Webinar – Why Does Surrogacy Cost So Much? – January 27, 2011

Hello and welcome to our webinar, Why Does Surrogacy Cost So Much?” My name is Carol Weathers and I am the founder and program director for Building Families, I have been involved in surrogacy arrangements for 20 years now. As you can imagine, I have seen much happen in the field of surrogacy, including some really great advances medically and legally speaking. I have also seen the costs rise significantly over the past 20 years. I expect that by the end of this webinar, you will have a better understanding of how and why these costs are necessary in every arrangement in order to reach a successful and safe ending for all parties.

I will start with addressing some of the administrative items to help ensure this is a great experience. I want to mention that my computer skills do have their limits, so let me apologize in advance for any slide mix-ups! Fortunately, I do have my IT guy here on hand ready to assist. First, we will be muting everyone during the presentation so only my voice will be heard. As soon as you think of a question, please send it to me via this webinar. You should type your questions in the chat box located in the Go To Meeting Control Panel. I will answer all questions at the end of the webinar.

If for some reason our webinar internet connection is interrupted we will attempt to reconnect for 15 minutes. If after 15 minutes we are unable to reconnect, we will email you with the rescheduled date and time.

And lastly, please understand that my role here today is not to dispense legal or medical advice as I am neither a lawyer or a doctor. I am providing you information that you could encounter yourself by doing investigative research as it is public information. Now let’s move on to the webinar!

Why Does Surrogacy Cost So Much???

I am going to discuss the 5 main financial components involved in a surrogacy arrangement which are Compensation paid to the Surrogate Mother, Medical Costs, legal costs, agency fees and other Expenses that a Couple should be prepared for. Please note that any process that I mention is applicable in the State of California as that is where we do business. As you must know, there is a significant emotional side to surrogacy and I would never diminish that in any way as it is one of the most critical components. However, our purpose today is to understand the financial aspect of surrogacy. So in the next half hour, I will be outlining the process discussing these five key points. Please note that this information is general but your agreement should be specific to your case.

The Surrogate Mother
You have probably seen this picture on my website. This is from one of our cases. I personally believe that our surrogates are absolute angels. You can’t really put a price on a surrogates mother’s contribution in this, but we really need to, for you, obviously. Although their motivation must absolutely be altruistic, and we all agree that a baby truly is a gift, there is value in this, we have to put into a number. So money is involved, and it is necessary. We have to offset her expenses, of course, which we will get into in a little bit, but there is another area that a lot of people just really don’t talk about, and that is the risk. Pregnancy can be dangerous for anyone, then throw in the possibility of multiples. We currently have a 40% twin rate ourselves. Most of the Surrogate Mothers have never been pregnant with twins so we can’t know how well it will go. I can tell you about a recent delivery we had, that was twins. The surrogate mom made it all the way to 39 weeks, which is an incredible feat all in itself. Most twins come in the 36th week so needless to say, we were super excited and she did deliver a healthy baby boy and girl to her Couple. But soon thereafter the surrogate mom started to hemorrhage. Thankfully she was in a state of the art hospital with well-trained physicians and of course they saved her life, which is the most important thing, but they also saved her uterus and her ability to go on and have more children, if she wanted. I have had clients who have had hysterectomies due to this very thing, as their own quality of medical care was not as high as ours and this was the only way they could save her life. I have to admit when this whole thing was happening we were all there at the hospital and we were scared, I mean this was certainly a dangerous situation. But then the doctor came out and said don’t worry, the bleeding was under control and the Surrogate would not need a blood transfusion. We were very, very relieved. But we started talking about other Surrogate Moms in other countries like Georgia, India, the Ukraine. If this had happened there, they most likely would have died. They don’t have the quality of care that we have here and talk about risk. These women are much more at risk for the worse possible outcome, yet they are being paid significantly less than Surrogate Mothers here and there is no provision for their families should this happen. The pregnancy mortality rate in the US, we have recently looked this up, is 8 in 100,000 but in countries such as the ones I just mentioned, it is closer to 8 in only 1,000. So, I mean these numbers are startling and you don’t hear anyone talking about it. So, when you consider whether or not a Surrogate Mother should be paid, just think of the risks she is taking and I’m sure you will agree that compensation is indicated. Now having done this work now for 20 years, I know that not every arrangement goes as smoothly for others as it does for us here. I think one of the issues, the biggest issue, is because compensation and reimbursement of expenses is not clearly outlined.

Let’s discuss that now.

Surrogate Mother Costs

The compensation, currently is between $0 and $75,000. That really depends on the arrangement type. It is a large range, I know, but lit is determined by the type, whether it’s a relative, sister to sister, Agency represented or Independent/freelance.

Surrogate Mother Costs
Arrangement Type: Relative

Arrangements between relatives is typically not handled by an agency, however, many families do hire an agency as a consultant, in order to ensure they are doing things correctly. There is a substantial financial savings as the Surrogate Mother in this case typically receives no compensation and the agency often discounts their fees as well, since the process of locating the Surrogate Mom is done.

Surrogate Mother Costs
Arrangement Type: Agency

An agency type arrangement is typically very structured, I mean the agent does have a structured payment plan that all of the Surrogate Moms fall into. The repeat Surrogate Moms do tend to receive a higher compensation due to their experience. The range these women are paid is between $25,000 to $40,000. Our Surrogate Moms receive $30,000 when they are a first time Surrogate and $35,000 when they repeat. We do limit the number of times she can act as a Surrogate Mom due to the increased risks involved with each pregnancy she has.

Surrogate Mother Costs
Arrangement Type: Independent (Freelancer)

The Independent arrangement, is completely different. The Surrogate Mom advertises herself, typically on the internet. She looks for email lists intended parents are on and she rationalizes her higher fees due to risks she believes she is taking by not going through the safety of an organized program and she also believes that the Couple have saved significantly by not hiring an agency and therefore she feels entitled to receive some of those savings. You can see these fees range from $45,000 and as high as $75,000.

Surrogate Mother Costs

Reimbursement of expenses, now this is the part that can get really sticky and typically when a Couple regrets not going through an agency, it is when it comes to this. Because who determines what expenses are reasonable? If it is specified in your legal agreement, then it’s clear, but even then some things may need to be reasoned out. A Surrogate Mom can ask for anything she deems as related to her Surrogate Agreement. I can give you an example, I read recently about a Surrogate Mom who thought her reimbursement of expenses should include any food expense that was directly related to her cravings. This was an independent arrangement so the Couple had no one to counsel them or their Surrogate Mom and they felt they had to comply with her demands, even though they didn’t feel it was fair or appropriate. If you have a good agent, they will help the SM realize what is reasonable and therefore keeping costs down. It can be difficult to reason with a pregnant woman, but it is impossible when she is pregnant for you. Too many emotions come in to play and no one wins in that situation. We realize that and we counsel our Couples and SMs to keep their relationship social and let us handle any business. With no agent or middle person, this task is more difficult as money is always a touchy subject between two persons in general, but especially between the Intended Parents and their Surrogate Mother. But regardless of the type of arrangement you enter, be sure these items are addressed in your contract so they are not discussed or negotiated once the Surrogate Mom is pregnant. This is not a fair negotiation.

Medical Costs

The other area is Medical costs. One IVF attempt, including the medications, can range from $15,000 to $35,000. (picture)

And then there are the costs relating to the pregnancy and birth of the baby. We are going to get into that in just a second.

Medical Costs

For the IVF process, clinics typically offer you two Plans. There is the pay as you go, which means you just pay for each service as they are performed and that cost can range anywhere from $15,000 to $25,000, depending on what those items are. Many times the clinic will offer what they call A Succes Plan or the Guarantee Plan, and it tends to be more global and it typically includes two IVF attempts at a lower rate, so instead of paying $15,000 to $25,000, you are paying let’s say $35,000, and that covers two IVF attempts. However, if you get pregnant in the first try, there is no refund.

What happens if you need more than 2 attempts? Unfortunately, there is no limit, so you will pay for each service after that.

Medical Costs

Now the costs relating to the birth of the child, the bulk of that is typically covered by the Surrogate Mom’s health insurance. It is absolutely imperative that she have health insurance to cover her pregnancy and delivery. There are not many options out there, but your agent will help you to find an appropriate policy. They do exist. I can tell you that all of our Surrogate Mothers have health insurance. Now you have to be a good consumer when shopping for a policy. If you are helping your surrogate find one, make sure you understand the coverage perfectly, and the extent of what it will cover, because typically it will never cover the newborn baby. Just the Surrogate Mother’s pregnancy and delivery and literally when they cut the cord those expenses for the child become the couples.

You can expect the premiums, co-payments and deductibles for a single birth to be about $10,000, this is for private policy. And if it is for twins, probably closer to $15,000. As I mentioned earlier, the intended parents should make sure they have coverage for their newborn baby, and that they understand how it works. This is critical too because what you want to make sure you follow their rules, or they won’t pay anything.

Legal Costs

Now the legal cost range between $1,500 to $8,000. This is another area that the services performed by the attorney varies and therefore so does the fee. And in this range is also the court filing fees and all of the legal costs associated with the pre-birth order and all the legal documents necessary to ensure the couple go home with their baby legally.

Legal Costs

You can read here what the highlights of the attorney’s role is, but the most important thing the lawyer can do for the Intended Parents is be knowledgeable and up-to-date on the latest changes in the law. He must have extensive experience as the legal process is what ensures the Intended Parents go home with their baby in the end. Never ever skimp when choosing a lawyer and never, ever use the template legal agreements can be found on the internet.

You will also see that the attorney will act as the escrow agent. This is another critical piece as there have been reports in the last couple of years, about agencies that have been acting as the escrow, and you know they were not bonded. When you put money in Trust, if you will, with someone, there is a risk of theft, and unfortunately that is what has happened. That is such an important area, and all of our Intended Parents money is with a bonded entity, basically the lawyer, so you must be certain your funds are safe and that is definitely the way to do it. Now it obviously cost money to have a lawyer manage the trust fund, but that is money very well spent.

Agency Fees

Now agency fees can range between $3,000 and $30,000, and again that is a huge range. And really, there are even some that have no limit as they base their fees on the performance of the Intended Parents and their Surrogate Mother. In other words, it is in their best interest that you not experience success the first time around as they receive additional compensation for each attempt. Here at Building Families, we base our fees on no one’s performance but our own and we stay dedicated until everyone’s goals are met!

Agency Fees

The agency differences, well there are those who call themselves surrogacy agencies, but they are not. They are a matching service leaving the Intended Parents and their Surrogate Mom to find their way through the legal, medical and even the emotional process. I receive countless e-mails from Couples who are so lost and haven’t done any of the legal legwork to ensure their baby will belong to them in the end because the attorney they found on the internet was just impossible to reach, at such a critical time. Their baby is due anytime and they are really desperate.

The other type is maybe a lawyer, doctor or psychologist’s office that is running a surrogacy program from their desks. Unfortunately, many important aspects of a surrogacy arrangement are overlooked due to their limited expertise. They are not familiar with the needs of an entire case such as choosing the right insurance policy, as I mentioned earlier. It is so important to ensure the Surrogate Mom is seeing an OBGYN that is approved on her own insurance. This mistake has cost Couples thousands of dollars since the insurance will only pay 50% typically when you don’t use their preferred physicians. Now the last in a Full Service agency. They not only finds you an appropriate Surrogate Mom but they also will refer you to reputable medical, legal and psychological professionals and see the Intended parents and their Surrogate Moms through until the Intended Parents, or new parents at that point, go home with their baby and the Surrogate Mom is completely recovered. There are so many details that need to be handled and most Couples don’t ever realize that which, in my opinion, is a good thing. It means that we are doing our job well.

Agency Fees; Be a Good Consumer

Unfortunately, you can’t determine the level of expertise of an agent based on fees.
You really need to be a good consumer. Ask for a professional referral .

Ask for client referrals. And of course, they are going to refer you to someone who had a baby with them, and needless to say they are going to be very, very happy as they have a baby now. But be sure to ask hard questions ask that client to look back over their journey and tell you what were the most difficult parts and how did the agency help them through that. How could the agent maybe have done a better job? So you know what to ask.

Be a good consumer, I can’t say that enough, really throughout this entire presentation, that is just so critical. Find out as much as you can about the agency before your hire them.
Find out what they offer in detail. You may encounter that their contract nly allows for one Mom, or maybe only two IVF attempts. Then you will have to pay their fee all over again if you want to proceed.

But we here, we do not limit how many Surrogate Mothers a Couple needs, we just do what is necessary until we all achieve our goal. As I mentioned earlier, we are in this until they go home with their baby, whatever that takes.

Other Expenses

Now there are other expenses that I don’t break down in great detail because the amounts are not as significant as the ones I just talked about. But I do want to touch on them, because these are areas that are necessary.

Life Insurance, as we talked about that earlier, is key. Typically you would see that cost be anywhere from $200-300 annually.
We always do Background Investigation, and that cost is right around $150.

The Psych Screening and Counseling is also a hugely, critically important component and probably should have its own slide, but we are talking $2K to $4K, depending on the services that the psychologist offers. I decided not to make it its own slide, but that component is critical in the success of a Surrogate Arrangement, I can tell you that.
The Hotel Stay for Surrogate Mom after embryo transfer is really key. This is when the pregnancy is going to occur, so we put all our moms in a hotel for those three days, because when she is released, she is hopefully pregnant, and that cost typically does not exceed $600 or $700, and it is an excellent investment.
Of course there is the Hotel, Travel & Car Rental for the couple. Depending on where they are coming from answers that amount. If you are local, that is a lot easier. But that is definitely a cost for many people.

There is the costs associated with the newborn baby. Obviously, these things are super obvious, but clothes, diapers, formula and of course travel arrangements if you are not local, you have to get a plane ticket for the new baby to go home. So this of course varies on whether it is a single baby, twins and where the couple lives, of course.
And then there are the Government documents like the birth certificate, and the passports, etc. – These costs typically do not exceed $300 unless it is twins, and then you can expect that to be double.

Other Expenses

Something we haven’t talked about is egg donation. Sometimes a Couple will also need the assistance of an Egg Donor. They are almost always provided by an agency, so there is definitely an agency fee and the costs associated with that. Because the relationship is typically anonymous, now if there is a family member donating her eggs, of course that’s different and that is why I put the range from 0 because obviously that tends to be, the family member doesn’t charge. But the agency fees and first time donor, a couple will typically pay $15,000, but once the donor has had experience or she has been a successful donor, then they tend to charge more. So I have seen that as high as double that, I’ve seen it as high as $30,000.00.


Now this brings us to the final totals. I have never seen Intended Parents spend less than $30,000 even when they use a relative and I have definitely heard of Couples spending upwards of $150,000 and more when they use an Independent Surrogate Mom and an Egg Donor. The average cost for a Couple here with Building Families is between $85,000 – $95,000 when they go home with a single baby. When they have twins, the tend to spend about $10,000 more.

Transition to Q & A

Well, thank you for attending our webinar. We are going to move on to the question and answer portion of the presentation. I have received several questions already so I’m going to begin with those. Please feel free to send any more questions anytime. I imagine you will have tons more afterwards we are done her today, so please feel free to email me anytime with your questions or if you want more information about our program here, I am absolutely happy to send that to you. So, let’s see here. So our first question is:

Q: You mentioned background check. Why is that necessary?
A: Well, we do background checks for various reasons. One is, credit. Not everyone has perfect credit, of course. But what we are looking for is, we want to make sure the surrogate mom isn’t about to be foreclosed upon, or in so much debt that she is going to be under tremendous amount of stress. That is not a good environment for your baby. We also look for any legal claims, and a DMV report. We want to make sure that she hasn’t had a DUI or definitely has a valid driver’s license. We also make sure that they have car insurance. This is a responsibility thing. We are looking for those kinds of things. Ok, I hope I answered that well for you.

Q: My brother is an attorney. Why can’t I use him?
A: Well, unless your brother is an attorney who has done surrogacy cases, it would take him years to get up to speed to know what the attorney’s that we work with know. This is the safety for the intended parents. The want to know that they are going to be able to go home with their baby at the end. The last thing you want, even if it’s free, you don’t want to have to pay for someone who is learning on the job. This is money very, very well spent. Use an attorney that has the right amount of experience. We have two attorney teams that we work with. One, I’ve been working with as long as I have been doing business, like I said 20 years, and the other is probably about 15 years. So they are very, very familiar with the legal climate regarding surrogacy in California.

Q: What does a psychologist look for?
A: Well, that is a good question. We are talking about costs her so, there’s two sides to this. There is the psychologist for the couple because we do have our couples that come into the program and see the psychologist. There is no test to know what kind of a parents they are going to be. There is no such thing, so we don’t do that. There are a couple of things that we are looking for. One is we want to see that the couple is not in such a fragile state that this is going to harm them. Even in the best situation, and everything goes beautifully, this is a very hard thing to do. So we want to make sure that they have the appropriate coping skills, if you will, to get through this safely. And also, there is a personality part that comes into play for me. When I am looking for your surrogate mom, I’m looking for someone who you are going to have a great experience with. We are going to be in each others lives for a year so I want to make sure that I understand and that the psychologist feels that your personalities are compatible with the surrogacy. Those are the things she does on the couple’s side. Now on the surrogate mom side, she is looking for someone who’s obviously, for everyone, somebody who is healthy, psychologically speaking. The personality is absolutely key. We are wanting to make sure that she does not have tendencies that would contradict her participation, trouble with authority, following direction, and even check on the status of her marital arrangement, making sure that it is solid. There is so much that we look for, much more that we look for in a surrogate mom, because we do rely on her heavily. She has the most important role, and that is to care for this child, this baby, this embryo, that turns into a baby of course, a healthy baby, that is what all of our goals are. So it’s very critical that you have a licensed psychologist who is very familiar in the testing.

Q: Isn’t the IVF process cheaper in other states?
A: Yes, of course it is. It can be cheaper here too. I have certainly come across that. I didn’t include that because I kept a certain range of success. You can pay less, but you are not going to see the kind of success rates that we see, if you do that. Other countries are the same way. I was speaking to someone going to Europe and they were saying it is a 4th of the cost to go there. But they were already on their second try, and there was no indication that it was going to work then either. I read about someone else who was on their third try, well by then, you would have spent what you would have spent here and it would have probably worked. We have an incredible, incredible success rate here with the doctors that we work with. So to answer your question directly, yes it’s cheaper in other places, but not as successful. In the end, that is what matters.

Q: Do the parents need to be from California or the U.S. to have the same legal rights?
A: No, actually, I’m not a lawyer, as I mentioned earlier when we started, but I have worked with a ton of international couples and they have not only the same rights, of course as parents here in the U.S. but they have the same responsibilities, and I think that is a key thing to mention. This is the intended parent’s baby whether you are here or not, whether you live in any other country, this is still your baby that’s here, and our laws here in the state of California look to the parents for everything. So yes, short answer, everyone has the same rights here and responsibilities as parents.

Well that was the last one.