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What is surrogacy?
Commercial Gestational Surrogacy: A contract in which a woman (surrogate) gestates a fetus created via assisted reproduction for intended parents, with payment for gestational services; the surrogate has no genetic link to the child.
Altruistic Surrogacy: Surrogacy in which the surrgogate does not recieve financial compensation. In this case, the surrogate is often a close friend or family of the intended parents.
Law and Policy: International Surrogacy
Surrogacy is a controversial practice internationally; policies range from complete bans to being unmentioned in legislation (Winkler 2024, The Surrogacy Law Center 2018, Gianluca et. al. 2025, Shenfield et. al. 2025). Most countries partially regulate surrogacy; altruistic surrogacy is more frequently legalized than commercial gestational surrogacy (Luo et. al. 2022, Shenfield et. al. 2025). Frequent regulations include limiting intended parents to specific demographics or to those for whom surrogacy is deemed “medically necessary,” and varying policies regarding legal guardianship (Luo et. al. 2022, Shenfield et. al. 2025).
Incomprehensive surrogacy bans and international inconsistencies increase surrogacy markets in less regulated countries, resulting in frequently exploitative contracts and conditions for surrogates (Nalbandian 2025, Beiner 2018, Hibino 2022, Luo et. al. 2022, Ramskold et al. 2013, Beiner 2018, Flores 2023). Transnational surrogacy can reinforce existing wealth gaps between countries; Hibino 2022 notes an increased demand “for surrogacy in developed countries… and economically vulnerable Asian women [are] lured by lucrative compensation.” This “surrogacy tourism” can also complicate child citizenship status, creating risk for child statelessness and complicated adoption procedures (Shenfield et. al. 2025). The UNESCO International Bioethics Committee calls for an international surrogacy ban on the grounds of risk for coercion by surrogate poverty and lack of adequate healthcare, and the argument that human cells and body parts (including a womb) cannot be sold (Flores 2023).
Figure 1. Asia regulations and bans on surrogacy. Figure created by Pedro Brandão & Nicolás Garrido in their article offering an overview of Commercial and Altruistic Surrogacy.
Figure 2. Europe regulations and bans on surrogacy. Figure created by Pedro Brandão & Nicolás Garrido in their article offering an overview of Commercial and Altruistic Surrogacy.
Laws and Policies: Surrogacy in the US and California
Figure 3. North and South America regulations and bans on surrogacy. Figure created by Pedro Brandão & Nicolás Garrido in their article offering an overview of Commercial and Altruistic Surrogacy.
Surrogacy is not federally regulated in the United States, ranging from legalization, to bans, to unacknowledgement across states (Gonzalez 2019, Legal Professional Group 2016-2024). Surrogacy lawyers and agencies often simplify state policies by categorizing them as different levels of “surrogacy-friendly” (surrogate.com 2025, American Surrogacy 2025). Generally, “surrogacy-friendly” states (including California) “allow compensated and uncompensated surrogacy agreements,” and “grant pre-birth orders regardless of intended parents’ marital status, sexual orientation, and in some cases, genetic relationship to the baby” (surrogate.com 2025). Surrogacy “non-friendly” states (primarily New York and Michigan) “generally do not recognize or enforce surrogacy contracts and have statutes or published case law prohibiting compensated surrogacy” (surrogate.com 2025). Most states fall in between, with complex surrogacy laws that “offer varying or uncertain levels of protection for surrogates and intended parents” (surrogate.com 2025). Some surrogacy lawyers and agencies further note that legislation does not equate to regulation or common practice; surrogacy processes are often primarily informed by personal cases and precedent. Law center American Surrogacy even comments that “[w]hat is written in state laws may not represent the way surrogacy is really practiced there, so don’t be discouraged” (American Surrogacy 2025). California is known as one of the most surrogacy-friendly states, “expressly permit[ing] surrogacy arrangements” and allowing pre- and post-birth parentage orders regardless of intended parents' marital status, sexual orientation, or genetic relation to the baby (Legal Professional Group 2024).
Laws and Policies: Survivor Advocacy Recommendations
Following UNESCO’s call for an international surrogacy policy, we suggest consistency across borders and between legislation and regulation. Exploitative surrogacy practices and difficulties in citizenship and guardianship documentation primarily occur in places with minimal regulation and subsequently increased markets. Increasing existing policy enforcement through a transformative justice framework and creating a comprehensive and unified surrogacy policy can limit surrogate exploitation and trafficking.
Surrogacy Markets
As of 2025, the global surrogacy market has an estimated value of 28 billion USD in 2025 and is expected to reach 201.8 billion USD by 2034. With a Compound Annual Growth Rate of 24.6%, surrogacy is one of the fastest growing sectors within the assisted reproductive technology (ART) industry(GMI, 2025).
(right) Figure 4. Anticipated global surrogacy market value in billions of USD. The market is estimated at $28 billion in 2025 and is projected to rise exponentially within the next seven years. Figure created by Jesus Mesa.
Where the Money Goes
There is a persistent imbalance in the distribution of funds within the surrogacy market. While each client is charged tens of thousands of dollars, organizations such as fertility clinics, hospitals, egg donor agencies, genetic labs, legal firms, etc. obtain most of the revenue, leaving surrogates with less than 25% of the total fees paid by the intended parent. Major companies shaping the market include IVIRMA, Bangkok IVF Center, Boston IVF, Bourn Hall International (TVM Capital Healthcare), and Circle Surrogacy, among others. These organizations maintain sophisticated international networks, enabling intended parents to seek jurisdictions with favorable laws, lower costs, or higher perceived medical standards (GMI, 2025).
Regional Market Shifts
The United States remains the largest surrogacy market, valued at USD 5.1 billion in 2024, due to advanced medical infrastructure, established legal processes, and high price tolerance among intended parents. As surrogacy grows and regulations shift, several stakeholders face financial losses. Ukraine offers an example of the economic losses surrogacy clinics and agencies face when markets are reduced; the recent conflict in Ukraine limited transnational surrogacy, shifting global surrogacy demand to Mexico. Similarly, agencies in countries tightening laws, including India, Thailand, and Cambodia, experienced steep declines after international surrogacy was restricted or banned. Intended parents often face rising costs as markets tighten or as demand shifts to more expensive regions. Smaller or less reputable agencies may be outpriced or outregulated by larger international networks. Surrogates themselves may lose income opportunities when countries impose new regulations or bans, even though they historically receive only a small share of total fees (GMI, 2025).
Drivers Behind Market Expansion
Many factors impact the surrogacy market, such as increased rates of infertility amongst couples due to lifestyle and hormonal changes, increased acceptance of LGBTQ+ couples, and greater public awareness for alternative fertility treatment options for parents who want biological children. Advancements in ART, including improved IVF success rates and preimplantation genetic testing, make surrogacy more reliable and appealing. These trends anchor surrogacy firmly within the broader ART sector, which continues to expand as infertility becomes a global public-health concern (GM1, 2025).
(right) Figure 5. Patient uses for Assisted Reproductive Technology. This chart details the reasons behind Assistive Reproductive Technology use increase. Figure created by USA Facts Team 2025.
Surrogacy Pros
Surrogacy opens access to children and family structure for non-heteronormative family structures (LGBTQ+ couples, infertility, etc.), as it “support[s] biological parenting even in the complex fertility situation” (GMI, 2025).
Surrogacy compensation can provide economic mobility for surrogates (ABC News In-Depth, 2019).
Legislation regulating or banning surrogacy practices the biopolitical control of women’s bodies. Increasing scrutiny on the already-policed female body can create concerns over further legislation limiting women’s bodily autonomy (Foucault, 2003, pp. 240-241).
Surrogacy Cons
Surrogacy is often an exploitative practice of labor trafficking. Surrogate wombs are commodified, and their lives are, at times, restricted and controlled by surrogacy agencies (Pande 2010, p.982).
Pregnancy is a high-risk bodily process, with lasting health effects and high mortality rates (Salamon 2022, Johnson 2021, Patel 2025, Gutzeit et. al. 2019, Sidney Pelvic Clinic 2025, Durning 2024). In the United States, an average of 18.6 women died out of 100,000 live births (National Center for Health Statistics 2023).
Practices of transnational surrogacy can lead to child statelessness. For example, both altruistic and commercial surrogacy are banned in Spain. As a result, many couples travel to Ukraine, where surrogacy is legal. In September 2018, Spain stopped registering the births of children born via surrogacy in Ukraine, leaving nearly 30 families stranded due to concerns about medical malpractice and possible child trafficking (Hyder-Rahman 2021, p. 126). This issue was exacerbated by the COVID-19 pandemic: when Ukraine's borders closed, foreign couples were not able to attend the births of their children, or were unable to return to their home country with their newborns (2021, p. 126). Hyder-Rahman 2021 notes that “one clinic alone counted 50 ‘stranded’ babies.”
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