Everything you need to know about Roots (IP edition)
I just received an email from a potential client that is doing research on agencies and had a TON of questions. I thought this would be a great opportunity to be able to answer all of these questions, not only for her, but for all parents doing initial research on Roots. Here goes…
Program Overview
How many births have you had in the past year? Five years?
In the past year, Roots Surrogacy supported 94 births. Over the last five years, our team has helped bring more than 400 babies into the world. We have had over 500 babies in our tenure.
How many case managers do you have?
We currently have six case managers, each with years of experience guiding families and surrogates through every step of the process.
How many cases are being managed by each case manager?
Each case manager supports an average 25-30 active journeys at a time, ensuring personalized attention and consistent communication.
How do you communicate with surrogates and intended parents?
We use whatever method of communication works best for the client. It is a mixture of email, phone and text messaging.
What makes Roots Surrogacy different?
Roots was founded with one intention; to be the agency we would want to use if we were a gestational carrier or intended parent. Our reputation is that of a “boutique agency” because of the level of personalization and connection we foster. We consistently serve our clients with transparency, ethical practices and educated guidance.
Surrogate Screening
What are the steps in your surrogate screening process?
Initial application and interview
Social Media review
Collection and review of medical records
Comprehensive background checks with a private investigator for GC and everyone in her household over 18
Psychological evaluation by a licensed professional
Education and readiness training
Does your agency have stricter requirements than ASRM?
Our criteria mirror or exceed ASRM guidelines. We typically accept women ages 22–40, with a BMI under 30, at least one prior uncomplicated delivery, and no major medical or mental health concerns.
Do you visit the home of potential surrogates?
No. Home visits are an antiquated practice that have shown little to no benefits. Instead, we focus on crating connective relationships with our surrogates. We learn about their lives, partnerships, support people and general stress levels. We want to understand who the surrogate is. Other factors that could be identified like smoking in the home will be tested in the lab work of the surrogate and her partner.
Are surrogates shown to intended parents while still being screened?
No. Surrogates must complete all initial screening steps before being presented to any intended parent.
Who do you perform background checks on?
We perform national criminal, civil, and driving background checks on the surrogate and her spouse or partner. Additionally, if there is anyone in the home over 18+, they are also background checked.
What medical records do you review?
We review full OB and delivery records, postpartum reports, surgical notes (such as C-section summaries), and relevant lab results. Records are obtained directly from hospitals and OB offices and reviewed by our nurse and screening coordinator.
How do you verify mental health and medication history?
Mental health is assessed through a psychological evaluation by a licensed professional. Current medications are verified during intake and again during the clinic’s medical screening.
Do you allow a history of miscarriage?
Yes. A past miscarriage does not automatically disqualify a surrogate; we review the medical cause and confirm clearance from her physician. We obtain OB clearance and typically an additional MFM clearance for all of our GCs.
What other tests are required?
Our surrogates complete full infectious disease panels, a pap smear (if due), drug screening, and psychological assessments prior to matching.
What training or education do surrogates complete?
Each surrogate completes educational modules that cover the surrogacy process, communication expectations, and emotional preparedness.
Do you review driving or civil history? What about her spouse?
Yes, we review civil, criminal, and driving records for both the surrogate and her spouse or partner to ensure a secure and responsible foundation for the journey.
Surrogate Population
Where do most of your surrogates live?
There is a surrogate shortage in the United States. We will take a surrogate in any state that offers a pre-birth order. We do not work in IN, AZ, LA,AL and TX.
What are the demographics of your surrogate community?
Average age: 34
Age range: 25–38
Race/Ethnicity: ~60% Caucasian, 20% Hispanic, 10% Black, 10% Mixed/Other
Do most surrogates have insurance that covers surrogacy?
About 35% have policies that include surrogacy coverage. For others, we arrange a comprehensive plan through a specialized insurance provider or the ACA, depending on timing.
What percentage of surrogates live in pre-birth order states?
All. 100%
Clinic Collaboration
What records do you share with clinics?
We share all relevant medical and psychological screening results with your fertility clinic.
Matching Process
What are the steps in the matching process?
Surrogate pre-screening and approval
Intended Parent profile review by our team
Parent is shown Surrogate profile
Reflection period (24–48 hours)
If confirmed, Surrogate is shown IP profile.
Reflection period (24–48 hours)
Both parties confirm the match
Medical records and relevant information is shared with your clinic for their initial approval
Match call and confirmation of match
Medical screening at your clinic
Do surrogates see multiple families at once?
No. We present each surrogate to one family at a time to ensure clarity and commitment.
What do intended parents review before a match call?
You’ll receive the surrogate’s full profile and Surrogate Benefits Package which is a line item sheet about the specific costs for that particular carrier.
How much time do we have to decide?
Typically, 48 hours to review her profile and 24 hours after the match call to make a final decision.
When is it considered an official match?
Once both parties agree to proceed and the surrogate begins her medical clearance at your clinic.
Can we request additional tests during medical screening?
Yes. We can discuss what additional testing you would like.
When do rematch fees apply?
Before transfer (medical or non-medical): No fee and you remain top priority for rematch.
Depending on the plan that you choose, there may or may not be a rematch fee after transfer. Both Harmony and Premium have a $15,000 rematch fee. Executive has no rematch fees.
Is surrogate compensation fixed or custom?
Compensation is customized based on experience. First time carriers are base compensation of $60k, second time $70k-$90k average, thrid+ is $90k+
Legal
Can we use our own attorney?
Yes, you may use any attorney experienced in assisted reproduction. We work collaboratively with external counsel.
What insurance do you purchase for surrogates?
If a surrogate’s policy excludes surrogacy, we arrange a comprehensive policy through providers like Lloyd’s or an ACA policy
Transfer & Medical
Can we do a mock cycle before transfer?
Yes — this is at the discretion of your clinic.
What percentage of transfers are successful on the first try?
Transfer success rates come from your clinic, not from the agency. Ask your provider what their live birth outcome is with your specific parameters.
How is surrogate compensation paid?
Payments are made in eight equal monthly installments following heartbeat confirmation, with prorating if a journey ends early.
Communication & Support
How hands-on is your team with surrogates and intended parents?
Extremely. Each journey has a dedicated case manager who stays in close touch with both parties. We provide ongoing emotional and logistical support through regular check-ins, group messaging, and consistent support. Many surrogates and parents describe the experience as “personal and family-like.”
Travel & Birth
What support is provided for surrogate travel?
Our travel coordinator arranges all flights, hotels, and transfers, balancing quality and cost. We provide reminders, itinerary support, and assistance with delays.
How do you prepare for the birth?
Before delivery, our team coordinates with the hospital, attorneys, and your case manager to finalize the birth plan, hospital rooms, and parent accommodations.
Additional Information
Are you a member of SEEDS?
Yes. Roots Surrogacy is a proud SEEDS member, following its ethical guidelines and best practices. I also sit on their membership committee and am the incoming Mentorship Committee Chair.
Do you work with international intended parents?
Absolutely. We’ve supported families from dozens of countries who wish to complete their journey in the U.S., however, our primary focus is domestic parents.
How long have you been in business?
Over ten years, with more than 500 babies born through U.S. and internationally
Can I see your agency agreement and cost breakdown?
Yes — we provide sample contracts, detailed fee schedules, and program outlines upon request. Our team is happy to walk you through every line so you know exactly what’s included. Here are our Plans and Pricing, Estimated Cost Sheet, Payment Timeline. Please reach out directly for our Agency Agreement.
Closing Thoughts
At Roots Surrogacy, our goal is simple: to create ethical, transparent, and deeply connected journeys for every family. Whether you’re just beginning to explore surrogacy or ready to move forward, we’re here to answer every question.
Learn more at www.rootssurrogacy.com or reach us directly at info@rootssurrogacy.com.