Post by Dr. Wendy Shelly
Gay men desiring to start a family need assistance coordinating the complex process of egg donation and gestational carriage (surrogacy). Choosing your egg donor (whether anonymous or a friend) and a healthy, appropriate gestational carrier (GC) (whether commercial or a friend) are the most important elements to ensure success.
With this in mind, I recommend beginning with a medical consultation with a board-certified Reproductive Endocrinologist (fertility specialist). This 2-3 hour visit will usually cost $250-$300 and is not covered by most insurance policies. You will meet with multiple team members who will be helping you on your journey. A fertility specialist will:
- Assess you (and/or your partner) for sperm quality and its use
- Screen potential egg donors for suitable egg quantity and health/genetic history
- Some fertility centers, like ours, have their own pre-screened anonymous egg donor pool
- Evaluate GC for likelihood of successful term delivery
- Explain and perform mandated (FDA) infectious disease screening on required parties
- Coordinate and conduct the actual getting pregnant part (IVF)
A fertility specialist will help you develop an efficient “Family Plan”, taking into account the number of children you ultimately desire. They will counsel you regarding options such as pre-implantation genetic screening, which tests embryos for chromosomal abnormalities prior to transferring them to your gestational carrier. This can improve implantation rates and decrease risk of miscarriage or IVF failure, potentially decreasing overall costs to delivery.
Once you have established care with a fertility specialist, you then have a firm grounding to move forward selecting the egg donor and GC. Some fertility clinics have their own pool of egg donors, which gives them the ability to screen donors to their own high standards as well as the opportunity to know them on a more personal level. Most specialists also work with egg donor agencies. If you have a friend or family member willing to donate eggs, they too can be screened by your fertility specialist. It is worthwhile to invest in appropriate screening for donors to ensure you have a healthy candidate to maximize your chances for pregnancy. This should include assessment of ovarian reserve with an ultrasound and an AMH (anti-mullerian hormone) level as well as basic genetic screening, including at a minimum Cystic Fibrosis. Certain ethnic groups may have additional genetic screening recommended. Most anonymous donors are compensated between $5,000 – $10,000 per cycle, though this varies from clinic to agency.
For a gestational carrier, I recommend you retain the services of a gestational carrier agency. Agencies will have a fee for their services, which usually includes finding a carrier, coordinating with your fertility specialist, and shepherding you and your carrier throughout the pregnancy. Most gestational carriers receive compensation around $30,000 – $50,000, with some fee retained regardless of whether a delivery occurs. It is important to obtain a clear list of services included in your fee package to assist you in understanding you final overall cost. Your gestational carrier should be evaluated by your fertility specialist or an obstetrician prior to an embryo transfer to ensure she is a good candidate to carry an uncomplicated pregnancy to term. You will also want to have an informed discussion with your physician and gestational carrier regarding the number of embryos to transfer and the risks associated with multiple gestations. Your gestational carrier agency can also help you hire an attorney. An attorney will draft contracts between you, your donor and your carrier as well as set up an escrow account to assist in payment for services.
Financially, fees will be associated with each member of your team – your fertility specialist, your gestational carrier agency and gestational carrier, your donor and your attorney. Total cost to delivery is usually around $90,000 -$110,000.
Some costs to consider:
- Agency fees
- Egg donor and gestational carrier compensation
- Legal fees
- Medical costs of IVF
- Obstetrical costs
Using an egg donor and a gestational carrier is a realistic and rewarding way to build a family and can run smoothly with the right team members. Take the time to research and find a fertility specialist and gestational carrier agency to guide you through this complicated and exciting process!