Remortgages and lines of credit: Infertility is an expensive diagnosis

A Dartmouth, N.S. couple are taking the CRA to task over fees they incurred while using a surrogate to carry their baby, shining a light on the huge costs of surrogacy. 

Shelly Lyn Maynard and her husband, Mark Foley, chose to adopt their child from a surrogate mother. In order to make sure that any legal ties between the surrogate mother and the baby are severed, intended parents have to arrange for either a parentage declaration or an outright adoption at the time of birth. Foley later applied for Nova Scotia’s adoption tax credit on his income tax return. He told the CBC the credit would have worked out to about $5,000 in recouped costs. But the CRA denied his claim because, unlike in the case of a regular adoption, families who use a surrogate and then adopt aren’t allowed to recover costs associated with the adoption. And so he and Maynard are now making a Charter of Rights and Freedoms challenge that will be heard in the Tax Court of Canada in April.

Maynard and Foley’s experience highlights just one of the many costs associated with an infertility diagnosis. Depending on which route an infertile person or couple decides to take to have a child (IVF, surrogacy, or adoption), the cost of infertility can wind up being more than $100,000.

And it’s not unusual for infertile couples to take serious financial measures in order to cover the expenses associated with infertility, either. “The desire to have a child is very real,” says Ellen Embury, an Alberta-based fertility lawyer who has seen people remortgage their homes, take out lines of credit, and even borrow money from extended family to make it work.  “They’ll do whatever it takes.”

Infertility is an expensive diagnosis. The below is by no means an exhaustive list of all the costs associated with trying to have a child as an infertile person or couple, but here’s a look at just some of the expenses those struggling with infertility are burdened with in trying to have a child.

In-vitro fertilization (IVF) 

For those facing infertility, in-vitro fertilization (IVF) can often be the first step in trying to conceive a child.

And it’s not a cheap one. The average cost of IVF in Canada ranges from $7,750 to $12,250, according to BabyCentre Canada. This includes semen analysis, medication, and the IVF itself.

The desire to have a child is very real. They'll do whatever it takes

In Ontario, IVF is partially funded by the government if you’re under the age of 43. The government will fund one treatment cycle per patient. It won’t, however, cover fertility drugs, which cost around $5,000 per IVF cycle, genetic testing, or the cost of storing sperm, eggs and/or embryos.

“By the time a heterosexual couple gets to me and is looking at surrogacy, very often they’ve gone through five, six, seven, eight IVF attempts themselves,” says Embury. “And so it would not at all be unusual for by the time they get to me to have spent $100,000 trying already, and then they’re turning around and starting again.”

Surrogacy

If IVF is unsuccessful, infertile heterosexual couples typically move on to surrogacy. Gay men facing infertility, however, would start with surrogacy, as it’s their only option besides adoption. 

According to Surrogacy in Canada Online, intended parents can expect to pay around $80,000 total. If they already have embryos frozen, then that number drops to around $60,000.

This number includes the fee to use a surrogacy agency, the legal fees associated with drafting a surrogacy agreement, a one-year life insurance policy on the surrogate mother, psychological and medical evaluation, potential counselling, and reimbursable expenses incurred by the surrogate mother.

It’s illegal in Canada under the Assisted Human Reproduction Act to pay a surrogate for carrying a child (and the fine for doing so can total $500,000, as well as up to 10 years in prison) — a rule that Embury says dates back about 20 years.

“It’s quite a paternalistic approach,” she says. “The idea is that the only women who would be interested in doing this are marginalized, low-income, women which is just not the case at all.” In fact, Embury is part of a wider movement to decriminalize paid surrogacy. “It is absurd that the criminal penalties for paying somebody to carry your child are higher than they are for some other crimes,” she says, such as advocating genocide or driving impaired. 

It is, however, legal for the surrogate mother to be reimbursed by the intended parents for certain expenses that she incurs during pregnancy, such as wage loss, travel, childcare, legal fees, maternity clothing, medications, and so on. According to Surrogacy in Canada Online, reimbursement expenses can range from $18,000 to $33,000.

By the time a heterosexual couple gets to me and is looking at surrogacy, very often they’ve gone through five, six, seven, eight IVF attempts themselves

Then there’s the legal fees that come with getting a surrogacy/egg donor/embryo donation agreement in place, which is required by surrogacy agencies and covers everything from a birth plan to dietary restrictions while the surrogate is pregnant to what happens if the intended parents die. 

“At the high end, I’m going to charge $3,500 for the drafting of the surrogacy agreement, and I will send the surrogate to an experienced fertility lawyer who knows what they’re doing but who won’t charge more than $1,500 in legals,” says Embury. “So the cost to get a surrogacy agreement in place is about $5,000, for both sides.”

In Alberta, it will also cost the intended parents between $2,500 and $5,000 for a lawyer to get them on the baby’s birth certificate at the time of birth using what’s called a parentage declaration. “It’s not going to be more than $5,000,” says Embury, “and typically it’s not going to take more than two to four weeks and that really differentiates it from adoption.”

Intended parents can also legally adopt their child at the time the surrogate gives birth, but it’s a process that involves much more paperwork, Embury says.

Adoption

Adoption can also be an alternative to surrogacy and IVF, however, for those experiencing infertility. And the cost varies, depending on the complexity of the adoption, such as whether it’s a national or international adoption.

International adoption, for instance, can cost between $30,000 and $50,000 and up, according to CanadaAdopts, whereas private domestic adoption can cost between $15,000 and $25,000 and up. Public adoption — where a child in foster care becomes a Crown ward and adoption is facilitated by a local Children’s Aid Society — can cost $0.

“If it’s a simple and straightforward adoption,” says Embury, “normally it costs about $6,000. But that would be plus costs for home assessments.”

A home assessment or homestudy is when a licensed social worker comes into the intended parent(s)’ home to ensure they’re fit to parent a child and that the home environment is ready for a child. A homestudy can run from $2,500 all the way up to $7,500 in Alberta, according to Embury. There’s no fee for the homestudy in a public adoption.

It’s likely parents will also be expected to undergo a medical exam, a background check, and courses/training. In Ontario, for instance, it’s mandatory for adoptive parents to undergo what’s called Parent Resources for Information, Development and Education (PRIDE) training, a 27-hour course that costs $1,300 per couple (or $650 per person). There’s no fee for PRIDE training in a public adoption.

If intended parents use an adoption agency, there will also be an agency fee to consider. 

After all the monetary costs are out of the way, there’s also the patience required going through this process — a cost all on its own in terms of effort and sacrifice.

“The problem with adoption, quite candidly, is that I’ve had clients who say that they’ve been on an adoption wait list for eight years,” says Embury.

“And I don’t want to be glib about it, but the reality is… kids are more sexually literate now. They’re aware of birth control as an option, so even if they’re becoming sexually active younger, this idea that there are lots of babies out there available is just wrong. So if you are looking for a healthy newborn — certainly it does happen — but the odds of being able to find one quickly on an adoption list are pretty low.”