For a long time, intended parents and surrogates have had to come up with ways to explain the surrogacy journey to their children. Surrogates will need to explain to their children that the baby they are carrying will not be part of their family but will join another family. Intended parents seek ways to explain to their children that they were born through surrogacy, or explain the role of their surrogate to their current children. While there is no hard and fast rule when it comes to discussing the surrogacy process to your child, some experts suggest to start it as early as possible. Fortunately, as surrogacy becomes more and more common, there are now more and more children’s books that address the subject. Reading to your child is a fun and age-appropriate way to explain and normalize surrogacy to your children, whether you are a surrogate or intended parent. In this article, we will discuss some children's books about surrogacy. 1. The Kangaroo Pouch: A Story About Surrogacy For Young Children By: Sarah A. Phillips (Author) and Laurie A. Faust (Illustrator) For ages: 2-6 years old Available on Kindle and in print. The Kangaroo Pouch  is a great start for children to learn the concept of surrogacy as it uses kangaroos as an analogy. It underscores the reason why a mother uses surrogate and portrays the situations during the pregnancy. One of the most important concepts highlighted by the book is the question on whether the baby is given back to their biological parents after conceived. The Kangaroo Pouch  is from the perspective of a child of a surrogate. Who is this book for: intended parents’ existing children, future children, and surrogates’ children. 2. Mommy, Who is Miss Amy? A Tale of Surrogacy By: J.D. Quarles (Author), Emily Ivie (Illustrator) For ages: 3 to 6 years old Available on Kindle Unlimited and in print.   Mommy, Who Is Miss Amy?  features a story of a young boy who is curious about his parents’ surrogate and learns how Miss Amy helped his parents’ dream of having him come to life. This will help the child understand the intended parents’ reasons for surrogacy and the step-by-step process of a surrogate’s pregnancy. Note that there is a companion book titled Mommy, Who is Miss Becky?  drawn from the perspective of a girl for intended parents of girls. Who is this book for: intended parents’ children born from surrogacy. 3. Mommy is a Basket: Our Journey as a Surrogate By: Cj Love (Illustrator), Linda Rinderknecht (Editor), Kya Buchanan (Author) For ages: 3 to 6 years old Available on Kindle Unlimited and in print.   Mommy is a Basket  features a story of a girl whose mother is about to become a surrogate, and how she learns about different aspects of her pregnancy. This picture book explains in detail the process of surrogacy from the surrogate’s perspective. Note that this story imagines a continuing relationship with intended parents after the birth which does not occur in all journeys. The art is also a bit limited and reused throughout book. Who is this book for: gestational surrogates’ children. 4. The Very Kind Koala By: Kimberly Kluger-Bell (Author and Illustrator) For ages: 3 to 6 years old Available in print only.   The Very Kind Koala  features a simple yet delightful introduction to surrogacy for young children by featuring a koala husband and wife who need the help of a very kind koala to carry their baby in her pouch. With its heartfelt drawings, this book can keep children engaged and is easy to understand. The Very Kind Koala is written from the perspective of the child born from surrogacy. One nice aspect is it allows the child to personalize the book with their own text or pictures from their own family. Who is this book for: Intended paren ts’ children born from surrogacy. 5. It Takes a Galaxy: A Surrogacy Story By: Auntie Boppy (Author) For ages :  4 to 8 years old Available in print and eBook formats. It Takes a Galaxy  tells the enchanting story of Taylor and Jamie, two unicorns in Unicorn Land, who dream of growing their family. With the help of several magical friends, they begin a surrogacy journey to welcome a baby into their lives. This heartfelt book highlights just how many loving people it takes to bring one special child home. What makes this book shine is how it keeps the magic alive while gently introducing the concept of surrogacy. The story celebrates teamwork, friendship, and the beautiful reality that families are built with the help of many hearts. It's a perfect starting point for parents to talk with children about surrogacy in a warm, whimsical way. Who is this book for: intended parents’ children, surrogates’ children, and any family wanting to share the magic behind their surrogacy story . 6. My Mom Has Superpowers By: Ellen M. Smith and Kenedi Smith For ages: 4 to 8 years old Available in print. My Mom Has Superpowers  is a touching surrogacy story told through the eyes of a child whose mother is helping another family grow. This heartfelt book is from the point of view of a young boy whose mom is going to be a surrogate for a gay male couple. Told with warmth and understanding, the story explains to the child why the intended parents are seeking to have a child, what steps the mom has to undertake to become pregnant, and how the surrogacy continues through the pregnancy through the birth.  Written by former surrogates and mother and daughter, Ellen and Kenedi Smith, this story shows the journey of a surrogate as one filled with kindness, strength, and love.  Who is this book for: children of gestational surrogates and families wanting to teach the value of helping others. 7. From the Start By: Stephanie Levich and Alana Weiss For ages: 4 to 7 years old Available in print. From the Start  by Stephanie Levich and Alana Weiss beautifully teaches children the many ways families can be started. The book's inclusive illustrations celebrate family diversity by depicting a variety of couples, mixed race couples, and even animal families. This book is valuable for families built through assisted reproduction because of its positive, age-appropriate portrayal of donors, surrogates, and medical professionals as essential helpers in a family-building journey. The authors introduces concepts like eggs and sperm by using relatable analogies that young children can grasp to maintains accuracy without overwhelming young readers. By normalizing the idea that some people need help to create their families and celebrating those who provide that help, From the Start  gives children a foundation for understanding and appreciating their own origin stories in a meaningful, developmentally appropriate way. Who this book is for: Intended parents’ children born from surrogacy, adopted children  This is just a small sample of the amazing children’s books about surrogacy that can help your children understand the complex process. For guidance on the legal aspects of surrogacy, by contacting Tsong Law Group.

Thinking about embryo donation? Whether you're considering donating your stored embryos or using donated embryos to build your family, it's important to understand the legal process involved. At Tsong Law Group, we specialize in helping families navigate these waters. Let's break down the legal steps of embryo donation in simple terms.  What is an Embryo Donation?  Embryo donation is when individuals or couples who have completed fertility treatments donate their remaining frozen embryos to help someone else have a baby. This can help people who can't have children on their own, like individuals or couples who have experienced infertility, same-sex couples, or those with genetic concerns. Embryo donation arrangements also occur between couples create embryos but split up or individuals who create embryos but then want to add a partner as a co-owner.   The Legal Process: Step by Step  1. Initial Screening  Prior to the contract drafting stage, both donor and recipient parties typically undergo psychological screening to ensure all parties understand the emotional and ethical implications of embryo donation. Unlike sperm or egg donation, embryo donation involves already created embryos, which means genetic and std testing has typically already been completed during the IVF process.  All embryo donations must use assisted reproduction techniques to achieve pregnancy, as the embryos will be transferred to the recipient's uterus (or a gestational carrier's uterus) by a fertility specialist.  2. Choosing Your Attorney  The legal stage consists of each party—the embryo donors and the intended recipient(s)—choosing and signing on with their own lawyer. Both parties will have separate legal representation throughout the embryo donation process. The legal fees for both parties are usually covered by the recipients or intended parents. It is crucial to select an attorney experienced in drafting embryo donation agreements and familiar with the applicable state laws.  3. Representation Agreement  Once selected, the lawyer will send the party a representation agreement or letter, which will explain the scope of services the lawyer is providing. Both the embryo donors and the intended parents will sign their respective lawyers’ representation agreement. This is not the actual contract between the parties but only your agreement to be represented by your lawyer.  4. Drafting the Embryo Donation Agreement  In some cases, the donor’s lawyer will draft the embryo donation agreement based on the information the agency have given them. In other cases, the intended parents’ lawyer drafts the embryo donation agreement. In some cases, the contract may be pre-drafted and the parties review and revise them separately.  Your embryo donation agreement will cover details such as:  Parental rights and responsibilities of any children born from the donated embryos  Financial obligations related to storage and transfer of the embryos  Future contact between the parties including with any resulting children  Sharing of medical information and updates on contact information  Confidentiality requirements  Disposition of any unused embryos  The agreement will also describe a level of disclosure of identities, ranging from anonymous to fully disclosed. Unlike sperm or egg donation, embryo donation involves genetic material from two people, and if one or more gametes is donated, then the contract must reference that the prior donor has relinquished their rights and there is no limitation on donation by the donors.   5. Reviewing the Embryo Donation Agreement   Schedule a review appointment with your attorney to go through the embryo donation agreement thoroughly. Read the agreement beforehand because your lawyer will not read it aloud for you. Make sure your spouse is also present for the review if they are co-owners of the embryo, or co-recipients, as they will be a party to the agreement. The review is the time to address any questions or suggest changes.  6. Negotiating and Finalizing  Once you approve the draft or redline your attorney sends you after your review, they will present it to the other side's attorney and the negotiation begins. Once both parties approve the latest version, a final embryo donation agreement will then be circulated for signing.  7. Signing the Agreement  Most of the time, the parties need to notarize their embryo donation agreements due to the significant legal implications of transferring potential human life. Some states such as New York will require a notarized contract to be effective. The attorney may send you a PDF which can be printed, or e-signed, and advise if you need to notarize the agreement.  8. Issuing of Legal Clearance  Once both parties have signed, the intended parents' attorney will issue a legal clearance letter to the fertility clinic which allows the embryo transfer procedures to occur or for existing embryos to be transferred to the intended parents' names in the clinic's storage system.  Common Questions About Embryo Donation Laws  Can embryo donors claim parental rights later?  Generally, no, if proper legal agreements are in place. Separate representation by lawyers will ensure there is no claim later on that one party didn't understand what they were signing. Be sure to talk to your attorney about whether you should do a second parent adoption if you are a same-sex couple. Some states may also recommend or require a post-birth legal proceeding to terminate donor rights and establish legal parentage for the recipient parents.  Do children have the right to know who their embryo donors were?  This depends on state laws and the agreement between donors and recipients. Colorado currently will provide adult donor-conceived children the right to access donor information, while other states like California and Washington will allow the donor to determine if they agree to disclosure if the child approaches the clinic after turning 18. Note that studies do show that donor-conceived children benefit from being told about their donor conception and having a chance to connect with the donors, especially in the case where they have biological siblings, from the donor’s family.  How is embryo donation different from embryo adoption?  While the terms are sometimes used interchangeably, "embryo adoption" often implies a more adoption-like process with home studies and other adoption practices. "Embryo donation" typically refers to the medical and legal transfer of embryos without the full adoption framework. However, both processes accomplish the same goal: transferring legal rights to frozen embryos from the creators to intended parents.  Final Thoughts  Embryo donation can be a wonderful way to build a family while helping another family complete their fertility journey, but the legal steps are important to protect everyone involved. Working with an experienced fertility lawyer ensures your family is legally protected now and in the future.  At Tsong Law Group, we help guide you through every legal step of the embryo donation process, explaining complicated legal terms in simple language and making sure your family's future is secure.  Have questions about embryo donation or other family-building options? Contact us today for a consultation about your specific situation.

Thinking about sperm donation? Whether you're considering becoming a donor or using donated sperm to start a family, it's important to understand the legal process involved. At Tsong Law Group, we specialize in helping families navigate these waters. Let's break down the legal steps of sperm donation in simple terms. What is a Sperm Donation? Sperm donation is when a man agrees to give his sperm to help someone else have a baby. This can help people who can't have children on their own, like single women, same-sex female couples, or heterosexual couples.  The Legal Process: Step by Step 1. Initial Screening Prior to the contract drafting stage, before a clinic will allow a sperm donation, the potential donor must have a health screening. These tests check for sexually transmitted diseases which may make the pregnancy unsafe or diseases and genetic conditions that could be passed to children. Donors may also answer questions about their family health history or undergo a genetic screening, and in some cases the parties will undergo psychological screening.  In some states, an home insemination may be permissible, in which case the parties do not have to perform a screening, but in all states where sperm donation is recognized, assisted reproduction and not sexual intercourse must be used to achieve pregnancy in order for it to be a legal sperm donation.  2. Choosing Your Attorney.   When a directed donation occurs, between a donor and the intended parents directly rather than a donor and the sperm bank or intended parents and a sperm bank, you should have a legal contract in place prior to the sperm donation. When a sperm bank is used, the sperm bank will have a contract predrafted, although you may wish to have a lawyer review the contract.  In a directed donation, the legal stage consists of each of the parties, the intended parents or recipients, and the sperm donor (and spouse if he has one) choosing and signing on with their own lawyer. Both parties will have separate legal representation throughout the sperm donation process. The legal fees for both parties are usually covered by the intended parents. It is crucial to select an attorney experienced in drafting sperm donation agreements and familiar with the law. You can read this blog article to see what qualities to look for when choosing your lawyer. 3.  Representation Agreement.   Once selected, the lawyer will send the party a representation agreement or letter, which will explain what the scope of services the lawyer is providing. Both the sperm donor and the intended parents will sign the representation agreement with their respective attorneys. This is not the actual contract between the parties but your agreement to agree to representation with your lawyer. 4.  Drafting the Sperm Donation Agreement.   The lawyer for the intended parents will typically draft the sperm donation agreement based on the information the agency or intended parents have given them. The sperm donor’s lawyer usually reviews the contract with the donor. In some cases, the contract may be pre-drafted and the parties review and revise them separately. Your sperm donation agreement will cover details such as: Parental rights and responsibilities of the child; Financial obligations to donor; What future contact the parties will have including with the child; Sharing of medical information and updates on contact information; Confidentiality requirements The agreement will also describe a level of disclosure of identities, ranging from anonymous to fully disclosed. An undisclosed or anonymous donation may have stricter FDA requirements on testing and quarantining.  5. Reviewing the Sperm Donation Agreement.   Schedule a review appointment with your attorney to go through the sperm donation agreement thoroughly. Read the sperm donation agreement beforehand because your lawyer will not read it aloud for you. Make sure your spouse is also present for the review if they signed the representation agreement, as they will be a party to the agreement. The review is the time to address any questions or suggest changes. 6. Negotiating and Finalizing.   Once you approve the draft or redline your attorney sends you after your review, they will present the draft or redline to the other side's attorney and the negotiation begins. Once both parties approve the latest version, a final sperm donation agreement will then be circulated for signing. 7. Signing the Agreement.   Most of the time, the parties do not need to notarize their sperm donation agreements. However, some parties will prefer to notarize if they want to verify the identity of the person signing and some states such as New York will require a notarized contract to be effective. The attorney may send you a PDF which can be printed and advise if you need to notarize the agreement. 8. Issuing of Legal Clearance .  Once both parties have signed, the intended parents' attorney will issue a legal clearance letter to the clinic or bank which allows the retrieval procedures to occur or for existing vials to be transferred to the intended parents’ names. Common Questions About Sperm Donation Laws Can a sperm donor claim parental rights later? Generally no, if proper legal agreements are in place. Separate representation by lawyers will ensure there is no claim later on that one party didn’t understand what they were signing.  Be sure to talk to your attorney about whether you should do a second parent adoption if you are a same sex couple. If you don't follow the legal process correctly, a donor might be able to claim rights or could be responsible for child support.  Do children have the right to know who their donor was? This depends on state laws and the agreement between donors and recipients. Colorado currently will provide adult donor conceived children the right to access donor information, while other states like California and Washington   will allow the donor to determine if they agree to disclosure if the child approaches the clinic after turning 18. Note that studies do show that donor conceived children benefit from being told about their donor conception and having a chance to speak with the donor. You can read our article on the different options for donor contact here. Final Thoughts Sperm donation can be a wonderful way to build a family, but the legal steps are important to protect everyone involved. Working with an experienced fertility lawyer ensures your family is legally protected now and in the future. At Tsong Law Group, we help guide you through every legal step of the sperm donation process, explaining complicated legal terms in simple language and making sure your family's future is secure. Have questions about sperm donation or other family-building options? Contact us today for a consultation about your specific situation.

In our previous blog , we discussed the legal stage from the perspective of the gestational surrogate. Now, as surrogacy lawyers, we explain what we do for intended parents in the legal stages of your surrogacy journey. Choosing the Right Attorney. If you are working with a surrogacy agency, they will assist in matching you with a Gestational Carrier (GC) and provide referrals to attorneys experienced in drafting surrogacy agreements and obtaining parentage judgments. Selecting the right attorney can take your mind off all the legal aspects of surrogacy. We have a blog article here on what to look for. Prior to selecting your attorney, you may wish to consult with the attorney to get an idea of the legal process in the state of your surrogate. We always offer free consultations for surrogacy law . Representation Agreement and Drafting Stage. You will next need to sign the representation agreement with your chosen attorney. Our representation agreement will identify the parties, the state where the contract is going to be drafted, and the fee for drafting and for the parentage order, if we will be responsible for one. Once this representation agreement is signed and we are informed you are ready to proceed with contracts, Tsong Law Group (TLG) will usually take 1-2 weeks to draft the surrogacy agreement based on the term sheet/benefit package provided by the agency. If you are doing an independent journey, we will supply you with a blank match sheet for you to complete ahead of time, with your surrogate’s approval. Reviewing the Surrogacy Agreement. Once you receive the draft of the agreement, you will be able to easily schedule an appointment online with TLG. Your review meeting with TLG will be over the phone or on an online platform like Zoom. Before your review appointment, you should read the drafted agreement and write down questions or changes you might have. The contract review will typically take about an hour, so allow for that amount of time. This will be the time to address any questions or concerns you have with the contract. Negotiating and Finalizing the Agreement. Following your review, our attorneys will incorporate any requested changes into a new draft. This redline will be sent to you and will need your approval. This approved draft is not ready for signing, it will next be sent to the surrogate’s attorney for their review with the surrogate. So, it will take a few days or longer for the surrogate attorney to review with their clients and return another redline, or in some cases, an approval with no changes. If there are additional redlines, you will have a chance to review and accept or disapprove of changes. Once every party has no more changes to the contract, a final version will be sent for signing. Signing the Agreement. Depending on state requirements, the final contract may need to be signed in the presence of a notary public. If you are abroad, we can set up a web notary appointment if a web notary is acceptable to the courts. You may be able to use a web notary if you are in the US, but check if it could be an issue with the court for the pre-birth order process. Obtaining Legal Clearance. Once all parties have signed the agreement, our firm ensures that the GC’s attorney provides legal clearance. This clearance is crucial for initiating the embryo transfer process, as we prepare the necessary documentation for the clinic when GC signs, the GC’s attorney sends us a legal clearance letter. Once all parties have signed, we prepare and send our own legal clearance letter to the clinic to begin the embryo transfer. Preparing for the Pre-Birth Order (PBO). After legal clearance, there is usually a lull in activity on the legal front. If issues arise during your surrogacy journey, you can always contact us for advice. The next major step is the parentage order, often called the PBO. You can read about PBOs here. Once we receive notice of a pregnancy, we calendar the due date. In most states we work in, we get started before the 20th week of pregnancy. This is so there is adequate time to prepare the pre-birth order and receive a judgment from the court. Reviewing and Signing PBO Documents. Once the PBO documents are prepared, we send them to GC’s attorney for them to review and sign with their clients. GC’s attorney will approve of the documents before we send them to you to review before signing. Some counties allow for electronic signatures which makes filing the PBO faster and more convenient. These documents will then be filed with the court, where we will wait for a signed judgment. In some counties, we also have to request background checks which will require your consent. Final Steps and Notifying the Hospital.   Once the PBO has been accepted by the court and a judgment issues, we contact the chosen hospital to provide them with a copy of the judgment and a hospital letter explaining the surrogacy arrangement . We often will provide GC with one certified copy of the judgment to bring with her in case the hospital does not have their own copy. In some cases, the intended parents cannot arrive at the hospital, so a power of attorney may be necessary to authorize someone else to pick up and care for the child until their arrival. Once the PBO goes to the hospital, our role is typically done, though we will assist with speaking with the hospital social workers if they have questions. At the end of your long journey, we are glad to be a part and hope you share us a baby picture with us. Our surrogacy lawyers are licensed in California, New York, Illinois, Washington, Arizona, and Oklahoma. As a top-rated firm in client satisfaction, we strive to make every surrogacy journey seamless. Contact us today.

By Lisa Schuman, LCSW and Mark Leondires, MD About the Authors Lisa Schuman is a licensed psychotherapist and co-author of Building Your Family who directs and founded The Center for Family Building, a resource hub supporting donor conception and surrogacy journeys. She previously led mental health services at Illume Fertility and Gay Parents To Be, and testified before the New York State Senate Judiciary Committee on compensated surrogacy. She is also an award‑winning researcher and host of the Building Your Family podcast , helping parents create healthy disclosure narratives and evidence‑based plans. Schuman opens up about the personal story of her journey with her husband Keith. Like many couples, they assumed pregnancy would "just happen." Dr. Mark Leondires is a board‑certified reproductive endocrinologist and the Founder and Medical Director of Illume Fertility, as well as the founder of Gay Parents To Be , an educational and care pathway for LGBTQ+ intended parents. As a gay dad through egg donation and surrogacy, he brings lived experience together with clinical expertise to guide patients through IVF and donor conception. He is a nationally recognized advocate for inclusive, evidence‑based fertility care. What The Book Covers Building Your Family: The Complete Guide to Donor Conception is a practical handbook for readers considering or navigating the donor conception process. The book walks readers through every stage of donor conception process: from making the initial decision, to choosing and screening donors, to understanding IVF and genetic testing. It also covers other considerations, such as the legal process, record-keeping, and consent. The authors also advise on how to talk with children about their origins, with guidance tailored to different age groups. The book addresses the unique needs of single parents and LGBTQ+ families, and discusses how to handle disclosure in the age of consumer DNA testing. Readers will find helpful tools like checklists, sample conversation scripts, questions to ask clinics and agencies, stress-management tips, and resource lists. Why This Book Is Different Building Your Family by Lisa Schuman and Dr. Mark Leondires stands out a guide because it addresses both the practical and emotional aspects of donor conception, two areas our clients navigate simultaneously. The dual perspective of a therapist and reproductive endocrinologist means the medical and technical aspects do not get a short shrift. Dr. Leondires brings clinical expertise while Schuman offers mental health insights and the stories of her clients, creating a more complete resource than typical guides. While this book is highly technical and detailed, it also tells personal stories that Shulman has encountered including Shulman’s own journey. Key Takeaways for Intended Parents The Emotional Reality. In one of the first chapters, the book explains that infertility patients experience depression levels similar to cancer patients. This data validates that many intended parents feel real prolonged grief. The authors thoughtfully explore how men and women often process this grief differently, and how these differences can impact relationships during an already stressful time. Throughout the book, one message resonates clearly: you are not alone . The authors weave in stories from diverse families, including mentioning celebrities who have used donor conception, normalizing what can feel like an isolating experience. Choosing Your Donor The book provides practical guidance on donor selection. Important considerations include: Medical history and lifestyle factors (like smoking history) Disclosure levels: from anonymous to open donation The reality that DNA testing has changed anonymity forever Discussion of donation transparency levels is particularly important in our current era, where DNA testing services like 23andMe have fundamentally changed donor anonymity. The trend toward open donations reflects a growing recognition that children may want to connect with their donors in the future, a possibility that requires thoughtful planning from the start. Creating Healthy Family Narratives This guide recommends starting age-appropriate conversations in early childhood using books and metaphors. The goal is preventing shock or surprise later while making donor conception a normal part of the family story rather than a sensitive secret. Support for All Family Types The authors acknowledge how LGBTQ+ families faced additional barriers and stigma in the past, while recognizing the progress made today, including more genetic information availability and opportunities for face-to-face donor interactions. Practical Application This guide is helpful because of its balance between emotional support and practical navigation. Beyond medical protocols and legal considerations, it includes stress reduction techniques and emphasizes ongoing mental health support. This combination makes it particularly valuable for those new to donor conception who need both information and reassurance. For our clients, this book serves as a comprehensive primer that complements the legal guidance we provide. It answers questions clients might not think to ask and addresses concerns they might hesitate to voice. Conclusion Building Your Family fills a gap in donor conception resources by addressing both logistics and emotions without sugar-coating either aspect. For anyone considering or pursuing donor conception—whether due to infertility, as a single parent, or as an LGBTQ+ couple—this book provides a realistic roadmap for the journey ahead and even after the birth. It will be more technical than other books in the field, it will address nearly every aspect of the journey, with exception of the legal stage or possibly insurance . Every family's path is unique, and having a resource that acknowledges both the challenges and possibilities of donor conception can make that path feel less isolating.

Introduction Let’s cut to the question everyone considering surrogacy or egg donation living in New York has : Does the law in New York require infertility coverage that includes procedures like egg retrieval on a donor or an embryo transfer on your surrogate?  Unlike Illinois  and California  in 2026, your infertility health plan coverage will cover only you, not a third party. Your plan may cover your own infertility treatment and, if you’re on a New York‑regulated large‑group fully insured plan, up to three IVF cycles subject to medical necessity and preauthorization. See the Department of Financial Services (DFS) overview  of infertility, IVF, and fertility preservation requirements but no coverage for a surrogate’s or donor’s procedures to treat your infertility under your policy.. Coverage cannot discriminate in application to LGBTQ+ individuals, however, this doesn’t appear to mean the same thing as in Illinois or California. What your plan may cover for you   All fully insured policies in New York must cover “basic” infertility services such as diagnosis and non‑IVF treatments (like IUI) when you meet the definition of infertility.  Under New York insurance rules, infertility  means a disease or condition characterized by the inability to impregnate another person or to conceive, defined as failure to establish a clinical pregnancy after 12 months of regular, unprotected intercourse or therapeutic donor insemination (or after 6 months if the female partner is age 35 or older), with earlier evaluation and treatment when clinically indicated.   Read the full definition .  Large‑group fully insured policies must also cover up to three IVF cycles, including IVF‑related prescription drugs; prior authorization and step therapy are allowed. Self‑funded employer plans are not bound by these state mandates, so their benefits depend on the plan document. For details, start with DFS’s insurer Q&A  on New York’s IVF and fertility preservation law.  New York also requires coverage for fertility preservation when medical treatment may cause infertility (including gender‑affirming care). Collection, freezing, and storage are included, but IVF itself is not required as a preservation service. Storage linked to an intended IVF procedure is covered during the window in which the three mandated IVF cycles are available.  Carriers cannot discriminate in infertility coverage based on sexual orientation, marital status, gender identity, age, or disability. DFS’s 2021 circular letter  explains how plans must provide immediate access to basic infertility services for people who need medical intervention to conceive, while still allowing appropriate step therapy before IVF. Surrogacy in New York: who pays for what  Your plan may cover your IVF to create embryos if IVF is part of your benefit. It will not cover a gestational surrogate’s embryo transfer, prenatal care, delivery, or postpartum care unless the surrogate is actually enrolled under that same policy. DFS’s consumer guidance makes this “covered members only” rule explicit.  Separate from insurance mandates, the Child‑Parent Security Act requires intended parents to provide a comprehensive health insurance policy for the surrogate from pre‑transfer meds through twelve months postpartum, plus certain other protections. New York’s Surrogates’ Bill of Rights  and CPSA pages  outline these obligations; build them into your agreement  and escrow before medications begin. Using donor eggs or sperm  Plans generally process the recipient’s side of care (monitoring, transfer, embryology) under the member’s infertility/IVF benefit if the cycle meets medical‑policy criteria. However, the statute does not expressly guarantee donor‑egg IVF; approval is plan‑specific, so preauthorization is essential.  A donor’s medical services and fees are different. Because insurance only covers its enrollees, your plan will not pay a donor’s screening, retrieval, medications, compensation, or agency costs. The Department of Health’s donor fact sheet  notes that, in most cases, the program or recipient pays the donor’s medical bills, and programs may require separate complication coverage. Budget accordingly and confirm billing with your clinic.  If you’re on a self‑funded plan or Medicaid  Self‑funded plans set their own infertility and IVF terms; check your Summary Plan Description and the plan’s medical policy. New York Medicaid offers a limited infertility benefit  (office visits, diagnostics, certain ovulation‑inducing drugs) and does not cover IVF. Medicaid covers maternity care for eligible members, which can include an eligible surrogate, but that is separate from the intended parents’ commercial plan.  Need legal guidance?   If you're pursuing egg donation, surrogacy, or both in New York , Tsong Law Group  can help you protect your family and finances. Our attorneys are licensed in California, New York, Illinois, Washington, Arizona, and Oklahoma—and we’ve helped families nationwide navigate fertility law with confidence. This article is for informational purposes only and does not constitute legal advice. It does not create an attorney‑client relationship with the reader.

Completing a surrogacy journey in California   will require a pre-birth order before the child is born. A pre-birth order, also known as a parentage judgment, is a court ordered judgment that establishes the intended parents as the sole parents of the unborn child and not the surrogate and her partner, if any. Check our previous blog “What is a Pre-Birth Order”   to learn what a PBO is.  1. When Should a PBO Be Started?  A PBO takes time to both prepare, to be signed by the parties, accepted for filing, and then reviewed by the judge and signed. Typically ,  the California PBO process can take 8 weeks from start to finish. Given the time needed, most intended parents want to start on a PBO by 20 weeks of pregnancy or earlier as there is a chance the baby may be born prematurely.   2. What is Needed For a PBO?  The process to get a PBO in California begins with your attorney gathering all the required information to complete the pleadings and forms.   These include:   A. Information relating to the Gestational Carrier  This includes the names, partner/spouse name, address, and her attorney’s information.  B. Information about the Intended Parents  In some counties in California, a background check of the Intended Parents is needed. International intended parents will need to provide their passport and a national ID for an international background check, while domestic intended parents can complete the background check online. Other information will be needed such as their full names and marital status.  C. Information about the Pregnancy  California law requires that the surrogacy contract list the source of the egg and sperm used to create the embryo and this information is provided to the court.  The attorney will also need information such as the date of the embryo transfer, the expected due date, how many embryos were transferred, how many fetuses the surrogate is carrying, and who did the embryo transfer.  We know that the information being provided may be sensitive. Don’t worry, under California law, the court proceedings are confidential and only a party to the case can have access to the case or the court filings.  3. Preparing the Pleadings  After this information is gathered, the intended parents’ attorney will prepare pleadings and forms using this information. The pleadings and forms will request that the court issue an order finding the parentage of the unborn child carried by the surrogate in favor of the intended parents. A declaration will be prepared for the IVF physician to sign stating that they performed the embryo transfer and are certain that the child being carried is from the intended parents’ embryo. Other declarations will be signed by the intended parents, surrogate and her husband and the attorneys stating facts that show the contract was in compliance with California law, and that the child is the intended parents’ child. There will be several forms and pleadings prepared that also allow the parties to stipulate to an uncontested matter and allow the court to decide the parentage without a hearing.  4. Filing the Action  Once all the forms and pleadings are prepared, signed by the parties, the case is ready for filing. In some California counties, everything is filed all at once, and the intended parents pay for the filing fee of both their filing and the surrogate’s response. In a smaller number of counties, the intended parents’ paperwork is filed first, then once confirmation it is accepted, the surrogate’s paperwork is signed.   The next step is waiting for the court to review. Some courts will schedule a hearing and usually the parties are not required to appear, and then sign the judgment at the hearing date. Others will simply review the judgment usually in order that the case was filed. This typically takes a month though some counties are faster or slower than others.   5. What if the Baby Comes Early?  A month it typically takes for the court to grant the pre-birth order can be a long time, and sometimes babies are born earlier than expected. Not to fear, a competent attorney will be able to handle this, usually by filing an emergency hearing called an ex parte, to get the court to review the paperwork usually the next court day.   Conclusion  A pre-birth order issued by the court is necessary to establish the parentage of the intended parents and the child carried by the surrogate. As attorneys licensed in California, we are experienced and reliable in obtaining prebirth orders . Contact us   today for your surrogacy case.

A critical step in the surrogacy process is obtaining a pre-birth order (PBO) from a state court. This parentage order officially recognizes the intended parents (IP) as the legal parents of the child born through surrogacy. Washington   is a pre-birth order state, meaning the parentage order from court is granted before the child's birth. Parties must show they have complied with WA law, which is outlined in our blog “Legal Requirements for Surrogacy Agreement in Washington.” Our blog titled "What is a Pre-birth Order?"   outlines the distinctions between a pre-birth order and a post-birth order.  I. When Should a PBO be Started?  The PBO process can take upwards of 8 weeks, so preparing the paperwork when the gestational carrier is around 20 weeks pregnant is ideal. This allows for adequate preparation time and time to ensure all the information is correct. If any party requests changes to the PBO forms, we will be able to make those changes without an emergency motion.   II. What is needed to start the PBO process?  The process to get a PBO in Washington begins with obtaining information from all parties. An intake form is sent to the surrogate’s attorney  or the agency where she will fill out identifying personal information and delivery hospital. Information will also be needed regarding the surrogate’s spouse. This PBO intake form will ask for an updated mailing address so that certified copies of the judgment can be sent. Washington requires that the surrogate and surrogate’s spouse provide their driver’s license number and state, employer’s name, address, and phone number, and date of birth. Some personal information will be provided to the court, but this will be confidential and only a party to the case will have access to what is filed with court.  III. Preparing the PBO Forms  Next, IP’s attorney will prepare all forms necessary for the specific venue in Washington. These forms will request that the court issue an order stating the intended parents are the legal parents. Each county may have different local forms, so an attorney who is experienced with filing PBOs in Washington will ensure all forms are completed. The forms signed by the surrogate will state that she is not the parent of the child, and the legal parents are the intended parents. This means that the surrogate agrees that she has no legal rights over the child. All parties will review and sign the PBO paperwork which requires coordinating with the surrogate’s attorney. Some counties like Pierce, King, and Snomish, offer electronic filing, and in these counties electronic signatures will also be accepted.   IV. Filing the Action  After the signing of all forms is completed, the preparing attorney will file the documents to the court. Next, the court will review and accept the filing. In some counties, the filing attorney will need to schedule a hearing to be held in front of a judge while others will consider the PBO without a hearing. Some courts will not require the parties to appear, but, sometimes, a remote appearance may be required. After reviewing the filings, the judge will sign the judgment and grant the PBO.   V. What if the baby comes early?  The court often takes one month to grant the pre-birth order. Sometimes babies are born sooner than expected but a competent attorney, like those at Tsong Law Group, will be able to file an emergency hearing. This emergency hearing is called an ex parte which requests the court to review the paperwork usually the next court day. The ex parte will notify the court that the parties are requesting an earlier hearing date for the specified reason.   VI. Receiving Certified Copies  After the judgment is issued, the last step is for the attorneys to request certified copies of the findings and order and the parentage judgment. Since the court file is sealed, a special request has to be made by the attorney. A certified copy will be provided to the hospital where the birth takes place, this will be sent to vital statistics so that the birth certificate will reflect in the intended parents’ names. Additional certified copies may be kept by the surrogate and intended parents should they ever need to prove the parentage of the child.   Conclusion  The pre-birth issued by a judge establishes the intended parents as the legal parents of the baby born to the surrogate. Attorneys at Tsong Law Group are licensed in Washington and have experience and success in obtaining PBOs. Contact us   for assistance in the PBO preparation process in your surrogacy case.

Definition of a Pre-Birth Order (PBO) and Post-Birth Order A Pre-birth Order, often called a "PBO," is a legal petition filed in court that requests the court rule that the intended parents are the legal parents of the baby carried by a pregnant gestational surrogate. This happens before the baby is born. On the other hand, a post-birth order is a similar court process, sometimes started before birth, but it is a process where the court grants the legal parentage judgment after the baby is born.  When your lawyer or agency says, "We are preparing the PBO," they mean they are preparing the necessary legal parentage pleadings to file with the court. The term "pre-birth order" can refer to the actual court decision, but it often refers to the paperwork setting that up.  When a pre-birth order is signed by the court, it is sent to the hospital, accompanied by a letter from the attorney stating that the intended parents should be acknowledged as the legal parents in the surrogacy case. The judgment also states that  the gestational carrier and her spouse will not be listed on the birth certificate or have any legal rights over the child. With this order, the intended parents can complete the birth worksheet or birth certificate, officially listing them as the parents on the only birth certificate for the child.   Post-Birth Orders: After Delivery In contrast, post-birth orders are granted after the baby is born. In some states, this means the birth certificate might name the gestational carrier as the mother. The post-birth order will order the state’s department of health to seal the original birth certificate and issue a new one, officially recognizing the intended parents as the legal parents of the child.  Whether a pre-birth or post-birth order will be requested depends on the laws and courts of the surrogate's state. In some states, like Washington,   California , and Oklahoma , the courts issue pre-birth orders. In these states, the court declares the intended parents as legal parents before the baby is born. On the flip side, other states like Texas and Florida are post-birth order states, where the legal judgment does not issue until after the baby is born. It's crucial for your lawyer to know the parentage process in the state of the surrogate.      Other states like New York   and Illinois   have administrative processes that allow issuance of birth certificates in surrogacy outside going through a court proceeding. However, if the intended parents need a court judgment affirming their parental status, they can pursue a post-birth judgment in Illinois or a pre-birth order in New York.   Is there a disadvantage to using a pre-birth order or post-birth order?   In most cases, there's no real downside to choosing a pre-birth order or post-birth order state. The result is the same: the birth certificate reflects the intended parents as the legal parents, not the surrogate. This is a consistent outcome in both types of states.  For some international intended parents, there may be different requirements or needs for a pre-birth or post-birth order. For some intended parents, having a pre-birth order may be helpful for obtaining a visa; this was the case during COVID-19 times when certain travelers could not obtain visas to the US. In France, a post-birth order is required to recognize the parentage, so in pre-birth order states, a second order is requested.   Tsong Law Group’s attorneys are well versed in preparing pre-birth and post-birth orders. Connect with the expertise of our experienced attorneys licensed in California, New York, Illinois, Washington, Arizona, and Oklahoma. Contact us now for your surrogacy legal needs.

Introduction If you’re building a family through egg donation or surrogacy in Illinois, you already know how quickly the costs can add up: from fertility treatments  to legal paperwork  to the medical care  itself. And while our recent blog on California’s SB 729  explains how California expanded its fertility coverage, the Illinois legislature enacted SB 773   (Public Act 103‑0751) in 2024. For group policies issued or renewed on or after January 1, 2026, any Illinois group policy that provides pregnancy‑related benefits must also include infertility coverage. Illinois readers, depending on your health plan, you may already have insurance benefits that cover key parts of your fertility or surrogacy journey, including egg retrievals, IVF, and some services furnished to donors or a gestational surrogate as part of treating the member’s infertility. Whether you're just starting IVF, planning to work with a gestational surrogate, or using an egg donor, understanding your insurance options in Illinois is a critical step. This article walks through what the law covers, what it doesn’t, and how to protect yourself from the unexpected. Illinois insurance mandates: what they cover Illinois is one of the few states that legally requires many fully insured group health plans to cover infertility diagnosis and treatment. The mandate arises from Section 356m  of the Illinois Insurance Code , which sets definitions, eligibility, and parity protections. Through December 31, 2025, it applies to fully insured group policies with more than 25 employees ; beginning January 1, 2026, it applies to all Illinois group policies that provide pregnancy‑related benefits. If your insurance plan is fully insured (as opposed to self‑funded) and your employer has 25 or more employees, your plan is likely required—today—to cover a broad range of fertility‑related services. This includes but is not limited to: In vitro fertilization (IVF) Uterine embryo lavage and embryo transfer Artificial insemination (IUI) Gamete intrafallopian transfer (GIFT) Zygote intrafallopian transfer (ZIFT) Low tubal ovum transfer Those procedures remain in the statute for 2026 and beyond, and surgical sperm extraction procedures are expressly referenced under the 2026 expansion. The IVF, GIFT, and ZIFT coverage requires that the covered individual has been unable to attain, maintain, or sustain a viable/successful pregnancy through reasonable, less costly medically appropriate treatments for which coverage is available. Illinois law defines infertility broadly—including individuals who cannot reproduce without medical intervention, regardless of partnership status. That means single individuals and LGBTQ+ intended parents can qualify. The law currently has a lifetime limit  of up to four completed oocyte (egg) retrievals , with the potential for two additional retrievals  if a live birth occurs. For group policies issued or renewed on or after January 1, 2026 under new subsection 356m(a‑5), that statutory retrieval cap is removed. All covered procedures must be performed at qualified facilities.  For plan years before 2026 , procedures must be performed at facilities meeting ASRM/ACOG standards;  for group policies issued or renewed on or after January 1, 2026 , procedures must be medically appropriate under ASRM/ACOG/SART guidelines and performed at facilities that are SART members in good standing. Perhaps most notably, Illinois law prohibits insurers from applying stricter deductibles, co‑pays, coinsurance, waiting periods, or coverage caps to infertility diagnosis/treatment (and standard fertility preservation) than apply to other medical care under the plan. Egg donation & retrieval coverage Under state law, qualifying plans must cover the medical aspects of egg donation and retrieval, including donor screening that an insurer requires (for example, physical exam, lab and psychological screening, and prescription drugs). If an oocyte donor is used, the completed retrieval counts toward the covered member’s retrieval limit. Non‑medical donor costs—like compensation, travel within 100 miles, agency fees, and legal fees—may be excluded. In short, Illinois law supports coverage for the donor’s medical retrieval and related infertility services—but not the full cost of using a third‑party egg donor. This is where legal planning and private financial arrangements become essential. Surrogacy‑related medical coverage Surrogacy introduces complexities when it comes to insurance. Under Illinois’ infertility mandate and Department of Insurance rules, an intended parent’s qualifying plan must cover infertility services that are delivered to a surrogate to treat the member’s infertility—subject to the plan’s medical‑necessity and network rules. That includes at least one embryo‑transfer procedure after the final covered retrieval and related infertility services until the surrogate is discharged to routine obstetrical care. After discharge to OB care, ongoing prenatal and delivery services may be excluded from the intended parent’s infertility benefit and are typically billed to the surrogate’s own policy. If the surrogate is in Illinois, her insurance does not have to be “surrogacy‑friendly,” but the Gestational Surrogacy Act requires that, at the time of signing, the surrogate has a health insurance policy covering major medical and hospitalization that remains in effect through the pregnancy and for at least eight weeks after birth. The policy can be procured by the intended parents. ( codes.findlaw.com ) Key Points: Mandated coverage:  Illinois law requires qualifying group policies to cover infertility services furnished to a surrogate that treat the covered individual’s infertility (including embryo transfer), with parity in cost‑sharing, until the surrogate is discharged to OB care. Policy for surrogate must be in place: The surrogate must have her own policy covering major medical/hospitalization through the pregnancy and eight weeks postpartum. Your responsibility:  Intended parents remain responsible for plan deductibles, copays/coinsurance, and any items not covered by either policy (for example, non‑medical surrogate costs). Setting up a policy:  If the surrogate’s existing plan excludes or limits coverage, you may need to help her obtain a policy (often via the Marketplace during open enrollment) that satisfies the Act’s requirement and your contract terms. Specialist consultation:  Consulting a surrogacy‑savvy insurance broker helps determine whether a secondary policy is prudent and how claims should be routed. Note: Some carriers have formally clarified operational details. For example, BCBSIL instructs providers to indicate “surrogate” or “donor” on claims and notes that infertility benefits applying to a member also apply to a surrogate until discharge to OB care; coverage details still vary by plan. ( bcbsil.com ) To learn more about Illinois surrogacy contracts— read our breakdown of the state’s surrogacy agreement requirements Need legal guidance? If you're pursuing egg donation, surrogacy, or both in Illinois , Tsong Law Group   can help you protect your family and finances. Our attorneys are licensed in California , New York , Illinois , Washington , Arizona , and Oklahoma —and we’ve helped families nationwide navigate fertility law with confidence. This article is for informational purposes only and does not constitute legal advice. It does not create an attorney‑client relationship with the reader.