By Molly M. Ginty
Monday, June 23, 2008
Increasing numbers of infertile people have been using surrogacy to have children. But it's expensive, and a tougher economy and tighter credit market are pushing it further out of reach for those with middle incomes.
(WOMENSENEWS)--In Orange County, Calif., Amy Kaplan of West Coast Surrogacy has seen intended parents--those wishing to treat their infertility problem by having another woman carry a fertilized egg for them--save money in various ways.
Some have relatives serve as volunteer carriers. Others donate their extra eggs to fertility clinics, which can sometimes lower their costs for having the eggs harvested for in vitro fertilization.
"I've seen intended parents consider hiring less-expensive carriers overseas," says Kaplan. "Recently, I've even seen them liquidating their 401(k)s in the hope of having a child."
Unlike procedures for treating breast cancer, heart disease or other major health conditions, surrogacy to treat infertility is relatively new, small scale and unregulated.
For these reasons statistics about the industry--including the income of its clients--are unavailable. However, extensive interviews with industry insiders challenge the stereotype--fuelled by Tina Fey's recent "Baby Mama" film--that surrogacy is only for the affluent.
But in the future, economic hardship may make that more true, says Kaplan.
"In the past, people would refinance their homes to get an extra line of credit," she says. "But since the subprime mortgage crisis struck last fall, that's now impossible for many people."
Surrogate births in 2007 rose to 1,000, up sharply from 260 in 2006, according to the Society for Assisted Reproductive Technology in Birmingham, Ala.
Health advocates cite several reasons for this rise. Surrogacy is becoming more effective, with a 70 to 90 percent success rate compared to 40 percent a decade ago. It's more acceptable thanks to media exposure like "Baby Mama," in which a marketing maven who's told her uterus is misshapen hires another woman to bear her child.
And it's in greater demand due to rising infertility, which has increased twelvefold since the 1930s.
At the same time, the costs of surrogacy have also risen, up by about 20 percent since 2004, well ahead of the pace of inflation.
Unable to pay for surrogacy procedures, which are not covered by health insurance, many intended parents are giving up sooner, after one or two failed attempts at fertility treatments.
Others are trying to save money by taking risky measures such as finding carriers without the help of an agency that can screen them, forgoing all but the essential legal paperwork, and working with doctors and carriers in developing countries for a savings of up to $50,000.
At a time when many Americans are struggling with job losses and high mortgage payments, surrogacy may seem like a luxury. But for women who feel a pressing need to bring new life into the world surrogacy can seem like a literal life line.
"Infertile people don't want to give up on their dreams, but the high price of surrogacy isn't changing to accommodate them if they've been laid off or lost homes in the mortgage crisis," says Anne Adams, a spokesperson for the New York-based American Fertility Association. "As the economy worsens, this only grows harder for them."
To avoid custody complications associated with artificial insemination--which costs $500 to $1,000 and can rely on the eggs of the gestational carrier--most intended parents opt for the more expensive in vitro fertilization (IVF, which costs $18,000 to $20,000 and uses the eggs of a non-carrier, usually an intended parent).
After fertility treatment, the expenses of surrogacy break into about four categories. Legal expenses range from $5,000 to $6,000. The carrier's health insurance ranges from $26,000 to $30,000. The carrier's fee--for services and living expenses--ranges from $20,000 to $45,000. The fee for the agency (which includes a legally-mandated $1,500 screening fee to check the carrier's background)--ranges from $3,000 to $25,000.
"If a carrier requires bed rest or a C-section, that can jack the price even higher," says Kaplan. "That's why the total price can be upwards of $100,000."
In Park Ridge, N.J., an intended parent recently asked reproductive lawyer Melissa Brisman to skip doing a legal review of her carrier's health insurance policy. "This client discovered after the fact that necessary procedures weren't covered," says Brisman. "By trying to save $5,000 she wound up losing $50,000."
To save money, intended parents can undergo in-vitro fertilization in Canada, where it can be 50 percent less expensive. But they can't legally hire carriers there. They can legally hire U.S. military wives who are stationed in the United States (helpful because military insurance usually covers surrogacy's medical costs) but these wives may move with military reassignment to one of the 12 states (including New York, New Jersey and Michigan) where laws restrict surrogacy.
Intended parents may cash in their airline frequent flyer benefits to meet carriers in India, Eastern Europe, Mexico, Russia, Thailand or South Africa, but once these air miles run out, they may be unable to afford $2,000 plane tickets so they can continue monitoring pregnancies and legal proceedings.
"Intended parents may not be able to find affordable options in the U.S.," says Steve Snyder, director of the International Assisted Reproduction Center in Minneapolis. "In the future, more of them will likely go abroad, and if that doesn't work out, they will be financially as well as emotionally devastated."
Molly M. Ginty is a freelance writer based in New York City.
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Institute for Women's Policy Research
Center for WorkLife Law
Centers for Disease Control and Prevention, "Breastfeeding in the United States: Findings from the National Health and Nutrition Examination Surveys, 1999-2006"
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