The Average Cost of Surrogacy
The United States is the “gold standard” destination for surrogacy, but the average cost ranges from $120,000 to $150,000. International surrogacy can cost as little as $50,000 in Eastern Europe or South America, but finding a reliable agency requires some research and guidance.
Jump Down this Article:
- SENSIBLE Low-Cost Programs & Prices
- Your U.S. Surrogacy Budget in Detail
- Affordable International Options
- Lower-Cost Independent Options
- Surrogate Costs with Twins
Also in the Cost Guide
Compared: Cost of Surrogacy Worldwide
No surrogacy destination is perfect, and each option should be weighed on it’s benefits and disadvantages. The United States has the best clinics and a supportive legal framework. But many couples find the cost of surrogacy in the United States to be exorbitant. Gestational surrogacy is available internationally for half the price of the U.S., but there are many inconveniences, and finding a reliable partner can be a challenge.
Parents should review all surrogacy options based on success, legal protections and cost. Legally protected commercial surrogacy is common in the United States and Eastern Europe. Other countries offer “altruistic” surrogacy laws, which limit the financial incentive for surrogates. Cheap, “high risk” programs abound in developing countries. The Surrogacy Guide includes a ranking of popular surrogacy destinations (based on security, success and affordability).
The table below shows an estimate of your total surrogacy budget in some popular surrogacy destinations. These average costs include the clinical fees, surrogate compensation, legal costs and agency fees. Intended Parents also should budget for egg donor compensation and fertility medication, as well as travel expenses (which are not included in these estimates).
Average Surrogacy Costs Compared
|Country||Surrogacy Costs with IVF||Surrogacy Costs w/out IVF|
Your U.S. Surrogacy Budget: Line by Line
In a typical U.S. surrogacy journey, your surrogate’s compensation will take almost one-half of the total surrogacy budget. The agency fees and legal fees may take another third. The rest of your budget is for clinic procedures and related expenses.
In the U.S., almost all of the budget will be paid up front (either to the clinic, agency or into escrow). Overseas programs will often charge month-by-month as a service is performed.
The following section details the cost of a typical surrogacy journey in the United States. (Prices are estimates and will vary from program to program.) Every program will be slightly different, but a complete program should include each of these fees. Some fees may be separated or bundled together. (NOTE: Click here to view the specific cost of surrogacy with SENSIBLE’s various programs.)
Intended Parents should become familiar with these payments, when they are due, and how much they add to the total surrogacy costs.
Managing Your U.S. Surrogacy Budget
$20,000 – $30,000
Due Upon the Start of your Journey
Managing a surrogacy journey is complicated and time consuming. Agencies perform this service for couples who don’t have the expertise or the time to handle the daily tasks themselves. But the agency’s services come with a steep price tag.
Agency fees are generally the first payment of the journey. They are paid only once and are non-refundable in most cases. Agency fees cover the agency’s activities from the moment you contact them to when you arrive home with your new baby.
Typical services provided by your Agency Fee:
- Finding a qualified surrogate and arranging her medical/legal/psych clearance
- Managing the surrogate’s fertility treatments, prenatal care and oversight during the pregnancy
- Acting as liaison with the clinic, donor agency, lawyers, and other service providers
- Managing the surrogate’s compensation, as well as the escrow account and journey finances
- Educating the Intended Parents, and keeping them informed throughout the journey
TIP: Make sure your agent represents you and is not paid by or is financially linked to the clinic. This may create conflicts in your agent’s priorities.
TIP: Independent Surrogacy can reduce costs by eliminating the agency and agency fees. An independent journey can be a challenge, because the Intended Parents must take on full responsibility for all the tasks.
$12,000 – $20,000
Due when you request a surrogate
Finding a qualified surrogate is the most challenging and time consuming task of the surrogacy journey. Intended Parents often spend years looking for a surrogate. Once found, the surrogate candidate still needs an array of costly medical, legal and psychological evaluations.
Surrogate matching is done by a professional recruiter with access to a network of sources. The time needed for a successful match will depend on the agency and the recruiter, but usually ranges from 1 to 3 months in the United States. A freelance recruiter may also be available for a service fee of $10,000.
The matching process also includes medical, psychological and legal “clearances”. Each evaluation has an added cost paid to the clinic, lawyer or therapist. These evaluations are not optional… all reputable surrogacy clinics will insist that the surrogate has a “Match Sheet” before starting any medical procedure. A match sheet includes the full medical records of the surrogate as well as the positive evaluations by the clinic, lawyer and therapist.
These costs may appear as separate items in your budget. Intended Parents often will pay these costs out of pocket:
- Fertility tests, including hormone screening and ultrasound exams
- General medical checkup, blood work, and STD screening
- Psychological evaluation
- Legal background check
- Personal insurance review
- Possibly more tests at the request of the Intended Parents
- Travel expenses for trips of more than 50 miles
Surrogates must have a completed Match Sheet before she can continue to the Surrogacy Contract phase.
$8,000 – $10,000
Part 1, Due Upon Drafting the Surrogacy Contract
Part 2, Due in Third Trimester
There are two major legal services in the typical budget: First is the contract drafting and execution. The second is the pre-birth or post-birth order. Both are required by law in most states.
Your agent will introduce you to an experienced lawyer to draft the Surrogacy Contract. When you begin, the lawyer will ask for a retainer that may include a limited number of draft revisions. The surrogate will also need her own lawyer to independently review the contract with her, and this is a cost the Intended Parents will cover.
Around the time of the birth, your lawyer will draft and file a motion to legally ensure your parental rights. In most states, a local court will issue a “Post-Birth Order” in the days/weeks after the baby is born. In very “surrogacy friendly” states, a “Pre-Birth Order” will be executed at the end of the 2nd trimester. Both have a similar legal affect.
$55,000 – $75,000
Paid in Full into Escrow Upon Signing the Surrogacy Agreement
A typical surrogate in the United States earns from $35,000 to $45,000 paid in a monthly salary. She also is paid another $5,000 to $10,000 USD in various benefits.
Surrogates with unique or desirable qualifications can be paid substantially more. For example, a surrogate with friendly medical insurance can earn an additional $5,000 in base salary. Experienced surrogates, who’ve successfully completed a previous surrogacy journey, can add another $10,000 to her salary. Surrogates on some geographic areas can also ask for higher compensation.
In the United States, you will pay the full surrogate compensation up-front into an escrow account. Payments are then released to the surrogate each month during the pregnancy. So expect a very large initial payment once the surrogate has been chosen and signed. This big payment is balanced by fewer, small payments made during the pregnancy itself.
Typical payments to your surrogate include a “base salary” plus the following extra benefits:
- Monthly allowance
- Start-meds fee, paid whenever she begins taking fertility treatments
- Embryo Transfer fee, paid whenever she undergoes an embryo transfer
- Invasive procedure fee, whenever she must undergo some other invasive medical procedure
- One-time maternity clothing allowance
- Travel expenses and child care during overnight visits to the clinic
- Medical insurance premiums and deductibles
For a more detailed breakdown of your cost surrogate’s compensation package, check out this article in the Surrogacy Cost Guide.
TIP: Overseas surrogacy program often pay the surrogate each month during the pregnancy. In this case the monthly payments for prenatal care are larger because they include the surrogate’s compensation as well as clinic fees.
Clinic Fees/IVF & Embryo Transfer
$25,000 – $35,000
Paid from Escrow When Scheduling the Donations or IVF Cycle
A “fresh” IVF cycle uses eggs retrieved directly from an egg donor (either the Intended Mother or a 3rd party donor). The IVF itself may cost up to $25,000, but medications, PGS analysis, embryo transfers and other minor expenses will push the cost up even higher.
The clinic payments are made when the parents begin working with their clinic. This fee pays for the egg donation, IVF cycle, and at least one embryo transfer. These procedures could happen right after the clearance fees. Sometimes parents can slow the pace of their expenses by breaking this process into multiple steps made weeks (or months) apart.
TIP: Different clinics and agencies will treat the cost of medication differently. A well-managed program will include the cost of the medication in the original budget. In other cases, the cost of meds is added as an extra expense. (This may be done to make the total cost of the program appear cheaper).
Prenatal Care and Oversight
$5,000 – $10,000
Paid Monthly from Escrow Throughout the Pregnancy
As soon as the bHCG test confirms that the surrogate is pregnant, she will start receiving prenatal care. That will include routine office visits to her obstetrician, monthly ultrasound scans, various vitamins and hormone supplements, and check-ins by your agency’s journey coordinator. She will also start receiving her monthly stipend as well as other benefits.
Payment for prenatal care begins when the surrogate is confirmed pregnant (which happens about 3 to 4 weeks after the embryo transfer. Office visits are usually paid by insurance, but there are often deductibles and co-payments that will be paid from escrow. Depending on the agreement, the surrogate’s medical insurance may now start being paid by the Intended Parents.
In the United States all of these payments should come from the escrow account, which is fully funded when the Surrogacy Agreement is signed (see above). However unexpected costs for things like travel expenses and child care are not unusual. Intended Parents will usually be asked to “top off” the escrow account with additional money from time to time.
TIP: Overseas programs, where parents pay directly for prenatal care and compensation (and not from escrow), prenatal care is separated into installments. If for some reason the pregnancy terminates, future installments are not needed, but the intended parents will lose any payments made to that point. Payments may be made every month, or every trimester of the pregnancy.
Delivery and Related Expenses
$5,000 – $8,000+
Paid by Insurance or Out-of-Pocket at the Time of the Birth
Cost of the delivery and any complications should be covered by the surrogate’s medical insurance. However, insurance companies routinely deny some charges and require co-payments for others. So leave a contingency fund to cover possible delivery costs that are rejected by insurance.
The cost of the birth will depend on several factors, most notably whether the surrogate will request a vaginal or c-section delivery. C-section is an expensive procedure that requires an operating room, anesthesia, and longer stays in hospital. C-section deliveries account for about 3 in 10 childbirths.
Babies conceived via IVF have a higher likelihood of premature birth (about 1 in 10 will arrive early) and dramatically higher for twins pregnancies. Premature birth has the greatest effect on medical costs. Average healthcare for premature/low birth weight infants is nearly 11 times more costly than that for newborns without complications, according to the March of Dimes.
TIP: In overseas programs, the Intended Parents will make this payment directly toward the end of the pregnancy. The payments cover the cost of the delivery of the baby and the post-natal care of the surrogate. Because deliveries often happen prematurely and without warning, this payment is often required at Week 28 (well before the estimated delivery date).
Bureaucracy & The Return Home
$2,000 – $3,000
Paid out-of-Pocket as Services are Provided
International parents must establish the baby’s citizenship and get a passport to return home. The process will add 3 or 4 weeks’ stay in the U.S.. DNA tests are common for international families, and they can cost up to $1,000 per test in the U.S.
While American couples having babies in the U.S. can typically return home once their birth certificate is issued (in a few days), international parents should expect DNA tests, application fees, translations and notary fees, and additional travel expenses for a 4 week visit.
The surrogate may also need to sign additional papers, and occasionally she’ll appear in person at the parent’s embassy. The surrogate usually continues to receive her monthly benefits until well after the delivery to cover expenses during her recovery. But her benefits also ensure she will continue to be available to help the parents return home of the baby.
TIP: Programs overseas may include add-on fees to assist the baby’s return home with the parents. The largest is often a DNA test, which can be $800 USD or more. If the legalization process requires a court order, parents can expect to pay legal fees directly to a local lawyer.
A well-managed IVF and Surrogacy package will budget for almost everything: surrogate compensation, egg and sperm donation, IVF procedures, prenatal care, and the delivery. Reputable programs also will include legal assistance for bringing your baby safely home.
Program fees typically do NOT include egg donors, hotel accommodations, airfare, country-specific legal processes, or extraordinary medical care for the baby or the surrogate. However, a reputable agent will work with you to develop a complete budget that includes all these non-standard surrogacy costs before signing any agreement.
Compared: Lower-Cost Independent Surrogacy
Independent Surrogacy costs less than “full agency” programs because there is no agent involved. Instead, parents work directly with their surrogate to manage most aspects of the surrogacy journey themselves.
Independent programs reduce the cost of surrogacy by $10,000 to $25,000. Agency fees are about 30% of total surrogacy costs, but such fees can be an expensive luxury. Many parents prefer an “Indy” journey, and they perform the agent’s tasks themselves. It may seem complicated, but resources are available to help parents through each task.
How Independent Surrogacy Lowers Costs
The most difficult part of an Independent Surrogacy program is finding a qualified surrogate and guiding her through medical and legal clearance. This is how agencies justify $30,000 or more for their services. To lower the cost of surrogacy, Intended Parents can find their surrogate through various private connections. Sometimes a friend or family member may offer to carry the pregnancy, significantly reducing the cost of a surrogacy journey. (This article has some useful advise on the cost of being a surrogate for a friend.)
Agencies have professional surrogate recruiters to find and evaluate candidates (and even so, the search can take months). Intended Parents most often find their own surrogates in online communities where surrogates and parents post messages. If parents can’t find their own surrogate, a freelance surrogate recruiter can often find candidates. In this case, the freelance recruiter works directly for the Intended Parents at a lower cost to the surrogacy budget.
The benefit of independence
Independent surrogacy can reduce costs in other ways, including access to lower cost services. Agencies may have exclusive commitments to clinics, vendors, and lawyers. Independent journeys can use lower-cost services. An Independent Surrogacy program allows parents to “shop around” for affordable options. Parents also negotiate the compensation of their surrogate themselves, and so may be able to reduce the costs even further.
Parents may also find local vendors near their home, which saves travel expenses. This also allows them to stay near their surrogate during her pregnancy.
The Unexpected Costs of Surrogacy with Twins
Intended Parents looking for a large family consider reducing costs by having their surrogate carry twins. The hope is that a twins pregnancy is a sort of “Buy one; get one free” deal. But a twins surrogacy has serious medical and financial costs.
Twins have a high probability of premature birth (about 65% of twins pregnancy ends prematurely.) Premature births run a higher risk of physical and cognitive developmental problems later in life. For this reason the ASRM recommends that embryo transfers use only one embryo. Also many surrogates will refuse to transfer multiple embryos to intentionally have twins (although would agree to carry twins if they arrive naturally) because of the difficulty and potential risks to their own health.
Premature delivery often includes additional medical care, insurance requirements and other costs for possible medical contingencies due to complications during the delivery. Here is a breakdown of the anticipated costs of a twins pregnancy.
There are two types:
Surrogate Costs for Twins:
- Extra compensation to the surrogate for twins: $7,500
- Compensation for child care during prescribed bed rest: $200/week
- Compensation for housekeeping assistance during prescribed bed rest: $250/week
- Lost wages if unable to work (on doctor’s orders): $500+/week
- In case of c-section (often required by twins pregnancy): $5,000
Insurance/Medical Costs for Twins:
- Private Health Insurance for newborns: $25,000*
- Private health insurance for the surrogate and pregnancy: $8,000*
- Health Insurance co-payment contingency: $10,000*
* HOWEVER… It’s difficult and expensive to buy insurance for a twins pregnancy — the likelihood of medical complications is too great. If you don’t buy insurance, you’ll likely face the cost of NICU care for two babies at about $5000 day. A stay of 2+ weeks is not unusual for a premature birth — so that’s $140,000 USD for basic care (not including medications and other surgical procedures if needed.)
Some Obamacare insurance policies will cover the cost of a surrogate pregnancy. U.S. insurance that will cover a twins pregnancy will have higher out-of-pocket maximums for the additional medical expenditures. We suggest a contingency of $5000 per baby to cover unexpected medical costs not covered by your insurance provider. This would be the best case scenario.
In addition, the health insurance that covers the pregnancy won’t cover the care of the twins babies after delivery. Non-U.S. couples that do not have an existing private insurance policy in the U.S. must buy insurance for their newborns… In the case of a singleton pregnancy, private insurance can be purchased for about $10,000 USD, with a minimal co-payment. But a twins pregnancy is much more difficult to find. A few “Surrogacy Insurance” policies are available from companies like NewLife that will cover your twins for about $25,000 USD. There’s a full discussion about medical insurance and the cost of twins and singleton pregnancies in the Surrogacy Guide.
Why Does Surrogacy Cost So Much?
Surrogacy costs depend on two factors: The first is the cost of living in your chosen country, which greatly influences the surrogate’s compensation. The second is the cost of medical care, including insurance for the surrogate and newborn.
Cost of living refers to the actual value of the money surrogates receive. If you pay your overseas surrogate in U.S. Dollars, then her modest salary is probably worth a lot more when converted to local currency. For example, surrogates in the Ukraine receive less than half the number of dollars as U.S. surrogates, but their actual compensation is about the same as American surrogates when adjusted for the difference in the cost of living.
The second factor is the cost of health care. Clinic and hospital fees are exceptionally high in the United States, but they are relatively cheap in clinics overseas for the same level of care. U.S. clinics are often touted as the most successful worldwide, but the lower price of procedures overseas affords multiple attempts that more than make up the difference. Meanwhile the cost of an IVF procedure in the U.S. is about $25,000 USD, clinic costs for surrogacy in the UK are about $20,000, and the same treatments in Ukraine cost about $8,000 USD.
The Cost of Quality
Some clinics publish very high pregnancy rates, which make them seem like a good deal. But published pregnancy rates may only include cycles using PGS analysis or proven hired egg donors. PGS can raise the success rate, but will also add $4,000 to $5,000 USD to your program. A donor hired through an agency can add $16,000 to $20,000 to your budget.
These may be among the many hidden costs in the published program budget for those clinics. In some cases, the cost may be a worthwhile investment if the pregnancy rate increases from 65% to 85%. If fewer embryo transfer attempts are needed, the investment may pay for itself. As with all items, a complete budget should be developed, and each option weighed, for the value it brings to your overall success.
Consider the graph above. Three example clinics charge the same price, but because the success rate is lower, clinics B and C require more procedures to reach the same success as clinic A. This means the actual price for these clinics is higher than expected.
Note that success rate for surrogacy implantation always includes numbers for Fresh Embryo Transfer (the first attempt) and Frozen Embryo Transfer (the subsequent attempts).
When considering the cost of surrogacy procedures, Future Parents must consider all these elements. Otherwise they may find the published price of their journey to be misleading.
Surrogacy Cost Explained
Surrogacy costs vary from country to country, as do success rates and legal requirements. Often non-standard expenses also can add thousands to your final price. Sometimes these costs are obvious. Other times the costs are more subtle.
The published cost of a surrogacy procedure is only part of the total expense. Future Parents will pay extras depending on the agency or clinic they use.
For example, Future Parents should consider not just the cost of surrogacy procedures, but also added medical expenses. In the United States, one night in the NICU costs about $5,000 USD without insurance. More than 15% of surrogacy babies require some NICU care. Just 1 week of care in the NICU can cost more than an entire surrogacy procedure overseas.
For international couples, the clinic may not include legal fees in its estimated budget. These fees may include the paperwork to support the child’s citizenship and passport application. Other minor (but overlooked) surrogacy costs include document translations, travel costs, emergency medical care for the surrogate or the baby, etc. All these vary depending on the cost of living in the chosen country.
Similarly, clinics with a low published price may seem like a good deal, but quality must be considered. The success rate per embryo transfer will impact the overall cost of your journey. If you don’t get pregnant on your first embryo transfer, parents are prompted to make a second attempt. Each additional attempt can be up to $6,000. If pregnancy rates are low, and multiple attempts are needed, the overall procedure will cost many thousands extra.
Frequent Questions about Surrogacy Costs
How much does surrogacy cost?
Surrogacy costs range from $120,000 to $150,000 in the U.S. International surrogacy starts at $50,000 in Eastern Europe or South America, up to $80,000 in Europe or Canada. SENSIBLE's independent programs start under $100,000 with no agency fee. Visit the Surrogacy Cost Guide for a comparison of worldwide prices.
How can I lower my surrogacy costs?
In the U.S., Independent Surrogacy can reduce costs by $10,000 to $30,000 or more. 'Assisted Surrogacy' programs eliminate expensive agency fees and give basic tasks directly to the Intended Parents. International surrogacy programs can cut the cost of surrogacy by half. Details on these lower-cost options are available at SENSIBLE's Surrogacy Cost Guide.
Is surrogacy overseas really safe and reliable?
Surrogacy programs overseas are secure, successful and very popular. The cost of international surrogacy is about half the cost of a U.S. program -- plus they often come with 'guarantees' of a successful birth. But not all countries have equally supportive laws or success rates. Surrogacy is secure and reliable for married couples in Ukraine, Greece and other Eastern European countries. Same-sex couples have excellent options in Colombia or Canada. SENSIBLE's Surrogacy Guide has a safety rating of all popular international surrogacy destinations.
Will insurance pay my surrogacy costs?
No. Medical insurance will not cover payments to a surrogate or agency, but it should pay for the prenatal care and delivery. A handful of U.S. states require insurance companies to cover fertility treatments, but most do not include basic IVF procedures. Check out SENSIBLE's Surrogacy Cost Guide for details on finding affordable insurance for your surrogate.
How do I find medical insurance for my surrogate?
In general, only 1 in 10 potential surrogates have insurance that includes maternity care. For those with insurance, most policies have co-payments and deductibles of $5,000 or more. Read more about insurance for your Surrogate in SENSIBLE's Surrogacy Cost Guide.
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