The Surrogacy Guide
“Fraternal Twins” is a popular option for same-sex male couples. The program conceives two sets of embryos using sperm from each of two fathers, but with eggs from the same egg donor. The result is that the babies are genetically related through the egg donor, but each carry the genetics of the respective father.
But there is a downside. While couples can share the same egg donor to conceive their “twins”, it is not as easy to share a surrogate. It is prohibited in most countries to implant embryos from two different fathers into the same surrogate. The only country where that’s sometimes allowed is the United States — probably because surrogate compensation is so high that hiring two surrogates is impossible for most couples.
Note that we use the phrase “Fraternal Twins” anecdotally here. The babies are technically half-twins, sharing DNA only from one parent. But the fact they are conceived at the same time, and are intended to be born around the same time, makes the term “twin” seem appropriate. We differentiate “fraternal twins” from “natural twins”, which would be two babies carried within the same surrogate, arising without any intervention from the IVF doctor.
Two fathers can each fertilize eggs from the same donor to create fraternal twins who share the donor’s genetics.
Most clinics do not allow embryos from different fathers in one surrogate due to medical and ethical risks.
Twin pregnancies carry high complication rates — around 65% are premature and often require costly care.
Using two surrogates is safer and more predictable than attempting twins with one surrogate.
The shared-egg method saves money by using one donor and one agency, though total costs are still nearly double a single pregnancy.
The option of transferring two embryos to a surrogate is called a “Double Embryo Transfer” (DET). Years ago, DETs were a common way to increase the likelihood of a pregnancy. Today fertility medicine has advanced and pregnancy rates are high enough that a multiple transfer is not needed. In the case of surrogacy, it may be harmful. And if your goal is to have two children from 2 fathers, it’s likely that the cost will be much greater than hiring two surrogates to carry the pregnancies.
Sharing a surrogate may be possible in the United States, but most clinics will recommend against it, and the ASRM guidelines explicitly instruct clinics not to do this, because a twins pregnancy has serious risks.
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. There are also serious financial risks with complicated twins pregnancies. For more info, check out this post on Twins Pregnancies in the Ask the Experts section.
Although sharing a surrogate may seem like a low-cost option, it’s usually not a very efficient or affordable process. Hiring two surrogates is a much better way to ensure you have twins than is the U.S. practice of transferring embryos from both parents into one surrogate.
To understand why using one surrogate actually costs more than two, remember that an embryo transfer with 2 embryos has a 65% to 75% chance of achieving one pregnancy, and only a 25% chance that both embryos will result in pregnancy. Assuming you are among the 75% who do not get two pregnancies, you will want to repeat the embryo transfer a second time. For this, you will have to hire another surrogate. Thus you spend the same money, but now the babies are on separate development schedules and will likely be born months apart.
There is also the risk that you may not know which parent’s embryos resulted in the pregnancy — so couples may end up with two babies related to one parent and no baby related to the second. In the long run, that adds to the overall financial and emotional cost of the program.
Overseas programs tend to cost less than half of what a program in the U.S. costs. A standard overseas program will run about $60,000, while a guaranteed surrogacy journey is usually about $75,000. So, the option pursuing two separate surrogacy journeys is really still about the same price as hiring a single surrogate in the U.S. However, in many cases, you are guaranteed to have your twins, and the risk to the surrogates’ health and the babies’ health is much lower.
The process of conceiving fraternal twins is similar to having two individual surrogacy procedures, except there is only one egg donor. The results of the egg donation are split between the two fathers, with half the eggs fertilized by each of the couple. Then two surrogates are hired, and embryos from one father are transferred to each of the women. Once pregnant, the prenatal care and delivery continue as normally.
The cost of the Fraternal Twins program is about 2x the cost of a standard IVF/surrogacy program. The notable exception is that you only have to pay one Agency Fee and only one Egg Donor compensation. So the program is somewhat less than double the standard cost.
On a personal note… my own babies were born through surrogacy overseas, and my husband and I had “twins”. We hired two surrogates to carry our babies. We split an egg donor; each of us fertilized our own embryos; and we transferred them to two different women. Those women gave birth to two babies about a week apart.
There is a caveat to having twins using two surrogates. Babies that are conceived with two different surrogates are not guaranteed to be born at the same time. Typically, an IVF clinic overseas has a pregnancy rate per embryo transfer of about 60-65%. This means that the most likely outcome of implanting embyos to two surrogates at the same time is that one will become pregnant and the other will not.
If that happens, your babies won’t be born at the same time. They are very likely to be born several months apart. This can significantly change your plans, especially if you need to travel overseas for the deliveries. You may have to extend your stay overseas for a several months or make multiple trips, depending on how far apart your babies are born.
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
Search our complete library for all the answers…
