Legal clearance is the written confirmation sent to the fertility clinic after the surrogate and intended parents have completed the required agreement with separate attorneys. It tells the clinic that the legal step needed before treatment has been completed.
Legal clearance is not medical clearance. It is not the contract itself. It also does not mean every later parentage or hospital document is finished.
Nia thought the contract was finished on Thursday
Nia approved her final contract edits on Thursday. She expected the clinic to send her medication calendar on Friday. Instead, her coordinator said legal clearance had not been issued.
One insurance exhibit still needed a correction. Both sides also needed to sign the final version. After that, the attorneys would send a clearance letter to the clinic.
Nia had finished her review. The case had not finished the legal-clearance step.
The path to legal clearance
- A draft is prepared. One attorney creates the first version.
- Each side gets independent advice. The surrogate’s lawyer represents the surrogate. The intended parents have their own lawyer.
- Questions and changes are discussed. The attorneys communicate based on their clients’ instructions.
- The final agreement is signed. Required signatures, dates, witnesses, or notarization must be complete.
- The attorneys issue clearance. The clinic receives written confirmation and any treatment limits it needs to know.
- The clinic confirms the next step. Do not begin medication until the clinic gives instructions.
ASRM recommends separate legal counsel and a fully completed agreement before treatment begins.1
What the surrogate reviews with her lawyer
- Her right to make decisions about her medical care
- Embryo number, transfer attempts, and treatment limits
- Compensation, expenses, escrow, and late-payment steps
- Insurance, medical bills, and uncovered care
- Travel, childcare, lost wages, and bed rest
- Pregnancy loss, failed transfer, cancellation, and delays
- Privacy, photos, social media, and communication
- Birth, postpartum support, and contact after delivery
Do not sign because a coordinator says a clause is “standard.” Ask your own lawyer what it means for you.
Do not confuse four different green lights
- Medical clearance: the fertility clinic accepts your medical review.
- Psychological screening: the required evaluation and counseling are complete.
- Legal clearance: the agreement is signed and the clinic has the letter.
- Cycle start: the clinic confirms all current requirements and sends instructions.
Read what medical clearance means and how surrogacy escrow works.
Questions women often ask
Who pays for my lawyer?
Intended parents commonly cover agreed legal fees, but the surrogate’s attorney still represents the surrogate. Confirm how the lawyer is selected, what the fee covers, and what happens if extra work is needed.
Can the agency explain the contract?
The agency can explain the workflow. It should not replace your independent attorney or give legal advice about your rights.
How long does legal clearance take?
It depends on attorney schedules, document complexity, insurance questions, state law, and how quickly each side responds. Ask for the current open-items list instead of a guaranteed date.
Can I start medication while one issue is open?
Do not rely on an informal yes. Follow the fertility clinic’s written instructions and your attorney’s advice. State law and clinic policy may require full execution and clearance first.
California law includes specific requirements for independent attorneys and timing before embryo-transfer medication or transfer.2 Other states may be different.
Wait for the letter—not the feeling that everyone agrees
Nia protected her health and timeline by waiting for formal clearance. Review the full surrogate process or ask how the legal and clinic steps connect.