Anyone considering a surrogacy and/or egg donation journey must take in to account a variety of interests to make sure that they are as knowledgeable and prepared as possible for this very special journey.
While surrogacy and egg donation arrangements have been carried out for decades in the United States, there are nuances to the family-building journey depending on if the intended parents (IPs) are domestic to the United States, or international.
For international IPs, there are additional considerations, from newborn insurance and financing options to intercontinental communication and traveling home with your bundle of joy.
In this blog post we dive into a couple of the areas where international IPs need to exercise additional care, as well as addressing some of the most common questions.
More specifically this blog post will focus on the following four areas:
Pursuing a surrogacy and/or egg donation journey is an expensive endeavor. Further, understanding the costs, particularly surrogacy costs, can be a tall task, which is better described in this article that breaks down surrogacy expenses, written by Hatch Agency President, Greg Wiles.
Most IPs rely on more than one source of funds to finance a family-building arrangement, for example turning to financing options such as Sunfish who offers solutions and financial support for all kinds of journeys to parenthood.
Unfortunately, most international IPs are not able to apply for loans through financing partners such as Sunfish, making financing options for them in the United States inaccessible. Many international IPs must rely on savings, selling stock or property, increasing the mortgage on their home, or rely on contributions from family and friends, for example parents who very much look forward to becoming grandparents.
With that said, there are still some organizations that could be of help, for example the non-profit organization Men Having Babies (MHB). MHB offers IPs discounted rates with their partnered agencies and clinic, such as Hatch and Pacific Fertility Center Los Angeles (PFCLA), under certain conditions. MHB mainly caters to gay men and same-sex male couples, even though heterosexual IPs can also enjoy some basic benefits and discounts as a MHB member and/or supporter.
While it is quite uncommon that employer benefits outside of the United States cover egg donation and/or surrogacy, it could still be possible and is worthwhile discussing with your employer. Some benefits might still cover IVF medical treatment, which might help lowering the costs of this journey.
Many agencies will offer payment plans spread over several months up to a year for when payments are due. This eases the financial stress on IPs. International IPs often must exchange local currency to US dollars for payments, adding an additional layer of complexity to the payment process. Many international IPs use the services of Wise or Revolut for potentially more beneficial exchange rates and a smoother process than many traditional banks can offer.
Being thousands of kilometers (or miles) away from your surrogate (and child) can be daunting as an international IP. Common questions revolve around how communication can be maintained and what the right amount of communication should look like.
Today there are a plethora of available tools of communication, from text message services to video communication software – many free of charge. The IPs and the surrogate can easily find solutions that are agreeable and comfortable for both parties.
International IPs with Hatch live all around the world and successfully communicate and keep in touch with their surrogate. Maintaining this communication and making sure that communication is regular, but also respectful, is the responsibility of both the IPs, Surrogate, and the agency! At Hatch, a Case Manager is assigned to each Intended Parent/Surrogate couple to step in and support healthy communication when necessary, even if most IPs and Surrogates communicate very well on their own.
Most international IPs communicate with their surrogate weekly, most commonly via text messaging. Every now and then the IPs and Surrogate would have a video meeting to get some more face time with each other and build a stronger bond during the 9 months of pregnancy. This is very much encouraged by Hatch, for the benefit of both IPs and Surrogate. It is quite rare that international IPs travel to visit the surrogate during the pregnancy (except for a couple of weeks before the birth), since travel can be costly and time-consuming. With that said, some IPs will travel to spend some time with the surrogate before delivery, for example for the embryo transfer or 20-week ultrasound.
Hatch recommends IPs communicate with their surrogate at least once a week before the pregnancy and 1-2 times a week during the pregnancy, either via text messaging or video calls. Don’t forget to keep in touch after the delivery as well! This can look very different depending on the IP and surrogate.
It is important to remember that the communication should be “social” and not only relate to the topic of the pregnancy. Surrogates love hearing about your joy throughout the journey. Supporting your surrogate means supporting your child!
Lastly, the key to positive communication is to find someone that wants the same level of communication as you – something that a Hatch Match Specialist will assist you with when considering your ideal surrogate match.
As previously mentioned, travel can be both expensive and time-consuming for international IPs pursuing egg donation and/or surrogacy in the US. The number of times international IPs are required to travel to the US depends on their specific situation and what services they need.
International IPs are not required to travel to the US to initiate their journey, sign the agency/clinic agreement or make payments. This can all be taken care of remotely with the assistance of the agency staff.
International IPs that plan on using their own eggs and semen for embryo creation must travel to the United States for the egg retrieval procedure (unless all FDA requirements can be fulfilled for embryo creation abroad with a surrogate transfer in the US – more closely described in this article about navigating rules and regulations of shipping eggs, embryos, and semen, written by Dr. Sahakian and Dr. Chavkin from PFCLA). While there might be options of shipping semen internationally, there are few, if any, options of shipping eggs or embryos for the same purpose for use with a surrogate.
Those using an egg donor, but their own semen, can simply either visit their IVF clinic for the required testing, screening and semen freeze, or do so internationally at certain select destinations. These costs are usually not covered in the clinic’s package and carried out with a third-party provider of those services. If the IP is using both an egg donor and semen donor (so called “double donation”), they are not required to travel to the United States at all at this stage.
Unless the IPs wish to travel to spend some time with their surrogate, the next occasion for travel would take place a couple of weeks before the delivery of the child. At this time, the IP needs to be in the surrogate’s state to prepare for and await the birth. This is also an excellent time to spend some quality time with your surrogate and her family in advance of the upcoming delivery.
After delivery, international IPs are expected to stay for about 3-4 weeks to finalize the legal documentation surrounding their parentage and apply for a US Passport (if desired). When this is finalized, international IPs can return home either using the US Passport, or by visiting their local embassy/consulate in the US to acquire temporary travel documentation for their baby. Hatch works with professional and experienced U.S.-based third-party attorneys that have worked with international IPs from all over the world but can also connect IPs to local attorneys in their home country for further guidance.
International IPs are recommended to buy flexible or open airline tickets since the timeframe for finalizing the parental establishment can vary. It is usually not possible to add your baby on the ticket until after the birth. Baby cots or other special equipment may be unavailable, meaning that you must keep your baby in your lap for the duration of the flight. Some airlines allow for the baby’s car seat to be used during the flight, but we recommend checking with the airline well before your departure.
Most agencies and clinics do not assist with booking your accommodation or making other necessary travel arrangements, but some do, making it worthwhile to ask the agency/clinic staff. Most international IPs rent an apartment long-term with vendors such as Airbnb or VRBO or stay at hotels with a kitchen or kitchenette. Hatch’s in-house clinic PFCLA offers unique accommodation before and after medical procedures in partnership with Immortelle Med.
Most international IPs do not have a U.S. insurance policy which will cover medical expenses related to childbirth in the U.S., nor are they able to purchase such an insurance for themselves. This means that international IPs must consider what is best for protecting themselves financially in the event of unexpected events after delivery.
Newborn Insurance aims at covering the costs of some high-cost scenarios such as a newborn stay in the neonatal intensive care (NICU) or other unexpected services such as ambulance rides, etc. The costs for such incidents can be very high in the US if the patient (the IPs and the child) are not insured. Normal delivery fees in the US can range roughly from $3,000 to $5,000. This is sometimes, but not always, covered by Newborn Insurance plans. NICU stays can exceed $100,000 or more if not insured.
While most agencies don’t include Newborn Insurance in their plans, they guide international IPs through the jungle of insurance options. Hatch recommends international IPs to speak to one or several insurance experts, such as ARTRISK, Surroplans, and International Fertility Insurance to understand their options and how they can best protect themselves. Hatch recommends International IPs connect with one or more insurance experts as soon as possible given that some newborn insurance plans need to be put in place even before the embryo transfer.
The cost for Newborn Insurance can generally range from $10,000 up to $15,000 (or more), depending on the level and duration of coverage that the plan offers. If considering twins, newborn insurance can exceed $100,000, if even available.
If you’d like to get to know us more, we offer in-person and virtual events throughout the year to provide resources and education about third-party reproduction. Get a chance to ask questions and learn from experienced intended parents, egg donors, and surrogates.
For more information, book a consultation with our International Manager, Edvin.
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