We knew we wanted to pursue surrogacy in India but still had to decide among the various clinics. To us, the primary goal was to be able to afford a few setbacks so we could stay in the game as long as possible. There are clinics that mostly cater to a Western clientele. Naturally, these tend to me more expensive. Also, clinics in major cities tend to be more expensive. Some don’t work with gay couples at all (really! How 1990s). Typically, clinics require one provide a large initial payment (usually between $8000-$15,000) which covers the egg donor, first IVF and preparations for surrogate. The next sum is typically due at confirmation of pregnancy where payments of about $15,000 to $20,000 are spread out over the rest of the pregnancy and this covers the actual surrogacy itself (including her fee) and birth. Sometimes there are extra costs for twins and hospital. This makes total cost of surrogacy anywhere between $25,000-$30,000 (this does not include at least $10,000 for the two trips over there, first a quick one for deposit, and second a longer one to bring home baby). Where clinics differ is what they offer for the initial payment. Most clinics offer a single IVF procedure, a fresh transfer of embryos, freezing of remaining embryos and then several frozen transfers following this. Other clinics will include only the first transfer and charge for each additional transfer.
Some folks are lucky, get pregnant within the first few tries and end of spending about 25-30K on the surrogacy itself. Our goal however was to prepare for failure (which we are really glad about now cause we have had a lot of it). If pregnancy did not occur within the first few transfers or if IVF did not yield enough viable embryos for several transfers then one must pay another large initial payment to start over. Too many failed transfers and this could really add up. We eventually found a clinic that included several IVF’s (and therefore many more transfers) in that initial fee, making it much more likely that we could cover cost of failure.
For about $15,000 or so extra, one can choose a caucasian donor. Once again, this can become prohibitively expensive if one needs more than one try with donor. We were a bit nervous only because we wanted to make sure our families would be open to loving our child, no matter what physical attributes they possessed (For us, we actually loved the idea of a multi-racial/multi-cultural family--which we pretty much already are). I brought this up with my parents and my step-dad looked at me as if I was crazy and said: are you kidding, it is the twentieth-first century, grow up. That ended those concerns!
Some people prefer to work with a US-based agency who handles communication with the clinic. We liked the idea instead of communicating directly with the clinic doctor. We emailed a lot of clinics at first and found ourselves focusing on those that responded fairly quickly and those that were willing to respond to all our inane questions. I asked lots and lots of questions around success rates (making sure never to confuse pregnancy rates with live-birth rates), whether babies go to full-term, conditions for surrogate living, not so much because the answers distinguished the clinics, but more because we wanted to see whether clinic was responsive in general and if answers seemed to add up. For us, the clinic we ended up working with was the most upfront about providing clear answers (They had many statistics at hand, and even though statistics can be tricky to interpret, I love a good statistic). Finally, we ended up getting a better vibe from the doctor and staff at one of the clinics so we chose it, but honestly financial considerations outweighed everything else.
It is important to acknowledge what for us was the major downside of pursuing surrogacy in India and that is the process of getting a US passport and bringing our baby home. Both of us had been to India before and knew how difficult the bureaucracy could be. One time, when traveling thru India, an airline lost my luggage and once they found it, it took quite a while to convince the airport attendant drunk on his authority over lost suitcases to return it to me (I suspect a little bribe would have helped). Typically, it takes about three weeks for US citizens to complete a process that includes getting the birth certificate, processing DNA tests, applying for and receiving an emergency passport and getting an Indian exit visa for the baby. I know from reading other blogs that for two men, trying to travel out of India can be awkward at best. We are expecting a lot of “where is the mommy?” We are trying to think of this as an opportunity, a chance to bond with our baby and learn how to take care of him or her without all the help that we will get down the road from well-meaning grandmas, aunties and friends. Neither of us knows much about taking care of a newborn, so we figure that by the time we get back to US we will be old hands. We worry a bit about dealing with time off from our jobs in US, but we know in the end it will work out.
The other issue we considered was one of ethics. I can see how some would find the idea of Westerners traveling to India and "renting poor women's wombs" disturbing. I think in a better world, for those that cannot conceive the old-school way, surrogacy would be a part of regular medical care. I don't think there is anything inherently unethical about a women choosing to become a surrogate, regardless if she decides to do it for compassionate or financial reasons. Our bodies are our bodies. On the flip side, there is no question that this provides poor families opportunities they might not otherwise get. Many buy homes or send their children to school. I just don't think there are any easy answers. For us, it was really important to meet the surrogates and make sure they lived in proper housing and were well cared for.
Once we picked a clinic and sent out our very large bank transfer (maybe the most anxious moment of the whole process, I was sure they were going to take it and close up shop) we were off to India. More on that in next post….