What ASRM's Updated Surrogacy Standards Mean for Intended Parents

If you have spent any time researching surrogacy, you have probably come across the acronym ASRM. You may have seen it cited by agencies, mentioned by fertility clinics, or referenced in conversations about what makes a program "legitimate." But what ASRM actually says — and how its guidance has been shifting — is rarely explained clearly for the people it affects most: intended parents.

As of early 2026, ASRM has issued updated guidance on gestational surrogacy at least four times in the past four years. The changes are not dramatic rewrites. They are a careful refinement of standards that were already well-established — with a few additions that carry real practical weight for anyone planning a surrogacy journey now.

This article walks through what changed, what stayed the same, and what any of it means if you are currently evaluating your options.

What Is ASRM and Why Do Its Guidelines Matter to You?

ASRM — the American Society for Reproductive Medicine — is a nonprofit organization of fertility specialists, researchers, ethicists, and legal professionals. It doesn't regulate clinics the way a government agency would. But its practice committee documents and ethics opinions carry significant weight: most reputable fertility clinics in the United States, and many internationally affiliated programs, use ASRM guidance as a benchmark for clinical and ethical decision-making.

When an agency or clinic tells you it follows "ASRM standards," that is a meaningful claim. It means the program is using screening criteria, counseling protocols, and medical recommendations developed and reviewed by specialists in reproductive medicine. It also means there is a published, verifiable document you can point to — not just a statement on a website.

For intended parents, this matters for one reason: it gives you a reference point. If you can verify that your agency's practices align with current ASRM guidance, you have a meaningful baseline for trust. If they cannot explain that alignment, that is worth noting too.

A Quick Timeline: How ASRM's Guidance Has Evolved Since 2017

ASRM doesn't revise its gestational carrier standards on a fixed schedule. Updates happen when the evidence base, legal environment, or ethical conversation shifts enough to warrant new language. Here is what has changed and when, as of early 2026.

2017: The Previous Baseline

The 2017 Practice Committee document set the standards most agencies were following for several years: age requirements for gestational carriers, prior pregnancy requirements, infectious disease screening, and an early recommendation for single embryo transfer. Many programs still reference elements of this version, but it has been formally superseded.

2022: The Current Practice Committee Guideline

The most substantive update came in 2022, when ASRM and SART jointly published a new gestational carrier committee opinion in Fertility and Sterility. The 2022 committee opinion incorporated updated guidance from the CDC, FDA, and American Association of Tissue Banks. Key practical changes included:

• Standardized requirements for psychoeducational and implication counseling — covering both the carrier and her support person, and intended parents
• A stronger, more explicit recommendation for single embryo transfer (SET) in all gestational carrier cycles
• Specific provisions for psychological evaluations conducted more than one year before a new surrogacy contract begins — a fresh evaluation is required
• Clear guidance on mandatory joint sessions between the carrier, her partner or support person, and the intended parents — led by a qualified mental health professional

2023: Surrogate Autonomy — the Ethics Committee Update

In 2023, ASRM's Ethics Committee updated its companion document, Consideration of the Gestational Carrier. The 2023 ethics opinion replaced the 2018 version with language that is notably more explicit about carrier rights. The core principle: gestational carriers are the sole decision-makers regarding their own medical care — from embryo transfer through prenatal care, labor, delivery, and aftercare.

This is not a new concept, but the clearer language matters. It establishes that intended parents cannot override the carrier's medical decisions. The same document reinforced the requirement that carriers must have independent legal counsel — their own attorney, separate from the agency and the intended parents' lawyer, whose fees are covered by the intended parents. More on why that protects you, too, is in the checklist section below.

2024: Family Members, New Laws, and a Medical Debate

In 2024, ASRM's Ethics Committee published updated guidance specifically addressing scenarios where a family member serves as a gamete donor or gestational carrier. That same year, two US states overhauled their surrogacy laws in ways that will affect intended parents living there: Massachusetts enacted its Parentage Act — creating clearer pre-birth parentage pathways — and Michigan repealed its previous criminal ban through the Family Protection Act, replacing it with a regulated framework.

Late 2024 also brought a significant published debate in Fertility and Sterility about whether surrogacy should require a documented medical reason at all. We cover that directly in the next section.

Early 2026: ASRM's Policy Statement on Gestational Carriers in the US

In January 2026, ASRM's Center for Policy and Leadership published a comprehensive fact sheet on gestational carrier policy in the United States. This document summarizes the current state-by-state legal landscape, reaffirms SET as the clinical gold standard, and outlines what evidence-based statutory frameworks should include. It is primarily aimed at legislators — but it also reflects where ASRM stands on several contested questions as of now.

What the Current Screening Requirements Mean in Practice

The 2022 ASRM guidelines establish specific eligibility criteria for gestational carriers. These are the standards a well-run agency should be applying before any match is made.

These are not suggestions that a responsible agency treats as optional. They represent the clinical floor — the minimum standard that should be applied before any embryo transfer occurs. Programs with strong track records often go further on several of these criteria.

The Elective Surrogacy Question: What Specialists Are Actively Debating

One of the more significant shifts in professional conversation came in late 2024, when a paper published in Fertility and Sterility directly challenged what some call the "gatekeeping" model in surrogacy: the assumption that intended parents must have a documented medical reason to pursue a gestational carrier arrangement.

Historically, ASRM guidance has framed gestational carriers as appropriate when a clearly documented medical condition makes pregnancy impossible or unsafe. The 2024 paper argued that requiring medical necessity may be an artifact of outdated assumptions. Its core point: the health risks a carrier assumes are identical regardless of the intended parent's medical status — and a carrier's capacity for informed consent and voluntary participation doesn't vary based on whether the intended parent has a diagnosis.

ASRM has not updated its practice guidance to remove the medical necessity emphasis. This remains a live professional debate, not a settled policy change. But it is a conversation worth knowing about, particularly if you have been told by a clinic or agency that your situation does not qualify.

For intended parents working with international programs, this debate often operates in a different legal context. What matters is whether the program can document the clinical rationale for surrogacy in a way that satisfies the requirements of your home country, your fertility clinic, and any legal authority that will need to recognize parentage. If you're considering surrogacy with donor eggs — which may change how the medical indication is framed — our donor egg surrogacy program overview explains how that works at Delivering Dreams.

How State Laws Are Changing — and Why That Matters

ASRM guidelines and US state laws are related but separate instruments. ASRM sets clinical and ethical recommendations; states set the legal frameworks that determine whether surrogacy contracts are enforceable and how parentage is established. As of 2026, there is still no federal statute governing surrogacy in the United States.

If you live in the US and are planning a domestic arrangement, the state where your carrier lives — and where the birth occurs — determines the legal pathway for parentage. If you're pursuing international surrogacy, the relevant legal framework is in the destination country, but your home country's recognition of parentage will also come into play.

Laws in this area change more frequently than many people expect. Consulting a reproductive attorney who is current with developments in your specific jurisdiction is the most reliable protection available. This article can give you context — it cannot replace that conversation.

What This Means If You're Working with an International Surrogacy Program

ASRM guidelines are designed for US-based practitioners. They don't directly govern what happens in Ukraine, Georgia, or any other country. But they remain a useful benchmark for anyone evaluating an international agency — because the values they reflect (thorough screening, informed consent, surrogate autonomy, single embryo transfer as a default) describe good practice in any setting.

When assessing an international program, consider whether its surrogate selection process would broadly meet ASRM criteria. Does the agency verify prior healthy pregnancies through medical records? Is psychological evaluation part of the screening process? Does the surrogate receive independent legal representation? Is single embryo transfer the default recommendation in most cycles?

In Ukraine, gestational surrogacy is legally regulated within a civil law framework. Parentage is established through a legal order at birth — without adoption proceedings. The legal process typically takes 10–14 days around the birth. For intended parents from the US, EU countries, and Israel, the legal coordination extends beyond the birth itself: your home country's recognition of parentage involves its own documentation steps.

For German intended parents, this process requires particular preparation. The Delivering Dreams legal team has direct experience supporting German families through every stage — from the surrogacy agreement in Ukraine through to parentage documentation accepted by German authorities. Legal coordination is handled on the client's behalf. Exit documents are processed through the German Consulate in Lviv, so there is no need to travel to Kyiv. Our step-by-step process overview describes what each stage looks like in practice.

How to Verify Whether Your Agency Follows Current Standards

You don't need to read the full ASRM committee opinion to evaluate an agency. These questions will surface most of what matters.

• Does the agency require psychological evaluation for every surrogate before matching? If the answer is conditional or vague, press for specifics.
• Is independent legal counsel provided to the surrogate — at the intended parents' expense? This is both an ASRM requirement and a basic contractual protection for everyone involved.
• What is the agency's default position on embryo transfer? A recommendation of single embryo transfer in most cycles aligns with current ASRM and SART guidance. Multiple transfers may be discussed with your clinic in specific circumstances, but SET should be the starting point.
• How does the agency verify prior pregnancy history? Medical records should be part of that process, not self-reporting alone.
• Can the agency explain how parentage will be established in your home country? For international programs, this is a legal coordination question that should have a specific, documented answer.
• What happens if a cycle doesn't result in a pregnancy? The answer tells you a great deal about how transparent the agency is about risk, and whether their program structure accounts for it.
• Is the agency affiliated with recognized professional organizations? Membership in ASRM, RESOLVE, or verified international networks provides some external accountability — though affiliation alone is not a substitute for direct due diligence.

Our surrogacy cost calculator and timeline estimator can help you understand what a well-structured program typically involves — and give you a reference point when comparing agencies. A useful set of additional questions is also available in our frequently asked questions section.

How Delivering Dreams Applies These Standards

At Delivering Dreams, the criteria described in this article aren't a framework we evaluate from the outside. They're part of how our program is built.

• Every surrogate candidate undergoes a full psychological evaluation before any matching takes place — interview and standardized testing both included.
• Every surrogate has independent legal counsel, separate from our agency and the intended parents' attorney, before any contract is signed. That counsel is retained at the intended parents' expense, as required.
• Single embryo transfer is our clinical default in coordination with the fertility clinics we work with, in alignment with current ASRM and SART guidance.
• Our program uses milestone-based payment, with funds released according to verified program milestones rather than in a lump sum. This provides financial clarity and protection for both parties throughout the process.
• We are members of ASRM, RESOLVE, and OVU Verified. Our practices are available for review and discussion at any point in your process.

If you want to see what our program looks like in detail — including what program costs include, what the guarantees and protections are, and what families who've been through the process say about it — those pages are a good place to continue. Or, if you have specific questions about how any of the ASRM updates described here apply to your situation, we're available for a direct conversation. You can also read stories from families we've helped to get a clearer sense of what the experience looks like in practice.

This article was reviewed by a member of our clinical coordination and legal compliance team, who oversees gestational carrier screening and program standards at Delivering Dreams. Our team works directly with ASRM-affiliated fertility specialists, reproductive attorneys, and international legal consultants to ensure every program match reflects current professional guidelines.