Single and gay fathers may have the most complex journey to parenthood of any group that shows up at a fertility clinic. The number of parties that need to be selected, and coordinated, can be as dizzying as the total cost.
So where do you start? Some say start with finding a clinic, because they may also be able to provide an egg donor and save you the agony of a donor search. Others believe you should start with finding a surrogate because that is the hardest and longest search and until you have that in place, all timelines are tentative. Others suggest starting with finding a donor because if that falls through, your surrogate won't wait and will move on to the next couple.
There are really two choices when it comes to locating an egg donor. The first is to go the "known donor" route, which involves using the eggs of someone a parent knows. In the circumstance of a gay couple, that often means a relative or sibling of the partner not contributing sperm. The benefit here is that both partners get to have a biological relationship with the child, but this choice requires a fair amount of work to make sure the arrangement is optimal for all parties involved.
Another route is to locate an egg donor through an agency or an egg bank. This option is more expensive than using a known donor because it involves paying a third party to do the matching. The pros to going through a clinic: the process is cheaper, donors have been closely vetted, and the clinic handles most of the logistics to obtain the donor's eggs. The pros to using a standalone agency: their pool of donors is often larger, and you're likely to work directly with the owner of the agency.
You can expect to pay a donor anywhere from $5,000 - $30,000 and an agency $3,000 - $15,000. While the difficulty of the donor search pales in comparison to a surrogacy search, it can still be frustrating. There is a finite supply of desirable donors, and they can get taken "off the market" relatively quickly.
The first thing to consider when it comes to finding a surrogate is the law in the state in which she lives. States like California and Connectituct have laws that make paid surrogacy agreements enforceable, and states like New York and New Jersey do not. The implications are that the surrogate may, or may not, have a legal claim of parentage over the child once it's born.
Most intended parents locate a surrogate through an agency which, like egg donation agencies, are often small businesses operating in an unregulated field. The degree to which agencies vet their surrogates varies dramatically. Agencies typically charge $15,000 - $30,000 and most add on to their quoted price with additional charges in the fine print.
Surrogates need to meet a number of strict criteria and pass a thorough medical evaluation to ensure they can carry a healthy pregnancy. They must also undergo a psychological evaluation to ensure that they are emotionally able to relinquish the child. Additionally, they need to be comfortable with the fact that the child will be raised in a single father, or gay couple's, household. What's more, there needs to be general agreement on how many embryos will be transferred, and what will happen if there is a need to "selectively reduce," or terminate the pregnancy altogether. Surrogates can cost anywhere from $20,000 - $50,000, with prices climbing if the surrogate has been a surrogate in the past or is willing to carry twins.
Fertility clinics and fertility doctors vary in their approach to protocols, how the clinic opeates, the quality of their laboratory and the prices they charge, amongst other factors. In this circumstance, they also vary in terms of how experienced they are in working with single and gay dads: this process is more complex than it is for most heterosexual couple clients.
There are a spectrum of medical questions for single and gay dads to contemplate, and whether to transfer one or multiple embryos is high on that list. The benefit to transfering multiple embryos is that it increases the odds that a child will result from that transfer, gives each member of a gay couple the chance to become a biological father at the same time, and offers a "two-for-the-price of-one" bonus. The downside to transferring multiple embryos is that health risks rise for the carrier and offspring. Many clinics will say they do not want to do a multiple embryo transfer, but quietly many make exceptions for single dads and gay couples.
By our count, the costs of this process range from $64,000 - $195,000. Unfortunately, most employers will not cover the expense. But there are ways in which single and gay men can defray some of the costs. First, men should have a semen analysis performed and, if the resulsts consistently reflect that the man may have a fertility challenge, he is in a better position to qualify as "infertile" and pick up coverage.
Second, men should look into the spectrum of programs available to help subsidize the costs. Men living in New York may be eligible for a generous subsidy from the state to address medical expenses, and there are other organizations, like Men Having Babies and BabyQuest, that offer grants to address egg donor and surrogacy needs.
Finally, there are plenty of examples of people who have found ways to cut back on the surrogacy process itself by working with no-frills agencies and selecting donors who have been overlooked by other customers.