Family law attorneys secure adoption judgments and orders of parentage when a child was conceived with the help of artificial reproductive technology (ART), especially if the child’s parents used third-party reproduction measures. Demand for ART-related family law services is on the rise. Yet, the impact of the state law insurance mandates on reproductive medical care dictate whether and when parents at lower income levels seek a lawyer for assistance obtaining their parentage rights.
ART presents an opportunity to have children despite a diagnosis of infertility. But that opportunity creates a tough dilemma if one’s earnings are modest. The choice to utilize modern medical technology to have children is hard for one obvious but multifaceted reason. Surrogacy, for example, may be the most complex ART path to parenthood. Medical care by a reproductive endocrinologist is a first necessary step for the intending parents (IP). Many life-disrupting moving parts come into play mapping the way forward. More to the point, the journey to parenthood by way of ART measures is a financially brutal one.
Laws that impact accessibility within the health insurance industry may prove to be a complete barrier for someone who is suffering from infertility.
A single cycle of in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and other physician assisted means of conception cost anywhere from $8,000 to $40,000. Add $700 (male gametes) and up to $60,000 (female gametes) if use of donor gametes is necessary. These are out of pocket costs for most patients. Insurance tends to exclude coverage for fertility treatment. Insurers also generally exclude coverage for the expensive medications necessary for assisted reproductive care. The sky-high costs to achieve parenthood in the USA by way of modern medical methods do not end there.
If IP require the help of a surrogate but has no one who can provide “altruistic” surrogacy, then IP engage a compensated carrier. Base compensation for a first-time gestational carrier averaged $55,000 during 2024. The compensation paid is exclusive of expenses incurred by a gestational surrogate as the direct result of participating in a surrogacy arrangement. IP also are responsible for the carrier’s lost wages, childcare for the carrier’s children during instances she is unable to care for her own children due to serving as a surrogate, necessary travel expenses of the carrier and her support person, life insurance, medications, and maternity clothing, for example. If IP need professional efforts to help locate a carrier, then factor into the mix a surrogacy agency.
Agencies recruit, screen, and match surrogates with IP. An agency works to eliminate all foreseeable risks of a surrogacy journey: an agency coordinates all the required steps of a surrogacy arrangement. It navigates all aspects of a surrogacy plan. A skilled, reputable agency can cost approximately $30,000 or up to twice that amount.
The steep price tag is a powerful deterrent to ART in the United States. Somehow, people press forward in the effort to achieve parenthood through ART despite not being affluent members of American society. Many successfully acquire access to an ART journey, at which point family law attorneys enter the picture.
IP engage lawyers to draft, negotiate, and review the surrogacy contract. If all goes well, the attorney later may be called upon to communicate with administrative agencies and hospitals, assist with travel documents, secure court orders, litigate adoption proceedings, or provide similar services required by a particular jurisdiction. Simply put, IP hemorrhage money throughout the entire process.
Differences in the costs revolve around geographic region, the reproductive clinic and other providers used, the medical treatment and legal service needs, and the prior experience of a given gestational surrogate. To an extent, shopping around helps but is unlikely to significantly reduce costs if care is within the same regions of the country.
ART journeys to parenthood demand emotional and financial sacrifice. According to the Data Query System of the Centers for Disease Control and Prevention (CDC), people who utilize fertility care hail from all walks of life. ART is not limited to rich and famous individuals, despite the astonishingly high, insurance-excluded costs of care.
The CDC National Center for Health Statistics and a 2023 Pew Research Center study indicate 42% of the adult population reported receiving fertility care or personally knowing someone who received infertility treatment.
For some, fertility care is possible only due to the generosity of friends, family, and supporters. For others, borrowing money is their way to overcome financial barriers to ART. Consumer loans can bring IP within closer reach to their dreams of having a family via ART.
Unfortunately, personal loans and other unsecured loan products provide little more than a drop in the bucket. This is because, even for IPs with excellent credit, it is difficult to locate lenders willing to extend unsecured credit in amounts sufficient to fund an entire surrogacy journey. Home Equity Lines Of Credit (HELOC) and other mortgage loans are the popular option for IP who go into debt to access the costliest types of ART services.
Grants also are an option. Organizations such as Hope for Fertility, Men Having Babies, and other nonprofits as well as private organizations offer grants. However, the level of competition for any non-loan sources of funds is considerable.
Lastly, benefits of employment are a resource to wage-earners pursuing ART.
Lots of employers offer fertility benefits or reimbursement. Companies known to offer substantial fertility and adoption benefits to their employees include:
Abbott Labs. American Express. Apple. Atlassian. AT&T. Bank of America. BlackRock Inc. Chanel Fashion Company. Cooley LLP. Deloitte. Disney. Estée Lauder Companies. Exelixis Inc. FM Global Insurance Company. Gilead Science. Google. IBM. Indeed.com. Intel. Intuit. Jazz Pharmaceuticals. Kirkland & Ellis LLP. Kroll. Liberty Mutual Insurance. Lyft. Medtronic. Meta. Morgan Stanley. Netflix. Nike. Paramount Global. PayPal. Salesforce. Snap Inc. Starbucks Coffee Company. State Street Corporation. Unilever Consumer Packaged Goods Company. University of Michigan.
Although many employers offer fertility benefits, many also do not offer them. Despite various types of assistance available to some intending parents, the path to parenthood through ART for lower income people is a daunting commitment. Financial help from private and non-profit sources is pretty hit or miss. For most recipients, loan and gift funds do not provide enough to cover the entire expense of a medically assisted fertility attempt.
Legislative reform of health insurance laws can make fertility care affordable for average-income families. Insurance coverage can mitigate financial burdens inherent to ART journeys. This would result in expanded access to fertility healthcare, which in turn also would make legal services more accessible to those medically in need of fertility care, regardless of whether IP happen to be wealthy or with an average income range.
