overview of family building options – surrogacy & donors · us & canadian surrogates...

Asia Seminar Oct 2019

Overview of Family Building Options –

Surrogacy & Donors

Sam EveringhamDirectorGrowing Families


Surrogacy Availability

USA, Canada,

Ukraine, Greece,

Georgia, Russia

Hong Kong

DIY Managed (legal framework)

Malaysia, Laos,

Thailand

Managed (no legal framework or illegal)


What to consider in choice of Country

• Who will be named on birth certificate?

Regulated surrogacy destinations (US, Canada, Georgia, Ukraine, Russia) provide just your name(s) on birth certificate

Unregulated destinations (Cyprus; Mexico; Kenya; Thailand; Africa) have Surrogate + IP on birth certificate

Note who is on BC doesn’t affect your eligibility for citizenship & passports


Your Budget

$915,000

$570,000 $570,000

$375,000 $300,000

$-

$100,000

$200,000

$300,000

$400,000

$500,000

$600,000

$700,000

$800,000

$900,000

$1,000,000

USA Greece Russia Ukraine Georgia

HK D

olla

rs

Country Engaged In

Total


KEY DECISIONS


Do you need an egg donor?

Friend/family member

from donor community (known)

from donor database (known or anonymous)


• 30-40% with eggs from 30 yr old




Success Rates Based on Egg Provider Age


What to consider in choice of Country

• Your comfort with known vs unknown donor

Country Donors

Greece Anonymous

Ukraine Anonymous

Georgia Known

US Known or anonymous

Canada Known or anonymous

• Think about the rights of your child to write to their donor


What to consider

• Altruistic vs agency –managed (compensated)• Altruistic comes with more risks of

• Surrogate dropping out /not continuing• Surrogate not following protocols/ getting pregnant with someone else


Some Countries Require Patience

Country Demand for surrogates

Supply of surrogates Wait times

Hong Kong Low Low ?

US High High 2 – 6 mths

Canada High Low 12 mths +


Altruistic (Hong Kong/Canada) means longer timelines

• Parents using altruistic often report

• Longer wait times to match with a surrogate (12- 18 mths)

• Surrogates dropping out

• Unsuccessful transfers / poor success rates

• spiralling timelines, costs & stress as surrogates and donors are changed

after repeated failure


Others are Quicker But Not all Eligible

Country Demand for surrogates

Supply of surrogates

Wait times Eligibility

Greece Low Low 1 - 2 mths Heterosexual couple, single women

Ukraine High High 1 - 2 mths Hetero married

Georgia High High 1 - 2 mths Heterosexual couple


Processes Differ

Country Process

Greece Up-front court case adds 3 mths

Ukraine Specific medical indication letter

Georgia Shipped embryos need significant paperwork


35 years experience

Best practice

Increased demand

Can be 6 mth wait for surrogate

Child awarded US citizenship

USA


RUSSIA

• Legal framework allows foreigners• Accepts heterosexual couples and singles• Short time to match• Gay men need to go through additional court

case post birth


• Hugely Increased demand

• Number of providers quadrupled

• No shortage of surrogates

• Good screening & medical care

• Prices are rising significantly

UKRAINE


Altruistic

Heterosexual couples & single woman

Both parents on birth certificate

Only a handful of good providers

Anonymous egg donors

IVF clinic plays the role of surrogacy agency

GREECE


What type of surrogate relationship?

Prefer to be Close /supportive - US/Canada/Hong Kong

Prefer more removed - Ukraine/Russia


Should I use a ‘Guarantee’ Program?

• Only available for donor egg surrogacy

• Not available for Canada or US only surrogacy

• Only recommended if you want a capped program for peace of mind

• Otherwise, the costs of adding extra embryo transfers if required are not significant


What to consider in choosing an Agency

Payment stages• What % up-front?• Are payments milestone-based?• What milestones are used?

• Surrogate match• First embryo transfer• Confirmed pregnancy• Week 12• Week 24• Birth

Your funds• If you are not happy with service, what

refunds are available?

• Who holds your funds?• Agency or third-party escrow account



Surrogate Recruitment• Should provide a maximum time within which will recruit surrogate or

refund monies

• What is their recruitment strategy?

• Who handles their surrogate recruitment and screening?

• If surrogate falls through, what is their ‘replacement’ policy?



Surrogate Contact• Should be able to meet surrogate up-front (at least online)


What to beware in choosing an Agency

Parent Referees • Most providers can find at least one parent who will say good

things about them• Need to look at a range of reviews

Law firms who operate their own surrogacy agency• Contracts often favour the agency• Risk not getting truly independent legal advice


What to beware in choosing an IVF Clinic

IVF Success ratesNeed to look at live birth rates (not pregnancy rates)For US clinics can research audited data www.sart.org

For other countries Success data is un-audited

http://www.sart.org/


Risks

Online AgentsWill sell vulnerable intended parents into high-risk, illegal programseg Thai surrogacy with births in China

Malaysian surrogacy


Risks

Multiple Embryo transferUS & Canadian surrogates typically refuse to undertake a double embryo

transfer given the great difficulties in carrying multiples

IVF clinics outside the US & Canada will routinely transfer 2+ embryos

poses a far greater chance of pregnancy complications, miscarriage, very pre-term birth and long-term health issues, additional costs & stress

You need to be firm with your IVF clinic if you don’t want this risk


Risks

Unsuccessful embryo transfersCan increase by

Using egg donor <30 yearsUsing proven donorPGD testing embryos where eggs are from 35+ yr oldThorough testing of IPs prior to embryo creation

MiscarriageA risk in ANY pregnancyEnsure you have a support network


Customised Support

Help you decide on a country/ provider

More hand-holding/concierge style service

Reliable, proven providers to meet your budget

Wide range of options

One hour or complete journey support

Email [email protected] or visit www.growingfamilies.org/customised-support/

mailto:[email protected]

http://www.growingfamilies.org/customised-support/

overview of family building options – surrogacy & donors · us & canadian surrogates...

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