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    surrogacy

    Factors That Influence the Cost of Surrogacy

    • 10785 views
    • 4.5   (1 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 11 Jun 2019 - Written by Dr. Kedar Marathe - Fellowship, MD, DNB - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    Surrogacy is a process where a surrogate carries the baby for the intended parents. This process is widely popular and is the last option for couples who want to have their baby eagerly. Surrogacy cost depends on multiple factors like package, country, center, surrogate, medications.

    Surrogacy is an arrangement which often is supported by a legal agreement, where a woman i.e. the surrogate mother agrees to carry the pregnancy and give birth to a child for other individuals who are the intended parents of the baby. (1) Surrogacy is the ultimate solution for infertile couples to accomplish their parenthood dream. There are two types of surrogacy i.e. Altruistic surrogacy and Gestational Surrogacy which helps a couple in having a child. Altruistic surrogacy refers to those surrogacy agreements where the surrogate does not receive any kind of monetary compensation. In the case of altruistic surrogacy, the pregnancy is being carried by a family member with a close relation to the intended parents. (2) A successful surrogacy at the end of which intended parents receive the happiness of parenthood is worth celebrating. An altruistic surrogacy with a close friend or family member can be a wonderful experience, but it is not always an option. In Altruistic surrogacy, no compensation is given to the surrogate mother. Only the travel allowance and the medical expenses incurred during the surrogacy procedure is provided to the surrogate.

    In gestational surrogacy, an egg is removed from the intended mother or an egg donor. It is then fertilized in an advanced IVF lab with the sperm of the intended father or a sperm donor. The fertilized egg, or embryo, is then implanted into the uterus of a surrogate mother who has agreed to carry the pregnancy further. The child is thereby genetically related to the woman who has donated the egg and the intended father, but not the surrogate. Mostly the same-sex couples find gestational surrogacy attractive because it permits one woman to contribute her egg and the other to carry the child. (3)

    In this article you will get to know about:

    1. Factors that influence the cost of surrogacy:

    Surrogacy Cost depends on various factors including surrogate compensation and expenses, fertility clinic fees, legal fees, and other factors as well. There is no specific amount that states surrogacy cost. It includes numerous other costs depending on the intended parents and the situation of a surrogate mother.

    Cost of Surrogacy

    The factors that influence the cost of Surrogacy are mentioned below:

    • Surrogate Mother Compensation:A potential surrogate who has passed the eligibility criteria successfully will be one who will be chosen as a surrogate for the couple. This person turns to a special one for the couple as the gift that surrogates provide is both remarkable and generous. In addition to the feeling of joy a woman experience as a surrogate, the intended parents help to ensure that the surrogate is paid for her efforts, including generous compensation for surrogacy-related expenses. (4) While the overall process of surrogacy treatment remains the same, the average pay for a surrogate mother can vary depending on location. Surrogates living in high-demand states are offered the most competitive compensation available. Mostly the first-time surrogates, living in the developed countries where surrogacy is in excessive demand will receive a specific and appreciating amount in this procedure. (5) A surrogate mother’s compensation package is high than her basic pay. It’s about trust and ensuring that a surrogate gets what she needs and when she needs it. (6)
    • Insurance: Surrogacy insurance is provided by various top insurance agencies across the world. The surrogacy insurance will not cover the surrogate's medical expenses, it generally covers the costs incurred during the significant step of In Vitro Fertilization treatment to create embryos. Some countries have legitimized laws requiring insurance coverage for multiple infertility treatments. (7) Depending on her health insurance, there might be an increase in her deductible i.e. out-of-pocket limit required to be paid by the insured before the insurance company pays 100% of covered services. Additionally, the gynecologist may reduce the appointments of the surrogate in the clinic and provide her the needful help at home. This is a tough cost to estimate because each pregnancy is different, but it may cost nearly couple of lakhs for this treatment.
    • Egg and Sperm Fertilization Cost: The cost of surrogacy treatment also depends on the package of In Vitro Fertilization (IVF) procedure. As in the process, the eggs are retrieved and is fertilized by the sperm in an advanced IVF laboratory. This results in the formation of an embryo, thus the formed embryo is then implanted into the uterus of the surrogate. Only the best quality sperm and eggs are used for fertilization.
    • Egg Donor Program: Egg donation is an additional fertility procedure where a woman receives an egg donated by another person, generally from a younger fertile woman. These eggs are then fertilized with the sperm of the male partner. (8) Embryos are created and are then subsequently transferred back into the uterus of the surrogate. The cost of surrogacy is also affected, in case the intended parents are using donor eggs for whom they are compensating. But if you are using eggs over the age of 35, it might take longer to achieve pregnancy.
    • Sperm donor program:Just like the egg donor program, the surrogacy cost is also influenced by the use of the sperm donor program. In this case, the donor sperm is utilized to fertilize the egg of the intended mother. After fertilization, the embryo is formed and is transferred to the uterus of a surrogate mother to carry the pregnancy further. 
    • Medical Screening:Medical Screenings are medical tests that doctors use to check for diseases and health conditions if present in the potential surrogate before her selection to carry the baby during pregnancy. (9)
    • Twin and Triplet pregnancy:The cost of surrogacy treatment also depends upon the number of babies conceived. If your surrogate is pregnant with twins then this adds a specific amount to her compensation package. Twin and Triplet pregnancy is extremely common in gestational surrogacy. It also relies on the number of embryos transferred to the uterus of a woman. Having twins is a blessing especially for the parents who are unable to have their child on their own. A surrogate, however, by very definition has no infertility issues and has completely healthy womb as it has proven in her medical screening procedures. It stands to reason that a surrogate would have a higher chance of maintaining pregnancy i.e. couple take the higher chance of success with multiple embryo transfer into the uterus of a surrogate mother. (10)
    • Travel Allowances of Surrogate Mother:The intended parents have to pay the required travel allowances of the surrogate mother as per the legal agreement.
    • Experience of the doctor: The cost of surrogacy treatment is also depended on the experience of IVF specialist. As the high experienced IVF doctor will charge as compared to the less experienced doctor.
    • Location and Infrastructure of the clinic: It is also one of the factors that influence the cost of surrogacy. Like the location and the infrastructure of the hospital also makes a difference in the provided facilities and services. This may form the difference in surrogacy cost. 
    • Miscellaneous charges: This includes lab tests and ultrasounds which are also the factor that influence the cost of surrogacy as it is included in the total cost of surrogacy.

    2. Reasons for surrogacy:

    Surrogacy is a great option for the couple who face problems in conceiving pregnancy successfully. Surrogacy is the last hope for the couples who still want a baby despite having reproductive challenges or other issues. It is estimated that 35,000 children have been born through surrogacy. Even celebrities have used surrogacy as a means to grow their own families and to fulfill their parenthood dream.
    Reasons for Surrogacy

    In this procedure a surrogacy arrangement may be considered if:

    1. A woman opts surrogacy procedure when she is unable to become pregnant or to carry a pregnancy. This can happen in various cases like a woman having endometriosis, blocked fallopian tube.
    2. Surrogacy can also be used in case a woman is not having a uterus because of a rare genetic malformation. This effect is found 1 in 12,000 women. The lack of uterus means a woman will never be able to carry her child. Surrogacy is for couples who want to have a child that is genetically linked to them. 
    3. A couple can opt for surrogacy if the female partner is having some health issues that make pregnancy dangerous. Surrogacy process makes it easy for the couple to have their baby despite present health issues. This is because the baby is carried by another woman. 
    4. If the woman is struggling with the reality of Postpartum Depression (PPD) but still have the desire to have a child, then they opt for surrogacy. PPD is a complex mix of physical, emotional, and behavioral changes that occurs in a woman after giving birth to a baby.
    5. A couple in a male same-sex relationship and wish to have a child using the sperm of one or the other partner. Surrogacy is a great option for gay couples who wish to have their baby. It is also a good option if the gay couple lives in a state that prohibits adoption for same-sex couples.
    6. Surrogacy can be opted by a couple if the male partner has low sperm count or any other infertility problem. It is estimated that up to 15% of these couples suffer from unexplained infertility. Typically, infertile couples have turned to IVF and Surrogacy to conceive a child. This process helps a couple to complete their family successfully.
    7. A single man can also opt for surrogacy if he wishes to have a child using his sperm. However, a decent number of single guys turn to surrogacy to start their families. The process is the same for men with one extra step of finding a donor egg along with the surrogate Mom. A single man can opt for traditional surrogacy and find one woman (egg donor) who will donate her eggs and carry the baby for them.
    8. A couple can opt for surrogacy procedure if a woman has failed in implantation of the embryo but she and her partner eagerly wants to have a baby. In this case, the surrogacy procedure is best for the couple to fulfill their parenthood dream.
    9. If a woman is having recurrent miscarriages then they can try again and succeed. Before giving up completely a woman can opt for another option to explore. Surrogacy is the best choice for these types of women.
    10. Adoption can also be an option for couples who desperately want to complete their family. But it's very expensive as compared to Surrogacy. Through surrogacy procedure, an individual or couples can still hold out hope for a baby who has a genetic connection with the concerned person. In this, the baby will be carried by another woman.

    3. How much does Surrogacy Cost from country to country?

    Every surrogacy case is unique and involves various factors that can influence the overall compensation. The average amount of surrogate's compensation, including all expenses, can reach a certain amount. However, the cost of surrogacy depends on the experience of the doctor and chosen surrogacy center. There are various states where surrogates are in excessive demand, i.e. they may be paid slightly higher. Legal requirements and the costs of other services provided to the surrogate can also vary from state to state. The cost of surrogacy has been rising internationally. This is because low-cost surrogacy destinations typically attract large numbers of anxious parents. This brings a sudden "increase" in IVF and Surrogacy procedure. The surrogacy regulation has been changing from time to time in various countries such as India and Thailand. For couples who decide to opt surrogacy in other countries may get a different experience. Like, the clinic may not include legal fees in its published price, including the cost of paperwork to support the child's application for citizenship in the country of origin of the couple or individual and passport. Other factors that influence the cost of surrogacy include the translations and legalization of official documents, emergency medical care for the surrogate and growing fetus and accommodations of the couple. All of these factors vary depending on the cost of living in the country chosen for the surrogacy procedure.
    Surrogacy Cost from Country to Country

    4. Cost of Surrogacy Compared:

    The cost of the surrogacy procedures varies from one country to another depending on some of the crucial aspects associated with the surrogacy procedure. The United States is an international destination for surrogacy. It is one of the most expensive countries for infertility treatments as compared to other international destination. The high price of Surrogacy in the US indicates the extraordinarily high medical costs. Expensive contracts in international countries also are needed to protect intended parents and surrogate mothers from the litigious culture of that particular country. Surrogate's compensation is also higher, reflecting the overall cost of living in International countries. Many infertile couples present worldwide are flocking to Asia most often due to the affordable cost of surrogacy. In Asia, the surrogacy procedures can be up to five times less expensive than in other countries. The process is also easier to perform as they use all the latest and advanced technologies to perform the surrogacy process. Also, the local laws protect the rights of both the surrogate and the intended parents. A couple can compare the cost of surrogacy and choose the best surrogacy package as per their convenience and financial goals. The proportion of costs allocated to different components of the surrogacy procedure very expensive in different countries. The cost of surrogacy procedure may differ due to general differences in the cost of living as well as the better management of medical care. In particular, medical costs comprise a much larger proportion of the total cost of surrogacy abroad. (11)

    5. Myths and Facts related to Surrogacy:

    Most of the intended parents have a lot of questions related to the surrogacy process. Some of the questions take the form of common myths. These myths need to be proven wrong before a couple could move forward with surrogacy procedure. Surrogacy is a personal and life-changing process that is used to have a child with the help of another woman. Being a surrogate is not an easy task. A surrogate is an ideal woman who underwent pregnancy and delivery of the baby for another woman. This process takes time and dedication. There are multiple myths and fact related to surrogacy such as:

    Myth 1: Surrogacy is only for wealthy people or celebrities 

    This myth exists because of the high cost of surrogacy procedure worldwide. Also, the surrogates fees and expenses vary considerably depending on various factors such as donor egg or own egg of the intended mother. However, the cost of medical care and health insurance policies are also one of the huge factors to be considered as there are some insurance carriers that exclude surrogacy. However, in some cases, there are some surrogate mothers who have the accessibility of health insurance that does not exclude surrogacy. In these surrogacy cases, there is low or no cost to the parents for any maternity, labor or delivery of their child. There are some selected fertility centers that offer in-house financing, payment plans or cash discounts to assist their patients in their surrogacy procedure. Patients need to check with the policies of the hospital to find such facilities in the concerned surrogacy procedure. 

    Myth 2: Some women opt surrogacy to save and maintain their body figure 

    Surrogacy is a very emotional and expensive process for a couple to have their child with the help of a surrogate mother. Surrogacy is the ultimate solution for couples who want to fulfill their parenthood dream. Generally, the decision is made after multiple IVF failure. However, there is no such truth about a woman going for surrogacy do the same only to maintain her figure. This is because most women who want to become mother care more about their feelings instead of temporary weight gain. Having a family is the most important aspect of a woman's life and it is also a number one priority for them. The surrogacy process is about one woman helping another woman (intended mother) to enjoy her parenthood. This has no specific relation with a mother to be concerned with her physical appearance during the time period of pregnancy.

    Myth 3: Surrogate Mother can try to take the custody on the child

    This is the most common myth people have about surrogacy procedure while thinking about the same for starting their family. To ensure that the intended parents are relaxed with respect to the surrogacy, a legal agreement is made between the intended parents as well as the surrogate mother before starting the surrogacy process. If in case, the legal agreement is not required then it is a good idea to consider it. Working with a reproductive law attorney will also be able to guide a couple on the surrogacy laws in that specific state and confirm if that particular state will recognize the intended parents for the child’s parentage. This happens despite the fact that surrogate will nurture the child throughout the pregnancy. However, the surrogate and gestational carriers are also aware from the onset that a surrogate will not be considered parent or have legal parentage rights of the child. (12) These types of disputes happen in the cases where a couple chooses their friends, family members or else when the couple engages with the surrogate in the states without any prior legal protections.

    Myth 4: It will be hard to have a bond with the baby

    It is one of the familiar myth in the intended parents. Most of the couple think that they can face problems in bonding with their child born through surrogacy. Bonding with the newborn is one of the most precious feelings for the intended parents (now parents of the baby). This is why parents worry to opt for the process of surrogacy. The bonding process begins after the child is born, not while he/she is in the womb of the surrogate. The bond between the baby and the intended parents begins right from the moment when the news of the nancy in the surrogate is received. It is the nurture and love given to the child by his/her intended parents that secure the forever bond. According to a study, it is suggested that the surrogacy process encourages positive relationships with the baby as the intended parents are involved in each and every step of surrogacy.

    Myth 5: My friend should carry the pregnancy for me

    A friend can carry the pregnancy for a couple in case of Altruistic surrogacy. Before becoming a surrogate, the friend of the intended parents has to go under some legal steps. These steps are the same for every woman is going to be a surrogate or is a surrogate. This is because the doctor screens several prospective surrogates before choosing one. The surrogate is chosen on the basis of her years of experience and whosoever best matches the particular needs of being a surrogate. A couple can take help of the surrogacy center to select the best matching surrogate. However, this is the most common myth of the parents that they can select a surrogate on their own. A surrogate has to go for multiple tests which states the possibility that she can carry the pregnancy successfully. While these cases don’t happen frequently, it still underscores major risk and inconvenience when a couple decides to use an independent surrogate over an agency. The couple should make sure that they check on the surrogacy laws in the chosen country before deciding to use a surrogate.

    6. Key factors for a successful surrogacy arrangement:

    Factors that can contribute to a positive surrogacy arrangement include:

    • Surrogacy can be successful if all parties i.e. surrogate and the intended parents are in a good mental and physical health status. 
    • Clear and open communication between the intended parents and surrogate can help in having a successful surrogacy procedure.
    • Having clear boundaries and mutual understanding between the surrogate and her family can also help in having a successful surrogacy.
    • A couple should keep realistic expectations about the chance of a successful outcome.
    • All the parties should have a good understanding of the medical process.
    • Couples opting for surrogacy should be prepared for the emotional responses and reactions that can occur during the surrogacy process.
    • The agreement should be clear between parties regarding fair and reasonable payment of the surrogate’s expenses.
    • A couple should be aware of and prepared for the financial costs involved in the surrogacy process. (13)

    Successful Surrogacy Arrangement
    Surrogacy helps most of the infertile couple to have their own baby. Usually, surrogacy treatment is recommended to the patient after IVF failures. The cost of surrogacy varies for every patient as it depends on a certain number of impactful factors and also on the medical case of the patient. There are multiple couples who are benefited by popular ART treatment like surrogacy. Elawoman has supported various couples in having a successful surrogacy treatment by connecting them with the best surrogacy centers near them. In case you have any doubt or queries related to surrogacy treatment or else you want to connect with the best surrogacy center then you can visit elawoman.com or can contact us on +918929020600.

    Dr. Kedar Marathe

    Written by

    Fellowship, MD, DNB, MBBS, Fellowship, Diploma
    Laparoscopic Surgeon
    Pune
    Dr Kedar Marathe is a renowned Gynaecologist, Obstetrician, Infertility Specialist and Laparoscopic Surgeon (Obstetrics and Gynaecology) in Pune. He has been working as a specialist in the above-mentioned field for over 13 years. Dr Kedar studied MBBS, DNB and MD (Obstetrics and Gynaecology) from BJ Medical College and later went to Germany to do Diploma in Advanced Gynaec Laparoscopic Surgery from Kiel University. He has obtained two fellowships in Reproductive Medicine and Minimal Access Surgery from recognized places. He holds expertise in Normal Vaginal Delivery (NVD), Caesarean Section (C Section), High-Risk Pregnancy Care, Diseases in Pregnancy, Maternal Care/ Checkup, Obstetrics / Antenatal Care, Epidurals, Abortion / Medical Termination of Pregnancy (MTP), Gynae Problems and so on. He is currently practising at Oyster and Pearl Hospital. Book an appointment with her on www.elawoman.com

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    Raghu Mongia

    May 31, 2019, 12:45 p.m. 4.5

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