When I helped my cousin research surrogacy in Russia last year, I noticed that almost everyone obsesses over cost and success rates and completely skips two things: legal risk and genetic screening. Honestly, those are the two areas where, if something goes wrong, there is almost no way to fix it afterward. Here’s the exact playbook I put together back then—you can literally use it as a checklist.
Which Countries Are Actually Legally Viable, and Why Russia Made My Shortlist
We started out torn between the US, Georgia, and Russia. The US was just too expensive—the whole process typically runs well over 1.5 million RMB (roughly $210,000+). Georgia tightened its rules for foreigners after 2026. Russia, at the time, was still open to married heterosexual couples, intended parents could be listed directly on the birth certificate, and the total cost sat somewhere between 600,000–900,000 RMB (about $85,000–125,000).
What I learned later: the gap between what agencies mean when they say “we can do everything” and what local law actually supports can be enormous.
Action step: Pull up the source text of the country’s current fertility regulations and confirm two things—whether intended parents can be written directly onto the birth certificate, and how household registration and travel documents work once you bring the baby home. If you can’t find the source text, don’t sign anything.
The Surrogate Screening Reports: Here’s What I Checked Line by Line
The Russian agency sent over surrogate profiles that ran 20+ pages each. My cousin initially only looked at photos and age. I made her go through every page with me, focusing on three things: age between 20–32, a history of at least one full-term delivery, and clean results on infectious disease panels and medication history.
One profile looked great on paper—28 years old, two natural births—but the psychological evaluation section was completely blank. That one got rejected on the spot.
Action step: When you receive a profile, flip straight to the psychological evaluation and obstetric records pages. If either is missing or blank, demand the agency complete it. If they can’t, switch candidates. Don’t feel awkward about it—this is your money and your risk.
Skip Genetic Screening and You Might Find Out After the Baby Is Born
We knew a couple where both partners carried a recessive deafness gene. The agency never ran preimplantation monogenic testing on the embryos, and the child was diagnosed after birth. They later did PGT-M in Russia—about 40,000 RMB extra for one round of embryos—but their next baby was healthy.
The point is, genetic screening is not optional. The correct order: both partners do carrier screening first to identify any shared recessive disease genes, and only then decide whether PGT-M is needed. Reverse that order and you’re gambling.
Action step: Before starting your cycle, request expanded carrier screening for both partners (the kind covering several hundred genes). Once you have the reports, confirm with the embryology lab that they can actually perform PGT-M, and get that in writing in your treatment plan.
The Contract Clauses I Went Over Word by Word
Our agency contract ran 31 pages total—the Russian original plus a Chinese translation. The clauses that mattered most:
- If fetal abnormalities appear during the surrogate’s pregnancy, who holds the decision-making authority over fetal reduction or termination;
- The exact caps on the surrogate’s monthly living allowance and on medical emergency costs;
- If the surrogate refuses to hand over the baby after birth, what the penalty is and what remedies are available.
We added one annex ourselves: the surrogate would receive roughly 1,500 RMB per month during pregnancy, but the medical reimbursement portion had a defined cap—and exactly how any overage would be split had to be spelled out.
Action step: Before signing, have a bilingual lawyer verify three clauses one by one: “termination decision authority,” “cost caps,” and “remedies for refusal of handover.” The translation and the Russian original must be signed simultaneously—never just one of the two.
If you’re considering surrogacy in Russia, my advice is very concrete: spend two weeks confirming how current law defines intended parents’ status, then screen the surrogate profiles for the psychological evaluation and obstetric records, complete carrier screening for both partners before starting your cycle, and finally have a bilingual lawyer tear apart the contract. Keep these four steps in order—each one you skip could end up costing you hundreds of thousands in tuition.