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Understanding the Costs of Surrogacy

If you're considering having a baby through surrogacy, you might be overwhelmed by all the information available. It's important for you to know what surrogacy involves, both financially and emotionally, and to compare it with other methods of conception before you make a decision.

Your Egg or Theirs?

Two main varieties of surrogacy are available. Traditional surrogacy uses the surrogate’s own egg fertilized by donor sperm from the male parent or a donor bank. Then there’s the type of surrogacy you find through an agency, which uses a donor egg and donor sperm either through an agency or the parents for in vitro fertilization.

“We don’t do traditional surrogacy here,” says Amy Stewart Kaplan, director of West Coast Surrogacy. “The emotional and legal risk of a woman using her own egg for the surrogacy is not necessary with the technology we have and the egg donors available.”

“People think ... you’re giving the baby away, but we’re never giving the baby away because the baby was never ours.” –Laura Davis, three-time surrogate and caseworker at West Coast Surrogacy

Some couples looking at surrogacy might be tempted to ask a friend or family member to be their surrogate, but they should be aware that the legal situation may be more difficult in those cases.

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Additionally, if the surrogate uses her own eggs, this could pose legal problems down the road. "The legal implications are more complicated ... because the surrogate will be pregnant with her own eggs, making her the biological mother,” says Dr. Vicken Sahakian, medical director of Pacific Fertility Center in Los Angeles.

Some parents not only want absolute legal security but also want to choose a biological mother with specific attributes, such as youth and perfect health, which may only be available to them via an agency egg donor.

“Most surrogates are not the best candidates to be egg donors as well,” Sahakian says. “Most surrogates are older women who already have children. People who want egg donors are often looking for young, pretty girls who are in college.”

If a trusted family member is available, you might prefer to be related to your child and take the legal risk of having your surrogate also be the biological mother of the baby.

Contracts and Money

You should have all the legal agreements in place for an agency to organize the process for you and the surrogate. But first you must find a surrogate who is the right match for your expectations.

“Initially there will be a meeting or phone call with the surrogate,” Kaplan says. “Then the surrogate will do a medical screening and a psychological screening. Once she’s completed that process they will enter into a legal contract. These contracts—especially in California—protect both the surrogate and the parents.”

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While the rights of the surrogate and adoptive parents vary by state, in some cases if the surrogate's egg is used, she is considered the mother of the child and may have legal rights to the baby.

It’s extremely uncommon for a surrogate to have regrets and balk about releasing the baby to the parents, Kaplan and Sahakian say.

“In 20 years I’ve never seen a case where the surrogate wanted to keep the baby,” Sahakian says, “or a case where the egg donor went after the parents.”

Even if you’re legally protected, your finances will definitely take a hit from surrogacy. It is by far the most expensive form of medically assisted conception.

“You are really looking at at least $100,000,” Kaplan says, “and parents traveling from other countries can be looking at $150,000 to $200,000.”

Finding a Match

“There are some basic factors that have to be a match between the surrogate and the parents surrounding a possible termination of the pregnancy if there’s an abnormality,” Kaplan says. “After that we can look more at their personalities and what type of person they’re looking for.

“All our surrogates have their own children—that’s one of the requirementsbut the couple themselves really need to have an honest look at what their needs and requests are around the pregnancy. Dietary, exercise and lifestyle requests and what type of relationship they would like to have with her have to be very clear in the beginning so we can avoid any upset or disappointment.”

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There are definitely some advantages to using surrogates who are already parents. "We'd like to see proven fertility and that their bodies can carry a healthy pregnancy to full term,” Kaplan says. “We want to make sure that not only do that have a child but they're raising a child so we want to make sure they understand the emotional aspects of having a child and parenting a child. I want to make sure she has carried full-term and she is a parent so she understands she's contributing to help other people be parents. An exceptional candidate would be someone who has proven her fertility and also is emotionally balanced at raising her own children."

Choosing the person who will carry your child might seem nerve-wracking, but Kaplan stresses that following your instincts is important. “It’s really like dating in the beginning and going with what your heart’s telling you about that person rather than going with her age and education.”

But if you’ve decided to go ahead with surrogacy, be prepared for the road ahead. “Sometimes there can be relationship struggles or challenges,” Kaplan says. “We have a team approach, and we work with counselors and life coaches and we all work together.” Given that it is a several month process, different issues will arise and situations will change during the term of the pregnancy.

"There could be trust issues basically stemming from something occurring in the relationship or someone having a history of trouble trusting another person anyway,” Kaplan says. “We have experienced surrogates asking for a little less contact, maybe setting up a structure on how often they're contacted and when they're contacted. For instance if it's been several times a day, maybe cutting down to once a day. We also have the other extreme where the surrogate might like to have more contact. Also, expectations can change throughout a pregnancy. During the pregnancy and the surrogacy we work with them to continue the relationship so there's communication."

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The Greatest Reward

Laura Davis, a caseworker at West Coast Surrogacy, has been a surrogate three times. “The most rewarding part of being a surrogate for me, and I think most of us, is the birth,” Davis says. “People think that’s usually the hardest and you’re giving the baby away, but we’re never giving the baby away because the baby was never ours.

"The birth is the most exciting part because that’s what we were all working for—that’s why we became a surrogate. So to actually have that experience be final is very rewarding.”

Additional Medical Options

If you’re not sure that surrogacy is for you, other options are available depending on your medical situation.

“A lot of women who have problems with ovulation can just use hormone pills or injections and get pregnant,” says Sahakian. “Some couples just have poor sperm and can go the cheap way and buy donor sperm, which would cost around $1,500 per month. But sometimes the only treatment that will work is in vitro fertilization, which will cost a lot because you’re doing a lot of the procedure outside the body using high-tech equipment. In that case, it costs a minimum in the U.S. of $7,000 to $8,000 to do a treatment cycle.”

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If the sperm isn't the issue but you need an egg donor, this will be considerably more expensive. “Using an egg donor will cost you $30,000 to $35,000,” Sahakian says.

IVF can require several cycles and might not be successful. “It depends on the diagnosis,” Sahakian says. “A younger woman might get pregnant the first time with IVF and that’s it. An older woman might have to do it three times. It might not work at all.”

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