Surrogacy is expensive, and to couples who know they want more than one child, it can feel even more so. 

For many, this can make the idea of twins (transferring two embryos in one procedure), feel financially attractive. Reproductive endocrinologists (REs) now recommend that only one embryo be transferred at a time, as singleton pregnancies are healthiest for the baby and for the surrogate. There are many more risks with a multiple pregnancy.  Twin pregnancies and deliveries are more expensive in terms of healthcare costs than singleton pregnancies and deliveries, not to mention insurance costs and NICU costs. Multiple pregnancies tend to be delivered earlier, which gives them a much higher chance of NICU time for the babies. Many surrogates are not willing to consent to a double embryo transfer as they do not want to intentionally put themselves in a position of carrying multiples.  There is already a risk of any given embryo splitting; so one embryo could become two fetuses and two embryos could become three or four fetuses!

While we understand the appeal of doing a double embryo transfer, our recommendation is two separate surrogacy journeys. The first journey with one partner’s genetic embryo and the second journey with the other partner’s genetic embryo. Under current ASRM guidelines the gestational carriers need to not be pregnant at the same time.  This is meant to have less risk for the surrogate and future children. We understand this takes more time; however, given higher insurance costs, NICU time and higher compensation to a gestational carrier it doesn’t necessarily mean twice the cost.

When looking into surrogacy and working with your fertility clinic, you should speak with your RE about the option of creating embryos using the same egg donor and the biology from each of you. In this scenario, half of the eggs will be fertilized with one partner’s sperm and the other half with the other partner’s sperm.  Of course, that doesn’t guarantee each partner will have the same number or quality of embryos, but this allows options to be explored for genetic parentage for each.

If that’s the route you pursue, how do you decide whose genetic embryo to use first? You need to talk with your fertility doctor/RE, your surrogate, and possibly even a counselor. Having open and honest communication with your partner and a plan going into this process is important. Other things to consider are semen and blood analysis, and then the genetic screening of the embryos.  Many of these tests can tell you about genetic issues or the quality of the embryos and can help you determine which embryo to use, with the advice and direction of your RE.

Another option to consider is having a genetic relative of one partner donate eggs and the other partner use their sperm in the creation of embryos.  This could be a sister or a cousin that is close relation that is willing to donate eggs and gives that genetic connection to both partners.

If you are looking for an agency, you can schedule a free consult with us here.