Ask the Surrogacy Experts

My husband and I live in Singapore, and a local IVF clinic has offered to perform our IVF cycle for a great price. The American clinic we talked to told us an IVF cycle would cost nearly $20,000 dollars. Can I have the cheap IVF cycle in Singapore and send my embryos to the US for the surrogacy?

Good morning Laura and Anthony.

There are cheap IVF clinics in many countries overseas – and many are just as reliable as a typical US clinic. So it’s tempting to perform your IVF overseas and then bring your embryos to the US for the surrogacy part of the journey. But wait! It’s not that easy.

To answer your question: The short answer is Yes, you can conceive embryos at a foreign clinic and bring them to the US.  However your IVF may not be as cheap as you think. Not all countries are possible, and there is significant special paperwork and costs involved.

Here are three important things you should know…

1. FDA approval… Both sperm and eggs for use in an IVF cycle need to be tested by a registered FDA tissue facility if the resulting embryos want to enter the United States. Registered FDA Tissue Facilities are few and far between… For example, there are only two such facilities listed in the entire UK, and only one in Germany. A quick search didn’t show any such facilities in Singapore. So your cheap IVF clinic may not be able to conceive embryos that can enter the US.

Cheap IVF and SurrogacyThe required tests themselves are rigorous and have to be done at the time of the donation. The exact tests can be found on the FDA website. Without these lab results, your embryos will be stuck overseas.

Sperm and eggs donated by parents for their own IVF cycle are considered tissue for transplant by the US government. As such, they are governed by the same regulations as a kidney or liver to be transplanted into a dying patient. It makes no difference that the eggs or sperm are never actually transferred into a human body, or that they ultimately may go into your own body. The oocytes (the technical name for eggs and sperm) will morph into embryos, and those embryos will be transferred into someone’s uterus. So transplant restrictions apply.

By law, all transplant tissues must have a series of FDA serology tests performed on the original donor. These tests must be done at the time of the donation, and also must be performed at an FDA Lab in the US.  Without the tests, no transplant can happen. In the case of embryos and sperm, that means no IVF cycle can happen. Every IVF cycle in the US must start with an FDA test of both the egg and sperm donors, period.

Most established IVF labs in the US are accredited by the FDA – so if you’re embryos were conceived in the US you probably don’t have much to worry about. But if your embryos were conceived overseas, you’re generally out of luck. The FDA doesn’t register many foreign clinics, so the clinic that did your blood test wasn’t FDA accredited. In short, those blood tests are worthless in the eyes of the FDA.

But there is a workaround… If your IVF clinic is in a country where thee is no FDA Tissue Facility, you can still arrange to have blood samples drawn and sent to an FDA lab in the United Stated for analysis.  The process is a bit complicated, but I’ve done it a few times for clients.  The cost of the testing kit and lab tests is about $1200 per donor (egg and sperm donors both need to be tested).  There’s also an administrative fee of about $2000 by the US clinic to deal with the extra bureaucracy. Your “cheap IVF” clinic will have its work cut out following the detailed instructions for correctly completing medical questionnaires, processing the blood serum in various ways, and finally packaging it all up for shipment to the US. It’s not or the feint of heart.

2.  Zika fears… I know Zika isn’t in the headlines anymore, but it hasn’t gone away completely. The US health department still has warnings on bringing oocytes into the US from countries where Zika is active.  A lot of countries touting cheap IVF clinics are also in warmer climates where Zika is still thriving. Basically bringing embryos in from Mexico or South America is impossible.  Northern countries should have no problem.  Some countries in Southeast Asia have Zika but are still deemed possible if the virus is well managed, but you would need to check with the clinic on each country.

3.  Shipping costs… Finally, everyone always underestimates the cost of shipping frozen medical samples internationally. It’s not as simple as jumping on a place with an icebox filled with sperm. Average individuals can’t carry these materials on a plane. Only professional couriers can handle medical samples can do it. Couriers are given special dispensation to carry nitrogen tanks on board a plane in the passenger cabin, and also to bypass x-rays at security.

If you are considering sending your embryos abroad, you should assume sending medical samples internationally will cost from $2000 to $4,000 USD — which may break your cheap IVF budget.

I hope this is helpful.
— Bill

About the authors

  • Bill-Houghton
  • Author: William Houghton

    Bill Houghton is the founder of Sensible Surrogacy, author of the Sensible Surrogacy Guide, 2x surrogacy dad, and a dedicated advocate for secure, legal and ethical Gestational Surrogacy. Read Bill's Biography

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