Ask the Surrogacy Experts

“We signed with a clinic in the United States, performed all of the genetic screening and FDA blood work, and signed with an egg donor agency for an IVF cycle. Now we are looking for a surrogate to carry twins for us (one embryo from each of us). We live in Europe, but have family in the US Midwest. Do you help us find a surrogate in that region?


Hello Aaron,

In the US a surrogacy journey costs between 100K to 150K… so it’s no wonder that couples who want a big family think of having twins. Essentially twins is like a 2-for-1 sale — for nearly the price of a singleton pregnancy you can (theoretically) get two babies. Ooooh, if only it were so simple!

But I before I get into the really bad news, the short answer is “Yes”. You may be able to find a surrogate who is willing to carry twins (I work with a great surrogate recruiter who can find just about anyone).  American surrogate mothers are a good-natured bunch, and many are generally amenable to helping out with your family planning. Certainly overseas surrogates are willing to carry twins, because they get proportionally more money than US surrogates for the added effort, which is a big motivation.

But be warned, your clinic will certainly advise your surrogate against attempting twins — pointing out the risk to her own health as well s the babies’. I’m actually surprised your clinic in Illinois is permitting this.  The ASRM has issued warnings for all US clinics to perform only single-embryo transfers because the of the medical risks associated with twins pregnancies. Many surrogates who are willing to carry twins at first, change their minds after their initial consult with the fertility doctor.

You may know, 65% of all twins pregnancies end prematurely, and that requires hospitalization of the babies.  Premature babies have much higher likelihood of long-term and short-term developmental problems. So we advise all clients not to pursue twins pregnancies simply for medical reasons. The Mayo Clinic lists these most common issues:

  • • Cerebral palsy
  • • Impaired learning
  • • Vision problems
  • • Hearing problems
  • • Dental problems
  • • Behavioral and psychological problems
  • • Chronic health issues


Honestly, I am often disappointed how that argument fails to disuade many couples. (When a couple are willing to put their child’s well-being in such obvious jeopardy, it makes you wonder how diligent their future parenting efforts will be).  

But if medical risks aren’t persuasive, there is also a financial argument. A twins pregnancy doesn’t mean you get an extra baby at no cost… You can expect to pay extra charges for the extra effort and risks. For example…

• Plan on $7,500 extra compensation to the surrogate for twins.

• Your surrogate is certainly going to have difficulties during the pregnancy, and that often means prescribed bed rest. Bed rest can add up to $1000 per week to your budget. (Child care during prescribed bed rest can add $200/week. Housekeeping during bed rest is an extra $250/week. Lost wages can amount to $500/week or more.)

• Twins pregnancies almost always require a c-section delivery, which will add from $5,000 to $10,000 to your budget (depending on your insurance provider).

For more info, visit

Do you have a private insurance plan in the United States to cover the medical care of the babies?  Most private insurance will not cover a twins pregnancy (or they charge ridiculously exorbitant premiums).  Our insurance providers have threatened to black-list any surrogacy agency that actively offers twins pregnancies as an option.

If you plan to pay for the delivery out-of-pocket, you should plan on a possible 2 – 4 week in NICU (which is about $5,000/day for each baby).  You may also be expected to  pay for additional medical care for the surrogate.

That said, I don’t think it’s impossible to find a surrogate that will carry twins…  but I am concerned you may expose yourself to serious financial and medical trouble going this route.

I hope this is helfpul,
— Bill


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