Surrogacy in Tennessee: The Complete 2026 Guide

Tennessee works well for intended parents in one specific configuration — and closes off another. Here the genetic link is not a detail, it is the route, and marital status decides much of the rest.

• It works if at least one of you will be genetically related to the child. Attorneys routinely obtain pre-birth Orders of Parentage for the genetic parent, and practitioners describe Tennessee as notably friendly for LGBTQ+ intended parents on that structure.
• A donated or double-donor embryo is the hard case. If neither of you is a genetic parent, practitioners report the usual pre-birth route unavailable and advise against it here. The full picture is in the table below.
• Long practice. Compensated gestational surrogacy has run here for years on contracts and court orders.
• Established fertility programs around Nashville — subject to a new state certification law from 2027.
• Central logistics. Nashville is within a day's drive of much of the Southeast and Midwest.

What Tennessee does not offer is a modern surrogacy act — the work is done by case law, court practice, and your attorney.

Tennessee has no modern surrogacy act. What governs is a handful of narrow statutes, a 2014 Supreme Court decision, and settled court practice — and the practice turns on one question: who is genetically related to the child.

Settled

• The surrogacy statute is a definition, not an authorization. T.C.A. § 36-1-102(52) defines "surrogate birth" in two narrow patterns: (A)(i), a married couple's own egg and sperm carried by another woman; (A)(ii), insemination of the carrier with a man's sperm — her own egg — for "the biological father and the biological father's wife." Only the first uses both spouses' gametes. Subdivision (B) waives surrender and adoption in those circumstances only; (C) adds that nothing in the definition "shall be construed to expressly authorize the surrogate birth process in Tennessee."
• Compensated gestational surrogacy is accepted in practice. The Academy of Adoption & Assisted Reproduction Attorneys reports that attorneys "routinely secure pre-birth Orders of Parentage" and that carrier support provisions are "often quite generous."
• A 1977 insemination statute, read gender-neutrally. § 68-3-306 legitimates a child born to a married woman by consented artificial insemination; Harrison v. Harrison (Tenn. Ct. App. 2021) applied it to a married same-sex spouse. It reaches only insemination within a marriage.

The genetic question — practice, not statute

• Practitioners report that a pre-birth Order of Parentage requires at least one intended parent to be a genetic parent. No statute states this and no published decision holds it — treat it as the working reality your attorney plans around.
• On that reported practice, donor sperm or donor eggs work; an embryo with both gametes donated leaves neither parent genetically related, and the usual pre-birth route is described as unavailable.
• The non-genetic intended parent's route is a post-birth related-parent (stepparent) adoption — which practitioners report Tennessee allows only where the couple is married. In their words, there is no mechanism for the unmarried partner of a genetic parent to adopt while preserving the genetic parent's rights, and a couple using donated eggs "need[s] to be married to have a Tennessee surrogacy journey." Because that route is an adoption, the adoption payment rules (§ 36-1-108, § 36-1-109 — enumerated, documented, court-reviewed expenses only) sit on it; map both steps with counsel before signing.
• Donated and double-donor embryos. The donated-embryo statute (§§ 36-2-401 to -403) is a non-adoption parentage route for relinquished embryos — but it is written around a recipient who carries the pregnancy herself (§ 36-2-402(4): transfer into the uterus of "a female recipient intended parent"). Practitioners advise against carrying a donated embryo with a Tennessee surrogate; an embryo created from two donated gametes sits outside the statute entirely. Get a written case-specific opinion before creating or transferring embryos.
• Other published decisions — In re C.K.G. (2005), In re Adoption of A.F.C. (2014), In re Amadi A. (2015) — each stop short of a holding you can plan on; together they are why Tennessee counsel is not optional.

Compensation — read In re Baby before you draft

In In re Baby (2014), the Tennessee Supreme Court held that public policy "does not prohibit the enforcement of traditional surrogacy contracts" but does prohibit compensation that "is contingent upon the surrender of the child, is contingent upon the termination of the surrogate's parental rights, or exceeds the reasonable costs of services, expenses, or injuries related to the pregnancy …". A schedule keyed to pregnancy milestones addresses the contingency prohibition. Whether the reasonable-cost amount limit extends to gestational contracts is undecided — the conclusion is framed around traditional surrogacy contracts, but the operative language speaks of "a surrogacy contract" generally. Anyone telling you a milestone schedule resolves In re Baby is answering half the case.

Traditional surrogacy: not workable in practice

In re Baby also held that a traditional surrogate's parental rights cannot be terminated through judicial ratification of the contract — statutory termination procedures must be followed. Practitioners describe genetic (traditional) surrogacy as the one arrangement they agree does not work in Tennessee. Ivy's programs are gestational.

Birth certificates — the rules changed in 2024

Since July 1, 2024, § 68-3-203(j) routes a pre-birth Order of Parentage through amendment of the original certificate, on receipt of the certified order. Practitioners have reported that these certificates do not display the "amended" mark subsection (b) generally requires, but that reporting predates the 2024 change — confirm the current output with your attorney and Vital Records. On the adoption route, practitioners report that once a new certificate issues, further copies of the original are likely impossible to obtain — if a consulate may want the certificate as originally filed, ask counsel early.

General information, not legal advice. Tennessee surrogacy agreements, parentage orders, and any adoption step should be handled by a licensed Tennessee attorney experienced in assisted reproduction.

Tennessee asks two questions before all others: is at least one of you genetically related to the child, and are you married? Where you land determines the route. These are the routes Tennessee practitioners report — not a checklist written in any statute:

Settle your row — in writing, with Tennessee counsel — before embryos are created. Two more practicalities:

• Where will the baby be born? Practitioners describe jurisdiction as requiring only minimum contacts relevant to the birth, with venue following a party's residence. Your attorney confirms the forum; confirm the delivery hospital's process well before the due date.
• International intended parents. Tennessee has enacted no nationality or residency restriction. Since July 2024 a pre-birth order runs through amendment of the original certificate; on the adoption route, practitioners report further copies of the original are likely impossible to obtain once a new certificate issues — if your consulate may want the original, ask counsel early.

Our Surrogacy by State comparison shows how Tennessee sits against the alternatives.

These are Ivy's quoted figures as of August 2026, not statewide averages:

• The surrogacy journey itself (~$140,000–$150,000). Agency fee, surrogate compensation, legal and escrow services, and health insurance — matching and contracts through pregnancy, delivery, and postpartum care. The Tennessee Order of Parentage sits inside the legal line.
• IVF and embryo creation (~$40,000, billed by the clinic). Stimulation, retrieval, embryo culture, transfer, and optional PGT-A testing. Billed separately from the surrogacy budget above.
• Egg donation (if needed, ~$30,000+). Donor coordination, compensation, legal work, and related expenses.

Putting it together: surrogacy only ≈ $140,000–$150,000; surrogacy + IVF ≈ $180,000–$190,000; surrogacy + IVF + egg donation ≈ $210,000–$220,000+. For breakdowns and sample payment schedules, see our surrogacy cost guide and egg donation cost overview.

One Tennessee-specific line to budget for: if one intended parent is not genetically related to the child, the post-birth related-parent adoption (available to married couples) is a separate legal proceeding with its own fees. Ask your Tennessee attorney to quote both steps at the start rather than discovering the second one later.

Your funds sit with an independent escrow company or attorney trust account, never with the agency itself — we've written about why in-house escrow is a red flag.

A Tennessee journey follows the standard gestational surrogacy arc, with two state-specific features: the genetic question at the front, and a possible adoption step at the end.

1. Confirm the genetic picture. At least one intended parent must be a genetic parent for the reported pre-birth route — settle it before embryos are created.
2. Matching. Counsel confirms which state's law applies to your match and what Tennessee will require.
3. Screening. Records review, IVF-clinic medical screening, and psychological evaluation; a partner is screened too.
4. Contracts. Each side has independent counsel — at Ivy the intended parents pay for the surrogate's; clinics require both, signed, before a cycle.
5. Cycle and transfer. Lining-preparation medications only: no ovarian stimulation, no retrieval, then transfer at the clinic.
6. Pregnancy. Payments flow from escrow, monthly from confirmation of a fetal heartbeat; care moves to an OB around 8–10 weeks.
7. Order of Parentage. Your attorney petitions before the birth; the certified order should reach the delivery hospital ahead of the due date.
8. Adoption, if needed. A married non-genetic intended parent completes a related-parent adoption after birth — plan for it from the beginning.

Most journeys take one to two years; the second legal proceeding adds time when it applies.

Tennessee has years of surrogacy practice but no modern surrogacy act, so your protections come from your contract, your own attorney, and escrow.

• At Ivy, your attorney is paid for by the intended parents and works for you alone, including on the medical decision-making and termination clauses. Subject to Tennessee law, you remain the patient and keep the authority to consent to or refuse care — a contract cannot compel a procedure or transfer your consent to someone else.
• Your payments should track the pregnancy, not the handover. In In re Baby the Tennessee Supreme Court held that surrogacy compensation cannot be contingent on surrendering the child or on terminating parental rights. Ivy's schedule runs monthly from confirmation of a fetal heartbeat — the structure that concern points toward — and the separate question the case leaves open about compensation amounts is one to put to your own attorney.
• Gestational only. A surrogate who uses her own egg cannot have her parental rights terminated by contract. Ivy's programs are gestational, meaning the embryo is not genetically yours.
• Tell the team early where you plan to deliver, and promptly if that changes.
• Have your health insurance reviewed professionally before you sign. Many policies exclude surrogacy, and that review belongs at the contract stage.

The application takes about ten minutes.

Tennessee sets no statutory age, residency, prior-birth, or marital rule for gestational carriers. The requirements that decide whether you can carry come from clinics and agencies. Ivy's guidelines:

• Age 20–36. You can apply at 20; screening and matching take months, so you'll typically be 21 or older by the medical process.
• At least one healthy, full-term pregnancy of your own, currently raising your child.
• BMI of 32 or below.
• No more than 2 C-sections, and no more than 5 total deliveries. These come from IVF clinic requirements rather than from state law; the treating clinic reviews your obstetric history and applies its own criteria.
• No smoking, vaping, or THC use — at least 6 months clean, verified by clinic testing.
• Financially stable and not relying on public assistance.
• U.S. citizen or permanent resident (green card) with a stable living situation.

The clinic then screens too: communicable disease, a current normal Pap, obstetric records, the uterus, and written psychological screening.

After a vaginal delivery you can apply as early as 3 months postpartum; C-section recovery takes longer. Unsure whether something disqualifies you? Ask before you self-reject — the application is the fastest route to an answer.

At Ivy, first-time base compensation in Tennessee is $40,000, with $45,000–$50,000 for a second journey and $55,000–$60,000 for a third or more — for proven surrogates, we're open to discussing beyond that. Total packages, with allowances and milestone payments, run $50,000–$100,000+. Payments are held by an independent escrow company or attorney trust account — funded before you start medications, disbursed monthly from confirmation of a fetal heartbeat on your contract's schedule. The full structure is on our compensation page, and your personalized estimate comes before you commit to anything — start your application to get it.

No Tennessee statute sets or caps what a gestational carrier may be paid, and practitioners report that generous support provisions are common here. The state-specific caution comes from In re Baby (2014): compensation cannot be contingent on surrendering the child or on terminating parental rights — Ivy's milestone schedule is built around exactly that — and the case's reasonable-cost language leaves an amount question that no published decision has resolved for gestational contracts. Ask your own attorney how they read it, how and when each payment is triggered, and what happens if the medical picture changes.

Tennessee's fertility infrastructure is concentrated in and around Nashville, with additional programs across the state:

• Nashville Fertility Center — Nashville, Franklin, Murfreesboro and Clarksville; publishes gestational carrier information
• Vanderbilt Reproductive Endocrinology and Infertility — Nashville metro (Franklin); confirm carrier services directly
• Fertility Associates of Memphis — Memphis

New for 2027: state certification. Public Chapter 1139 (SB 2461), signed May 22, 2026, requires fertility clinics operating in Tennessee to hold a Department of Health certificate beginning January 1, 2027 — including verified SART membership (or a department-approved equivalent), a passed CAP or Joint Commission laboratory inspection, an emergency plan for moving stored embryos if the clinic ever closes, and clinical-director qualification requirements. It regulates clinics, not surrogacy parentage — the legal analysis above is unchanged — but it is one more reason to confirm a clinic's standing directly; the SART directory lists reporting programs.

Which clinic you use usually follows where your embryos are created: embryos can be shipped in, or the surrogate can travel to your existing clinic. And because the reported pre-birth route depends on a genetic parent, settle the gamete plan and the legal plan together.

• Statutes: § 36-1-102(52) (definition of "surrogate birth"; no surrender or adoption needed in the described circumstances; no express authorization), § 36-1-108 and § 36-1-109 (adoption placement and payment rules), § 68-3-306 (artificial insemination, 1977), § 68-3-203 (vital-records amendment; subsection (j), added 2024), §§ 36-2-401 to -403 (donated-embryo parentage, 2013; § 36-2-402(4) defines the recipient as the woman who carries).
• 2026 clinic law: Public Chapter 1139 (SB 2461) — fertility-clinic certification from January 1, 2027.
• Case law: In re Baby (Tenn. 2014) — compensation limits and termination of parental rights; Harrison v. Harrison (Tenn. Ct. App. 2021) — § 68-3-306 read gender-neutrally; In re C.K.G. (Tenn. 2005); In re Adoption of A.F.C. (Tenn. Ct. App. 2014); In re Amadi A. (Tenn. Ct. App. 2015).
• Birth certificates: TN Vital Records.
• Attorneys: the AAAA directory lists Tennessee fellows.
• Compare states: Surrogacy by State, North Carolina, Georgia, California.