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1. What is traditional surrogacy compared to gestational surrogacy?
“Traditional surrogacy” is the process where the surrogate undergoes either artificial
insemination or in vitro fertilization (IVF) using sperm from the male partner/partners
involved or from an anonymous sperm donor. The surrogate herself provides the eggs
and is therefore genetically related to the child. This is a riskier approach to surrogacy
because of the genetic connection. With “gestational surrogacy”, the surrogate does not
have a genetic relationship to the child. The embryo(s) transferred into the surrogate
utilizes either the egg and sperm from the commissioning couple or utilizes donated
eggs and/or sperm. Gestational surrogacy makes up the vast majority of modern
surrogacy arrangements due to the elimination of any risk of the surrogate having a
genetic connection.
2. What should I look for when selecting a surrogate?
All surrogates should be fully informed of the entire surrogacy process. It is important for
her to understand that she will have to interrupt family and work schedules to attend
medical appointments, undergo fertility drug protocols and embryo transfers, perhaps
multiple times. It is essential that surrogate and commissioning couple agree about the
difficult issues relating to the pregnancy, such as how many embryos to transfer and
whether or not she agrees to termination or selective reduction of the pregnancy if
medically necessary. You want to ensure she leads a healthy lifestyle (i.e. diet,
exercise, no drugs/alcohol, no diseases or health conditions that would impact the
pregnancy), that she has good support system, that she has had a prior uncomplicated
birth, that she is free of a criminal history, and that you feel in your gut that you can trust
her with this important role. The surrogate should be no older than 40 and prior csections
should be limited. It is helpful to determine that the surrogate has a car or
readily available transportation so she can get to the numerous appointments.
Additionally you should consider her job to see if it is conducive to working while
pregnant. Surrogates are generally reviewed by a medical doctor, psychologist, and
surrogacy agency (if applicable) to help assist with these determinations.
3. What is the approximate breakdown of cost associated with surrogacy?
Surrogacy costs vary depending on numerous factors; however, the price for surrogacy
can range from $15,000 (friend/family member with no compensation, referred to as a
“compassionate surrogacy”) to upwards of $150,000. The commissioning couple
seeking to use a surrogate is responsible for all of the costs relating to the journey
which include (all estimates), but are not limited to, the fertility clinic, obstetrician, and
hospital expenses for the surrogate (prices vary), a lawyer for the commissioning couple
($6,000-$10,000) and surrogate ($500-$1,000), psychological review of the surrogate
and spouse/significant other ($400-$600), surrogacy agency fee ($10,000-$16,000),
reasonable living expenses of the surrogate ($200/month), the surrogate’s fee ($20,000-
$35,000), health insurance for the surrogate (varies depending on insurance of
surrogate, if any), term life insurance policy for the surrogate ($150-$200), and
maternity clothes ($800). If a donated egg is required, the costs include the egg
donation agency which may include insurance and lawyer fees ($4,500-$10,000) and
donor compensation ($5,000-$20,000). There are certain contingent payments that may
be due to the surrogate, for example, twins ($4,000), c-section ($1,500), loss of organs
($5,000), and surgery on fetus ($500).
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