The LGBTQ2+ road
For LGBTQ2+ people planning on having a child of their own, fertility bills often start arriving far earlier than the baby. Knowing what awaits you in clinics and lawyers’ offices — and what the costs may be — can help prepare you for a road to baby-making that is rarely straightforward.
Originally published March, 2017
If you are an LGBTQ2+ person, you know the manual on having kids is still being written. In fact, it may be a long time before the final editions are complete. Changes in society, in the legal world and in fertility science all mean family-building will continuously evolve — and nobody’s baby stories will be exactly the same.
For instance, the costs of family-building for people who use reproductive technologies begin a great deal earlier than for most couples and are considerably more expensive than diapers. It’s important to understand the intricacies of the family-building process and enlist expert financial advice along the way.
Heather Richardson, Vice President, TD Wealth, says that family planning for the LGBTQ2+ community can have additional bills that most heterosexual couples may not have to worry about, but the strategies for meeting those costs are the same as meeting any other financial goal. People need to plan ahead and design a financial strategy to ensure they have the money to create a family. “You have to be crystal clear on what your desired outcome is and you have to put a plan in place to achieve it,” she says.
Andy Inkster is a Health Promoter at the Sherbourne Health Centre in Toronto that services the LGBTQ2+ parent community. He says, “the range for surrogacy, for instance, including egg donation and in vitro fertilization (IVF) procedures and legal costs can be anywhere from $30,000 to $150,000 with around $70,000 being typical — that’s a lot of money. People ask, ‘How are we going to pay for this?’”1
Take Mary and her partner Norah*, from the Greater Toronto Area. Mary said 15 years ago there weren’t a lot of obvious avenues out there for them to build a family. They tried different routes to start their family, finally opting for home insemination with a known donor since the costs were low and they felt uncomfortable about shopping for a donor in a catalogue.
IUI: Intrauterine insemination
A fertility procedure in which sperm is introduced into the uterus when a woman is ovulating. Cost: $500 per insemination. Donor sperm: $1,000 – $2,000 per cycle.
David Clemmer, television personality and celebrity stylist, and his partner Stéphane Aubin, used surrogacy, but were completely unprepared for the twists and turns their road to parenthood would take. “It doesn’t matter how you much you plan, if the universe has something else in store — you’re powerless — decent bank account or not,” says David.
For those who do not want to adopt and wish the child to have a parent’s DNA, fertility procedures and drugs are expensive, as are obtaining eggs or sperm. Every couple or individual starts from a different place and must make decisions as procedures and events dictate. If the parents-to-be are healthy, the ‘having a baby’ challenge means obtaining eggs or sperm, moving through fertility procedures to ensure pregnancy and, if the intended parents are men, finding a gestational carrier or surrogate.
Visiting your doctor and a fertility clinic is usually a good idea before prospective parents embark on the road to family building. In addition, since fertility law in Canada is evolving, a trip to an experienced lawyer will help everyone see what the legal implications are once a child is born since same-sex couples still face legal ambiguities and complexities.
One aspect of Canadian law people must consider is that altruistic egg and sperm donation or surrogacy — where no money changes hands — is legal in Canada. However, it is illegal to purchase eggs or sperm from a donor or a person acting on behalf of a donor. It is also illegal to pay a surrogate to carry a child, although it is above board to pay for expenses relating to the pregnancy.
Inkster says in his experience a successful pregnancy is the usual outcome at most fertility clinics. But when considering costs, he says potential parents must understand some techniques are tried without success three or four times before a couple moves on to a different method of conception, and all those ‘misses’ cost money.
IVF: In Vitro Fertilization
A fertility procedure in which a woman’s egg is removed, fertilized with sperm in a lab. Once the egg has begun to grow, the egg is replanted back into the woman or into a gestational carrier who carries the fetus to term.
IVF medications: $3,000 to $8,000 per round.
Note: As of October, 2015, Ontario became the first province to fund the first round of IVF, including ICSI, for women under 43.
Mary and Norah: Home insemination
Mary and Norah, after a long search for a donor, have a friend, Daniel, who stepped forward to volunteer. It was ideal for them because they wanted their child to have some kind of father-figure in the family.
The couple used home insemination and — success! — Norah got pregnant. While Mary and Norah were lucky that time around, a few years later they wanted to get pregnant again and this time have Mary carry the baby. Home insemination did not work so they opted for help from a fertility clinic. Next they tried intrauterine insemination (IUI) with the help of fertility drugs, but there was no success. They moved on to one round of (IVF) but Mary still didn’t conceive.
At this point they decided that Norah may have a better chance of becoming pregnant again through home insemination and Mary and Norah had their second child in 2011.
The costs of LGBTQ2+ family building
It is difficult to give specific numbers for the costs of having a child using a fertility clinic because of the individual situations families face. There could be different fertility needs and familes may have a variety of resources at their disposal. As well, associated costs can grow depending on the progress of each fertility treatment.
In addition, government and insurance coverage for procedures and fertility drugs vary depending on the province you live in. A fertility clinic may or may not be for profit and fees will differ accordingly. Counselling and administrative costs may be separate costs or form part of larger fertility fee.
Incidental expenses also have to be taken into consideration. If a couple needs a surrogate, they’ll need to pay for any expenses relating to the pregnancy. This can range from taking cabs to the fertility or the maternity clinics, reimbursing the surrogate for missed wages or paying for a nanny to look after existing children.
The Road to Family Building
1. LGBTQ2+ individuals have a variety of fertility methods at their disposal with a corresponding array of costs but fertility treatments, and sperm and egg banks push the costs considerably higher.
2. If a parent chooses to work with a fertility bank, they must make decisions about the child’s genetics. Egg programs usually start at $10,000; sperm can be $1,000 to $2,000 per insemination.
3. People may wish to utilize a surrogate who may carry her own fertilized egg or have a fertilized egg transferred to her. Surrogates can’t be paid but couples could pay for fees like compensating for missed work.
4. The first fertility procedure may be IUI. Costs may start at $500 per cycle but fertility drug cycles may push costs higher.
5. If IUI is ineffective the next step is IVF, which is $8,500 per round. IVF medications can be $3,000 to $8,000 per round.
6. For surrogacy, all parties should seek legal advice. In all cases, seek qualified legal help before you begin your family; costs can vary widely depending on your situation.
Everyone’s situation and road to parenthood is different so costs vary accordingly. As well, provincial health coverage, clinic fees, insurance and drug coverage can vary widely.
David and Stéphane: Using a donated egg and surrogate
While the procedure for IVF is the same for any couple, gay men, like David and Stéphane, must also seek out an egg donor and surrogate. The donor selection includes considerations about the donor’s characteristics, such as skin colour, and couples may opt for a known or altruistic donor. For instance, a sister of one of the men may volunteer her eggs and/or agree to carry the pregnancy. In that case, the costs are minimal, but if prospective parents need to go to an egg bank, the costs involved are quite a bit higher.
“Egg donor programs work in different ways, and fees — usually over $10,000 — are paid to an egg bank, who then sends frozen eggs to the fertility clinic you are working with,” Inkster says.
“Stéphane and I agreed we would split the egg count and each fertilize 50% of the eggs harvested. We implanted two embryos each time . . . and we prayed to the ‘baby gods’ that at least one would take,” David says. David and Stéphane found the process of seeking a surrogate unbelievably overwhelming.
“Imagine picking from 2,000 strangers the person you want to carry your child. Yikes,” recalled David.
They selected a married woman with two children who lived two hours away from their home in Toronto who had previously been through the IVF process with her own first child. Their first embryo transfer was successful and they waited expectantly for the six-week ultrasound with their surrogate.
“The tech performing the ultrasound had a look on her face we will never forget. She left the room quickly and returned with the IVF doctor,” recalled David.
ICSI: Intracytoplasmic Sperm Injection
A procedure in which a single healthy sperm is selected and implanted into an egg. Cost: $1,500.
The doctor explained it was a tubal pregnancy that would need to be terminated. Tears all around — but they all decided to try again.
Following this, the couple learned their donor couldn’t provide any more eggs. After a long search, Stéphane’s (adopted) cousin volunteered her eggs and they tried again. Again, they had success. But again they had another tubal pregnancy.
The third try was the charm. Their daughter Frankie was born in January, 2016.
LGBTQ2+ parents are strongly advised to work with a lawyer who is versed in fertility law throughout the family-building process, says Sara R. Cohen, founder of Fertility Law Canada. But she said it is hard to ballpark legal costs because there are so many different paths for parents, and everyone’s situation is different. For example, surrogacy is more expensive in terms of legal fees than is gamete donation, and parents may need different services, requiring both egg donation and surrogacy, sperm donation only, or sperm donation, egg donation and surrogacy.
Cohen says, Ontario’s recent legislation, the All Families Are Equal Act, made great progress removing obstacles for LGBTQ2+ parents. The Act eliminates discrimination against same-sex parents by removing the legal requirement for parents who use a surrogate or donated cells to formally adopt their kids or to draw up a declaration of parentage. But Cohen says there are still problems that the Act could have addressed but didn’t.
She said that the law stipulates surrogacy agreements between parents and a surrogate are no longer enforceable. This means that if a surrogate changes her mind about keeping a child, it is unclear how a court would rule if there is an agreement in place specifying her previous intentions to just carry the child. To protect all individuals involved in the evolving legislative world, she strongly recommends agreements be drawn up to establish, for instance, the aims and wishes of the parents, altruistic donors and surrogates (as applicable), and that all parties obtain independent legal advice on the agreements.
The term for a woman who carries a fetus to term for another couple. Also known as a pregnancy surrogate.
Saving for a family
TD’s Heather Richardson says that preparing yourself financially will take some of the stress and anxiety out the process. She said unfortunately the final costs are not known until the baby arrives. “There’re a lot of unknowns going into this. It may be that an individual or a couple has set aside a significant amount of savings and they can go through that very quickly,” she says.
But she said that planning a budget, paying the fixed costs like mortgages and credit cards, and then adjusting discretionary spending by changing lifestyle expenses may help you reach your goal. And if you are a home owner, you may be able to tap into the equity of your home.
But above all, she said those who are family-building must feel comfortable working together and sharing these aspects of their lives with a financial planner.
Happily ever after
With her family now in place, Mary is able to reflect on how her family came together and the roles everyone plays. There are two moms on the kids’ birth certificates and their friend Daniel has a managed relationship with her children, but the structure and dynamics of the family did not come without discussion and sweat.
“The only ones who have never been bothered by any of this stuff were the kids themselves . . . . They just have three parents and they are totally cool with that and they don’t have any problems expressing love for us and more.”
David Clemmer said their child was the best investment they ever made.
“If we knew before that this would be our path, we may have gone another route. So it’s a blessing in disguise the way things happened as they did. Otherwise there would be two very sad and very lonely daddies out there missing their little Frankie,” David said.
*Mary, Norah and Daniel’s names have been changed.
— Don Sutton, MoneyTalk Life