Surrogacy agency staffing and caseloads: roles, capacity and when to hire

Ask how many journeys a case manager can carry and you will hear very different numbers, because there is no published industry standard and it depends on what each role does. This guide covers the roles, a way to work out your own capacity, and the signs it is time to hire.

Short answer: Most surrogacy agencies are built around four roles: intake (new applicants and inquiries), case management (matches from introduction to delivery), matching (often the owner or director in smaller agencies) and marketing and recruiting, with finance, legal coordination and admin shared or outsourced. There is no reliable industry-wide caseload number. Work out your own by measuring how many hours each stage of a journey takes your team, weighting active journeys by stage, and comparing that with real working hours. Hire when response times slip, overdue steps rise, or one person becomes the only one who knows how things work.

The core roles

• Intake coordinator: answers new surrogate applicants and intended parent inquiries, runs intake calls, and moves people through screening. Fast, warm and organised; often a former surrogate. Bilingual if you recruit in more than one language.
• Case manager (journey coordinator): owns matches from introduction through contracts, medical, pregnancy and delivery; the main contact for both sides.
• Matching lead: decides which profiles to share and makes introductions. In small agencies this is usually the owner.
• Marketing and recruiting: ads, content, recruiters and referral programs, and measuring what works.
• Egg donor coordinator, where there is a donor program: donor intake, the database, and cycle coordination.
• Finance and escrow coordination: fees, milestone confirmations and statements; sometimes part of case management.
• Leadership: the owner or director, who in a small agency also covers matching, difficult conversations and escalations.

In a new agency one person may do all of these. That is normal; what matters is that every step has a named owner and the process is written down. See the operations checklist.

Working out a caseload

Caseload numbers quoted in the industry vary because roles vary: a case manager who also handles escrow and travel carries fewer journeys than one who does not. Rather than borrow someone else's number, measure your own:

1. List the stages a case manager covers: legal, medical and transfer, pregnancy, delivery and post-birth.
2. Estimate hours per journey per month in each stage, from your team's experience or a few weeks of rough time tracking. Legal and medical months are usually heavier than mid-pregnancy months; delivery weeks are the heaviest.
3. Count active journeys by stage for each person.
4. Multiply and add to get each person's expected monthly hours.
5. Compare with real capacity: working hours minus meetings, admin, training and on-call time. Leave headroom for the unexpected; a complication can take a week of one person's time.

Do the same for intake, using applicants and inquiries per week and minutes per step. Review it every quarter. Every hour that software saves (automatic reminders, messages that send themselves, portals that answer “any update?”) raises the number of journeys a person can carry well.

Signs the team is overloaded

• New applicants wait longer for a first reply.
• Overdue checklist steps are rising.
• Surrogates or intended parents complain they have not heard anything.
• Coordinators answer messages late at night as a matter of routine.
• Mistakes increase: a missed appointment reminder, the wrong document sent.
• Staff turnover. Burnout is a serious risk in a job this emotional.

Track the first three as KPIs. See agency KPIs and reporting.

Backups and coverage

Every journey should have a backup who could take it over tomorrow. That only works if everything about the journey is on the record (the checklist, messages, notes, documents and the next step) rather than in one person's inbox and phone. Plan on-call coverage for due dates, holidays and weekends, and agree what counts as urgent out of hours.

When and whom to hire

• First hire for most founders: an intake coordinator, because response speed is the first thing to slip and it costs matches.
• Next: a case manager when active journeys exceed what you can follow closely.
• Then: marketing help when recruiting is the constraint; finance coordination when payments start to slip.
• Hire before the overload signs become a pattern; a new coordinator takes weeks to learn your process, faster if it is written down and built into your system.

A worked example

The numbers below are made up, to show the method; they are not a benchmark. Suppose your team estimates a journey takes about 10 hours a month in the legal stage, 8 in medical and transfer, 4 in a typical pregnancy month and 20 in a delivery month. A case manager with 4 journeys in legal, 3 in medical, 10 in pregnancy and 1 delivering expects about 40 + 24 + 40 + 20 = 124 hours of journey work that month. If she has about 140 hours after meetings and admin, she is close to full, with little room for a complication. Moving two of those journeys to a colleague, or automating the routine reminders and updates, changes the picture. Recalculate when journeys change stage, not only when new ones arrive.

How SurroHub helps

SurroHub is built so a small team can carry more journeys well, and so any journey can change hands without a handover call.

• Unlimited users. Add coordinators, case managers and part-time staff without per-seat costs.
• Workflows that do the remembering. Steps with owners and due dates, messages that send themselves, and late steps flagged to the right person.
• Everything on the record. Messages, notes, documents, to-dos and full activity history on each profile, so a backup can step in.
• Surro, an AI coordinator. Answers new applicant texts 24/7 within the guardrails you set, drafts messages, and suggests to-dos and bookings from incoming messages.
• Portals that answer “any update?” Surrogates, intended parents and donors see their own progress.
• Role-based access. Give each role what it needs, and remove access in one click when someone leaves.

Want the facts in one place? SurroHub by the numbers: what it is, who built it, and what agencies run on it today.

Frequently asked questions

← Back to SurroHub