20 Questions to Ask a Surrogacy Agency Before You Sign (Surrogate Edition)

We've been doing this for over a decade—more than 500 families created since 2015—and we've heard every version of "I wish I had asked that sooner." So we're putting the questions out there for you, along with our honest answers, because we don't gatekeep information here.

Whether you're evaluating Roots or comparing us to other agencies, these are the questions that separate good agencies from great ones.

The Agency Itself

1. Who founded the agency, and do they have personal experience with surrogacy?

This matters more than most people realize. Founders who've lived this process—as a surrogate, as an intended parent, or both—build programs differently than those who approach it purely as a business.

At Roots: Brooke Kimbrough, our co-founder and CEO, is a former gestational carrier. Cassie Wright, our co-founder, became a parent through IVF. They started Roots in 2015 specifically to build the agency they would have wanted for themselves. That perspective shapes every policy, every process, and every decision we make.

2. How long has the agency been operating, and how many journeys have you completed?

Experience isn't everything, but it's a lot. An agency that has navigated hundreds of journeys has seen the complications, the edge cases, the things that go sideways—and knows how to handle them.

At Roots: We've been operating for over 10 years and have facilitated 500+ successful journeys. We match approximately 125–150 families per year. That's not a startup learning on your dime.

3. How large is your team, and who will actually be managing my case?

Some agencies look polished on the outside and have two people running everything behind the scenes. Others have large teams where you're passed between departments and never build a real relationship with anyone.

At Roots: Our team is nine women strong—female-owned, female-operated, female-led. You'll start with our intake team (Carly and Terez), who walk you through onboarding and prepare you for matching. Once you're matched, you transition to a dedicated case manager who is with you from that point through the birth of your baby and beyond. One person. Consistent. Accountable.

4. What is your caseload per case manager?

A case manager handling 60+ journeys simultaneously cannot give you the attention you need. Ask directly.

At Roots: We deliberately limit caseloads to protect the quality of care every family receives. Our boutique model exists for a reason: we'd rather do fewer journeys exceptionally well than more journeys adequately.

Surrogate Screening & Matching

5. How do you screen your surrogates, and what does that process actually include?

Vetting language is everywhere in this industry. What you need to know is what's actually being checked, by whom, and how long it takes. A thorough vetting process takes months—not days.

At Roots: We accept approximately 1% of surrogate applicants. Our vetting process runs four months and includes:

• Full medical history and pregnancy record review
• Comprehensive lab work (infections, STIs, toxicology)
• Transvaginal ultrasound and health screening
• Driving record check
• Full background investigation via private investigator—including everyone in the household over 18
• Ongoing social media monitoring (Facebook, Instagram, Snapchat, TikTok)
• Two-part psychological evaluation: licensed mental health professional interview plus formal psychological testing

By the time a surrogate's profile reaches you, she has been rigorously evaluated. We're confident in every candidate we present—because we've done the work.

6. How does matching work? Do I see a database of surrogates, or is it curated?

There's a significant difference between scrolling a database and receiving a thoughtful, curated match. Databases can feel efficient, but they shift the burden of evaluation onto you—and you don't have the context to evaluate it well.

At Roots: There is no database. You see one profile at a time, selected for you based on your preferences, values, and clinical needs. We consider personality compatibility, communication expectations, lifestyle alignment, and medical fit. If you pass on a surrogate, you stay at the top of the list—but she moves to the next family. If you accept, your profile is shared with her. If both parties agree to move forward, her full file goes to your clinic for approval, and we schedule a match call to introduce everyone, set expectations, and talk through the timeline.

It's intentional. It's personal. And it protects everyone involved.

7. How long does matching typically take?

Wait times are one of the most anxiety-producing parts of this process. There is a genuine surrogate shortage in the United States, and any agency that tells you matching is fast and easy without context isn't being straight with you.

At Roots: Most of our families are matched within three months. We also offer plans that can significantly expedite that timeline—our Total Assurance Program™, for example, guarantees a surrogate match within 4–8 weeks.

8. Do you support double embryo transfers (DETs)?

This is a values question as much as a medical one. DETs significantly increase the risk of multiples, which carries serious health risks for both the carrier and the babies.

At Roots: We do not support double embryo transfers. Full stop. This is non-negotiable, and it reflects our commitment to the health and safety of our surrogates.

9. Do you only work with gestational carriers, or do you also facilitate traditional surrogacy?

Traditional surrogacy—where the surrogate uses her own eggs—creates significant legal and emotional complexity. Most reputable agencies don't offer it.

At Roots: We work exclusively with gestational carriers. Your surrogate will never be genetically related to your child.

Legal & Medical Coordination

10. What states do you work in, and what are the legal considerations in my surrogate's state?

Surrogacy law varies dramatically by state. Some states have clear, protective frameworks. Others are legally murky or outright restrictive. Your agency should know this landscape cold.

At Roots: We have experience working with surrogates across multiple states and understand the legal considerations in each. We do not work with surrogates in Louisiana, Nebraska, or Indiana due to legal restrictions. Our legal team ensures that your contract, your rights, and your surrogate's protections are properly structured based on her state's laws.

11. Will you refer me to a surrogacy attorney, or do I need to find one myself?

Legal contracts in surrogacy are not DIY territory. You need an attorney who specializes in reproductive law—not a generalist.

At Roots: We refer you to experienced reproductive attorneys. Your attorney drafts the Gestational Carrier Agreement (GCA), you review it together, it goes to your surrogate's independent attorney, and once everyone signs and notarizes, you move into the escrow funding phase.

12. How is escrow handled?

Escrow is how your surrogate's compensation, medical expenses, insurance premiums, and all other costs are managed and disbursed. It should be held by a licensed, neutral third party—not the agency itself.

At Roots: We work with licensed escrow services to manage all payments. Your funds are held securely and disbursed on a clear, agreed-upon schedule. You will know exactly what's in escrow and where every dollar goes.

13. What clinics do you typically work with?

Your surrogate will travel to your clinic for the medical screening and embryo transfer. Knowing which clinics your agency has established relationships with matters for logistics and coordination.

At Roots: We work with top-rated fertility clinics across the U.S., with the majority located in California, New York, New Jersey, Washington, Texas, and Oregon.

Financial Transparency

14. What is the total estimated cost of surrogacy, and what does your agency fee cover?

This is the question most families are afraid to ask directly. Don't be. Any agency worth working with will give you a clear answer.

Here's the honest picture: total surrogacy costs in 2026 typically range from $150,000 to $200,000+ depending on the plan you choose, your clinic, insurance situation, and how many transfer cycles are required. Agency fees are one component of that total.

At Roots, our plans are:

Plan

Agency Fee

Payment Schedule

Harmony Plan

$50,000

$25,000 at agency contract signing; $25,000 at legal contract signing

Premium Connection Plan

$72,000

$25,000 at agency contract; $25,000 at legal contract; $22,000 at embryo transfer

Executive Bliss Plan

$150,000

$50,000 at agency contract; $75,000 at legal contract; $25,000 at embryo transfer

Total Assurance Program™

$400,000 (all-inclusive)

$50,000 at agency contract; $300,000 into escrow at GCA signing; $50,000 at first embryo transfer

The Total Assurance Program™ is our most comprehensive option—it covers surrogate base compensation up to $80,000, unlimited embryo transfers, unlimited rematches, IVF-related clinical costs up to $75,000, OB care, hospital and delivery costs, insurance, legal fees for both parties, medications, psychological evaluations, escrow coordination, and full case management from match through birth. It's designed for families who want one clear financial commitment and no surprises. Note: No guarantee of pregnancy or live birth is made. If no pregnancy is achieved and you choose to cancel your contract with Roots, a $100,000 refund is applied.

15. What is surrogate compensation, and who pays it?

Intended parents fund surrogate compensation through escrow. Understanding the full compensation structure—base pay, allowances, and milestone bonuses—helps you budget accurately.

At Roots: First-time surrogates earn $70,000+ in total compensation and benefits, including a $60,000 base, monthly allowances, medical and travel reimbursements, childcare support, wellness benefits (doula, chiropractic, massage, acupuncture), and milestone bonuses. This is paid monthly through escrow, on time, every time.

16. Are there costs I should expect to pay out of pocket, or are expenses handled through escrow?

Surprise out-of-pocket costs are one of the most common complaints families have about agencies that don't communicate clearly.

At Roots: Nearly all expenses flow through escrow. Your surrogate is rarely, if ever, out of pocket—and when she is (a meal, an Uber ride), she submits receipts and is reimbursed promptly. You'll have visibility into the escrow account throughout your journey.

Support & Communication

17. How will you communicate with me throughout the journey, and how often?

Silence is one of the most stressful things an intended parent can experience. You should know exactly how and when you'll hear from your agency.

At Roots: We use a structured communication framework called 5 Touchpoint Weeks—consistent, scheduled check-ins across every phase of the journey (Seed, Water, Grow™). You're never left wondering where things stand.

18. What happens if the match doesn't work out?

Rematches happen. Medical clearance can fall through. Compatibility issues can surface after the match call. A good agency has a clear plan for this—and doesn't charge you a fortune to navigate it.

At Roots: If a rematch is required for medical or situational reasons, our Total Assurance Program™ covers unlimited rematches at no additional charge. Other plans address rematch scenarios clearly in your agreement—no surprises.

19. What support do you provide during pregnancy and after birth?

The birth is not the end of the journey. Post-birth support—especially for your surrogate—matters, and it reflects how an agency actually values the people in its program.

At Roots: Case management continues through the birth and into the postpartum period. We support your surrogate through what we call the "fourth trimester," and we stay connected with your family as you transition home with your baby. For surrogates, we also provide wellness support, emotional check-ins, and community connection throughout.

20. Can I speak with families who have worked with your agency?

References matter. Any agency confident in its work should be able to connect you with past clients.

At Roots: Yes. We encourage it. We'll connect you with families who've been through the journey—because the best way to understand what we do is to hear it from the people we've done it for.

What "Good" Actually Looks Like

We've worked with hundreds of families, and the ones who feel most confident going into their journey are the ones who asked the hard questions early—about costs, about process, about what happens when things don't go as planned.

Here's what good looks like in plain language:

• A vetting process that takes months, not days. If a surrogate is available immediately with minimal screening, ask why.
• Transparent, itemized costs. Not ranges so wide they're meaningless—actual numbers, actual payment schedules.
• One dedicated case manager. Not a department. A person.
• Clear legal protections. Independent attorneys for both parties. Escrow held by a neutral third party.
• A values match, not just a logistics match. The agency you choose will be in your life for 12–18 months. You should trust them, like them, and feel confident they'll tell you the truth—even when it's hard.

We're not the right agency for every family. We know that, and we're at peace with it. But if what we've described here resonates with you—if you want a process that's ethical, guided, and grounded in real relationships—we'd love to talk.

Ready to Take the Next Step?

Click the Apply Now button, or schedule your first conversation with Brooke, our co-founder and former surrogate, who will walk you through the process, introduce the team, and answer every question you have—including the ones you're not sure how to ask yet.

Schedule Your Intro Call with Brooke →

No pressure. No pitch. Just clarity—because that's how we do things at Roots.