10 Questions for Gay Men to Discuss Before Starting Surrogacy

Written by Bryan McColgan, Physician Journalist

Dr. Bryan McColgan is an international authority on IVF and surrogacy for gay men. He is the founder of the Gay Dad Reporter, the world’s first online platform dedicated to news about surrogacy and rainbow families with a focus on gay men.

Starting a family through surrogacy is an exciting yet complex path for many gay men. From navigating genetics and logistics to choosing the right country, egg donor, and surrogate, there are countless factors to consider. This article highlights 10 key questions you and your partner can discuss to prepare for the journey ahead, helping you feel more informed, confident, and ready to take the next step toward fatherhood.

So, you're a gay, bi, queer-identified man who has thought about becoming a father through surrogacy. Amazing.

A surrogacy journey is called a journey for a reason. It’s long, complicated, and there are many decisions along the way. In order to make it less overwhelming, there are things you can ask yourself before starting the process.

In this article, I wanted to share some key questions that you can think about and/or discuss with your partner to clarify your thoughts and make planning for surrogacy as a gay man a bit less daunting.

Why surrogacy?

The first question may seem unnecessary. After all, you are reading this because you are interested in surrogacy. However, it’s important to really understand if this is the best process for you. Rainbow family building can be done through several options, including adoption, fostering, and surrogacy.

Surrogacy has been growing in popularity among queer men, but it’s important to think about the best way for you to have children. I think the two most important factors to consider are genetics and logistics.

Genetics simply refers to the fact that with surrogacy, you can have a genetic link to your child. For some people, this is important. For others, not so much. If you index highly on at least the potential of having this genetic connection, then surrogacy is the option for you.

Logistics is the second main consideration. By this, I mean that surrogacy is more of a predictable process. Sure, there will be challenges, delays, and potential heartbreak along a surrogacy journey with picking an egg donor, making embryos, and getting pregnant, but for the most part, we are talking about an optimal reproductive situation with young, healthy gametes (i.e., sperm and eggs) and a medically cleared surrogate.

The process can generally be done more efficiently than adoption or fostering, both of which can be filled with years of delays, legal complications, and the challenge of uncertainty underwriting the entire journey. Also, adoption and fostering as a single gay man or same sex male couple may be more challenging where you live, so this is another consideration.

If you are not built for the logistical rollercoaster that often accompanies adoption or fostering, then surrogacy is potentially a better path.

What country do we do our surrogacy journey in?

Surrogacy is global. However, regulations are rapidly evolving, and it’s important to know where surrogacy is allowed and what types of surrogacy can be pursued in a given territory.

Surrogacy is not permitted in most of Europe and many countries around the world. You should not pursue surrogacy in these locations. In some countries, surrogacy operates in a legal gray area (i.e., there are no specific laws permitting or preventing it). In these settings, the surrogate (and potentially her partner) is the parent of record regardless of who donated the sperm and egg, and the laws around transferring parentage to the intended fathers could be challenging or impossible.

My recommendation is to only pursue surrogacy in areas where it is legal and well-regulated. This protects everyone involved and allows for an ethical and enjoyable journey.

The United States is the leader for compensated gestational surrogacy, meaning the surrogate is compensated directly for carrying the pregnancy. However, the United States is also the most expensive country to pursue surrogacy, with the average total cost being around $225,000. Many intended fathers explore more affordable options in Mexico and Colombia, where the average total is around $70,000.

With non-U.S. commercial surrogacy options, there are considerations regarding legal challenges in terms of parentage, paperwork, and actually bringing your new bundle of joy back to your home country. The U.S., especially surrogacy-friendly states like California, makes the intended father(s) the parent(s) of record from the delivery, making the immigration and legal situation much more straightforward. Countries outside the U.S. often have longer timelines for getting the paperwork in order, meaning weeks or months could be spent waiting in the foreign country until you and your family can travel home.

If you are considering a newer destination for surrogacy that is less established than the U.S., it’s critical that you consider what is needed for the journey to be ethical and safe for the intended parents, the baby, the egg donor, and the surrogate.

In terms of altruistic surrogacy or gestational surrogacy, where the surrogate is not directly compensated, this can be done in several countries, with Canada and the United Kingdom being the most established. However, the U.K. is only an option for U.K. residents, while Canada is open to anyone regardless of their residency. Altruistic surrogacy still means the intended parents cover reasonable costs such as clothing, food, travel, and obviously all medical expenses incurred by the surrogate, and it’s important to note that the wait time to match with a surrogate in an altruistic country is significantly longer than with a compensated arrangement.

Legality, cost, and timing are all considerations with regard to the geography of surrogacy, and choosing where you have your journey is a big decision in the process.

Which of the intended dads donates sperm?

Before you even decide who will donate sperm, be sure to get your sperm tested. RFK Jr. is not completely wrong when he said that the quality and quantity of sperm in the male population are declining compared to previous generations. It’s important to know your sperm quality, as it can affect your journey, and there are lifestyle and medical changes you can make to improve your sperm.

When you are ready to start making embryos, it’s important to know if you want the option for one genetic father or two. On average, the process of making embryos results in 6 high-grade embryos for transfer. For my husband and I, we ended up having 3 high grade embryos in what I described as the Embryonic Olympics. If you split the eggs, as many gay couples do, and both fertilize half, the number of embryos that have your genetic contribution will be even smaller.

You do have the option to utilize frozen eggs that are already retrieved. Frozen eggs are less expensive than a fresh retrieval, but these are often in batches of 6 and have varying success when it comes to fertilization.

It is likely that with a young, healthy egg donor, if you both contribute sperm, then you will each have at least one high-grade embryo. So, whose embryo will be transferred first? In general, successful transfers with gay intended fathers and appropriately medically cleared surrogates are about 70%, so the first transfer is likely to take. What if you end up only wanting one child? Would you be okay if the first embryo chosen was not from your sperm? Also, clinics, agencies, and surrogates are becoming increasingly more restrictive on multiple implantations, given the higher risk of complications, so this is another aspect to consider if you are thinking you can easily navigate this by having twins and selecting one embryo from each intended father.

It’s a numbers game, and it’s crucial to know how you and your partner want to navigate those numbers when it comes to how your rainbow family is created.

Who is the ideal egg donor?

Until scientific advancements allow for IVG (in vitro gametogenesis), where a man’s sperm could be made into an ovary, gay men have to rely on an egg donor for the creation of embryos.

Choosing an egg donor is the first concrete step in a surrogacy journey where the story of your child really starts to be written. After all, you are choosing 50% of their genetic makeup.

Thinking of this ‘story,’ as in the story you want to tell your child about where they came from, is the best way to view an egg donor.

When your child asks how you picked the egg donor, it can be as simple as ‘I/We liked the way she looked.’ However, in addition to the physical appearance, perhaps there is a cultural or ethnic connection that you would like to have represented in your family, given the background of you or your partner? Maybe she is artistic, scientific, driven, caring, or has some other personality trait(s) that you value. Thinking about who she is, even if your child has no relationship with her and never sees her, is important, as your child will always think of her as ‘part of’ them.

Most importantly, in my opinion, is this ability to have your child reach out to them in the future. I believe that it is imperative to have this option for the health and well-being of the child, but many egg donors want to remain anonymous. This was a large factor for my husband and I when we chose our egg donor.

Think about talking to your 6-year-old, 16-year-old, and 26-year-old. What do you want to say to them as they grow up and have questions about their own identity?

What support do we need during the surrogacy journey?

Surrogacy is a long and challenging process. Whether you are a single intended dad or in a relationship, you will need support from family, friends, and/or chosen family. However, it’s important to think about what support you will need to navigate the ins and outs of the medical, legal, and financial landscape of surrogacy.

Knowing who you are, how much research you have done or want to do, and how much time and money you have will help inform the type of support you will need on your journey. Having a child through surrogacy is like building your own village. You need an IVF clinic, an egg donor, a lawyer (most likely more than one), and a surrogate at the bare minimum.

You can find and organize all this yourself in what is aptly called an ‘independent’ journey. Many dads opt for independent journeys for their second or subsequent children. However, being new to the process on a first journey, it is common to want more support from people like care coordinators and surrogacy advocates. These support structures are available through a surrogacy agency, which can provide everything from general advice to full concierge service at varying price points.

Time, money, emotions, planning, and details. These things mean different things to different people, and it’s important to weigh the pros and cons of each of these aspects in your journey to know what you can manage and what type of support you need.

It’s important to also think of this process as not just something to ‘get through,’ but rather as something to be cherished and enjoyed. It’s hard work to become a father through surrogacy, but you also want to look back on this time with joy and excitement. The best way to do that is to ensure you have the support that is right for you, right from the beginning.

What makes a good surrogate match?

The surrogate will be an integral part of the process, and this is the relationship besides the one with yourself and your partner that is most important on the journey.

Whether you are working with an agency or going independent, it’s imperative that the surrogate is medically qualified. In the U.S., it is very challenging for women to qualify as surrogates. However, a medical qualification is only one of many aspects that make a surrogate a good match. Trust, communication, and honesty. These are the pillars of any solid relationship between an intended parent (IP) and surrogate.

While you can put any number of agreements, restrictions, or clauses in the contract between IPs and a surrogate, this is really only a substitute for these three pillars. Knowing yourself, and the surrogate knowing herself and being able to communicate needs, wants, and knowing the difference between these are critical aspects to a good match.

This strategy will fare much better than a contractual agreement stipulating countless hypothetical scenarios. Don’t get me wrong, the contracts between the IPs and the surrogate are crucial, and they should each have their own lawyers and do a critical review of the agreements. This is a process my husband and I just completed.

Also, there are parts of the contract that are essential, such as alignment on conditions for potential termination of a pregnancy, to make sure everyone is in complete agreement. However, at the end of the day, this journey involves people, and people are not perfect.

Being able to navigate the challenges that cannot be foreseen involves being able to communicate and trust each other. Finding someone whom you can trust and who can trust you is the most important part of matching with your surrogate.

How will we navigate the pregnancy?

Navigating the pregnancy involves deciding with your partner and your surrogate what medical appointments are most important for you to attend, and seeing what your budget will allow. For international IPs like my husband and I, frequent travel can be cost prohibitive and difficult with work.

FaceTime and WhatsApp video messaging allow IPs to virtually attend appointments. However, there are a few appointments that every IP should consider being present for:

• Implantation: This can be challenging, as it can put a lot of pressure on the surrogate to have the implantation ‘stick.’ However, it is the ‘first moment’ of the pregnancy, so discussing if this is important to you, your partner, and the surrogate is a good idea.

• Heartbeat: Usually around the 10-week visit, this is an exciting moment for IPs and surrogates. This is right before the time when you can start more openly sharing the pregnancy in the second trimester, and the heartbeat is the first ‘communication’ from your baby.

• Anatomy scan: This is a must for most IPs. It’s the 20-week visit, and it’s a detailed ultrasound that goes over every part of the baby’s body. There can often be a 3D reconstruction as an image to keep, and it’s the first time you can see your baby actually looking like a baby.

In addition to appointments, how you will communicate between medical visits is also an important consideration for navigating the pregnancy. Aligning with your surrogate on how you both want to communicate, how frequently, and what you prefer to discuss (i.e., sometimes both parties just want to chat and stay in touch and not always talk about the baby).

This varies for international IPs or IPs who may live close enough to visit in person, so you have to decide as well how important the communication and visitation are during the pregnancy to also know where your surrogate can possibly be located.

What are the plans for the birth of our child?

This discussion is about how much time you can spend near the surrogate before the pregnancy. Some agencies require international IPs to spend at least 1 month near the surrogate before the due date, in case the baby comes early.

For those having twins, IPs often come earlier as twins have a higher likelihood of complications and longer hospital stays. If you are thinking about having twins, this is a consideration regarding how much time you will have to be away from your home, work, or even your country before and after the birth.

Depending on which state your surrogate is giving birth in, there may be a certain amount of time after the birth before the paperwork and documents are ready for you to travel with your baby, either domestically or internationally. Some states offer pre-birth orders, while others have post-birth orders. These refer to the legal documentation and processes to have you and your partner as the parents of record, and, as the names suggest, they can be done at different times relative to the delivery and take different times to process. The types of orders are determined by the state, and this is another consideration when choosing what state(s) you prefer your surrogate to live in.

Lastly, you may be spending a considerable amount of time in another city, state, or country. Thinking about who you want with you and around you is important. How close do you need to be to your friends, family, or chosen family during this process? How does this compare to finding the ‘best possible surrogate,’ who may not live in a city or state near you or those you want around?

There are a lot of logistics around the birth, but thinking of these ahead of time can help make the actual birth and first meeting of your child all the more magical.

How much will the surrogacy journey cost?

The cost of IVF and surrogacy for gay intended dads is expensive. There is no other way to say it.

Between the clinic, lawyer, egg donor, surrogate, hospital, travel, insurance, and everything else along the way, the estimated cost for a journey in the United States is $225,000. As I stated above, there are less expensive options for compensated journeys in Mexico and Colombia, where the average total is around $70,000. In all countries with compensated surrogacy, these costs can vary widely depending on the compensation for specific egg donors, surrogates, and agencies.

For altruistic journeys, Canada is estimated to be around $100,000. While the UK can go up to around $80,000.

These are all estimates, and the costs can vary in any country depending on how you navigate your journey. Perhaps you have a step-sibling or close friend who wants to donate eggs or be the surrogate, both options saving considerable expense. Perhaps you have multiple failed transfers and have to make another set of embryos, doubling the costs for this part of the process.

The most important thing is to be realistic about the cost and consider all the pros and cons of each geography when it comes to your journey.

How do we pay for the surrogacy journey?

The good news about the cost is that there are options to pay for the journey.

For those in the U.S., you should have a discussion with your employer. Many companies across different industries, such as Google, Disney, and Johnson & Johnson, offer financial support for IVF and/or surrogacy. You should ask your HR team if you have these benefits and how to access them.

If your company doesn’t have these benefits, you can work to get them. This is something I am doing at my company. My company currently offers fertility benefits to the U.S.-based employees, but not international employees. If this is the case for you, or if your company doesn’t yet offer benefits to U.S. employees, you can contact companies such as Carrot Fertility, Progyny, or Maven Clinic. These fertility benefits companies work with employers to put together packages for IVF and surrogacy for their employees. It’s a win-win for your company to recruit and retain good talent and for the fertility company to expand its offerings.

Another financing option includes Men Having Babies’ Gay Parent Assistance Program (GPAP). Men Having Babies (MHB) is a non-profit organization that puts together incredible conferences all over the world to educate and connect IPs with IVF clinics, lawyers, and surrogacy agencies in the U.S. and Canada. MHB’s GPAP offers financial assistance based on your and your partner’s income, allowing for various degrees of discounts on parts of your journey.

Even if you don’t qualify for MHB’s GPAP, I would highly recommend going to a MHB conference. My husband and I attended one in Berlin, and it was the moment that really kick-started our own journey. Lastly, financing options also include loans, refinancing of your house, GoFundMe campaigns, and help from friends and family.

The journey is not cheap, and it takes years. However, if you want to become a father as a gay man through surrogacy, know that it is doable. Start with these questions and discussions, and then the process will start to take shape.

You can do it. Feel free to reach out to me on my website at any time with any questions.

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Read more from Bryan McColgan

Bryan McColgan, Physician Journalist

Dr. Bryan McColgan is a Stanford and Columbia University-trained physician who is currently on his first journey to fatherhood through surrogacy. Navigating IVF and surrogacy in the United States from his current home in Sweden led Bryan to start the Gay Dad Reporter, the leading online platform dedicated to assisted reproduction for gay intended fathers. His mission is ethical surrogacy for gay intended dads everywhere.