but it controls when money moves. Families should also plan past the delivery date: raising a child adds a second bill, tracked in these US childcare cost statistics, where the national average for infant care already runs into the tens of thousands of dollars a year.
Surrogacy Laws by State 2026: Where Compensated Surrogacy Is Legal
RECENT STATE SURROGACY STATUTES (effective dates)
Massachusetts Parentage Act | January 1, 2025
Michigan Act 24 of 2024 | April 2, 2025
Hawaii Act 298 | January 1, 2026
| Legal Posture | States |
|---|---|
| Comprehensive statutes, compensated gestational surrogacy and parentage orders | California, Colorado, Connecticut, Delaware, District of Columbia, Maine, Nevada, New Hampshire, New Jersey, New York, Vermont, Washington |
| New frameworks, 2025–2026 | Massachusetts, Michigan, Hawaii |
| Contracts unenforceable or unclear | Arizona, Indiana, Nebraska (contracts void by statute) |
| Most restrictive | Louisiana (compensation barred; narrow eligibility) |
Source: Michigan Legislature, MCL 722.1701 et seq.; state-by-state legal summaries from surrogacy law firms and agencies, 2026. Classifications vary by source and are not legal advice.
Michigan made the biggest move. Its Assisted Reproduction and Surrogacy Parentage Act repealed the 1988 Surrogate Parenting Act, which had made Michigan the only state to criminalize surrogacy contracts, and the new law took effect on April 2, 2025. Hawaii’s Act 298 followed on January 1, 2026 with a parentage framework based on the Uniform Parentage Act of 2017, including pre-birth order pathways.
The restrictive end is narrow. Nebraska declares surrogacy contracts void, and Louisiana bars compensation and limits eligibility to married couples using their own gametes, according to law-firm summaries. Families in those states often work with a carrier in another state. Intended parents usually reach surrogacy after other treatment fails, and the size of that pool is covered in these infertility rate statistics in the US.
Federal Citizenship Orders and Surrogacy 2026: What Changed
2026 FEDERAL TIMELINE
Jun 30 | ████ Supreme Court decides Trump v. Barbara
Aug 6 | ████████ Executive Orders 14418 and 14419 signed
Sep 2 | ████████████ Preliminary injunction on Order 14418 (class-wide)
| Date | Development |
|---|---|
| June 30, 2026 | Supreme Court holds in Trump v. Barbara that children born in the US to unlawfully or temporarily present parents are citizens at birth |
| August 6, 2026 | Executive Order 14418 directs agencies not to issue or accept citizenship documents in listed cases, including commercial transactions with a surrogate in the US |
| August 6, 2026 | Executive Order 14419, “Ending Birth Tourism,” directs State and DHS on visas for travel to give birth |
| September 2, 2026 | Federal court in Maryland blocks Order 14418 for a certified class; Order 14419 is not halted |
Source: Executive Orders 14418 and 14419 (Federal Register, August 2026); U.S. Supreme Court; CASA, Inc. v. Trump preliminary injunction, September 2, 2026; law-firm analyses by Charles Russell Speechlys and Foster + Bloom.
The orders do not ban surrogacy. Law-firm analyses say they address federal citizenship documents and visas, and they do not cancel state parentage orders or invalidate state surrogacy statutes. Order 14418’s surrogacy language targets non-citizen parents in commercial arrangements, so it matters most to international intended parents.
The September 2 injunction is preliminary and covers a defined class of children, so it does not settle every surrogacy case. Parentage, birth certificates, passports and visas are separate legal questions. A carrier’s citizenship, each parent’s status, the state parentage process and the visa category all affect the analysis, which is why attorneys advise individual review before travel.
Surrogacy Legal Safeguards 2026: ASRM Standards and Parentage Orders
ASRM CARRIER LIMITS (1 block = 1 delivery; age range 21-45)
Prior term pregnancies, minimum | █ 1
Prior deliveries, maximum | █████ 5
Prior cesareans, maximum | ███ 3
| Safeguard | Standard |
|---|---|
| Carrier age | Preferably 21–45 |
| Prior pregnancy | At least 1 term, uncomplicated pregnancy |
| Prior deliveries | No more than 5; no more than 3 by cesarean |
| Psychosocial evaluation | Strongly recommended for carriers and partners |
| Legal representation | Separate, ongoing counsel for the carrier and intended parents |
| Embryo transfer | Single embryo transfer recommended |
| Parentage | Pre-birth or post-birth order under state law |
Source: American Society for Reproductive Medicine Practice Committee, Fertility and Sterility 2022;118(1):65–74.
ASRM’s guideline sets the medical and legal floor, and it is a recommendation, not a law. A Utah study of birth certificates from 2009 to 2018 found nearly 1 in 5 carrier pregnancies did not meet ASRM guidelines, which shows why clinic screening and independent counsel matter. The strongest protections combine three pieces: a written agreement signed before medication starts, a state parentage order and escrowed funds.
Health outcomes need a benchmark, and national birth data provide one. Preterm and twin rates by race and region are in these American birth rate by race statistics. Compare carrier results against those figures, not against marketing claims.
Frequently Asked Questions About Surrogacy in the US 2026
How many babies are born through surrogacy in the US each year?
No agency publishes an official count. CDC recorded 8,862 carrier embryo transfers in 2021, and applying a 54.3% live birth rate gives roughly 4,800 deliveries as an estimate.
What percentage of IVF transfers use a surrogate?
Carriers received 4.4% of US embryo transfers in 2021, down from a 5.4% peak in 2019.
What is the success rate of surrogacy?
Transfers to a carrier produced a live birth 54.3% of the time in 2014–2020 SART data, compared with 43.6% for other transfers.
How much does surrogacy cost in the US in 2026?
Industry sources put a typical full journey at $150,000 to $220,000, with complex cases above $250,000.
How much do surrogates get paid?
Estimates range from about $45,000 for first-time surrogates at some agencies to $110,000 or more in total packages at others. Established programs often start near $60,000.
Is surrogacy legal in all 50 states?
Not uniformly. Most states allow it, Nebraska voids surrogacy contracts, Louisiana bars compensation, and Arizona and Indiana are classed as unclear or unenforceable.
When did Michigan legalize surrogacy?
Michigan’s Assisted Reproduction and Surrogacy Parentage Act took effect on April 2, 2025, repealing the 1988 ban.
What is the difference between gestational and traditional surrogacy?
In gestational surrogacy, the carrier has no genetic link to the child. In traditional surrogacy, the surrogate’s own egg is used. CDC tracks gestational carriers.
Does health insurance cover surrogacy?
Often not. Many plans exclude surrogate pregnancy, so agencies budget $10,000 to $30,000 for insurance and screening.
What are ASRM’s requirements for gestational carriers?
Preferably ages 21 to 45, at least 1 term uncomplicated pregnancy, no more than 5 deliveries or 3 cesareans, psychosocial evaluation and separate legal counsel.
Do the August 2026 executive orders ban surrogacy?
No. Orders 14418 and 14419 address federal citizenship documents and visas. A court blocked Order 14418 for a certified class on September 2, 2026, and state law still governs parentage.
Are surrogate pregnancies riskier for babies?
Preterm risk was 20% lower with a carrier after adjustment, but 14.8% of carrier live births were multiples versus 12.6%. Single embryo transfer reduces that risk.
How long does a surrogacy journey take?
Agency estimates run about 11 to 15 months from match to birth.
Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.