Heading to India for a Longed-For Child

By Margot Cohen

October 7, 2009 / Wall Street Journal

On their third trip to India, Rhonda and Gerry Wile finally heard a sound they thought they might never hear: the heartbeat of their unborn child. It was beating in the womb of a surrogate—a woman halfway around the world from their Mesa, Ariz., home, whom they had paid to carry their child.

The Wiles had spent four years trying to conceive. And four nerve-racking months after that joyful ultrasound moment, their son arrived in a hospital in Mumbai. They named him Blaze Xennon Wile, the middle name chosen from a book of baby names that gave its meaning as "from a foreign or faraway land."

A growing number of clinics throughout India now offer surrogacy, where women bear children on behalf of other people, often in return for money, a practice that is legal in India. India has about 350 facilities that offer surrogacy among other infertility-treatment services, triple the number in 2005, according to Hrishikesh Pai, a Mumbai-based in-vitro fertilization specialist and vice president of the Indian Society for Assisted Reproduction. Last year, Dr. Pai says about 1,000 pregnancy attempts using surrogates were made at these clinics. This year, he estimates the figure will jump to 1,500, with about a third of those made on behalf of parents from outside India.

The high costs and legal murkiness of surrogacy arrangements here in the U.S. are driving some would-be parents to India. The price tag can be anywhere from $70,000 to $130,000, and many people pay more for multiple attempts, says Richard Vaughn, managing attorney at the National Fertility Law Center in Los Angeles.

Also, most states don't have laws regarding the practice. Other states prohibit surrogacy agreements altogether. Some allow them but have restrictions on certain types of agreements, such as those where surrogates are compensated or where the surrogate mother also contributes the egg—and therefore is the biological mother.

Surrogacy in India can cost less than half of what it would in the U.S. PlanetHospital, a medical tourism company based in Calabasas, Calif., offers a package that includes the services of an Indian egg donor for $32,000, excluding transportation and hotel expenses for the intended parents. Rudy Rupak, the company's president, says in the first eight months of this year he sent 600 couples or single parents overseas for surrogacy, triple the number in 2008 and up from just 33 in 2007. Most were from the U.S.

In most surrogacy arrangements, the egg comes either from the woman who wants to become a mother but can't carry a child, or from an egg donor. The egg is then fertilized with sperm from the intended father, or a sperm donor, and implanted in the womb of a surrogate who bears the child. To lessen any bond the surrogate might form with the child, doctors in India generally discourage the practice of egg donors and surrogates being one and the same.

In India, critics of surrogacy contend it treats children as a "commodity" and opens poor women up to exploitation. "Making [a woman] a child-producing machine is not acceptable to us," says Ranjana Kumari, president of WomenPowerConnect, a coalition of 800 organizations across India that lobbies government on women's issues. "There should be controls so it is not an open market as it is at the moment."

Since 2005, the practice of surrogacy has been loosely operating under guidelines established by the Indian Council of Medical Research, a government body. But a new law is in the works that aims to regulate surrogacy by standardizing such things as contract terms and surrogate compensation, which currently ranges from about $2,000 to $10,000. To avoid potential legal disputes, it will also govern what parental information is given on birth certificates. And the new law, which could be introduced in Parliament as early as December, would require clinics to register surrogacy cases and report their outcomes.

For the Indian surrogates themselves, the process is daunting and fraught with emotional conflict. Fearing social censure, many surrogates hide their pregnancies from relatives and friends by moving away temporarily on the pretext of having secured a job elsewhere. Some doctors separate the surrogate from her family to ensure she gets the proper nourishment, while avoiding risks to the fetus such as sexually transmitted diseases and second-hand cigarette smoke. Surrogates are sometimes put up in dormitories or in a hospital ward for their entire pregnancies.

Still, it's a way to raise money in sometimes desperate circumstances.

Sudha, a 25-year-old mother of two, now works as a maid in Chennai earning $20 a month. She said she owed moneylenders about $2,700, borrowed to pay bribes to secure a government job as a street sweeper that never materialized. A neighbor told her she could earn about $2,000 at a local clinic by bearing a child for an infertile couple. She gave birth in July 2008—and is haunted by the memory. "Whenever I have free time and I lie down, I think about the child," she says.

Sudha, who asked that only her first name be used, has cut the debt to about $600, but the family struggles to eat. One solution, her husband, Umat, says, is for Sudha to act as a surrogate again. But he adds that he "won't force her if she says no."

For the would-be parents, the process can be stressful: They may fret over delayed transmissions of a scan or the health of a surrogate half way around the world. Add to that the unfamiliar environment, language barriers and potential legal risks of doing it in India.

And once a couple has a baby in their arms, there is a significant amount of paperwork required to take the child home. In order to secure U.S. citizenship—and a passport—for the baby, Americans must provide medical documentation that proves the couple has a biological link to the child. In some cases, a DNA test is recommended, with certification from an accredited lab in the U.S.

Michael Bergen and Michael Aki, a gay American couple who work as graphic designers in Massachusetts, decided to try surrogacy in India after they waited three years to adopt a child in the U.S. "We looked at Panama and the Ukraine," recalls 39-year-old Mr. Bergen. "But India had better infrastructure, more high-tech facilities and the healthier lifestyle. [Most women] don't smoke, they don't drink and they don't do drugs."

Mr. Rupak's PlanetHospital steered the couple to the Rotunda-The Center for Human Reproduction, a Mumbai clinic that markets its services to the overseas gay community. The couple chose an anonymous Indian egg donor from profiles provided by the clinic that included the women's education and family status. Then the couple spent four days in India in July 2008 to give sperm samples.

Both wanted to be a genetic father, so they each gave a sample. Using eggs from the same donor so that the offspring would be kin, doctors fertilized them with the respective sperm of the two men and implanted the embryos in two separate surrogates. Both women became pregnant. Mr. Aki became the father of Rose, born March 24, and Mr. Bergen became the father of Eva, born April 12.

Mr. Bergen estimates the couple spent about $60,000, including travel costs and $10,000 for each surrogate.

Mr. and Ms. Wile, the Arizona couple, started trying to conceive in mid-2005. They underwent fertility treatments, which failed. They ruled out adoption, discouraged by the red tape. A doctor, meanwhile, had recommended surrogacy, and Ms. Wile saw a TV program about surrogacy in India on "Oprah." They settled on Surrogacy India, a newly established private Mumbai clinic. They liked the quick response to their questions and the clinic's policy of encouraging surrogates to move into designated quarters with their families during the pregnancy, rather than splitting them apart.

The price was also right. "We didn't want to go broke" and "bring a child into the world bankrupt," Ms. Wile said during a trip to India last April, when the couple heard their child's heartbeat.

The couple made two unsuccessful attempts with Ms. Wile's own eggs. For their third try, they picked an egg donor using the clinic's Web site. Then they picked out a new surrogate, KT, a married woman with the Indian equivalent of a seventh-grade education who has two small boys of her own. In her profile, KT described herself as having a "supporting nature" and listed her motivation in becoming a surrogate as "financial, to educate [my] kids."

Donor eggs fertilized with Mr. Wile's sperm were implanted. This time it worked. The Wiles used Skype from Arizona to talk to the surrogate through an interpreter. In April, the couple made their third trip to India to meet KT face-to-face. (Requests to interview KT for this article were declined.)

The Wiles made their fourth trip to India shortly before their baby was born. As their baby arrived via Cesarean, the Wiles were right outside the operating room door. "It seems unreal. We hold him and kiss him a thousand times a day," Mr. Wile says. "It's so lucky that it worked out for us."

The couple would like to have another child. "We've had a very good experience with surrogacy and we're definitely going try it again."

They will have to find another surrogate, though. Mr. Wile says KT, declined to carry a second baby for them.

—Anjali Athavaley contributed to this article.
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