Gestational Surrogacy

As we mentioned, the legality around gestational surrogacy is highly-variable and so too are the costs (if any) associated with the process.

Below we chronicle some of the line items intended parents see in a country where compensation is legal. These costs exclude IVF costs which vary dramatically by region.

While there are often alternative ways of funding fertility treatment, gestational surrogacy can create an immediate financial drain on intended parents.

In countries where compensating a carrier is legal, more often than not, intended parents will work with a carrier who insists upon compensation (unless a friend or family member is prepared to be an “altruistic” gestational carrier).

In this case, costs typically adjust based on a few factors. “Supply-and-demand” market forces allow gestational carriers living in surrogacy-friendly regions to ask for more compensation.

Similarly, a gestational carrier who’s been through the process before typically commands a premium, the intuition being they’re more prepared for, and more reliable during, a complex process.

Finally, a carrier who’s prepared to carry twins (we’ll discuss the risks of this more in depth in a later lesson) also tend to be compensated more highly.

Often, intended parents need to be introduced to a gestational carrier. While some intended parents will use their own network to market their needs and find a match (known as “independent surrogacy”), most will enlist a third party (e.g. agency, attorney) to make a connection.

Gestational surrogacy can involve numerous steps and moving parts—agencies that provide more resources and hand-holding, and which are more established, tend to cost more. As you’ll see in our next lesson, intended parents often pay third parties upon milestones (e.g. successful match, signed contract, confirmed fetal heartbeat, delivery).

Private health insurers often dislike covering a pregnancy under an existing policy if it’s a pregnancy via surrogacy. As a result, alternatives may need to be found, and they’ll cost money.

Addendums to update an existing plan, or an altogether new plan, may feature steeper premiums or higher deductibles as insurers know they’ll be paying for a major medical expense in short order and want to factor that into the charges they’ll collect from you.

Insurers are particularly worried about surrogacy pregnancies because as recently as 2016, in situations where multiple embryos were created, 80% of transfers to a surrogate used two-or-more embryos. That matters because the cost of delivery goes up substantially in the case of twin-or-triplet pregnancies. For a sense of proportion of how the costs rise (regardless of who may be paying), below is data published in the American Journal of Obstetrics and Gynecology.

The cost of policies can adjust depending upon how many embryos were transferred (if coverage is obtained before the transfer) or how many heartbeats were seen on ultrasound (if coverage is obtained after).

For this reason, some employers who pay for portions of the surrogacy bill tend to insist on transferring one embryo at a time.