Margaret DiSantis always wanted a child. But the Chicago
advertising executive never expected she would have to sell her house, drop out
of business school and move back in with her parents to tackle costs associated
with hiring the surrogate mother who delivered a healthy baby girl on her
behalf earlier this year.
She joins the selective but growing ranks of would-be
parents - primarily upscale professionals with ample discretionary cash -
turning to gestational surrogates to help them fulfill their dreams of having biologically
connected children. This differs from traditional surrogacy, in which the
surrogate is the child's genetic mother.
Costs involved in surrogates
But the costs faced by people working with gestational
surrogates are daunting, with few options outside of creative self-funding or
high-priced loans."I felt like movie stars do that," said DiSantis,
who despite a six-figure-plus income struggled with expenses that she said
ultimately approached $300,000(R27 6637).
"I didn't know what it was or how it worked."After
considerable research, DiSantis chose surrogacy because she was battling
Crohn's disease and did not want to risk carrying a baby herself. Instead,
frozen embryos created with her eggs and a friend's sperm were implanted in a
After a grueling
two-year process that included several failed attempts and a lifestyle shift
from buying Prada boots to living in her parents' basement, DiSantis is now the
single mother of a 2-month-old baby girl. Babies born to gestational surrogates
are clearly on the rise.
In 2011, the Society for Assisted Reproductive Technology
(SART), a Birmingham, Alabama-based nonprofit group, tracked 1 593 babies born
in the United States to gestational surrogates, as reported by its member
clinics, up from 1 353 in 2009, and just 738 in 2004.The numbers of total
babies born to gestational surrogates could be slightly higher because some
clinics handling these procedures are not reporting to SART.
Having the procedures
Some medical expenses including in-vitro fertilization (IVF)
may not be covered under the intended parent's insurance policy. And while the
surrogate's healthcare policy typically may cover her prenatal and delivery
costs, much of her health expenses may be picked up by the intended parents.
Some experts say they see more health insurance companies
specifically excluding surrogacy costs as the practice increases."We are
seeing more and more surrogacy exclusions," said Robin von Halle,
president of Alternative Reproductive Resources, the Chicago-based agency that
DiSantis enlisted to handle everything from finding a surrogate to managing
"The insurance companies have got a clue that so many
people are doing surrogacies."It is too soon to tell, but those exclusions
could increase as the US Affordable Care Act pulls more people into health
Every state gets to set its own requirements for what is
mandatory in health policies under the health reform law, which takes effect
next year. Some states, such as Illinois and Connecticut, already require
insurers to cover IVF.
While costs of some procedures such as IVF have come down
due to advances in medical technology, the shift has not been enough to offset
the rise in the amount a surrogate charges to reach a healthy pregnancy.
Alternative Reproductive Resources' surrogates typically
charge $30,000 (R 276 637) to $35,000(R322 743), excluding legal and medical
fees. Depending on the parents' situation, Von Halle typically asks them to set
aside anywhere from $75,000(R691 593) to $120,000(R1106 549) for the entire
DeSantis' costs were much higher, in part, because of
several miscarriages and other complications. Von Halle's total includes her
agency's fee of $18,500 (R 170 593), legal and medical costs, and incidental
expenses such as travel, so the surrogate and parents can negotiate the
contract and typically have the birth in the state where the parents have
These financial deterrents do not appear to be thwarting
demand."We have a three-to-six-month wait" to find a surrogate, said
von Halle, whose agency works with both domestic and international clients.
That may be because the process has become more socially
acceptable, according to John Weltman, a Boston-based lawyer who says he and
his husband were the first gay parents to each father a child by the same
gestational surrogate. The children are now in their late teens.
Weltman helped others with the process, ultimately founding
Circle Surrogacy. The 17-year-old organization is one of the longest-running US
agencies matching so-called intended parents to suitable surrogates."You
have a legal setting that is much more secure," he said, noting that
courts now typically side with the intended parents when disputes arise, as
compared with a decade ago."
Celebrities who had
On top of that, numbers of people have come out about their
surrogacies, people like Kelsey Grammer, like Elton John, like Sarah Jessica
Parker."Circle is trying to keep up with what Weltman characterizes as
"enormous growth" since 2005. He has boosted the number of attorneys,
social workers and other employees on his staff to more than 30 from three in
Circle, too, has a
waiting list. At Circle and other reputable matching organizations, the
screening process is rigorous for both sides. Weltman rejects about 99% of
surrogates who apply, based on disqualifiers such as age, pregnancy history and
lifestyle issues like whether there is a smoker living in the house.
His agency also
thoroughly vets clients to make sure they are prepared for the rigors of
parenthood."We try to determine why they want to have kids and whether
they'd be good parents," he said."We want to make sure they have a
support system, parents or friends or family who will be there for
While many intended parents struggle to foot
the costs for surrogacy out-of-pocket, there are some alternatives cropping up.
One is CapEx MD, a five-year-old private financing company
that helps parents pay for a range of alternative reproductive services,
CEO Jules Segal said that customers use CapEx MD loans for a
portion of their overall costs, in what continues to be a tight banking market
for uncollateralized loans."We develop long-term relationships with these
people," said Segal, whose firm typically lends amounts from $30,000 to
$50,000 at fixed interest rates which he says start in the single digits.
CapEx MD only funds individuals referred by a select group
of reproductive services agencies. This helps the firm manage risks, Segal
said. Such an option might have helped ease the burden for Margaret DiSantis,
who found herself financing medical procedures with credit cards and facing
unexpected costs such as a month's worth of hotel fees and lost wages to put
her Wisconsin-based surrogate up in an Illinois hotel.
Her new suburban condo is a far cry from the single-family
home she previously owned in the city. Even so, DiSantis would not hesitate to
make the same sacrifices all over again."It was the best experience of my
life," she said.