Building a Family: Options and Costs for Same-Sex Couples

Health Insurance

For same-sex couples trying to have a baby, the price tag depends in large part on luck: whether you can “get pregnant” on the first try.

Whether the partnership involves two men or two women will greatly determine the options for having a biological child, and men can end up paying far more than women. Legal and medical costs, including the fertility clinic and services involved, your and your partner’s age and your reproductive health all play a part.

The medical costs of fertility are high and they likely won’t be covered by health insurance policies; the few plans that offer such coverage may require an infertility-related diagnosis. Here are some common options on estimated costs and ways to pay.

Female couples: artificial insemination

The simplest route for female couples to have a biological baby is artificial insemination, where one or both partners become pregnant using donor sperm. Intrauterine insemination (IUI), the most common method, results in pregnancy about 15% to 20% of the time, so it may take multiple cycles to get pregnant.

Each cycle can run up to $4,000, according to the American Pregnancy Association. This includes the charges for the insemination visit and procedure, and the cost of donor sperm.

Female couples: IVF or reciprocal IVF

In vitro fertilization is another option available to female couples. In IVF, embryos created from the eggs of either partner and donor sperm are implanted in the uterus of one partner at the right time of the month. Some couples opt for reciprocal IVF, where one partner carries the other woman’s biological child.

The national average cost of an IVF cycle is $19,857, according to data collected on 3,192 IVF patients provided to NerdWallet by FertilityIQ, an online resource for those seeking fertility treatments. This pays for the doctor, support staff and the cost of transferring embryos, among other services.

Male couples: surrogacy and IVF

Gay couples will need a surrogate to carry the biological child of one or both partners. They would typically use IVF with one man’s sperm and an egg from a donor who is not the surrogate.

The process is lengthy, and you should see an attorney as soon as you decide to have a baby, says attorney Richard Vaughn, founder of International Fertility Law Group in Los Angeles. The woman giving birth is always presumed to be the mother when hospitals create birth certificates, so couples using a surrogate must hire an attorney to guarantee parental rights and guardianship, Vaughn says.

The costs of surrogacy can include:

  • Paying the egg donor and surrogate
  • Paying the agencies that help find them
  • Clinical costs of IVF
  • Expenses for the surrogate, such as maternity clothes, legal fees, health insurance and medical visits

These costs typically total $64,000 to $205,000 per pregnancy, according to FertilityIQ.

Dr. Shahin Ghadir, a founding partner of the Southern California Reproductive Center fertility group, says it’s “almost impossible” for the process to cost less than $100,000.

Frozen embryos donated by other couples may be cheaper, but the success rates are lower. In 2014, the latest year for which data is available, 56.8% of fresh donor embryos used in assisted reproduction resulted in live births, compared with 41.5% of frozen donor embryos, according to the Centers for Disease Control and Prevention.

For male couples, it’s critical to find a fertility clinic with a large third-party division, Ghadir says. Also called a donor and carrier matching service, this division works to find the right egg donor and surrogate. Otherwise, it’ll be up to the couple to contact separate egg donor and surrogacy agencies, which could lengthen the process.

Ways to pay for fertility treatments

Most health insurance plans don’t cover fertility treatments for same-sex couples. To determine if they’ll pay for treatment, insurers typically use the medical definition of infertility: trying to conceive by having unprotected sex for 12 months without success, for those under 35.

That definition excludes same-sex couples from coverage, but insurers may interpret rules differently, so it’s worth asking your insurance company if any fertility services are covered.

If you can’t afford the costs of having a baby, read NerdWallet’s guide on paying for IVF. You may consider a personal loan from one of these sources:

  • Credit unions, which typically have the lowest interest rates
  • Online lenders, which can be more flexible with poor credit and may have tailored loans for medical or fertility treatment
  • Medical lenders that work directly with doctors and specialize in fertility treatment

For additional resources, check out the Gay Parenting Assistance Program (for men) and Path2Parenthood.

All couples: adoption

Adoption is now an option for same-sex couples in the United States, but some state laws are more LGBTQ-friendly than others. Adoption across state lines is more complicated. Start by researching your state laws and then find an experienced attorney.

Adoption costs can range from $3,000 to $50,000, depending on whether you adopt through an agency, independent attorney or through fostering.

Some good news if you go this route: You may be able to claim the adoption tax credit, which rose this year to $13,570 per adoption.

Lacie Glover is a staff writer at NerdWallet, a personal finance website. Email: [email protected]. Twitter: @LacieWrites.