Path to baby joy costs dearly
The cases of Irish couples caught up in a Mexican adoption scam and children born abroad to surrogates being left in passport limbo trained a spotlight on how daunting some routes to parenthood can be.
Any couple struggling to have a family can attest to the emotional price involved, but it can be extremely financially draining, too.
The US is one destination for couples who want to have a child through surrogacy, but the process there cost one Irish couple in excess of €90,000. Those pursuing fertility treatment or adoption face spending thousands.
Last week, a conference on assisted human reproduction was told that the cost of egg and sperm and egg donor services could jump by 60 per cent if new Irish law includes an expected ban on anonymous donations.
We took a timely look at the financial side of fertility treatment and other means of having children.
Treatment varies for every couple, depending on what's required.
One cycle of IVF costs in the region of €4,000. Adding medical techniques that assist the IVF (such as ICSI or IMSI) costs about another €1,000 to €1,500.
With a success rate of 30-40 per cent, many couples will opt for several rounds of IVF, with costs incurred each time. There are also extra expenses, such as for storing embryos, blood tests, scans and counselling.
IVF treatment in the Czech Republic has grown in popularity as the highly professional service costs from €2,000 to €3,000 per cycle, giving couples the chance to be able to afford to try more times, but there are accommodation and travel expenses.
Only one Irish health insurer provides any cover for infertility treatment. Women insured with Quinn Healthcare can claim up to €1,000 towards the cost of IVF and related treatments on the Family Care, Health Manager Silver or Health Manager Gold schemes, at approved Irish clinics.
Tax relief applies to fertility treatment at 20 per cent for unreimbursed expenses, so you could get €1,000 back for treatment costs of €5,000.
"If you're going abroad, this still applies," says John O'Connor of Red Oak Tax Refunds. "The key thing is that either person can claim -- something that's changed in recent years. Previously, only the person in receipt of treatment could claim."
Medications required for IVF are covered under the Drugs Payment Scheme, so everything after €132 is free.
Most clinics supply price lists itemising the cost of each treatment, but couples tell us that with everything else going on it can be difficult and confusing to keep track of it all.
Some clinics give an all-inclusive price so that there are fewer price shocks along the way.
Because of the need to be near to the clinic during treatment, choices of clinic are limited outside Dublin -- there is just one clinic in Cork, one in the Midlands and one in Galway.
You have to plan ahead. Maria, a 38-year-old from Cork and her husband Frank have paid over €10,000 for IVF treatments and the scans, blood tests, storage and other costs involved.
"It can have an impact on work," she advises. "I'm self-employed so it's easier for me, I don't have to explain to my boss or look for time off, but many people don't tell their employers and have to make up excuses to get to appointments.
"And at the early stage in treatment, possibly for the first two weeks, you may need to attend the clinic every day."
Even though surrogacy is fraught with problems, interest among Irish couples is thriving, Helen Browne of the National Infertility Support and Information Group has found.
"We've had about 20 couples at each of our surrogacy meetings and a lot of phone calls" said Ms Browne, "it's an interest partly driven by the difficulty in adopting".
The main surrogacy destinations are the US, India, Ukraine and to a lesser extent Georgia. Many feel the US is prohibitively expensive. (As a surrogate mother in Ireland would be deemed the child's parent in law, it would be a legal minefield to pursue surrogacy here.)
Dublin family law solicitor Marion Campbell has represented an Irish couple whose costs for a US surrogacy ran to $120,000.
"It's huge money, but for that you get your US passport because the child is a US citizen, it's very vetted, all medical aspects and documentation is taken care of," she says.
"If you go to India or Ukraine there are major issues around getting the child back into Ireland. Once the surrogate baby is born and is handed over to the parents, the agencies don't give a damn. They've already pocketed the money, their job's done -- and the problem then lies with the parents trying to get the baby back here."
Up to a year ago, the Department of Foreign Affairs would issue emergency travel documents in such cases but it has stopped doing so. "You have to get a declaration of parentage and that involves legal costs," she says.
Surrogacy through a clinic or an agency in the Ukraine costs around €20,000, and around that figure or less in India.
As the recent Mexican case highlighted, couples adopting outside of Ireland (there is very little possibility of adopting in Ireland) need to stay within Irish and local law.
"It is a criminal matter to pay for a baby, no money can be seen to be changing hands," warns Ms Campbell. For both adoption and surrogacy, "legitimate expenses" are permitted.
Couples looking at inter-country adoption still have to be HSE approved through the Adoption Authority, the country they are adopting from has to be approved and the adoption agency must be reputable. It's a lengthy process (taking up to five years) and it excludes people who are single or gay.
Before travel and other expenses, it could cost from €20,000 to €30,000 in agency fees.
The Donor Route
Around 500 children a year are born in Ireland via donor method.
Costs start at about €900 and from there start to travel rapidly upwards.
Egg donation requires travelling abroad, again most often to Spain or the Czech Republic. "Clinics will charge from €4,000 to €6,000 -- but after you pay for the travel, for your accommodation and other medical expenses, we would suggest that people set aside roughly €10,000," Ms Browne says.
"People usually go to Spain. You could go to Britain, but the waiting list is two to three years, whereas in Spain it is about two to three months."
Sunday Indo Business