How Expensive is Surrogacy?

Many families see surrogacy as an increasingly common and necessary way to have children.  With increasing infertility rates among heterosexual couples and more LGBTQ+ families forming across the world, demand for surrogacy has never been higher.   However, put very plainly, surrogacy is expensive.  Alternative options such as adoption can be significantly cheaper, but the industry is fraught with difficulties and the process carries high uncertainty around timing.  The result is that many families are searching for ways to understand how they can afford a more reliable path such as surrogacy.   Below we’ll review the costs of surrogacy at a broad level of detail; those looking for more specificity on costs can find a more detailed breakdown here.

Costs of Surrogacy

Surrogacy expenses can be categorized into 5 primary buckets. 

•         Base compensation
•         Surrogate expenses and allowances, including travel and lost wages
•         Medical expenses, including health insurance
•         Legal expenses
•         Surrogate agency fees

The amounts of these expenses can vary depending on the surrogate’s location, her employment status, and her medical needs.  In total a surrogacy journey can cost as little as $130,000 and up to $250,000, excluding the IVF costs or potential donor costs necessary to create and store embryos.  With costs this high and variable, proper financial planning is crucial to ensure you can pay for this journey. 

Surrogacy Costs by State

Surrogacy costs can vary depending on where the surrogate lives in the U.S.  In high cost of living states such as California and New York, surrogates typically earn higher base compensation, which is the amount paid to the surrogate to compensate them for the time, effort, and inconvenience of carrying your future child.  These surrogates also tend to have higher amounts of reimbursable expenses, which include lost wages for time away from work during and after the pregnancy, and travel expenses to and from medical appointments. 

Furthermore, state regulations can increase costs as well.  For example, New York passed a law legalizing surrogacy in 2021.  The law imposes some additional requirements on the process, including extended legal consulting requirements and provision of healthcare coverage beyond usual limits, together which can increase the cost of a surrogacy there by $10,000 or more.  Further, the laws in each state that govern the establishment of parentage vary and significant court costs may be incurred to ensure that you are on the baby’s birth certificate at the time of birth.

There is also variability in the cost of medical care, which can vary both in-state and within states between larger cities and smaller towns.  It’s difficult to know in advance how expensive medical care will be where your surrogate lives, but most agencies will work to call the hospitals to get information on their costs for a birth to at least provide you with an estimate. 

Medical Expenses in Surrogacy

Aside from the base compensation and expense reimbursements for a surrogate, the medical expenses she incurs during and after pregnancy is the most significant – and variable – cost in the journey.  First, the IVF cost to create embryos that can be transferred into a surrogate is between $25,000 and $50,000, and an additional $30,000 or more if you need to work with an egg donor.  Once those embryos are ready to transfer, IVF clinic will then charge between $5,000 and $10,000 to transfer one of those embryos to your surrogate.  It’s important to be fully informed from your IVF clinic about what those costs are, fully loaded, up front and to ensure that you know what additional costs are incurred if you need to transfer a second or third embryo to get a successful pregnancy. 

The surrogate must have comprehensive, surrogacy-friendly, and continuous health insurance coverage from the beginning of the pregnancy until 3- or 6-months postpartum (to cover any possible postpartum complications).  Many surrogate candidates have no health insurance coverage or are on a Medicaid or Tricare program that are not permitted to be used for surrogacy.  In these situations, a new health plan must be obtained for her for the journey.  If the timing of the pregnancy is during the end of the year, the surrogate can be enrolled into an ACA Plan.  If you expect the pregnancy to begin at the beginning of the year, then she can get a special Maternity plan via Lloyd’s of London until open enrollment period for the ACA, which can be significantly more expensive.  Ideally, the surrogate or her partner have health insurance coverage through their work which is surrogacy-friendly, and you would only be responsible for paying her monthly premiums and out-of-pocket maximum at birth.  Below is a broad estimate of the total prenatal and delivery costs for surrogacy in the U.S. under the 3 scenarios I described above.  Your surrogacy agency can provide more information on this area or you can also consult the top experts on surrogacy insurance in the field, ART Risk and IFI, for a consultation.

•         Surrogacy-friendly employer plan: $5,000-$8,000
•         ACA plan: $12,000-$18,000
•         Lloyd’s plan: $25,000-$35,000

Legal Fees and Contracts

Not surprisingly, lawyers are an integral part of the surrogacy journey.  The intended parents and the surrogate each have a lawyer representing them in drafting and reviewing the surrogacy contract.  The contract is drafted according to the state law of the state where the surrogate will deliver the baby, so local attorneys who are familiar with the law of that state must be involved on at least one side of the contacting process.  During the pregnancy, usually after the first trimester, an in-state attorney will work with the local judicial system on the court (or administrative process) to establish parentage pre-birth in most cases. 

The total cost of the legal process is about $15,000 including court costs.  Most attorneys in the surrogacy field charge a fixed cost for their services so you don’t need to worry about hourly charges racking up.  The largest variability in these costs is with the intended parent’s drafting attorney.  The largest law firms with expertise in surrogacy, Vorzimer Masserman, Klein Fertility Law, and IFLG, have large teams of lawyers, many years of track record, and experience with the complexities of international intended parents and so tend to charge higher amounts for their services, while there are dozens of smaller firms, many of them alumni of the big 3 firms, that charge less for drafting and representation services.  Some surrogacy agencies are owned by lawyers or have surrogacy attorneys on staff and may include those services as part of their fees.

Agency vs Independent Surrogacy Costs

What does a surrogacy agency do?  While there is no simple answer, a full-service agency will:

•         Recruit and screen surrogates
•         Match the intended parent(s) with their surrogate
•         Coordinate the journey from match until birth, and provide support afterwards

For these services U.S. agencies charge between $30,000 and $50,000.  Agency fees have risen substantially in recent years as a response to the shortage of surrogates in the U.S.  Recruiting, screening, and successfully clearing surrogates with IVF doctors has become increasingly difficult since 2020 due to ever stricter medical criteria and challenging supply/demand dynamics.  To save on these costs, intended parents can choose to undertake an independent journey, where they find a surrogate outside of agency channels and manage the journey themselves.  In an independent journey, the intended parents and surrogate must work through the medical, insurance, and legal complexities described above without agency support.  Most surrogates tend to want the full support of an agency (at no additional cost to them) so surrogates available for independent journeys on online forums tend to be the candidates not accepted by agencies for one reason or another.

How to Reduce Costs

Given this cost environment, how can one keep the costs of a surrogacy journey closer to the $130,000 number?

1.     Surrogate-friendly insurance: only match with a surrogate who has a surrogate-friendly insurance policy with her employer.  Your agency can provide a review to ensure that her policy is friendly.  Note, however, that if the surrogate or her partner lose the job the insurance is connected to for any reason, you would need to obtain a new plan for her – so this would not be a zero-risk approach.
2.     Location: Avoid states such as California and New York with higher compensation, cost of living, and medical costs.  Also, if your surrogate can live near your IVF clinic you will save on airfare and hotel costs for the medical screening and embryo transfer procedures.
3.     Surrogate’s work: If your surrogate supports her family from home without a full-time job, you will save on lost wages for appointments and post-partum, and if bedrest unexpectedly becomes necessary during a pregnancy.
4.     Independent journey: Avoiding agency fees can save substantially on costs, but the intended parents must be prepared to undertake a part-time job managing the financial, legal, medical, and emotional aspects of this journey without expert support.

Hidden Costs and Unexpected Expenses

There are many things that can crop up during a surrogacy journey where the intended parents will end up paying thousands of dollars of additional expenses that were not expected at the beginning of the journey.  These are largely out of anyone’s control, but they can add up.  These include:

•         Failed embryo transfers
•         Doctor-ordered bedrest
•         Miscarriage, termination, or stillbirth
•         Other pregnancy complications
•         Invasive medical procedures
•         Change in surrogate’s or partner’s job situation
•         Surrogate rematch due to doctor disqualification

Each of these occurrences can add thousands of dollars to the cost of the surrogacy journey; many of these costs will be outlined specifically in the surrogacy contract.  Most surrogacy experts recommend setting aside 10-20% more than what you are quoted by an agency for the total costs to ensure you are able to fund these unexpected costs if the arise. 

Funding Options for Intended Parents

Where do I get the money to pay for surrogacy?  At 2x+ the average median income in the U.S., a single surrogacy journey can seem unattainable for most people.  Fortunately, there are many ways to find the money to pay for this journey:

1.     Employer benefits: hundreds of companies provide surrogacy benefits to their employees, with some benefits as high as $100,000.  Some people switch employers to those with more generous benefits in order to take advantage of these benefits.  You can also contact your employer’s HR representative to ask about adding these benefits.  The total cost to the company is usually minimal since so few people undertake a surrogate journey, but it can help the employer retain key talent when these benefits are offered.
2.     Personal loans: there are a few providers of fertility-specific loans with interest rates a bit below the average rate for general personal loans.  Providers such as Future Family and Sunfish understand the surrogacy journey and can offer loans of up to $50,000 to help finance the journey.  Just note that interest rates are double-digit and will need to be repaid in 5-10 years.
3.     Fertility grants and discounts: some organizations offer fertility grants to families struggling with infertility.  These are usually on the smaller side but any bit can help. Men Having Babies supports LGBTQ+ couples with discounts at some agencies and pro bono services at agencies for those with very low incomes.  And the Gift of Surrogacy Foundation accepts applications for a pro bono journey annually. 

However, my best recommendation is to ask your parents.  For folks in their 30s and 40s considering a surrogacy journey, many of their parents are likely sitting on a large amount of housing wealth.  Gen X benefitted from the housing boom over the last several decades and many of these potential future grandparents would jump at the opportunity to have a grandchild in exchange for pulling forward a future inheritance for their children.  “Ask the parents” is an increasingly common strategy for most of the folks undertaking surrogacy today, and one worth exploring.

Ultimately, strategic financial planning is the key.  When contemplating a surrogacy journey you should sit down with a spreadsheet, map out funding sources and possible expenses, and ensure, above all, that you have the funds identified before beginning your journey.

At Hatch Egg Donation and Surrogacy, we’ve simplified everything about the cost of surrogacy.  With a single, fixed-price journey that covers all fees, contingencies, and expenses, you don’t need to worry about spending over your budget or finding the unicorn surrogate who minimizes every expense.  Find out more at https://www.hatch.us/peace-of-mind-program.