SmA.R.T. Planning for those seeking cross-border egg donation or surrogacy

SmA.R.T. Planning

Start Now and Save Time and Money Later

"The best preparation for tomorrow is doing your best today." – H.Jackson Brown Jr.

Our “SmA.R.T. Planning” program allows prospective parents that are seeking cross-border egg donation or surrogacy programs to:

Avoid 6 – 12 months waiting time to start treatment, once things get back to normal;
Pre-arrange a credible egg donor and/or surrogate mother of their choice;
Fix treatment prices before they go up due to the dramatic increase of demand

What does the SmA.R.T. Planning cover?

Our program allows you to get fully prepared during this year for fertility treatment with egg donor and/or gestational carrier (surrogate) and start is as soon as it gets safe and practically possible. All paperwork and communications will be handled remotely, so there is no need for you to travel to Ukraine at this point.

SmA.R.T. Planning includes:

Dealing with all legal formalities related to commencement of treatment in Ukraine;
Enrolment to treatment program with Ukrainian clinic;
Search and matching of an egg donor and/or a gestational carrier (surrogate);
Formal pre-arrangements with chosen egg donor and/or a gestational carrier;
Formal pre-arrangements with fertility clinic (fixing treatment prices).

How do I Start SmA.R.T. Planning?

It is easy. You may fill this short form and we will get back to you with additional questions and a personalised fee quote.

Why the SmA.R.T. Planning?

The outbreak of COVID-19 forced most prospective parents to put on hold their plans in relation to cross-border infertility treatment. Such situation will inevitably lead to dramatic increase in demand for infertility treatment with egg donation and surrogacy, as soon as things will start getting back to normal. Our analysis (please see this article for more details) shows that by this September the unsatisfied demand for surrogacy in Ukraine is likely to be 6 times higher than available capacity. With very optimistic predictions, it will take at least half a year until the capacity of clinics and agencies will match it. As a result, as soon as travel restrictions are lifted and it becomes relatively safe to commence treatment protocols, prospective parents are likely to face long waiting lists at clinics, shortage of credible egg donors and gestational carriers, and an increase of prices for both, medical and ancillary services.

Are there any Extra Fees for the SmA.R.T. Planning?

If contracted prior to 1 May 2022, there will be no extra fees on the side of our agency or involved clinics. Rather to the contrary, the idea behind the SmA.R.T. Planning is to use the current period of “calm before the storm” in the most efficient manner that will also allow fixing all related fees and most costs at the current level. There may be, however, some minor extra cost related to retaining of chosen egg donor and/or a surrogate (if we ask them to wait for commencement of treatment) that will be discussed and agreed upon on a case by case basis.

Please note that during COVID-19, we attempt limit physical contact as much as possible. Consequently, it might be possible handle all the arrangements with no need to travel to Ukraine, at least at the initial stages of a program. For more details please see our COVID-related notice here.

Questions
and
Answers:

Questions and Answers:

What types of fertility treatment is available in Ukraine?

Due to rather liberal legal regulations and a large number of well-equipped private clinics with highly qualified and experienced professionals, the most up-to-date types of fertility treatment is available, in particular:

non-invasive treatment with medications;
surgical procedures (e.g. laparoscopic surgery for endometriosis, fibroids, etc.);
treatment using assisted reproduction technology (ART).

Furthermore, in addition to in vitro fertilization (IVF) or IVF with intracytoplasmic sperm injection (ICSI), Ukraine is popular for its fully legal and regulated egg donor and surrogacy programs.

Genetic testing is also legal and such tests as a preimplantation genetic diagnosis (PGD), non-invasive prenatal test (NIPT), and amniocentesis are often exercised within ART programs.

After numerous unsuccessful IVF attempts, I have exhausted all options in my home country. Is there anything else I can do to have a child?

Yes, donated gametes or paid gestational surrogacy, or a combination of both can dramatically increase your chances of having a baby. In Ukraine gestational surrogacy is available only for officially married heterosexual couples, whereas, oocyte donation is available for both, married couples and single women.

Since sperm donation programs are widely available in most countries, we will focus here only on egg donation.

1) Egg Donation (more details available here)

IVF with donated oocytes often helps women to become pregnant and give birth to a healthy child, even in cases of infertility caused by prior illness, chromosomal abnormalities, early menopause, premature ovarian failure, or poor egg quality.

Although the child will not be genetically related to its mother, many may find this option to be more socially acceptable than paid surrogacy. Ukrainian law ensures the treatment is fully confidential and allows intended parents to decide if they want to disclose at some point the use of donated oocytes to their child or share any personal information with a an egg donor. Furthermore, some clinics offer a mixed transfer to embryos. This is an IVF procedure when two types of embryos are transferred simultaneously, an embryo created from gametes of intended parents and an embryo created from donated oocytes.

Donation is also less complicated from the legal and organizational standpoint because there is no need to have contact with the gestational carrier or formalities related to the child’s citizenship, etc.

2) Surrogacy Arrangements (more details available here)

A surrogate mother or surrogate pregnancy is normally practiced when a medical condition precludes the intended mother from carrying a pregnancy or would pose a significant health risk to the woman or the foetus. In such cases, intended parents may use embryos created from their own gametes or those from donated gametes, provided there will be a genetic relation to at least one of the intended parents.

Are commercial donations of oocytes (eggs) available in Ukraine?

Yes, commercial donations of oocytes are legally available in Ukraine. More information is available here.

Is egg donation for IVF anonymous or open?

Both options are available. The law requires that clinics secure confidentiality of their donors. At the same time, patients are allowed to bring their own donors (e.g. relatives or close friends that fulfil qualification requirements) or they may bring a donor matched by the agency (for more information please see Egg Donation).

At Fertility Ukraine we offer three different options:

open donor – this is when both parties are introduced to each other, may exchange personal data, photos, and keep in touch even after the treatment is successfully finished;
semi-open donor – this option allows Intended Parents to obtain additional information about a donor, including her photographs and videos, sometimes photos of her child, etc. At the same time no personal information and contact details will be disclosed. Any contacts between intended parents and the donor in this case is administered by the agency;
confidential donor – the donor will be matched based on the description and standard set of features, in some cases photographs may be available. There is no contact between Intended Parents and a donor.

In all cases, relations between Intended Parents and a donor are based on mutual consent of all parties to disclose/exchange information and are duly documented in written form. The consent form or contract may be either a direct one or executed via our agency (in which the agency acts as a veil to keep information confidential).

Are there any waiting lists?

There are no waiting lists, unless the donor of your choice is in another program and agrees to make a donation after it, which takes about two months after the previous stimulation. Matching an appropriate egg donor or gestational carrier may take some time (up to couple of months). It all depends on how long is your checklist and your readiness to agree on compromises should not all of your criteria be met.

Please be aware that during the coronavirus pandemic, many intended parents have decided to delay their treatment until the situation improves and this is creating a backlog in demand. Consequently, once everything settles down, it is likely that we will face delays and probably will have to introduce waiting lists to cope with an increased number of programs. Please check the KNOWLEDGE section for our recommendations on how to avoid this issue.

Is commercial surrogacy available?

Yes, paid surrogacy is available and is legal in Ukraine. Please note that only gestational surrogacy (where the surrogate has no genetic link to the child) is legal in Ukraine. Furthermore, infertility treatment with surrogacy is only available to heterosexual couples that are officially married. More information is available here.

Do age limits apply to intended parents who participate in a donation or surrogacy program in Ukraine?

No, there are no age limits established by law. However, a physician will decide on the on possibility to apply a particular protocol on a case-by-case basis (depending on the intended parents’ screening results, prior medical history, etc.)

Can I get a passport of my country issued to my baby if s/he was delivered by a gestational carrier (surrogate) in Ukraine?

In most cases, yes. Your embassy will issue a valid travel document (passport) for your child. There are some exceptions though. At Fertility Ukraine, we have a rule to work on surrogacy programs only with clients from jurisdictions, where embassies issue travel documents for children born via surrogacy in Ukraine. More information is available here.

Do I need to get an opinion from a physician in my home country prior to approaching a clinic in Ukraine?

In case your medical insurance policy covers infertility treatment or there is a special program funded by the government, it is always worth to explore those options in your home country first. In most cases, intended parents who approach have already conducted a number of unsuccessful IVF attempts at home and are considering oocyte donation or surrogacy abroad, since those types of treatment are either not available or are hardly accessible in their home country. In this case, the patient’s medical record, which clearly outlines the medical condition, could prove useful for the Ukrainian clinic to choose the best treatment plan.

Some medical indications may be clear enough (e.g. absence of uterus, significant uterine anomaly, or absolute medical contraindication to pregnancy, etc.) and, if duly documented (e.g. certified by a licensed physician in the country of origin), may be satisfactory to enrol in a paid surrogacy program at a Ukrainian clinic with no additional tests, etc.

Alternatively, we can assist you with the entire process at the Ukrainian clinic, starting from the very beginning (including screenings, consultations, etc.) and will guide you all the way until you reach your goal.

Do I need to travel to Ukraine to get enrolled in an ART program?

In most cases yes. Only a duly qualified medical specialist may choose the right treatment that will work in each particular case. Our agency will guide you through the process and assist with all paperwork and formalities, so you can even have enough time to enjoy some sightseeing during your short visit to Ukraine.

Regarding surrogacy programs, quite often a medical condition may be clear enough and if duly documented (e.g. certified by a licensed physician in the country of origin), we may enrol intended parents in a program without having to travel to Ukraine and be present at the clinic (initial communication with physician may be done online). Subsequent visits will be planned on a case-by-case basis.

Please note that during the COVID-19 pandemic, we try to limit physical contact as much as possible. Consequently, it may be possible to do all arrangements with no need to travel to Ukraine, at least at the initial stage of the program. Please check the KNOWLEDGE section for more details.

What screening tests for patients are required prior to treatment?

In Ukraine, there are compulsory medical screening requirements for intended parents prior to enrolment in an ART program (the list may be shorter in surrogacy programs or if gametes of one of the intended parents are not used to create embryos).

A standard compulsory medical screening for women includes:

evaluation by physician of somatic health and absence of contraindications for pregnancy (if applicable);
blood type and Rhesus factor;
clinical blood test;
coagulogram;
blood tests for syphilis, HIV, Hepatitis B and C (not older than 3 months);
blood tests (IgM, IgG) for toxoplasmosis, Chlamydia trachomatis, Cytomegalovirus, and Rubella Disease;
bacterioscopic analysis of swab obtained from the vagina, urethra, and cervical canal;
cytological analysis of swab obtained from cervix;
general gynaecological examination;
ultrasound examination of pelvic organs;
blood tests for Anti-Müllerian hormone (AMH), Prolactin (PRL), Follitropin (FSH), Luteinizing hormone (LH), Progesterone (P4), and Estradiol (E2).

A standard compulsory medical screening for men includes:

blood type and Rhesus factor;
blood tests for syphilis, HIV, Hepatitis B and C (not older than 3 months);
Semen Analysis (Spermiogram).

A standard compulsory medical screening for men includes:

blood type and Rhesus factor;
blood tests for syphilis, HIV, Hepatitis B and C (not older than 3 months);
Semen Analysis (Spermiogram).

Please note that additional testing may be requested by the physician in charge of the program.

It is also highly recommended that intended parents who plan on using their own gametes also do Karyotyping, or a chromosome study. An absence or presence of chromosomal abnormalities may influence the choice of treatment (e.g. it may influence the decision to use own or donated gametes, etc.) or decision on genetic testing of foetus at the early stages of pregnancy.

All of the listed tests and examinations may be done in Ukraine upon your first visit to the clinic. Nevertheless, to facilitate the process we recommend that intended parents conduct the following tests that are required in every scenario before visiting a Ukrainian clinic:

Both intended parents – blood type and Rhesus factor, blood tests for syphilis, HIV, Hepatitis B and C;
Intended parents whose gametes will be used to create embryos – Karyotyping and Spermiogram (in case of intended father).

Are there any conditions that may disqualify intended parents from participating in an ART program?

In most cases intended parents with HIV, Hepatitis B or C are ineligible for enrolment in an ART program at a Ukrainian clinic. Any other type of active infection will require prior treatment and retesting.

Furthermore, Intended Parents may be rejected by an agency or clinic for one of the following non-medical reasons:

inability to maintain a respectful and caring relationship with an open egg donor or gestational carrier;
abnormal psychological evaluation;
unresolved or untreated addiction, child abuse, sexual or physical abuse, depression, eating disorder;
unresolved or untreated major depression, bi-polar disorder, psychosis, or significant anxiety disorder or personality disorder;
current marital or relationship instability;
failure to agree with a gestational carrier on the number of embryos transferred;
ongoing legal disputes;
significant and ongoing problematic interpersonal relations;
history of noncompliance or ongoing problematic interactions with an ART program or medical staff.

What paperwork is required to fulfil all formalities?

Once we receive your application form and you confirm our fee quote, we may proceed to completion of legal formalities. From your end we will require scanned copies, followed by notarized paper copies of passports of both intended parents and a notarized and apostilled copy (or apostilled original) of your marriage certificate. For single women, just a copy of a passport. Depending on the circumstances and required treatment, we may also ask you to send us originals of a letter certified by a licensed physician in your country of origin or the country where you were undergoing previous treatment, results of earlier medical examinations, tests, etc.

Once we receive scanned copies of the required documents, we will prepare the following (for your review and signing):

a service agreement with our agency;
consent forms and acknowledgements required by Ukrainian law to start ART treatment;
contract with the corresponding clinic.

Depending on the program, a contract with the egg donor (either a direct one with intended parents or we, as an agency, will act on your behalf) and/or a notarized form contract with the gestational carrier will be required. A direct contract is required by law. However, in some cases our representatives may sign it on your behalf based on a notarized and apostilled Power of Attorney.

Additional documents may also be required from intended parents by their country’s embassy in order to issue a travel document (passport) for your child who is delivered by a gestational carrier in Ukraine. Our lawyers will guide you through this process and we will address this matter a few months before birth to handle all formalities in a timely and efficient manner when that occasion arises (more information available here).

What are the costs? What is the fee payment structure and payment schedule?

Oocytes Donation Program: total costs for the IVF with a donated oocytes program (including medical screening, agency and legal fees, clinical fees, medication, and egg donation pay) may range from approximately EUR 11.000 with an anonymous donor and up to approximately EUR 17.000 in a semi-open or open program. More information is available here).

Average Cost of Gestational Surrogacy Program: total costs for a gestational surrogacy program (including medical screening, agency and legal fees, clinical fees, medication, surrogate cost, and maternity hospital fees) may range between approximately 51.000 EUR when transferring cryopreserved embryos that were earlier created by the intended parents and then shipped to Ukraine and up to approximately EUR 60.000 – 70.000 if the surrogacy involves donated oocytes and a fresh transfer (more information is available here).

Please note that fertility treatment has numerous elements that may influence the total cost. Each case is unique, as well as the needs and expectations of the involved parties and there are no “one-size-fits-all” solutions here. Once you provide us with more information (by submitting the online application form here) we will be able to offer you a custom tailored fee quote for our services and related costs, addressing your current situation and requirements.

Agency Fees and Third-Party Costs:

At Fertility Ukraine we are fully transparent in what we do, how we do it, and how we charge for our services and handle any third-party expenses. Unlike most other Ukrainian agencies charging you a “package” fee that covers “everything” (creating an inevitable conflict of interest, since the less they spend on your behalf the more they earn), we clearly distinguish our fees from any third-party expenses that are handled separately and are charged at cost. We provide our clients with regular reports, confirming receipts, etc. This approach allows us to be on your side all way through your journey, since we represent your interests and act on your behalf, rather than trying to “sell” you something.

Payment Structure and Schedule:

We will charge you a portion of our fees at the initial stage, together with signing of the agency agreement. The remaining portion of the agency fee will be charged in additional instalments, upon achieving certain milestones in the selected program. Third-party costs and expenses may be also split into several instalments, for the additional comfort of intended parents. For some, a minor fee is added based on a separate contract if our agency also acts as your escrow agent, managing your program costs and making sure that all costs and expenses are paid in a duly and timely manner.

Does your agency offer guaranteed packages?

Our agency does not offer any “guaranteed” packages. First of all, it is unethical. Offering a guaranty of pregnancy and/or delivery is unethical, it may create unrealistic expectations, and it is basically a false promise. Second, such “guarantees” usually do not promise anything and are used by fertility clinics or agencies as a simple marketing trick. In fact, such a guaranty is a sort of a risk-sharing mechanism where the client is charged for a fixed number of embryo transfers, regardless of the number of transfers that will be required to achieve pregnancy. This could make sense in the U.S. or Canada, where the cost of embryo transfer is high, but it does not make much sense in Ukraine where such procedure will cost you slightly above EUR 1.000. Please check the KNOWLEDGE section for a more detailed analysis of this issue.

What we also don’t practice are “one-size-fits-all” package solutions. Fixed price packages offered by agencies create a serious risk for conflict of interest, since they tie the agency’s profitability directly to third party costs. In other words, the less an agency spends on behalf of its clients, the more money they make. This approach doesn’t take the client’s best interests at heart and may lead to numerous compromises in quality of services, medications, etc.

At Fertility Ukraine we are guided by the principle of full transparency with our clients. We clearly distinguish our fees from any third party expenses that are handled separately and are charged at cost. This approach allows us to secure the best quality of third party services, whose prices are discussed with and approved by our clients on a case-by-case basis.

Visit our OfficeStudentska Street 5-7 B 04050, Kyiv, Ukraine MON-FRI 10:00 – 19:00