The Surrogacy Landscape in 2015

Surrogacy in US or abroad can be wonderful. Our family is living proof.

Surrogacy in US or abroad can be wonderful. Our family is living proof.

A lot has happened in the 2 years since DJ and MJ were born in India.  India has implemented the discriminatory regulation that surrogacy can only be offered to heterosexual couples married for more than two years.  Gay couples looked toward Thailand as an alternative only to have it shut down amidst military coup and scandal last year.  The next destination, Nepal, was hit with an earthquake earlier this year, and yesterday a court in Nepal suspended commercial surrogacy pending further review.  The options for gay couples seeking to become parents through surrogacy have become much more limited, and so my 2013 comparison of international vs. domestic surrogacy is no longer accurate.  International surrogacy has become a treacherous path to parenthood that I cannot in good conscience recommend because of possible disastrous situations like this one and this one.  I will be taking down the comparison page and leave the original 2013 entry in my archive for historical purposes.  Surrogacy in the US remains a safe option, and costs have decreased somewhat as more agencies come into operation to compete for clientele.

Josh and I are forever grateful for our positive surrogacy experiences in both California and India.  We are saddened that the options for gay couples hoping to become parents through surrogacy around the world have dwindled so.  I can only hope that in places like the UK, Israel, and Australia, their respective governments can recognize the extraordinary lengths gay couples have gone to have children, and better allow for well-regulated fair practices of surrogacy closer to home.

End of Summer Road Trip to Visit Our First Surrogate

Marie, our first surrogate, gave birth to AJ and JJ while she and her family were living in California.  Being a military family, they have moved a few times since then to Tennessee, Alaska, and just recently Georgia.  We were excited that they are closer than ever to Florida, so we decided to celebrate the end of summer vacation by piling into the minivan for an old fashioned road trip.  It has been a few years since Marie and the twins have seen each other, and both our families have welcomed two more additions since last we met, but everyone including all eight children got along wonderfully like lifelong friends.  We are so grateful to be connected to such an amazing family in such a special way!

Surrogacy and Other Paths to Gay Parenthood

In my previous post, I have alluded to discussions I have had with people extremely critical of us as gay parents through surrogacy. My position is that while questionable surrogacy practices do exist, problematic situations can often be avoided by intended parents who proceed with caution, and prevented by government with regulation that better protects the babies, the surrogates, and the intended parents. I believe that surrogacy when done right can be a positive experience for all involved.

With that said, I recognize and respect the many different paths to parenthood, which can be quite varied for LGBT people from adoption to surrogacy to co-parenting. We recently contributed our story to a book about these many paths to gay parenthood. We are pleased to announce that the book has been picked up by a publisher and will be released next year! I encourage any LGBT people considering their many options in becoming parents to check out the Author website at:

Taking a fair and balanced view of surrogacy is important

Taking a fair and balanced view of surrogacy is important

Domestic vs. International Surrogacy

*Note: This blog entry remains here for archival purposes.  Please see my comment below re: the current international surrogacy landscape.*

Ever since DJ and MJ arrived home, I have been formulating my thoughts about our unique experience and the purpose of this blog moving forward.  Having gone through the process twice, both domestically and internationally, Josh and I have a unique perspective and ability to compare and contrast two major options in assisted reproduction.  Thus, I present here some of my collected thoughts looking at domestic vs. international surrogacy head to head.  I hope this post will help people that are curious about these options, and possibly interested in exploring one of these avenues as intended parents themselves.

I am breaking down the comparison under several headings based on factors that may be important in deciding between the two.  I should add that some of this is specific to our experience with a particular agency in California, USA and an IVF clinic in Mumbai, India, and may not be exactly the same as all the domestic and international options currently available.

Agency Organization

When we pursued domestic surrogacy in 2006, we went to one of the first and biggest agencies at the time.  Located in Los Angeles, California along Wilshire Boulevard, this agency presents itself as a one stop shop for all of your surrogacy needs.  They have a large staff with a psychologist that locate potential surrogates and match them with the perfect intended parents.  They work closely with the best Beverly Hills fertility Doctors to make the pregnancy happen.  They have lawyers ready to get the legal situation sorted out before the birth even occurs.  And they have case managers that are assigned to each case coordinating communicating between all the different parts of the process like a well oiled machine.

Compared to our domestic experience, our surrogacy abroad was a much more a la carte affair.  We had a contact person in Michigan that referred us to an IVF clinic in Mumbai.  We were matched with a  surrogate through the clinic.  From there, the clinic outsourced embryology labs, OB/GYN Doctors, and hospitals scattered around Mumbai to do their parts at different points in the process.  Because there was no case manager per se coordinating all these different players and because we were relying on email alone without frequent phone calls, we felt rather uninformed at times and felt that the process was less organized.

Advantage: USA




The surrogacy agency in California did a marvelous job of matching us with the perfect surrogate.  They carefully screened potential surrogates for medical issues and did psychological testing to ensure that they are mentally prepared for the process.  They had the surrogate and us both complete extensive questionnaires about our expectations, and then presented the surrogate with profiles of hopeful parents with compatible preferences for the surrogate to choose.  Our surrogate Marie told us she was presented with another profile initially that she declined before she was given ours.  She liked what she saw in our profile, and when we met in the Fall of 2006 a lifelong friendship was made.  We visited Marie frequently during the pregnancy in California and got to know her whole family.  Since AJ and JJ were born, we have remained close even though Marie has moved several times since and now resides in Alaska.  Even though she is far away, we still keep each other frequently updated and she is always the first to like Facebook photos of the boys as they grow up!

The IVF clinic in India had many women seeking to become involved in surrogacy.  Whenever we visited Dr. M, we waded through a group of not yet pregnant women waiting in the lobby.  They all stared at us with a hopeful look in their eyes because being chosen to work with us could mean a huge boost in their family’s socio-economic standing.  We were presented with a couple different surrogate profiles that were screened medically and were prepared for the IVF procedure, but I do not have the sense that they were as carefully informed about the emotional aspect of carrying someone else’s baby in their womb.  Therefore, we chose the surrogate that had done surrogacy once before and knew exactly what she was getting herself into.  After we made our choice, we know that we made our surrogate very happy because she was smiling like she won the lottery the next day.  Because of language barriers and less frequent contact, however, we knew that our relationship with Pavitra wasn’t going to be nearly as close as the one we maintain with Marie.

Advantage: USA

Our friend for life, Marie. Eternally grateful!

Our friend for life, Marie. Eternally grateful!

Egg Donors

The surrogacy agency in California had their own database of potential egg donors that they compiled on an internet website.  We were able to peruse profiles of many young woman and we found the variety of candidates from different ethnicities to be helpful given that we were seeking to have children that were half Asian and half Caucasian.  We sometimes felt looking at questionnaire answers, video clips and smiling headshots like we were looking at an online dating website rather than seeking an egg donor to help create our family!

The selection in India was understandably more limited.  There was some racial heterogeneity in the egg donor pool, but not a lot.  Nevertheless, we were able to find the egg donor that suited our goals, and moved forward making the complementary genetic contribution on our end to make the children we hoped for.

Advantage: USA

Searching for our golden eggs

Searching for our golden eggs

Legal Issues

As I have mentioned previously, the agency in California had lawyers that specialized in family law working with us during the pregnancy prior to the birth.  The lawyers attended a hearing in California family court during the latter half of the pregnancy.  Because the surrogate was not genetically related to the babies she was carrying, and because the egg donor was anonymous and had already signed away any parental rights, maternity of the babies was deemed by the family court Judge to be “in doubt” and the Judge issued the order before the birth that birth certificates be recorded with both our names as Intended Parents alone.  The babies were automatically considered US Citizens at the time of their birth.

In contrast, India listed only one of us as the genetic father of the twins, and the space for the mother on birth certificates was left blank.  The babies spent a few weeks in India after their birth as we proved to the US Consulate that they were US Citizens, and we obtained exit visas allowing them to leave the country.  Now that we are home, we are working with our own lawyer to get a second parent adoption in Florida that will allow both of our names to appear on important documents.

Advantage: USA

As gay parents, legal protections for our family are important.

As gay parents, legal protections for our family are important.


IVF Success Rate

In the US, most reputable IVF doctors are happy to discuss their success rates while marketing their services.  Some of the IVF clinics in India appear to keep this information closer to the hip, but not necessarily because they are any less effective.  I think another reason for this may be is cultural.  Being of Chinese descent myself, I know that being overly forward and boastful about your success is something that is frowned upon in many Asian cultures.

Being healthy gay men with no infertility issues other than our lack of uterus, we feel very blessed that both IVF processes were successful on our first attempts.  In the US we transferred three embryos and two took resulting in a twin pregnancy, and in India we transferred two embryos hoping for one more child and both took anyway, giving us our second set of twins.

Advantage: Tie?

Don't be afraid to ask for hard statistics if they aren't readily volunteered.

Don’t be afraid to ask for hard statistics if they aren’t readily volunteered.


Quality of Medical Care

In the US, the quality of the medical care for the surrogate and the babies is pretty uniformly good due to healthcare regulation.

In India, high quality medical care is also available as long as you have the money to pay for it!  DJ and MJ were born at Hiranandani Hospital in Mumbai.  We found this private teaching hospital to have very well trained doctors.  They even had cord blood banking services available just like in the US.  We paid a bit extra (still reasonable by US standards) and ended up staying with the babies in the Presidential Suite with dedicated 24/7 Nurse and a Butler preparing our meals.  For a moment I felt like how JLo, Celine or Mariah must have felt right after their twins were born!

Advantage: Tie

Hiranandani Hospital

Hiranandani Hospital


Up until this point, it appears that US surrogacy is equal or superior to options abroad in most areas.  But let’s face it.  An important deciding factor is the bottom line.  Surrogacy in California through a premium agency cost us well into the six figures USD, while surrogacy in India was a fraction of the cost.  If we had decided to try and save as much as possible in India, we probably could have spent about a third of what we spent the first time around in the US.  Instead, we decided to treat ourselves to some luxury amenities in the hotels and hospital because we don’t have the opportunity to travel much anymore after AJ and JJ arrived.  Even treating ourselves, we estimate our costs in India are still less than half of our expenses in California.

Advantage: India

A little USD gets you a lot of Indian Rs

A little USD gets you a lot of Indian Rs


In summary, we went on two different journeys because those were our best options at different times in our life.  Obviously, we are very happy with the similar outcomes for each – two sets of healthy twins of our own.  For people considering gestational surrogacy in the US or abroad, the decision may ultimately boil down to what is important to you, and what you can afford.  If certain things like choice egg donors, ideal surrogate, constant communication and legal protections are things that you are not willing to compromise on, you may want to take out a loan and pay for the premium service closer to home.  On the other hand, if you have a taste for adventure, are a pragmatist, and simply want a healthy baby without worrying about too many other details you consider trivial, an international destination may offer you the family of your dreams at a cost within your financial means.

In trying to present a fair overview of domestic and international surrogacy for future intended parents, I have deliberately left out specific names of agencies and other details particular to our own process.  I did this because I don’t want to be viewed as wholeheartedly endorsing or advertising for anybody in particular.  To any readers who have any more curiosity or seek more unfiltered commentary, please feel free to contact me privately with the form below.

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Or you can leave a general public comment below.  Feedback is appreciated!

Lesson Learned, Then and Now

Hiranandani Hospital lobby

Hiranandani Hospital lobby

As I have mentioned previously, we have learned a lot with our first set of twins. We are hoping these lessons have taught us what to expect with the second set.

One of the first things we learned with AJ and JJ is that twin pregnancies can turn on a dime. On the last Friday in June 2007, it was Josh’s turn visiting California to attend an ultrasound appointment with our surrogate Marie. At 32 weeks gestation, things looked completely normal. Josh took a redeye from California back home to Florida on Sunday night, and I picked him up from the airport on Monday morning for both of us to go directly to work.

The call came Monday afternoon.

Marie had suddenly developed heart palpitations and was being whisked to the hospital to try and prevent premature delivery.  Within about three hours, AJ and JJ were born before we could even book the next flight back. We met them when they were 16 hours old — the soonest we could get from Florida to California.

Not being present for their birth has been something I have always felt badly about, and I decided we would do our best to be present this time, India or not.

Today, we went to Hiranandani Hospital to attend Pavitra’s 34.5 week ultrasound. We were told everything looks completely normal, plan for C-section in about 2 weeks. We only momentarily doubted ourselves about coming to India too early before we got a call three hours later that Pavitra was having some pain and the doctor admitted her for observation because she was beginning to dilate. So now we are camped out minutes away from the hospital feeling as prepared as possible for the events likely to occur over the next few days.

Nice try, babies. Your big brothers faked us out 6 years ago, and it ain’t gonna happen again.