March marks Surrogacy Awareness Month, a time dedicated to education, visibility, and honest conversation around one of the most misunderstood paths to parenthood. Despite growing demand for gestational carriers and increasing global need for family-building options, surrogacy – especially cross-border surrogacy – often remains clouded by misconceptions and outdated narratives.
For many intended parents, surrogacy is not a luxury or a last resort; it’s the only viable route to having a biological child. Yet the process is often portrayed in extremes: overly simplified, sensationalized, or reduced to headlines that don’t reflect the lived experiences of families or surrogates. At pregnantish, we honor Surrogacy Awareness Month by aiming to shift that narrative, spotlight the real stories, real challenges, and real support systems that make surrogacy possible.
It’s also a moment to highlight the importance of ethical, transparent, and well-supported programs, particularly for those pursuing fertility care across borders. As the landscape becomes increasingly global and as patients look at their increased options, navigating medical, emotional, and legal complexities requires trusted partners who understand the nuances, and who center the wellbeing of everyone involved.
Surrogacy is on the Rise
It is estimated that roughly 20,000 children are born through surrogacy each year worldwide – a number expected to climb as more people turn to third-party reproduction to build their families.
In the United States alone, from 1999-2013, nearly 31,000 surrogate pregnancies resulted in about 18,400 births, and since then, demand has only increased among heterosexual couples facing infertility, LGBTQ+ parents, and international intended parents navigating restrictive laws at home. Because so few countries keep comprehensive surrogacy records, global figures are stitched together from research studies, country-level reports, and industry estimates, making it difficult to quantify the full picture, but the trendlines are unmistakable. Surrogacy is not niche; it’s a growing, global pathway to parenthood.
That growth is shaped heavily by geography. Surrogacy laws vary: some countries offer no legal framework at all, others allow only altruistic arrangements, and a handful – including the U.S., Ukraine, Russia, and Georgia – have historically been known for more permissive commercial surrogacy policies, drawing intended parents across borders.
This geographic variability fuels a global fertility ecosystem now valued in the tens of billions of dollars, with recent market reports placing surrogacy-related services alone around $22–28 billion in 2024-2025. And because surrogacy is intertwined with assisted reproductive technologies (ART) like IVF, which has already resulted in tens of millions of births worldwide, its growth mirrors the broader shift toward more personalized, medically supported family building.
Even with imperfect data, one thing is clear: surrogacy has become a significant, expanding part of modern parenthood, shaped by science, policy, and the universal desire to grow a family.
Cross Border Surrogacy and Immigration Laws: What Intended Parents Should Consider
Tifany Markee, Founding Member of Foster + Bloom: Family Formation Law Group, shared her perspective on international surrogacy:
“I’m an Immigration Attorney, licensed in California and Colorado, and a Founding Member of Foster + Bloom, the first law firm in the nation focused exclusively on domestic and international family formation. We’re growing and expanding, with the goal of becoming a true national firm that can handle surrogacy and adoption issues across jurisdictions. My legal work sits at the narrow intersection of immigration and international family formation laws. I handle international surrogacy and adoption cases – truly the cross-border creation of families, with my focus on assisting families and individuals with any family formation steps (adoption or surrogacy) across borders, that naturally triggers immigration considerations.
I work with families who are going through My Surrogacy Journey (MSJ) between the U.S. and Mexico City. I’m often one of the first touchpoints for MSJ’s intended parents, both to answer any questions they have and to screen for any issues upfront, before signatures, payments, or a pregnancy, to ensure the child conceived is entitled to US citizenship at birth.
My role is to ensure that citizenship can be conferred at birth, and that families can predictably return to the United States shortly after the birth of their children in Mexico. For any surrogacy done abroad, the key requirement is that at least one intended parent has a genetic connection to the child (otherwise it’s viewed as an international adoption case, which entails a different complex process). My job is to make sure families have a clear and legal pathway home. Families always breathe a huge sigh of relief knowing their baby will be born a U.S. citizen, despite being born in Mexico. For any surrogacy done abroad, the key requirement is that at least one intended parent has a genetic connection to the child (otherwise it’s viewed as an international adoption case, which entails a different complex process). My job is to make sure families have a clear and legal pathway home. Families always breathe a huge sigh of relief knowing their baby will be born a U.S. citizen, despite being born in Mexico.
Once the pregnancy is underway, MSJ works through the AMPARO Resolution process – the equivalent of a pre or post birth order – which recognizes the intended parents as the only legal parents. It’s a court action that confirms exclusive legal parentage in the intended parent(s), and leads to the issuance of a birth certificate, which then allows us to complete the Consular Report of Birth Abroad (CRBA) and US passport process.
What impresses me most about MSJ is their commitment to building an ethical, high-quality program in a foreign country. They are genuinely concerned about the health and welfare of surrogates – ensuring they aren’t being taken advantage of financially and instead are gaining opportunities, like education. The surrogates have their own legal counsel. MSJ has extremely high standards and a strong regulatory structure, in large part due to their origins in the UK, where courts extensively review these processes. They’ve carried those high standards into the U.S.
One misconception I hear often is that families will be stuck abroad for months due to legal delays. In my experience, court orders come through in a matter of weeks. If you have a pre-birth order, families typically spend about 4-6 weeks in Mexico City. If the parentage order comes post-birth, it may require 8-12 weeks in Mexico City to finalize everything and pick up the birth certificate at the registry. Mexico City – and Polanco especially – is stunning. On a personal level, I was surprised by how much I loved it. As someone from a U.S. border town, I expected something entirely different. It’s an incredibly metropolitan, European-feeling city. It’s beautiful. Most people in Mexico City speak English, and there are many Americans and Spaniards living there, so the language barrier isn’t a problem as some may think. It’s much more accessible than people expect. One misconception I hear often is that families will be stuck abroad for months due to legal delays. In my experience, court orders come through in a matter of weeks. If you have a pre-birth order, families typically spend about 4-6 weeks in Mexico City. If the parentage order comes post-birth, it may require 8-12 weeks in Mexico City to finalize everything and pick up the birth certificate at the registry.
Cross-border surrogacy should be seen as a valid option, not a last resort. If done correctly, with a reputable agency that follows strong ethical practices, it can be just as positive and rewarding as domestic surrogacy. In fact, your child having a meaningful international cultural connection can be a beautiful part of their story. I’d encourage intended parents to be conscious of the ethics of the agency they choose, and ensure to ask questions like: How are surrogates recruited? How are they compensated? Transparency is paramount because oversight varies by country. But with the right partner, this pathway is absolutely feasible and it can be incredibly rewarding.”
Spotlight on the Founders of My Surrogacy Journey: Why They Created a Global Surrogacy Organization to Provide Intended Parents with a Safe, Supported, Affordable and Ethical Option
For many intended parents, especially LGBTQ+ families, surrogacy isn’t just a medical process; it’s a maze of misinformation, inconsistent support, and systems that weren’t built with them in mind. Too often, people enter this journey hopeful, only to find themselves navigating extremely high costs, inaccessible pathways, and emotional landmines no one warned them about.
Mike and Wes Johnson-Ellis know this firsthand because they lived it.
What began as their own complicated, and at times painful, entry into U.K. surrogacy became the spark for My Surrogacy Journey: an organization that they say they designed to provide the clarity, ethics, and humanity they wished they’d had as they navigated fertility via surrogacy. Mike and Wes have dedicated their lives to ensuring that international surrogacy can be an accessible, safe, and rewarding option for intended parents.
Mike:
Wes and I met in 2012 at Birmingham Pride – not exactly the place either of us expected to meet a future husband! Wes already had a child, and I’d always wanted to be a parent too. Very early on, we started talking about building a family. Surrogacy felt like our natural path; adoption wasn’t the right fit for us, and back then I was very focused on having a genetic link to my future children. Once we started researching, though, we realized just how confusing and unstructured the U.K. surrogacy system was. We were excited, vulnerable, and eager to move forward, but we kept running into people who weren’t prepared for families like ours.
Wes:
It always felt like we were on the outside. We weren’t expecting special treatment, we just wanted to feel included in the process like any other family. But the system wasn’t built with two men in mind. That became very clear when we left the relative safety of the fertility clinic and entered the NHS. The stares, the questions, the microaggressions: ‘Who’s the real dad?’ ‘Why is the surrogate’s husband here?’ It was constant. The moment we walked in for our first scan, we were told only the ‘real dad’ could come in. It wasn’t just disappointing, it was dehumanizing, and we later learned – discrimination.
Mike:
That moment pushed us into needing legal advice. The breaking point came when the hospital said the baby would have to be handed to us ‘off hospital property’ – so we were told we were to pick up our newborn baby in a car park – to avoid anything that might look like ‘human trafficking.’ It made the whole thing feel gross and wrong, especially when you’re talking about your child. Our lawyer found 14 counts of discrimination under the Equalities Act. That’s when we knew: people before us must have just been tolerating this, and we just weren’t willing to.
Wes:
So we told the hospital we’d drop the case if we could work with them to create a new policy for intended parents through surrogacy. And we did, alongside the head of midwifery and medical directors. That experience changed everything. Once the policy was fixed, our birth experience was beautiful, affirming, and inclusive. It proved that the care people deserve is possible when institutions are willing to evolve.
Mike:
Around that time, we also started realizing that no one talks about the emotional side of family building for queer men, like genetic grief, postnatal depression, and all the unspoken pressure. On each journey, one of us was genetically linked to one child, and we both struggled quietly with how that felt. We didn’t have language for it, and we didn’t have support. At one point, the emotional strain was so intense we questioned whether our marriage could survive it. That’s a huge part of why we created something more comprehensive. We didn’t want anyone else to go through this alone.
Wes:
And that’s where My Surrogacy Journey came from. Before MSJ, we launched Two Dads UK – we were speaking in Parliament, pushing for law reform, educating thousands of nurses, and trying to dismantle the misconceptions about surrogacy. But we wanted something more holistic. Something that would actually walk families through the journey with legal support, counseling, clinical guidance, prenatal education, and emotional care built in. That didn’t exist. So we built it. Before MSJ, we launched Two Dads UK – we were speaking in Parliament, pushing for law reform, educating thousands of nurses, and trying to dismantle the misconceptions about surrogacy. But we wanted something more holistic. Something that would actually walk families through the journey with legal support, counseling, clinical guidance, prenatal education, and emotional care built in.
Mike:
We launched MSJ in 2021 with the vision of changing the UK landscape. And we did. In about 18 months, we became the biggest surrogacy organization in the UK, not because we wanted to dominate anything, but because there was such a clear need for integrated support. The old model had been the same for 30 years. People were ready for something better.
Wes:
But the UK alone wasn’t enough, especially when many intended parents didn’t have the patience for the long UK process or the budget for a US journey. And with the war in Ukraine, people were turning to unsafe destinations. We knew we needed a middle ground. For us, Mexico, specifically Mexico City, offered the cultural, legal, ethical, and medical stability families needed. It was the only global destination that met our ethical criteria.
Mike:
Our Mexico City pathway is grounded in ethics and safety – the welfare of the child is central, always. And unlike other agencies, we don’t outsource surrogate recruitment. We screen every surrogate ourselves: legal checks, psych evaluations, socioeconomic assessments, home visits, pap smears, cultures, infectious disease screening, thyroid, glucose, hypertension, uterine evaluations – you name it. No one else screens this thoroughly, globally.
Wes:
And because I know US intended parents worry about healthcare quality: it’s world-class. Truly. The hospitals and NICU in Mexico City are exceptional, better than many US hospitals. People arrive and say, ‘This isn’t what I expected,’ and we joke, ‘What were you expecting? Tumbleweed?’ The misconceptions are wild.
Mike:
Cost is the other piece. With MSJ’s Mexico City pathway, the total cost – including IVF, medical care, birth, and legal processes – is about $101,000. Families can often have two children for the price of one US journey.
Wes:
For intended parents who already have embryos, we offer a membership that includes cryo-shipping support. Our philosophy is simple: everything you need should be included—no hidden extras.
Mike:
And what keeps us going is the people. Most surrogacy seekers today are arriving at this option as a last hope. They’re scared, exhausted, and out of options. Our mission is to show them that a safe, ethical, emotionally supported pathway does exist. We’ve lived the hard version of this journey so they don’t have to. Most surrogacy seekers today are arriving at this option as a last hope. They’re scared, exhausted, and out of options. Our mission is to show them that a safe, ethical, emotionally supported pathway does exist. We’ve lived the hard version of this journey so they don’t have to.
Why Samuel Burke Chose Surrogacy with My Surrogacy Journey and in Mexico
Samuel, who is an American living in the UK with his husband, knew early on that building their family would require navigating systems that weren’t always designed with same-sex parents in mind. After exploring adoption and fostering options that felt unpredictable and opaque, the couple turned to surrogacy as a more transparent and structured path to parenthood. What followed was a thoughtful, international search for an ethical, supportive, and culturally aligned experience – one that ultimately led them to Mexico and to My Surrogacy Journey (MSJ), the agency that helped bring their daughter into the world.
“We first looked into fostering and adoption in the UK, but the uncertainty was overwhelming. Though nothing is ever guaranteed, the lack of clarity in those systems felt especially daunting. When we explored surrogacy in Europe, we ran into a similar problem: altruistic surrogacy was so undefined that we didn’t know what would be expected in return – friendship, involvement in the child’s life, or something else entirely. Commercial surrogacy ultimately made more sense to us because everything felt transparent.
That’s when we began hearing about My Surrogacy Journey – not just their services, but the advocacy work Mike and Wes do for all types of intended parents. We already knew of a couple stranded in Northern Cyprus, the only place in Europe that allows surrogacy, and how Mike and Wes stepped in to help get them and their baby safely home. That said everything to us about their integrity and leadership.
From our first conversations, MSJ stood out because they weren’t only focused on intended parents, they were just as committed to surrogates. The idea that a surrogate would have to leave her own family or be put in a compromising situation so we could build ours didn’t sit right with us. MSJ understood that immediately and shared how they structured their program in Mexico with ethical protections for everyone involved.
I had lived and studied in Mexico when I was younger, so I already knew the medical care was excellent and that the culture is incredibly warm and family-oriented. That made the prospect of working with a surrogate there feel natural to us. When we factored in the ethics, speed, cost, and overall approach, Mexico — specifically with MSJ — became the clear choice. The lawyer MSJ works with in Mexico City is Harvard-trained, the medical experience exceeded all expectations.
Our doctor – Dr. Cruz – wanted to optimize every step. That mindset continued throughout the process; he was always asking, “What can we do at this point to maximize the outcome?” It worked. We got pregnant on the first transfer with an incredible surrogate.
One thing MSJ was very honest about is that surrogacy is never linear. There are bumps along the way, and they told us that up front so we were prepared. When we hit those bumps, they were fully there for us emotionally, logistically, and medically. For us, this was the true test of an agency: how they show up when things get complicated and in those moments, MSJ was at their best. One thing MSJ was very honest about is that surrogacy is never linear. There are bumps along the way, and they told us that up front so we were prepared. When we hit those bumps, they were fully there for us emotionally, logistically, and medically. For us, this was the true test of an agency: how they show up when things get complicated.
Their holistic model made everything feel well-rounded and thoughtful. Every angle of the process was considered for both us and our surrogate –.counseling, nutrition support, legal guidance, medical oversight, and Debbie Evans, their lead nurse, was invaluable. She’s been in the fertility world for decades and acted as our medical guide. She helped us interpret documents, understand procedures, and even supported us after the birth when we had newborn questions.
We only needed to be in Mexico toward the end of the pregnancy, and we stayed in Polanco in walking distance to the hospital, surrounded by world-class museums, incredible food, and a vibrant, diverse community. MSJ prepared us for holiday slowdowns in Mexican bureaucracy, and even with that, we were home in just over two months.
After our daughter was born, the support continued. MSJ connected us with The Mindful Birth Group who specializes in working with same-sex parents, which was crucial because traditional prenatal classes are geared toward pregnant women and heterosexual couples. She guided us through what to expect in the hospital and what would and wouldn’t apply to our situation. They also recommended nanny nurses who helped us with those early newborn moments – bathing, nail filing, spotting small issues – the kind of hands-on reassurance every new parent needs.
Looking back, the feeling of holding your child for the first time is unlike anything else. Surrogacy is not easy, as so much of it is out of your hands, but choosing the right agency makes all the difference. Sure, there may be agencies that are faster or cheaper, but MSJ struck the balance we were looking for: ethics, quality, speed, and support. If someone is unsure about taking the leap, I’d tell them to do their research, join support groups, listen to what past intended parents say after the sales pitch is over, and wait for the agency that genuinely makes you feel like you’re in the best hands possible. That’s what MSJ was for us. I’d also suggest following the social media accounts of the organizations who advocate for pursuing surrogacy. In our case, we started following Gays With Kids and seeing those images and videos of families – talking about their successes and their struggles – made it all seem so normal. ”
The Future of Surrogacy & Global Family-Building
As surrogacy continues to grow worldwide, the landscape is shifting in meaningful and hopeful ways. Demand is rising across borders, fueled by several factors including increased awareness, protection under law, LGBTQ+ family building, and intended parents who are priced out or timed out of domestic options – and with it, a clearer recognition that international surrogacy is a viable, rewarding path to creating a family.
Policy, meanwhile, is beginning to catch up. Countries with outdated laws are being pushed to confront modern realities, and others are exploring new frameworks designed to better protect surrogates, children, and parents alike. At the same time, advancements in reproductive science – from enhanced embryo diagnostics to AI-enabled gamete grading – are expanding what’s possible and offering intended parents more confidence than ever before.
What’s clear is that we’re entering a moment where better global frameworks aren’t just helpful, they’re necessary. Families are building across borders every day, often navigating systems never designed for international movement of embryos, gametes, or parental rights. The future of surrogacy will depend on cross-border collaboration between countries, clinics, and legal experts.
Ultimately, with thoughtful coordination and continued innovation, we have the opportunity to build a surrogacy landscape that is safer, more transparent, and more ethical — one that protects surrogates, supports intended parents, and expands responsible access to this life-changing path to parenthood.
This article is presented by My Surrogacy Journey, a global surrogacy organization who are setting the standard for safe, supported and ethical surrogacy. Discover more about what makes them stand out and their exceptional levels of support at mysurrogacyjourney.com.
Listen to stories, share your own, and get feedback from the community.
