According to the Centers for Disease Control and Prevention (CDC), the U.S. has seen a decline in fertility in recent years, stating that approximately 19% of women between the ages of 15 to 49 experience infertility. However, women are not the only ones experiencing fertility issues. In fact, roughly one-third of couples experiencing fertility complications stem from the man.
Experts cite a variety of sources for this reduction in the fertility rate. These could be environmental, economic, and/or societal. Studies have shown that high unemployment rates and periods of economic downturn can have a detrimental effect on birth rates. Additionally, couples are having children later and prioritizing work, education, and travel earlier in adulthood. With these ever-changing factors, many are turning to alternative methods for building a family. While there are now more ways to become a parent than ever, it can be confusing and costly to navigate.
Whether you are embarking on your own journey or are a family member looking to assist financially, it’s helpful to know the different options and the potential costs associated with these common paths to parenthood.
In Vitro Fertilization
Often the first stop for couples experiencing fertility issues is to see a fertility specialist. While there are a variety of treatments available, a common and widely used treatment is in vitro fertilization (IVF). Unfortunately, the process is complicated, expensive, and can be very challenging for both the carrier of the child and her partner. While some couples are successful and lucky enough to conceive a child after just one round of IVF, others may endure multiple cycles with no positive outcome.
After undergoing costly genetic testing, a couple is ready to start an IVF cycle. This complex cycle consists of growing and retrieving eggs, assisted hatching of the embryos, embryo testing, and finally, implantation. The goal for any IVF cycle is to have three healthy embryos per child conceived. To achieve this number of healthy embryos, a couple may need to repeat this first stage multiple times before starting the implantation stage of the process. Once the embryo is implanted, there is still no guarantee it will ‘stick,’ and they may need to implant another embryo. This cycle continues until the couple either becomes pregnant or runs out of money or energy to continue trying.
While some insurance carriers and employers may provide fertility benefits, there are still costs involved that a couple may need to cover. On average, each cycle costs approximately $15,000 plus $5,000 to transfer each embryo but doesn’t include physician and surgical costs, medication, and equipment, which can cost upward of $3,000. Keep in mind the cost of using a sperm or egg donor will also increase the overall cost.
Surrogacy is when a woman agrees to carry and deliver a baby for another family who will become the child’s parents after birth. There are two types of surrogacies: traditional and gestational. A traditional surrogacy is when the surrogate is both the egg donor and the carrier, while gestational means that the carrier has no genetic link to the fetus because a fertilized embryo will be transferred by IVF to the surrogate.
Although less frequently utilized and much more expensive, traditional surrogacy can increase success rates over IVF alone. Traditional surrogacy offers fewer medical procedures and can often be completed by a less complicated procedure called intrauterine insemination (IUI).
The CDC reports that fertility centers in the U.S. have a success rate of 75% with surrogacy versus 52% with IVF alone. Costs can vary depending on agency fees, legal costs, surrogate compensation, and medical fees. The average cost to use a surrogate in the state of Florida ranges from $110,000 to $200,000.
There are many types of adoption and thus many decisions to make: international vs. domestic, public adoption vs. private, and adopting an infant vs. an older child or children. Each of these different paths can differ widely in the time requirements and financial commitments.
Private adoption is the more expensive route, with costs varying depending on the agency or attorney, where you live, and whether the adoption is domestic or international. The Family Equality Council estimates the cost for domestic infant adoption ranges between $20,000-$45,000 compared to $35,000-$70,000 for international private adoption. Public adoption, through a state-run foster care system, typically comes at a lower financial cost. Many public adoptions have minimal legal fees and some present no up-front expense to the parents.
Whether public or private, most adoptions understandably require parents to undergo a tedious process to be eligible. For private adoptions, an agency or attorney will assist parents in completing the necessary paperwork and guide them throughout the process. For public adoptions through the state of Florida, parents must complete a weeks-long training course in addition to a complete home study, providing background information and character references. Once all of this is complete, parents are matched with a case worker to help navigate the delicate process of matching with a child.
There are financial resources available to adoptive parents. The Federal Government offers the Adoption Tax Credit for qualifying adoption expenses up to $15,950 for 2023. The state of Florida offers resources to children adopted from the foster care system, including free tuition to any public Florida university, Medicaid coverage through the age of 18, and even an adoption subsidy for parents that adopt children who meet specific criteria.
Additionally, many nonprofits in the adoption arena can take donations on behalf of the adopting family. These donations are tax deductible to the gift giver. These gifts go directly to the nonprofit, which can be the adoption agency, and offset the adoption expenses. However, there are strings attached to this and you will want to make sure to talk to your CPA first.
A Priceless Gift
For many families struggling with infertility, the financial assistance of their families can be a lifeline in the efforts to build their family. A parent, grandparent, or any other person may wish to assist with these expenses but may be concerned about the gift or estate tax consequences of such assistance. In 2023, a gift of up to $17,000 per donor/per beneficiary is automatically excluded from gift tax. This money can be used for whatever the donor and beneficiary want it to be used for. However, you can also pay medical expenses directly to the medical provider, and those amounts are excluded from that $17,000 limit. There is some debate, but even the medical costs of surrogacy may be able to fall into this category. Regardless of how you get there, the journey to parenthood is a significant one. The choices and possibilities can be overwhelming, but resources are available to help guide you or your family members along the way.
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