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Best IVF and Fertility Clinics in United States

Top IVF Clinics in United States

Clinics with the highest ratings and verified quality care in this region.

United States
star 4.2 (39)

Reproductive Medicine Associates | Sound Fertility Care

Reproductive Medicine Associates (RMA) is a fertility clinic network located across the United States—including California, Colorado, Delaware, Florida, New Jersey, North Carolina, Pennsylvania, Texas, Utah and Washington—specializing in comprehensive assisted reproductive technologies such as IVF, IUI, ICSI, egg freezing, blastocyst culture, single‑embryo transfer, embryo biopsy and advanced genetic testing that have been shown to increase live‑birth rates. RMA offers a full suite of services in one place, from diagnostic testing and personalized treatment planning to on‑site IVF laboratories, morning monitoring, same‑week appointments and onsite urology, supported by a team of board‑certified reproductive endocrinologists, embryologists and dedicated nursing staff who emphasize compassionate, patient‑centered care and a collaborative “woman‑to‑woman” approach. Unique features include a partnership with the IVI RMA North America Network spanning 22 state‑of‑the‑art labs that have helped bring more than 220,000 babies into families, a nationally recognized REI fellowship program, extensive insurance and financial guidance, a 24/7 patient portal, and robust educational resources. Patient stories highlight high success rates and individualized support, while the clinic’s consistent standard of care, transparent communication and multidisciplinary expertise make RMA a distinctive choice for anyone seeking hopeful, evidence‑based fertility treatment.

United States
star 4.2 (30)

Life IVF Center Los Angeles

Life IVF Center is a fertility and reproductive medicine clinic located in Southern California, with state‑of‑the‑art locations in Irvine (3500 Barranca Pkwy, Suite 300) and Arcadia (289 W Huntington Dr, Suite 400), specializing in personalized in‑vitro fertilization (IVF) and comprehensive family‑building solutions; the clinic offers a full spectrum of services including Precision ART™ IVF, intrauterine insemination (IUI), egg and embryo freezing, pre‑implantation genetic testing, platelet‑rich plasma (PRP) therapy, LGBTQ family building, third‑party reproduction (donor eggs, sperm, gestational carriers), mini‑IVF, and travel fertility programs, all supported by cutting‑edge laboratory technology and a commitment to flexible, affordable care. Led by a multidisciplinary team of experienced physicians—Dr. Frank Yelian, Dr. Jackson Wu, Dr. Salman Okour, Dr. Michelle Yu—and skilled nurse practitioners Vivian Duong and Samira Shir, Life IVF Center emphasizes a precision‑treatment approach that tailors protocols to each patient’s history, goals, and medical profile, resulting in consistently high success rates highlighted on their “Life IVF Success Rates” page. Patients benefit from complimentary initial consultations, a robust patient portal, financing options, educational webinars, and a uniquely accessible website that offers multiple disability‑friendly modes, ensuring comprehensive support throughout every step of the fertility journey.

United States
star 4.2 (27)

Family Fertility Center

Family Fertility Center is a reproductive endocrinology and infertility clinic located in Bethlehem, PA (with a second office in Clarks Summit, PA), specializing in comprehensive infertility diagnosis and treatment for couples and individuals; founded in 1994 by Dr. H. Christina Lee, a board‑certified REI specialist who also holds rare embryology and high‑complexity laboratory director credentials, the center offers a full spectrum of services including ovulation induction, intrauterine insemination, IVF, ICSI, preimplantation genetic screening and diagnosis, egg freezing, a successful donor‑egg program, gestational‑surrogate coordination, and minimally invasive reproductive surgeries such as laparoscopic myomectomy, tubal reversal and operative hysteroscopy. Unique features include the Lehigh Valley’s first and only in‑house IVF laboratory, full CAP accreditation, CLIA‑certified hormone testing, and membership in SART with success rates that consistently exceed the national average and are reported as live‑birth rates per cycle start. The multidisciplinary team—led by Dr. Lee, supported by all‑female fertility specialists, a dedicated embryology staff, on‑site psychological counselors, and a proactive financial office offering multi‑cycle discounts, refund programs and veteran benefits—delivers personalized, patient‑centered care with same‑day monitoring, early‑morning appointments, rapid phone response, and compassionate emotional support throughout every step of the fertility journey.

United States
star 4.2 (68)

SGF Houston – Texas Medical Center

Shady Grove Fertility is a leading reproductive medicine clinic with a national presence across the United States, operating 58 locations including major centers in Richmond, VA, Houston, TX, and Philadelphia, PA, and specializing in comprehensive IVF, egg freezing, IUI, gestational carrier programs, and LGBTQ+ family‑building services; the clinic’s proven process combines cutting‑edge technology, a “shared‑risk” IVF guarantee that offers a full refund if a cycle does not result in a live birth, and personalized care that ensures patients understand their odds, costs, and options. Key services include fertility testing, advanced embryo transfer, donor egg and sperm programs, and extensive mental‑health and support‑group offerings such as online and in‑person sessions for singles, queer families, and those experiencing recurrent loss. With more than 100,000 babies born, a reported 96 % patient recommendation rate, and a baby delivered on average every two hours, Shady Grove highlights its high success outcomes. The multidisciplinary team of renowned physicians, embryologists, nurses, and support staff emphasizes a relationship‑based, compassionate approach, while accepting all major insurances and providing financing options, making the journey emotionally and financially supportive for every family‑building patient.

United States
star 4.2 (89)

Shady Grove Fertility in Fair Oaks, VA

Shady Grove Fertility is a comprehensive reproductive medicine clinic with a national presence across 58 U.S. locations, specializing in personalized IVF, egg‑freezing, IUI, embryo transfer, gestational‑carrier cycles and LGBTQ+ family‑building services; the center offers advanced fertility testing, donor‑egg and embryo programs, recurrent pregnancy‑loss treatment, and male‑infertility solutions while accepting all major insurance plans and providing innovative financing and a “shared‑risk” guarantee that refunds treatment costs if a baby is not achieved. With more than 100,000 babies born, a baby delivered every two hours and a 96 % patient‑recommendation rate, Shady Grove highlights its proven success and national leadership in reproductive health. The multidisciplinary team of world‑renowned physicians, embryologists, nurses and support staff embraces a relationship‑based, compassionate approach, continuously integrating the latest technologies and evidence‑based protocols. Patients benefit from extensive support services including virtual and in‑person support groups, educational seminars, mental‑health counseling, and a dedicated support team that guides individuals through every step of their journey, ensuring both emotional and financial needs are met throughout the family‑building process.

United States
star 4.2 (104)

Denver Fertility Care

Denver Fertility Care is a fertility clinic located in the greater Denver area with two convenient sites in Englewood (South Denver‑I‑25 and Lincoln) and central Denver on the Rose Hospital campus, specializing in comprehensive reproductive endocrinology and infertility treatment; the practice offers IVF, IUI, egg freezing, donor programs, fertility surgery, pre‑implantation genetic diagnosis, LGBTQ family‑building, gestational surrogacy, and a dedicated PCOS Life Program. As a physician‑owned practice led by board‑certified Medical Director Dr. Dana Ambler, Dr. Bruce Albrecht, NP Ellen DiSesa, and Lab Director Dr. Bryan Kloos, the team emphasizes a patient‑centered, conservative‑first approach that combines personalized diagnostics with the latest assisted‑reproductive technologies in a fully accredited IVF lab featuring advanced LifeAire filtration and expert embryologists. The clinic maintains competitive success rates while keeping costs among the lowest nationally, offering transparent pricing, insurance verification, and financing through Prosper Healthcare Lending. Unique features include a small, intimate office model that limits patient volume for high‑touch care, virtual consultations, a robust counseling and wellness program, a patient portal, and regular events such as half‑off egg‑freezing consultations, all designed to support patients emotionally and financially throughout their journey to parenthood.

IVF from 16300 USD View Profile arrow_forward
United States, California
star 4.2 (59)

Fertility & Lifespan Medical Institute

Fertility & Lifespan Medical Institute is a comprehensive reproductive medicine clinic located in San Diego, CA, specializing in integrative fertility care and lifespan health for women and men; under the leadership of Dr. Steven A. Brody, MD, PhD, the institute offers world‑class IVF at a transparent low‑cost cycle price of $5,990 that includes physician fees, monitoring, ultrasounds, egg retrieval, ICSI, embryo transfer and freezing, as well as advanced genetic testing, pre‑implantation diagnosis, egg donation, egg freezing, mini‑IVF, aggressive IVF protocols, hormonal balance programs, bioidentical hormone therapy, anti‑aging peptides, and treatment for PCOS, endometriosis, recurrent miscarriage, low sperm count, and menopausal symptoms. Unique features include San Diego’s first board‑certified program offering advanced genetic testing, a multidisciplinary team with board certifications in Internal Medicine, Endocrinology, Obstetrics‑Gynecology and Reproductive Endocrinology, and a strong emphasis on personalized, compassionate counseling that fosters long‑term patient relationships; the clinic also provides extensive patient support services such as 24/7 phone access, online appointment booking, insurance acceptance (Aetna, Cigna, Medicare, UnitedHealthcare, etc.), and educational resources through blogs and videos. While specific success rates are not listed, the institute highlights a less‑than‑2% true unexplained infertility rate and numerous patient testimonials attesting to high satisfaction and successful outcomes.

United States
star 4.1 (40)

Shady Grove Fertility in Baltimore – Harbor East

Shady Grove Fertility is a fertility clinic located in the United States, specializing in comprehensive reproductive medicine and family‑building solutions; with more than 58 locations nationwide it offers IVF, IUI, frozen‑embryo transfer, egg freezing, donor egg and sperm programs, gestational carrier services, LGBTQ+ and reciprocal IVF options, and advanced care for age‑related or male factor infertility. The center highlights a proven track record of over 100,000 babies born, a 96 % patient recommendation rate and a baby delivered roughly every two hours, and it pioneered a shared‑risk IVF program that refunds treatment costs if a cycle does not result in a live birth. A multidisciplinary team of board‑certified physicians, embryologists, nurses and compassionate support staff follows a relationship‑based, personalized approach, while accepting all major insurances and offering financing and flexible payment plans. Extensive patient‑centered services include mental‑health counseling, numerous online and in‑person support groups, educational seminars, and a dedicated support team that guides patients through odds, costs and options, ensuring a warm, welcoming experience throughout the fertility journey.

United States, Florida
star 4.1 (102)

Assisted Fertility Program

Assisted Fertility Program is a comprehensive fertility clinic located in Jacksonville, FL with additional offices in Orlando and Deerfield Beach, specializing in assisted reproductive technologies such as IVF, IUI, ovulation induction, tubal reversal, egg donation, gestational surrogacy and LGBTQ‑inclusive family building; the clinic offers personalized one‑on‑one care, discounted pricing, insurance coordination and third‑party financing, as well as a full suite of patient support services including 24/7 phone access, post‑procedure follow‑up calls, email counseling, travel and lodging assistance, and legal referrals for surrogacy contracts. Led by Program Director Dr. Marwan Shaykh, a board‑certified obstetrician‑gynecologist with a subspecialty in reproductive endocrinology and over 35 years of experience, the team combines expert physicians, skilled nurses and dedicated coordinators to create a supportive, family‑like environment. According to CDC data the clinic’s success rates exceed the national average, and IVF cycles using donor eggs and surrogates achieve a reported 60‑70 % live‑birth rate. Unique features include a long history dating back to 1985, a partnership with ReproTech for cryostorage, and a commitment to serving the LGBTQ+ community without discrimination, making Assisted Fertility Program a top‑rated choice for patients seeking high‑quality, compassionate fertility care.

United States
star 4.1 (154)

Advanced Fertility of Chicago

Advanced Fertility Center of Chicago (AFCC) is a comprehensive fertility clinic located in the Greater Chicago area, with offices in Chicago, Gurnee, Downers Grove and Arlington Heights, specializing in assisted reproductive technologies such as IVF, IUI, egg freezing, third‑party reproduction and LGBTQ+ family building. The center offers a full suite of services—including pre‑implantation genetic testing, gestational carrier programs, hormonal monitoring, and personalized medication plans—backed by state‑of‑the‑art, CAP‑accredited laboratories and cutting‑edge embryology research. AFCC’s distinctive strengths include an inclusive financial model, transparent reporting of success rates that have consistently exceeded the national live‑birth average for more than 20 years, and detailed age‑specific, blastocyst, IUI and egg‑donation outcomes reported to SART and the CDC. The award‑winning team of doctors, nurses and embryologists brings over 28 years of experience, having helped more than 8,300 babies born, and is committed to ongoing learning, stringent quality control and one‑to‑one patient investment. Patient support extends beyond medical care to emotional‑wellness resources, stress‑reduction guidance, mental‑health counseling, and medication‑discount assistance, ensuring a compassionate, professional journey toward parenthood.

United States
star 4.1 (154)

Institute for Reproductive Health | Cincinnati Fertility

Institute for Reproductive Health (IRH) is a fertility and reproductive‑medicine clinic located in the Tri‑State region, specializing in comprehensive IVF, IUI, and inclusive family‑building solutions for diverse patients. IRH offers a full spectrum of services including intrauterine insemination, conventional and reciprocal IVF, donor‑egg cycles, gestational‑carrier programs, and fertility preservation for transgender individuals, positioning it as the Tri‑State’s most experienced IVF center with a reputation for high success rates that the clinic proudly highlights. The multidisciplinary team—led by physicians such as Dr. Michael Awadalla, Dr. Michael Scheiber, Dr. Thomas Burwinkel, Dr. Isela Robertshaw, Dr. Vinita Alexander, Dr. Marja King, and Dr. Sherif Awadalla, supported by advanced nurse practitioners and registered nurses—delivers personalized, compassionate care, encouraging patients to ask questions and actively participate in their treatment plans. Unique features include dedicated LGBTQIA+ programs, reciprocal IVF for lesbian couples, and seamless coordination of egg donors and gestational carriers for gay male and transgender families. Patient support extends beyond clinical care to include counseling, educational resources, and a nurturing environment that celebrates each journey, as reflected in numerous patient testimonials praising the clinic’s empathetic staff, transparent communication, and commitment to creating miracles every day.

Tennessee, Nashville
star 4.1 (33)

Tennessee Fertility Institute

Tennessee Fertility Institute is a fertility clinic located in Nashville and Franklin, Tennessee, specializing in personalized, one‑to‑one fertility care. The award‑winning center offers a full spectrum of services including IVF, egg freezing, egg donation, fertility testing, and emotional wellness resources such as stress‑reduction tips and mental‑health support, all delivered by innovative and empathetic reproductive endocrinologists and a CAP‑accredited laboratory team that maintains stringent quality control and direct patient‑embryology interaction. Since 2024 the clinic has welcomed over 600 babies, reflecting its high success rates, and its top‑rated doctors have been voted the best in the state. Patients benefit from quick response times, multiple touch‑points with physicians, 24/7 access to resources, and a compassionate approach that ensures every individual feels seen, heard, and supported throughout their journey, whether they are seeking to build a family now or preserve fertility for the future.

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Frequently Asked Questions

Everything you need to know about fertility treatment in United States.

Can single women do IVF in United States?

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Yes, single women can pursue IVF in the United States, as the legal framework allows individuals to undergo fertility treatments regardless of marital status or sexual orientation.

Single women have full legal access to IVF and other assisted reproductive technologies without needing a male partner, and they obtain sole legal parental rights upon the birth of a child conceived through IVF with donor sperm, with the donor legally waiving all rights and responsibilities. Access to donor sperm is readily available through sperm banks offering diverse profiles including physical traits, medical history, and ethnic background, and while anonymous donation was common, many states now favor ‘open-ID’ donors who can be contacted by the child in adulthood.

While there isn’t a universal maximum age for IVF, most clinics limit treatment with a woman’s own eggs to ages 42-45, considering overall health on a case-by-case basis, and age limits are less strict when using donor eggs; however, public funding for IVF for single women is not widely available, though some non-profit organizations and foundations may offer assistance.

When was the first IVF baby born in United States?

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The first baby born in the United States through in vitro fertilization (IVF) was Elizabeth Jordan Carr, born on December 28, 1981.

Her birth took place at Norfolk General Hospital in Virginia and was a significant milestone in reproductive technology. The IVF procedure was carried out at Eastern Virginia Medical School, led by Doctors Howard and Georgeanna Seegar Jones.

Prior to this, the first human IVF pregnancy had been reported in 1973 by researchers from Monash University, though it did not result in a live birth, and Louise Brown was born as the first IVF baby globally in 1978 in England.

Is IVF legal in United States?

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In the United States, In Vitro Fertilization (IVF) is legal and widely practiced, although the regulatory landscape is complex with oversight at both federal and state levels.

There isn’t a single federal law governing all aspects of assisted reproductive technology (ART); instead, a multi-layered system involving various agencies and state regulations exists. The Food and Drug Administration (FDA) regulates human eggs, sperm, and embryos, ensuring adherence to processes designed to prevent the spread of communicable diseases, and approves drugs and devices used in IVF. The Centers for Disease Control and Prevention (CDC) tracks the success rates of fertility clinics and oversees laboratory certifications, while the Clinical Laboratory Improvement Amendments (CLIA) set federal standards for laboratory testing used in IVF.

The Centers for Medicare and Medicaid Services (CMS) also plays a role in the regulation of ART, and there have been executive orders and proposed legislation related to the field.

What is the age limit for IVF in United States?

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In the United States, there isn’t a federal law establishing a maximum age for undergoing In Vitro Fertilization (IVF). However, age cutoffs are influenced by medical recommendations, clinic policies, and whether a woman is using her own eggs or donor eggs.

The success rates of IVF decline with a woman’s age when using her own eggs, especially after 35 and more sharply after 40. The American Society for Reproductive Medicine (ASRM) indicates that most clinics set an upper age limit between 42 and 45 for women using their own eggs, though some may have lower limits or none at all depending on the patient’s health. When using donor eggs, the age of the egg donor is more important, and women in their 40s and 50s often have success carrying a pregnancy with donor eggs.

Public funding for IVF, like through Medicaid, often has age requirements, such as New York’s program covering services for members between 21 and 44 years old. Egg donors are typically between 20 and 32 years of age, with some centers specifying 21-31.

How does IVF work in United States?

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In Vitro Fertilization (IVF) in the United States is a multi-stage process that includes ovarian stimulation, egg retrieval, fertilization in a laboratory, embryo culture, and finally, embryo transfer followed by pregnancy testing.

An IVF cycle typically starts with fertility medications to stimulate the ovaries to produce multiple eggs over approximately 8-11 days, with regular monitoring via blood tests and ultrasounds to track development. Once mature, eggs are retrieved and fertilized with sperm in a lab, and the resulting embryos are cultured for 3 to 5 days before being transferred. The number of monitoring visits usually falls around four, but can range from three to six depending on individual response to medication.

The regulatory environment for IVF is complex, varying by state, and currently 22 states and the District of Columbia mandate some level of insurance coverage for infertility treatments like IVF, with laws like California’s SB 729 expanding coverage for larger employer-sponsored plans starting in 2026.

Can gay couples do IVF in United States?

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Yes, gay couples can pursue IVF in the United States, with various legal and practical pathways available for building their families.

The process typically involves egg donation and/or surrogacy, and legal recognition of parentage is crucial. Regulations surrounding surrogacy vary significantly by state, with some states like California, Nevada, and Illinois being more supportive of same-sex couples through clear legal frameworks and the availability of pre-birth parentage orders. Egg donation is also a well-established option, allowing couples to select a known or anonymous donor who undergoes thorough medical, genetic, and psychological screening.

For male same-sex couples, embryos are created using donated eggs fertilized with sperm from one or both partners, often utilizing intracytoplasmic sperm injection (ICSI) to enhance fertilization rates, and clinics can even offer a ‘split fertilization’ approach to utilize both partners’ sperm.

Is sperm donation legal in United States?

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Sperm donation is legal in the United States and is regulated through a combination of federal guidelines from the Food and Drug Administration and individual state laws.

When conducted through compliant clinics and sperm banks, sperm donation is lawful, adhering to federal safety regulations and state parentage laws; the FDA oversees donor screening, testing, and record-keeping. While there isn’t one single federal law governing all aspects of sperm donation, organizations like the American Society for Reproductive Medicine and the American Association of Tissue Banks offer additional recommendations and guidelines.

The issue of donor anonymity is evolving, as direct-to-consumer DNA testing can now allow donor-conceived individuals to identify their biological donors, despite initial intentions of anonymity; some states, like Washington and Colorado, have laws addressing donor-conceived individuals’ access to identifying information and have even banned donor anonymity in some cases.

What is the IVF success rate in United States?

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IVF success rates in the United States vary considerably based on a woman’s age, with younger women generally experiencing higher live birth rates.

For women under 35, the live birth rate per IVF cycle is approximately 55.6%, decreasing to 40.8% for those aged 35-37, and 26.8% for women aged 38-40. Women over 40 have a success rate of around 7%, though rates can be higher for those under 42. Utilizing donor eggs generally leads to higher success rates, ranging from 70% to 80%, as donor eggs are typically sourced from younger individuals and result in improved embryo quality.

One study showed a pregnancy rate per embryo transfer with donor eggs of 56.9% and a delivery rate of 42.2%, compared to 34.6% and 25.0% respectively when using one’s own eggs. While the US has a lower per capita utilization of IVF compared to countries like Israel, Japan, and Denmark, it still performs a high total volume of cycles, ranking third globally after China and Japan.

Can lesbians do IVF in United States?

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Lesbian couples can pursue IVF in the United States, with options and legal considerations available to help them build families.

The process commonly involves using donor sperm, and there are ways for both partners to participate in the biological and gestational aspects of having a child. Sperm banks offer both anonymous and known donor options, and fertility clinics can help with the selection process, while legal frameworks generally support fertility treatments, with some states and federal legislation working to further secure access.

Reciprocal IVF is a popular method, allowing one partner to provide the eggs which are fertilized with donor sperm, and then the resulting embryo is transferred to the other partner to carry the pregnancy, fostering a shared experience of parenthood. Legal recognition of both parents is generally attainable, especially for married couples, and options like second-parent adoption are available for those who are not married or to further secure legal standing.

Is embryo donation legal in United States?

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Embryo donation is legal in the United States, though the legal specifics are complex and differ from state to state, frequently being handled as a property transfer rather than an adoption.

Currently, there isn’t a single federal law governing embryo donation; instead, regulations focus on clinic standards and reporting. In most states, embryos are considered property, meaning donation is governed by contract law, which differs from the requirements of traditional adoption like home visits or post-birth finalization. Some states are developing laws regarding embryo disposition and custody, and a few classify frozen embryos as children, potentially affecting IVF procedures.

Informed consent from genetic parents is essential, requiring them to understand they are giving up all parental rights and responsibilities, and is usually formalized in a legal agreement. The American Society for Reproductive Medicine recommends psychological counseling for donors, and both donors and recipients must complete medical screening, including infectious disease and genetic testing, as required by law. Anonymity is becoming more challenging to maintain due to DNA testing and social media.

Is reciprocal IVF (ROPA) allowed in United States?

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Reciprocal IVF, also known as ROPA, is a fertility treatment option available to same-sex female couples in the United States, and there are no federal restrictions preventing access to it.

In this process, one partner provides the eggs which are fertilized with donor sperm, and the resulting embryo is transferred to the other partner to carry the pregnancy. While legally permissible federally, the laws regarding parentage can differ significantly from state to state, and it is advisable for couples to seek guidance from a reproductive attorney to understand and secure their parental rights.

For married couples, the genetic mother generally has legal parentage established at birth with written consent, while unmarried couples may require additional legal consent or steps for both partners to be recognized as legal parents. Clinics across the country, including UCSF Center for Reproductive Health, Houston Fertility Center, The Fertility Center of Las Vegas, and New Hope Fertility in NYC, offer reciprocal IVF to LGBTQ+ families.

Is egg donation legal in United States?

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Egg donation is legal in the United States and is a frequently utilized method within assisted reproductive technologies.

The practice is guided by recommendations from organizations such as the American Society for Reproductive Medicine (ASRM) and regulations from the U.S. Food and Drug Administration (FDA). Donors undergo thorough screening, including detailed medical and genetic history, medical examinations for infectious diseases and reproductive health, and psychological evaluations to ensure their emotional well-being.

Generally, egg donors are between 21 and 34 years old, though some programs may accept donors slightly outside this range. Donors are compensated for their time and commitment, with the amount varying based on individual circumstances.

Is surrogacy legal in United States?

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The legality of surrogacy in the United States is complex, as it is regulated at the state level and there are no federal laws governing it.

Because of this, the permissibility of surrogacy contracts, the establishment of parentage, and whether surrogates can receive compensation all depend on the specific state. Gestational surrogacy, where the surrogate has no genetic link to the child, is permitted in many states, including California, Illinois, and Oregon, and these states often have enforceable contracts and allow for pre-birth parentage orders. Traditional surrogacy, where the surrogate is genetically related to the child, is less common and often restricted or outlawed due to legal parentage complexities.

Surrogacy can be either altruistic, with only expense reimbursement, or commercial, involving additional compensation to the surrogate, and the legality of commercial surrogacy also varies significantly by state.