Surrogacy costs

Introduction

Surrogacy is an arrangement where a woman carries a baby on behalf of intended parents. These intended parents want a child who is fully or in part genetically related to them but for various reasons are unable to carry or give birth to the child themselves. So a surrogate carries their child for them.   

This page provides an overview of the possible costs you might incur during a surrogacy process. Draagmoederschap.nl cannot give you a precise sum. It all depends on the decisions you take. We can simply provide an overview of the most commonly occurring costs.  

No rights can be derived from this list. We cannot guarantee that you won't encounter additional or unforeseen costs not included here. 

How much does surrogacy cost? 

There are various stages in surrogacy. There are costs at every stage. Exactly how much each stage costs depends on the decisions you take. Is the surrogate going to get pregnant with her own egg? Will the egg and sperm come from the intended parents? Or will the help of a donor be required?  

Will you be travelling abroad or will everything happen in the Netherlands? It's impossible to say exactly how high the amounts will be because they too depend upon the decisions you take. But we can take you through an overview of the costs you need to be aware of.

Making agreements about costs

Intended parents, the surrogate and a possible donor make agreements prior to the pregnancy about who pays for or advances what costs. The intended parents pay the costs involved in the surrogacy process. How do they go about paying the surrogate's and donor's costs?  

Will the intended parents transfer a monthly sum, will the surrogate be given access to a designated bank account, or will she send a payment request every time she incurs expenses? How will you handle this for a potential donor? It is important to keep talking to each other about finances. Unforeseen costs may occur that you hadn't previously foreseen.  

The various stages where you'll incur costs are:   

 

see below for an overview of:

Preparatory costs for surrogacy

You can use this website to gather initial information about surrogacy without incurring any costs. 

Once the intended parents and surrogate have found one another, the first costs will occur. Costs during the preparatory stage may comprise:   

  • Costs for an initial encounter (for example, having a meal together, going for a walk, etc.) 
  • Travel costs + entrance tickets for the intended parents to attend information sessions
  • Travel expenses + entrance tickets for the surrogate parents to attend information sessions
  • Legal advice from a specialist surrogacy lawyer for the surrogate
  • Legal advice from a specialist surrogacy lawyer for the intended parents
  • Legal advice from a specialist surrogacy lawyer for the donor (if there is one )
  • Legal expenses for drawing up a surrogacy agreement by a specialist surrogacy lawyer
  • Legal expenses for drawing up a donor agreement by a specialist lawyer (if there is a donor) 
  • Taking out addition insurances such as:
  • Counselling by a specialist surrogacy counsellor. Dutch clinics employ psychologists with expertise in surrogacy for this counselling. Even if you are not using a Dutch clinic to get pregnant, it's a good idea to get counselling and guidance from a specialist surrogacy counsellor. 

Surrogacy treatment costs

Treatment costs vary depending on whether the surrogate gets pregnant using her own egg or whether she gets pregnant with an embryo made from the egg and sperm of the intended parents. If a donor's help is needed, the costs will change again.  

Treatment costs using surrogate's egg

If the surrogate is going to get pregnant using her own egg, then she can try to get pregnant through self-insemination. The costs involved are:  

  • Transport costs for the intended father (or his sperm) to the surrogate 
  • Contraceptives for the surrogate and her partner, if she has one
  • Folic acid and vitamin D for the surrogate
  • Ovulation tests for the surrogate
  • Semen container with lid for the intended father
  • 2 ml or 5 ml syringe per insemination attempt 
  • Pregnancy tests for the surrogate 

 

If the surrogate needs treatment because she fails to get pregnant through self-insemination, there will be costs for this treatment. 

Treatment costs for the egg and sperm of the intended parents

If the surrogate is to get pregnant from the intended parents' egg and sperm, IVF treatment is required.  

In this case, the intended mother's healthcare insurance will cover the screening and examinations to determine whether the treatment can be performed safely, plus IVF treatment up to and including making the embryo. The medication required for IVF stimulation will also be covered.  

This is the case if the intended mother is covered by Dutch healthcare insurance. If the intended mother has foreign healthcare insurance, we recommend checking with the insurer to see if they'll cover treatment costs in the Netherlands.  

It is primarily the healthcare insurer's responsibility to assess whether the insured is entitled to have her costs covered. If the insured disagrees with her insurer's decision, she can request they review their decision.  

If a request is still refused after review, the insured can bring her complaint to the Stichting Klachten en Geschillen Zorgverzekeringen (SKGZ).   

See the SKGZ website for how this works

Embryo transfer to the surrogate is covered neither by the intended mother's healthcare insurance nor by the surrogate's insurance. These costs fall to the intended parents.   

Please see the Netherlands Health Care Institute's letter of 22-10-2018 to the Minister of Health explaining how surrogacy costs are shared. 

read the letter on the Netherlands Health Care Institute's website (in Dutch).

The Netherlands Health Care Institute made a recommendation (on 26-01-2022) on the future of surrogacy compensation. Their advice was to wait for legal certainty before including it in the basic insurance package. It will be up to the Minister to decide whether to act upon this advice. 

For further information, please visit this page of the Netherlands Health Care Institute (in Dutch)

A breakdown of costs includes:  

  • Folic acid for the intended mother
  • Folic acid and vitamin D for the surrogate
  • Cycle monitoring and transfer of embryo to the surrogate / ovulation tests
  • Possible medication for the surrogate
  • Contraceptives for the surrogate
  • Travel costs for the intended parents 
  • Travel costs for the surrogate parents 
  • Reimbursement of the surrogate's deductible
  • Pregnancy test for the surrogate

Treatment costs for surrogacy with donor

Donor egg or sperm  

If a donor's help is needed in addition to the egg or sperm of the intended parents, reimbursement will depend on the intended parents' insurance.  

This is not reimbursed as a standard from the basic insurance package. Ask your healthcare insurer what they can do in your case.  

The costs incurred are

  • Screening and examinations for intended parents, surrogates and donor 
  • Full IVF treatment for egg donor or intended mother
  • Medication for egg donor or intended mother
  • Cycle monitoring and transfer of embryo to the surrogate / ovulation tests
  • Embryo transfer and potentially medication for surrogate 
  • Contraceptives for egg donor 
  • Travel costs for the intended parents 
  • Travel costs for the surrogate parents 
  • Travel costs for donor 
  • Reimbursement of the donor's deductible, if applicable 
  • Pregnancy test for the surrogate
  • Allowance for healthy eating 
  • Compensation for missed workdays for surrogate and donor
  • Possibly costs for an extra babysitter during treatment 
  • Contribution towards (healthcare) insurance, for using up your deductible, disability insurance, term life insurance, life insurance.

 

Depending on the clinic and the sort of treatment, the costs in the Netherlands can range from 15,000 to 30,000 euros.  

Pregnancy and childbirth costs

Prenatal and childbirth costs are reimbursed by the surrogate's healthcare insurance, providing she is insured in the Netherlands. If the surrogate has foreign healthcare insurance, ask her insurer if she is covered for treatment in the Netherlands.   

There are other costs beyond medical ones. All the surrogate's prenatal and childbirth costs are typically covered by the intended parents. 

The costs at this stage include, for example:   

  • Pregnancy vitamins for the surrogate
  • Pregnancy clothes for the surrogate
  • Additional prenatal support for the surrogate (for example, housekeeping help, babysitter, dog walker, etc.)
  • Prenatal gym for the surrogate
  • Postnatal physiotherapy costs or fitness club membership allowance for the surrogate
  • Travel and treatment costs for the surrogate 
  • Allowance for healthy eating or cravings for the surrogate
  • Compensation for missed workdays for the surrogate and her partner, as well as allowances for irregular working hours, adjustment of duties, loss of income if the surrogate is self-employed, and missed bonuses for the surrogate
  • A contribution towards healthcare insurance, compensation for the use of her deductible, disability insurance, life insurance for the surrogate
  • Childbirth extras, for example, water birth or doula (childbirth coach) etc. for the surrogate
  • Legal: notarial costs for drafting or amending a will also fall to the intended parents
  • The initial preparatory legal steps for the transfer of legal parenthood. The particular steps required depend on your situation. Consult your specialist surrogacy lawyer.  

Postpartum costs (in the postpartum period)

The surrogate's healthcare insurance (providing she is insured in the Netherlands) will reimburse postpartum care.  

It is sometimes possible to get the insurer to agree to split the costs between the surrogate and the child so that the intended parents can receive part when the child arrives home with them. Another solution is for the intended parents to buy additional postnatal help.  

  • Additional postnatal care for the intended parents
  • Additional care for the surrogate such as housekeeping help, babysitter, and/ or dog walking service. 
  • Legal costs for the intended parents' legal process (for example, legal advice costs, court costs) 
  • Legal costs for the surrogate parents' legal process (legal advice costs)  

Complications during treatment 

What if the surrogate has complications?   

Complications comprise, for example, miscarriages or ectopic pregnancies (see medical aspects). Providing the surrogate has Dutch healthcare insurance, the requisite medical care will be covered by her insurance. 

If the surrogate has foreign healthcare insurance, ask them if this medical assistance would be covered in the Netherlands. We recommend checking this before the surrogate gets pregnant.  

What if the egg donor has complications?   

Complications may comprise hyperstimulation, infections, or bleeding (see medical aspects). Providing the donor has Dutch healthcare insurance, the requisite medical care will be covered by her insurance.  

If the egg donor has foreign healthcare insurance, ask them if this medical assistance would be covered in the Netherlands. We recommend checking this before the egg donor starts treatment.  

What if the intended mother has complications?  

These costs will be reimbursed by the intended mother's healthcare insurance providing she is insured in the Netherlands. If the intended mother has foreign healthcare insurance, ask her insurer if she is covered for treatment in the Netherlands.   

It is primarily the healthcare insurer's responsibility to assess whether the insured is entitled to have her costs covered. If the insured disagrees with her insurer's decision, she may request a review of the decision.  

If a request is still refused after review, the insured may be able to bring her complaint to the Stichting Klachten en Geschillen Zorgverzekeringen (SKGZ).  

See the SKGZ website for how this works

Overview of legal costs only 

During preparation  

  • Legal information for the surrogate 
  • Legal information for the intended parents 
  • Legal information for the donor (if applicable) 
  • Drafting a surrogacy agreement 
  • Drafting a donor agreement (if applicable)  

 

During the pregnancy  

  • Drafting or amending the intended parents' wills to include the surrogate child 
  • The initial preparatory steps for transferring legal parenthood. What these steps are depends on your situation. Consult your specialist surrogacy lawyer.  

 

After the birth  

  • Advisory costs regarding the legal process for the intended parents 
  • Advisory costs regarding the legal process for the surrogate parents  

Costs for the surrogate abroad 

If you opt for surrogacy abroad because It proves impossible in the Netherlands, the costs will be higher, not only because some aspects may be more expensive, but also because you will incur additional costs. This list may not cover everything, but has been included here to provide you with an idea of the possible additional costs you may incur.  

For surrogacy abroad, It is important to get comprehensive legal advice from a Ducth family law lawyer specialised in surrogacy abroad so that you don't have any nasty surprises. 

  • Travel costs 
  • Accommodation costs 
  • Foreign lawyer and legal costs for the process abroad in addition to the Dutch lawyer and legal costs for the process in the Netherlands 
  • Surrogate fee 
  • Agency fee 
  • Possible donor fee   

Should you transfer one, two or more embryos? 

As each embryo transfer has to be paid for separately, some people consider having two embryos transferred to the surrogate at the same time. The chance of pregnancy is not much higher than when a single embryo is transferred on two occasions.  

However, the likelihood of a multiple birth (twins, triplets or more) is greater. The surrogate is also more likely to suffer complications with a multiple pregnancy. There is also a greater probability of the surrogate giving birth very prematurely or to low birth-weight babies. Please see medical aspects of surrogacy. Besides worries, this can also result in extra costs.

This can cause permanent consequences in the child's later life. Therefore, we recommend transferring a single embryo to a surrogate rather than two or more.   

The fee for a surrogate abroad with a multiple pregnancy can be higher.

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