Infertility is the scourge of modern society. Specialists identify three main reasons for the inability of women to become pregnant. These are mainly ovulatory disturbances (36%) and tubal patency problems (30%), in the third place is endometriosis (18%). But reproductive medicine does not stand still.
The American professor Bruno Lunenfeld, the general secretary of the Asian-Pacific Initiative on Reproduction, President of ISSAM, reports that, as of now, over 12 million babies have been born as a result of ART. Thanks to progressive assisted reproductive technology, already in the 80s the number of successful deliveries increased from 5-10%, and now their number reaches 40%.
The inability to conceive a baby in the conventional way forces couples to use assisted reproductive technology, such as pre-implantation genetic diagnostics, surrogacy, and human genomics. In this case, another woman carries and gives birth to a child for a couple.
To better understand what kind of surrogacy is recommended and available to a childless couple, let us first consider the following types of surrogacy:
In the latter, the following types can be distinguished:
The most important criterion for the availability of surrogacy is the remuneration for a surrogate mother. In this case, surrogacy can be:
Surrogacy in most cases is used to treat female and even male infertility. However, it also happens as a consequence of a social phenomenon. The following life circumstances force people to turn to a surrogate mother for help:
In a number of countries where surrogacy is allowed, it is impossible to turn to a surrogate mother for a service without a direct medical prescription (for example, in Russia, Belarus, Georgia, etc.). The clinics warn in advance of this limitation. But often, in such cases, the clinics conduct an examination, and their specialists give such a conclusion.
Since the service itself is delicate and confidential, the doctors cooperate in the conditions of non-disclosure, a clause that is necessarily written in the contract. Therefore, the most striking example of surrogacy are people who are always in sight - artists, actors, politicians, just rich people. In the world elite, surrogacy services are becoming more and more popular.
For example, the king of pop Michael Jackson became the father of his third child from a surrogate mother. The star of the series “Sex and the City” Sarah Jessica Parker used the service of a surrogate mother and now brings up two twin girls. And the legendary football player Cristiano Ronaldo became dad three times, and all thanks to a surrogate mother. The outrageous celebrity Kim Kardashian and rapper Kanye West experienced the joy of parenthood for the third time after the birth of the baby Chicago from a surrogate mother. Maestro Elton John and his partner David Furnish, after an unsuccessful attempt to adopt a Ukrainian baby, decided to turn to the services of a surrogate mother twice. Now the star couple are the parents of two healthy boys. And the singer and actress Kandi Burrus recently became the mother for the third time, and also thanks to surrogacy. There are many such cases, which gives evidence that surrogacy is effective and safe.
What if a woman wants to carry and give birth to a child herself, without involving another woman? Or if a couple is very conservative and religious, and faith forbids the use of such modern ART method as surrogacy? There is an alternative in the form of uterine transplantation.
A uterine transplant is a surgical operation in which a healthy organ is transplanted into another woman's body. Transplantation is performed only from close relatives (sister, mother, father's or mother's sisters) for a better match of the type of blood and tissues.
Let us consider the advantages of this method to combate infertility:
Now let us pay attention to the weaknesses of the method:
When a couple turns for uterine transplantation, the specialists:
Based on the foregoing, it is clear that for the successful completion of a set of tasks, from transplantation of the uterus to the birth of a healthy child, it is necessary to have too many positive factors. Ukrainian transplantologists have an impressive experience in uterine transplantation. The Prof. Feskov Clinic offers its clients a similar operation in rare and complex cases. When the donor and the recipient have satisfactory somatic health, and the transplanted uterus is biologically sound in order to fully perform its function. All this is determined already at the preliminary consultation. The preferred recommendation, confirmed by our experience and knowledge, is surrogacy. If we compare this method with surrogacy, then its effectiveness is lower, and the price, respectively, is higher, as are the risks. [https://www.eshre.eu] Operation itself, medication, rehabilitation require large expenses, both material and moral. For guaranteed success, surrogacy packages are the optimal solution.
The attitude in society towards surrogacy is ambiguous. Some believe that this is an immoral act of turning a child into a product and exploiting the female body. Others think that this is the only opportunity for childless people to get a genetically own baby. We discussed this issue in our other article.
Let us dwell in more detail on state regulation of this issue. Surrogacy is strictly prohibited by law in Muslim countries - Pakistan, Turkey, Saudi Arabia, as well as in Japan and China. Germany, Sweden, Switzerland, France, Norway, Austria forbid at the legislative level to use surrogacy. Some states of America - Arizona, New Jersey, Michigan also prohibit this.
Choose your country of citizenship:
There are jurisdictions that allow the use of surrogate services, but on an altruistic basis - these are the Australian state of Victoria, Portugal, Canada, Great Britain, the US states of New Hampshire, Virginia.
In many European countries, such as Belgium, Spain, Greece, the Czech Republic, there are no clearly defined legislative acts on surrogacy, but in fact it takes place. This means that future parents do not receive any legal guarantees - a surrogate mother can take the newborn for herself, and they, having paid for procedures, will be left with nothing.
It is worth noting that in some countries (Canada, the Netherlands, Finland), the relevant law prohibits anonymity in matters of surrogacy, IVF or donation of biological material. This also obliges parents to provide complete information about the donor and the facts of birth the child over 18 years of age.
|Country||Rules regulating surrogacy||Risks/advantages||For foreign citizens||Type of surrogacy|
|Albania||not regulated by law||no legal guarantees||+||commercial|
|Argentina||no final laws||no legal guarantees|
|Armenia||allowed||specific mentality, strict traditions, medum quality medicine||commercial|
|Australia||no clear laws||no legal guarantees, anonymity prohibited||+||altruistic|
|Belarus||allowed for heterosexual couples and single women for medical reasons||citizenship for baby, medum quality medicine||+||commercial|
|Belgium||not regulated by law||no legal guarantees||-||-|
|Brazil||no final laws, for medical reasons||no legal guarantees||altruistic|
|Bulgaria||allowed for heterosexual couples citizens of the country for medical reasons||partial limitation||-||altruistic|
|Canada||Completely allowed, except Quebec||citizenship for baby, anonymity prohibited||+||altruistic, not more than 22 000$|
|Chile||not regulated by law||no legal guarantees||-||-|
|Colombia||no final laws||no legal guarantees||-||-|
|Cyprus||no final laws||no legal guarantees||-||altruistic|
|Czechia||not regulated by law||citizenship for baby||+|
|Ecuador||no final laws||no legal guarantees||-||-|
|Georgia||allowed for heterosexual couples for medical reasons||citizenship for baby/ strict traditions, medum quality medicine||+||commercial|
|Great Britain||legalized only for citizens||no legal guarantees, anonymity prohibited, citizenship of parents is required||-||altruistic|
|Greece||allowed for heterosexual couples and single women for medical reasons||citizenship for baby||+||commercial, not more than 12 000 euro|
|Hong Kong||Not used||-||-||-|
|India||allowed for indian heterosexual couples for medical reasons||citizenship of parents is required||-||altruistic|
|Ireland||The laws are being developed||no legal guarantees||-||-|
|Israel||allowed for Israeli heterosexual couples||citizenship of parents is required||-||commercial|
|Kazakhstan||allowed for heterosexual couples||birth certificate issued immediately, medum quality medicine||+|
|Kenya||allowed||birth certificate issued immediately, low quality medicine, specific phenotype||+|
|Korea||no final laws||no legal guarantees||-|
|Kyrgyzstan||allowed for heterosexual couples||specific mentality, strict traditions, low quality medicine||commercial|
|Laos||no final laws||no legal guarantees||+|
|Mexico||no final laws||no legal guarantees||-||-|
|Netherlands||no final laws, advertising the service is prohibited||no legal guarantees, anonymity prohibited||-||altruistic|
|New Zealand||no clear laws||no legal guarantees, anonymity prohibited||+||altruistic|
|Nigeria||not regulated by law||no legal guarantees||+|
|Portugal||allowed for heterosexual couples for medical reasons||anonymity prohibited||+||altruistic|
|Russia||allowed for heterosexual couples and single women for medical reasons||citizenship for baby, not full legal guarantees||+||commercial|
|South Africa||Only for citizens||no legal guarantees||-||altruistic|
|Ukraine||allowed for heterosexual couples for medical reasons||citizenship for baby||+||commercial|
|USA||Completely allowed, except some states||citizenship for baby||+||commercial|
At the same time, Ukraine, Russia, Georgia, many US states have fully legalized this method of reproduction. It is successfully used by people who want to have a baby.
Bill Houghton, head of Sensible Surrogacy, a consulting company, said: “These are mainly representatives from England, Sweden, Germany and France. Half of them are traditional couples, half are homosexual.” At the same time, it is even more difficult for representatives of non-traditional sexual orientation - they can use to this service without problems only in the USA and Canada.
With all the advantages of the countries of North America in this matter, in Canada there are a number of restrictions on surrogate motherhood, and in the USA it is very expensive. Not every childless couple can afford such a luxury.
On the European continent, only in Greece and the Czech Republic is it possible to use the services of a surrogate mother, and even then with restrictions. For example, in the Czech Republic, a surrogate may leave the child with her until she signs child abandonment. And after the surrogate’s child abandonment, future parents will have to go through the bureaucratic procedure of adopting their own child. And the fact that it is simplified does not console much. And in Greece, to become full-fledged parents, a court decision is required; without it, the surrogate is recognized as the mother of the child.
The surrogacy service is also allowed in Kenya, but the specific African phenotype, the level of medical service and the particular location make this state not very popular for surrogacy tourism.
Surrogacy is legal in Ukraine, Russia, Georgia, Kazakhstan and Armenia. However, there are pitfalls. In Georgia, the quality of medicine is not very high, the Georgian phenotype is specific (in case of oocyte donation) and there are strict conservative traditions. The same is true of Armenia and Kazakhstan. Surrogacy here seems to be allowed (with certain restrictions), but in practice it is almost never used.
Russia is a rather loyal country to surrogacy, but excesses are also possible here, since the concluded service agreement does not give any guarantees for its execution. It happened in the case of the Frolov family and the surrogate mother T. Suzdaleva. Despite the court decision in favor of the Frolovs, Suzdaleva continued litigation throughout the year so as not to give the two boys to their biological parents. [https://spb.aif.ru]
Based on the foregoing, the benefits of Ukraine are obvious here – a convenient geographical position, health and cleanliness of Ukrainian women, loyal laws, medical services and high-level services with guarantees, and prices are much lower. Below you can compare the prices for surrogacy in different countries:
|Country||Price||Legalization of a child||Quality of medicine||Advantages|
|Russia||60 - 80 000€||Child abandonment of the surrogate mom, birth certificate issued||High enough level||citizenship|
|Ukraine||50 - 80 000€||Birth certificate issued||High enough level||citizenship|
|Greece||75 - 85 000€||Simplified adoption||High enough level|
|65 - 85 000€||Child abandonment of the surrogate mom, simplified adoption.
The surrogate mother can keep the baby
|Georgia||30 - 60 000€||Birth certificate issued immediately, child abandonment of the surrogate mother not needed||Average level||citizenship|
|Kenya||40 - 50 000€||Birth certificate issued immediately, child abandonment of the surrogate mom not needed||Average level|
|Canada||100 - 110 000€||Birth certificate issued immediately||Very high level||citizenship|
|The USA||110 - 180 000€||Birth certificate issued immediately||Average to very high level||citizenship|
We have every reason to affirm that Ukraine is one of the world centers for surrogacy.
Over the past 18 years, with the direct use of ART programs, more than 54 thousand babies were born in the country. Due to progress in Ukrainian reproductive science, high fertility rates for children under the surrogacy program have been obtained.Feskov A.M. Prof. of Medical Sciences, member of ASRM, ESHRE, UARM
These numbers are approximate and may vary depending on the conditions of the program. For example, some clinics in Ukraine provide a very high quality of medicine through cooperation with American clinics, but the price of the contract is lower than a direct contract with an American institution.
Usually a childless couple turns to a surrogate agency that provides a database of surrogate mothers and egg donors (if required), and also finds a suitable clinic. An agency also leads the whole process from beginning to end, provides legal, consulting and other intermediary services. But you can go directly to a reproductive clinic. Note that there are clinics that do not work directly with a client, but only through an agency. But there are also clinics that do not work with agencies. The latter necessarily have their own base of surrogate mothers and donors. Compare the advantages of both cases:
Thus, there is both an advantage of working with a mediation agency and risks.
Often people wonder how to find a serious reproductive clinic and determine its reliability. Based on our experience, we provide the following criteria that will help choose a well-established and trustworthy medical institution:
In turn, let us also consider the criteria of reliability of a surrogate agency:
On average, payments are as follows by country:
This takes approximately 20-50% of the total budget. Is it much or little? Whether it is worth it is up to you. But if you are worried about the price, then you should remember that the final cost of the service may differ from that which you initially were told by an agency or clinic. Often the amount you see does not include the surrogate mother fee or the number of transfers of embryos. Usually an agency enters into a contract with a clinic, which indicates one, maximum two, transfer of an embryo, as the profit of the agency decreases with the increase in the cost of the clinic fee.
To understand how much the total amount for the surrogacy service can change, let us take a closer look at what the cost of surrogacy consists of.
A reproductive program involving a surrogate mother is quite expensive. Depending on the country of provision, the cost varies from 30 to 180 thousand euros. The price strongly depends not only on the country, but also on the agency or clinic providing the service. Of course, the type of service, as well as its components, are different. You should be aware that there are required and optional costs during the process. Expenses begin already at the stage of examination, both of a couple and of a surrogate mother.
|Country||Price||Quality of service|
|USA||110 - 180 000€||Very high||You have to pay for everything separately|
|Canada||100 - 110 000€||Very high||You have to pay for everything separately|
|Greece||75 - 85 000€||High enough|
|Russia||60 - 80 000€||High enough|
|Ukraine||50 - 80 000€||High enough||You can choose package programs with a guarantee|
|Georgia||30 - 60 000€||Average||Allowed for married heterosexual couples, phenotype features, traditions|
|Kenya||40 - 50 000€||Average||Allowed for everyone, phenotype features|
Payments to a surrogate mother begin from the moment of her pregnancy. The cost of treatment varies depending on the course of pregnancy, difficulties encountered, complications and postpartum problems. Of course, all medical expenses are required.
For example, the in vitro fertilization procedure itself costs:
The amount is influenced by factors such as:
It should be noted here that reproductive activities (fertilization, microscopic examinations, embryo selection, etc.) in countries with expensive high-quality medicine can be quite costly. For this, a clinic should have special modern equipment and specialized doctors. The best solution is to carry out such delicate and costly actions in Ukraine, with the quality of the level of leading medical institutions. So the total cost of the package in our Prof. Feskov Clinic with the delivery in the United States will be much cheaper than the same procedure in the United States.
So, the reproductive actions include:
When turning directly to the clinic - there is no fee for intermediary services, and the clinic itself puts more in the budget in the medical part of the program. In good clinics, the number of embryo transfers is unlimited, up to successful delivery. We designate the budget for the cost of medical procedures and IVF up to 50%. The budget may be lower depending on the amount of IVF needed.
Some clinics provide an opportunity for future parents to involve their surrogate mother in the program. We are often asked a question - is it possible to become a surrogate mother for your sister or even son? Yes, it can be a relative or close friend. We understand that the birth of a baby is a delicate matter, and you want to entrust it to a person close to you. The cost of the entire service in this case will be lower than when a surrogate mother is provided by the clinic.
Not every woman can be a surrogate mother, let us consider the basic requirements for her:
For future parents, it is not so important how a surrogate mother looks phenotypically, more important is cleanliness, health, decency and responsibility; willingness to help become parents, psychological stability. Also, a surrogate mother is obliged to abandon bad habits during the course of pregnancy.
Sometimes clients come with specific requests: for example, the American reproductive doctor Ashid Kumar says that one Englishman demanded that a girl who must have completed Harvard be the donor of oocytes. “Of course, we found her, but it was very expensive,” Ashid laughs.
Financial compensation to a surrogate mother for participation in the program can reach 25% and it includes:
This also includes directly the delivery of a surrogate mother, which is a rather costly process. Especially if the birth will take place in the United States or Canada. In this case, the amount will be different. However, the fee of a surrogate mother from Ukraine, who gave birth in the United States, will be significantly lower than the fee of a surrogate mother from the United States. This allows to reduce the price of the surrogacy service with its high quality.
Cost of surrogacy with agency services
Cost of surrogacy without agency services
In addition to all of the above, you will have to spend money on legal services and the preparation of relevant documents, including those for a future child. And also, trips to the necessary country, with a stay there - it will also require a part of the budget.
|IVF fertilization “in vitro”||5000 – 40 000€ +|
|Additional medical procedures (material donation, several IVF attempts, etc.)||3000 – 15 000€ +|
|Surrogacy agency||8000 – 30 000€ +|
|Legal support (country of destination)||6000 – 9000€ +|
|Surrogate mother financial compensation||10 000 – 40 000€ +|
|Other expenses (travel, force majeure, insurance, deposit, etc.)||10 000 – 30 000€ +|
|TOTAL||50 000 – 180 000€|
Some clinics provide clients with package programs, such as "all inclusive", adapted to different requests. In this case, the clinic becomes interested in high-quality and most successful embryo transfer. This is especially beneficial if a couple have issues that complicate the procedure (age, bad habits, etc.). For them, this is the best option. Having paid such a program once, future parents no longer pay for anything and can calmly be engaged in the process. Having arrived in the city where the clinic is located, you will not have to look for a hotel, arrange accommodation and solve many other problems. In a normal high-quality service, everything is provided, down to the smallest detail: transfer, translator, legal services, accommodation, meals, medical examination, rest program and even the provision of a local SIM card. The package program includes not just an examination of a man, but also his preliminary treatment by an andrologist (in case of problems). Indeed, in surrogacy, 30-40% success depends on the reproductive functions of future parents.
All participants in surrogacy programs are concerned about the question - where to start? How is everything happening? Let's review the procedure step by step. The whole surrogacy process can be divided into stages. Some of them can be done remotely, without the arrival of future parents in the country.
Remember: surrogacy is a serious step, it is the future of your family. This is the destiny of your child, of a new human being. Your choice and actions should be 100% correct. In any case, feel free to ask our experts any question about surrogacy.
The Prof. Feskov Clinic has been working in the reproductive technology market for over 15 years and is one of the best in Ukraine. Our leading experts have developed technologies that are the standard in global surrogacy. Our advantage is package programs, which include an unlimited number of IVF attempts, special offers and guarantee. Our clients are sure to become parents. We solve all medical, legal, logistic and business issues. Sensitive attitude to clients, attentive accompanying through all stages, round-the-clock support give comfort and peace to future parents while waiting for their own baby.