What is a “Pregnancy Guarantee” and is it worth the cost?

Guarantee programs (a.k.a. Baby Guarantees) have become a popular option for nervous couples starting a daunting surrogacy journey in a foreign country. Here is what you should know when considering the options.

Also in The Cost Guide:

• The Surrogacy Cost Guide
• Understanding the Costs of Surrogacy
• Buying Insurance for Your Surrogate
• All About Surrogate Compensation
• Lower-Cost Independent Surrogacy
• Financing the High Cost of Surrogacy

 

It’s understandable why some couples are drawn to “Baby Guarantee” programs — especially in the United States where surrogacy costs are so high. A Guarantee can add a lot of value for nervous clients who are worried about surrogacy and need reassurance about the success of their IVF process. But for most couples, its value is more about a feeling of security than actually increasing the likelihood of a pregnancy.

The extra costs of a “Pregnancy Guarantee” is not for any medical service, but really to give a sense of security for the Intended Parents. Statistically, a Pregnancy Guarantee program may cost more money in the long term and doesn’t improve the chance of success. But that extra expense gives peace of mind.

Pregnancy Guarantee programs are now available through theSENSIBLE Surrogacy Agency in both Kiev and Bogota.

What is a Pregnancy Guarantee.. and what it’s NOT.

What most US programs offer is not really a “Pregnancy Guarantee” program. A “guarantee” suggests that if you don’t get pregnant the clinic will refund your money. What these programs are offering is an “multiple attempts” program, which means the clinic will keep doing embryo transfers until you are either pregnant, or until you give up trying.

Either way, the clinic can’t offer 100% certainty that the Parents will have a baby. (That level of certainty is reserved for higher powers.)

It is a fallacy to equate the term “Guarantee” with “Certainty”. The purpose of a guarantee is to limit the risk — but not to increase certainty. Some “Money Back” programs are available at clinics in unregulated countries like Kenya. These programs will offer a partial refund if you do not achieve a successful pregnancy within 5 attempts. The chance of pregnancy is the same, but the risk is lower becasue parents are promised some of their money back. (But the larger risk of unregulated surrogacy in such a destination remains.)

Compare that to an “unlimited attempt” program, where the clinic will continue performing IVF cycles until there is a successful delivery. Multiple IVF procedures will not make an infertile couple more fertile. But the likelihood of having a baby is higher if the parents are not forced to stop trying because they run out of money.

Can a Pregnancy Guarantee program save money?

To answer this question, you need to do some simple math.

If the likelihood of pregnancy is 70% for a fresh embryo transfer, and 50% for each subsequent transfer, then the likelihood of getting pregnant after just 3 attempts is about 92%. The likelihood of pregnancy after 5 attempts is about 99.5%.

Of course 99.5% is not “certainty”, but it’s pretty close.

Most likely the Pregnancy Guarantee program costs an additional $20,000 USD; and that’s the cost of about 4 or 5 additional attempts. So you would need to have about 5 total attempts before the cost of the Guarantee becomes justified. Those five extra attempts will take you from 99.5% chance of pregnancy, to about 99.8% chance of pregnancy.

But here’s the rub… It’s unlikely that IPs will use 5 attempts. There are three reasons…

• First, because they are 99.8% certain to be pregnant before the 5th attempt.
• Second, if you don’t get pregnant by the 5th attempt, it’s most likely because of a fertility issue with either the sperm or egg donor — and you’ll probably want to take a break and get some more in-depth fertility testing done.
• Third, most couples do not have the emotional strength to go through 5 failed pregnancy attempts (most can’t really handle even 3 attempts — it’s just too hard emotionally.)

(Of course this assumes that you have a good outcome from your IVF cycle and you have are plenty of healthy embryos to transfer. If you’re egg donor gives a poor performance and you end up with only 2 or 3 healthy embryos, you’re likely to need an additional IVF cycle to reach that 5 transfer milestone. So thumbs-up to the guarantee if you have any doubt about your egg or sperm donor!)

So here is a summary on Baby Guarantee programs… If you feel the need for an assurance and a sense of “trust” in the IVF process, then a Guarantee is a great idea. It may cost extra, but it will definitely buy you some peace of mind. However, understand that the Guarantee program may not save you money nor can it ensure that you will have a baby.

If you want assurance that you will have a baby, the best way is to check out the quality of the clinic and their success rates. In the U.S. there are independent services that track success rates. If there is no independent agency that reports those stats for your region, you can ask the related service providers who do businesses in the region (egg donation agencies often keep note of how many of their donations result in pregnancies).

Intended Parents can also take steps on their own to improve dramatically the likelihood of a successful program. The most critical factors are often not the doctor’s competence, but things that are in the parents’ own control, such as the quality of the sperm and the fertility health of the egg donor. Most often the greatest point of risk of an IVF programs is within the control of the Intend Parents, more so than the clinic. And no Pregnancy Guarantee program will help there.