By Deborah L Cohen
CHICAGO, March 18 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.
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. "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
surrogate. 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.
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
contractual details. "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 U.S. Affordable Care Act pulls more people into health
insurance coverage. 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 to $35,000, excluding legal and medical fees.
Depending on the parents' situation, Von Halle typically asks
them to set aside anywhere from $75,000 to $120,000 for the
entire process. 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,
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
"We have a three-to-six-month wait" to find a surrogate,
said von Halle, whose agency works with both domestic and
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 U.S. 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.
"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 2005. Circle, too, has a waiting
At Circle and other reputable matching organizations, the
screening process is rigorous for both sides. Weltman rejects
about 99 percent 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 them."
While many intended parents struggle to foot the costs for
surrogacy out-of-pocket, there are some alternatives cropping
One is CapEx MD, a five-year-old private financing company
that helps parents pay for a range of alternative reproductive
services, including surrogacy.
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.
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