My son was born by a gestational surrogate. The process was a whirlwind for my husband and me. We had to think about things like how would we find an egg donor? How much would this cost in total? Would our attempts fail? Or would this take years to have a baby? How would we navigate this? Totally new considerations for us! But by the time we had Ben in our arms, we were overcome with joy. As a bonus, our gestational surrogate, Katelyn, has become a wonderful part of our family, too. 

Our experience with surrogacy is what makes me so passionate about sharing information and helping educate LGBTQ families about their family planning options. Having a family is an important part of life, and that includes the lives of LGBTQ people. The good news is that multiple avenues exist through which we can build our families. 

Today we’ll do a deep dive into surrogacy. Many people like me and my husband choose surrogacy to grow their family because they can have a biological tie to their child. It’s a popular choice for gay men or for anyone who can’t carry or doesn’t want to carry a pregnancy to term for health or other personal reasons. There’s a lot to know about surrogacy, but I’m hopeful that this guide will give you some clarity and direction.

What is surrogacy?

Simply put, surrogacy is when a person with a uterus carries a pregnancy to term for another person or couple. 

Helpful definitions

Gestational surrogacy: When the carrier, or gestational surrogate, does not have a genetic tie to the child they are carrying. The intended parents provide sperm and/or egg through IVF or donation. In case you’re wondering where you find a gestational surrogate, it’s done through a surrogacy agency. 

Traditional surrogacy: When the carrier, or traditional surrogate, does have a genetic tie to the child they are carrying. The surrogate is artificially inseminated with sperm. This method is not as common today because of potential legal issues.

In-Vitro Fertilization (“IVF”): The process of creating an embryo by fertilizing an egg with sperm in a laboratory and then transferring the embryo to a uterus (in this case to the surrogate).

Compensated agreements: Contracts where the surrogate or gestational carrier receives compensation above other incurred costs that accompany the process and gestation.

Compassionate surrogacy agreements: Contracts where the surrogate is usually a friend or family member who agrees to carry a pregnancy for the intended parents without charging a surrogate feed. The intended parents still cover all the costs of the process and pregnancy.

Note that each state is different in regards to the legality of a surrogacy arrangement, which is why it’s important to work with an agency and attorney who specializes in surrogacy, adoption, or reproductive law in your state.

Generally, this is done through a surrogacy agency. The agency handles all of the logistics of matching you with a surrogate, connecting you with attorneys, and managing all the details between the transfer to birth.

For a helpful definitional guide, read Family Equality Council’s guide here.

Planning Backwards: When do you want to have a baby?

One of the most important parts of the process is figuring out when you ideally want to have a baby. While we all know that ultimately nature and the baby are in control of the exact “when,” we can make an educated timeline by working backward.  

Surrogacy throws a lot of uncertainty into the process of having a baby; from when you start the process to when you have a baby could happen as fast as 12-14 months and take as long as two years or more. Timing will depend on how quickly you are matched with a surrogate and also on the initial success of the IVF process. But you have to be financially ready for the quicker timeline. When you know your timeline, you can then work on your costs and determine how to fund it and how to prepare in the meantime.

After deciding that surrogacy is the right option for you, here’s a brief overview of what to expect:

Step 1: Educate Yourself

Spend time getting educated about the process. Resources like Men Having Babies and Family Equality Council are terrific places to start.

Step 2: Choose a fertility clinic

An important first step in the surrogacy process is choosing a fertility clinic/doctor and going through the fertility process. Not what you expected, right? Some people assume that you need to choose a fertility clinic and then immediately go to surrogacy, but that is not necessarily the case. Surrogacy agencies want to work with you when you’re ready. You can start the first part of the process (fertility) and then pause if you need to, but you can’t work with a surrogacy agency until you have the fertility set up. Here are several questions you should ask when choosing an LGBTQ-friendly fertility clinic/doctor. 

Step 3: Choose a surrogacy agency

Once you have a fertility clinic chosen or while you are in the process of choosing a fertility clinic, choosing the right surrogacy agency is an important next step. It may be helpful to inquire with your fertility clinic about which surrogacy agencies they have worked with in the past and if they have recommendations. Once you have a surrogacy agency, they will set up an account called a Trust where all the money for the surrogate (their compensation), the insurance, and all the other little bills get paid out of. 

Step 4: Understand Your Legal Parentage

Depending on where you are doing surrogacy, your status as parents may be that one parent is on the birth certificate or that both are, legally giving you parentage. When you work with your attorney (a natural part of the process), you’ll find out if your parentage order or birth certificate are adequate or if you need to pursue a second or step-parent adoption.

Step 5: Pregnancy & Beyond

Once a pregnancy is established, from thereon out the financial burdens are largely taken care of by the Trust and funds already set aside. This part is really about the partnership between you and the surrogate. You’ll keep your communication open, create a birth plan, and plan for everything after. 

Understanding how the cost of surrogacy

Think about the costs of having a child in surrogacy as falling into two major buckets: fertility and surrogacy. It will help you break down where your money is actually going. 

In-Vitro Fertilization (IVF) Costs:

Total cost: $30,000-60,000 

The fertility (or IVF) portion of the cost consists of all expenses to make embryos including purchasing donor eggs, sperm retrieval, making and freezing embryos and having them transferred to the surrogate. Usually, none of this is covered by insurance, though you can check with the carrier. While this estimate is a helpful total sum, the reality is that a number of costs go into these estimates, but agencies will help to estimate and budget them all out together. 

After you choose your fertility clinic, you’ll have some things to consider: 

• Sperm Collection and Analysis: These procedures can cost around $300. Doing an analysis of sperm can save money and time.
• Egg Donation (or Sperm Donation): What type of donor will you choose? Will you purchase the frozen eggs/sperm (from a donor bank) or selecting a donor to do a retrieval process. While the former may have more of a fixed cost, the latter may cost somewhat more for all the medical costs and the procedure itself. 
• IVF may take a few attempts. The first transfer may not always be successful, so have a thorough understanding of how the fertility clinic charges for various attempts. Do you get a certain number of tries included within your fee? 
• Legal Costs: Included in the costs of the IVF procedure will be the legal fees to set the agreement between you and your donor. Whether or not you use an anonymous donor or a donor who would like to have some sort of connection, you will need to have a legal agreement in place. You may want to do embryo testing, which does genetic screening. The total cost of genetic screening for all the embryos created in one IVF cycle can be $3,000 or more.

Surrogacy

Total cost: $50,000-$130,000

The costs for surrogacy include the agency fees (the fee you pay to the agency for their coordination, medical screening, matching you with a surrogate, the fee to the surrogate (their pay for carrying the baby), legal costs to complete the surrogacy contract, the surrogate’s insurance, and all the other little costs that might be there (out of pocket medical, medications, lost wages if bedrest is required, etc.). All of this will be stipulated in the agreement.

Incidentals

When tallying up all the costs above, don’t forget to leave some room for incidental expenses like travel to your surrogate or to the fertility clinic (if not local), costs to stay in the area after birth, any gifts for the surrogate and her family, and your costs to stay near the surrogate after birth.

Typically, after being matched with the surrogacy the bulk of these costs will go into a Trust. Those funds are then dispersed as needed, so you will need to have the full amount of money ready at the beginning of the process. 

How to fund it?

This is the big, intimidating question. One of the obvious answers is to start saving money (which is why planning backwards is so important for your timeline!). But we know it’s not that simple for everyone; depending on your situation, saving money for surrogacy can look a few different ways:

• Consider your financial options. Many parents-to-be consider home equity loans, taking out a second mortgage or looking into their 401k as options for paying back the funds over time. Medical financing companies also offer secured or unsecured loans as options for funding. Surrogacy agencies will offer financing options, so include asking questions about financing in your search for the right agency. And, as always, consult your financial advisor for any tax implications.
• Evaluate benefit options. It’s true that most insurance does not cover surrogacy or fertility for surrogacy. However, your company might cover some of the out of pocket expenses of third party reproduction, so check with your Human Resources department.
• Look into different fertility clinic options. Most fertility clinics offer packages, so research to see which one works for you. 
• Ask family and friends for help. Oftentimes, sharing your story with loved ones will move them to support your journey. If you have some family who you know wants to help out, this is an opportune time to have a discussion with them about the cost of surrogacy. Even if it’s not financial, the support you’ll need from loved ones will be crucial for the ups and downs of the surrogacy process.
• Look for grant programs. LGBTQ organizations will often have some funds to support LGBTQ family planning. Men Having Babies partners with clinics and agencies to help offer discounts as well as offer grant programs. They are also an amazing educational organization.

Here are some other ideas of how to reduce your surrogacy cost.

Whatever your journey to surrogacy, you’ll want to work with LGBTQ-friendly services and people who will advocate for your best interests and understand your perspective in family planning. A financial advisor who specializes in LGBTQ family planning can help you navigate the stormier waters of the process. If you’re looking to start a family, reach out to me for a free consultation. 

Read More: A Guide to Queer Family Planning

Read More: Planning for a Baby, Financially? Some Things to Consider