Another look at the burgeoning reproductive tourism industry:
Victor and Mary Hui-Wee, who were having no luck with adoption after they were unable to conceive a child, had all but given up on welcoming a newborn into their lives after 22 years of marriage. That changed when the Kalamazoo, Mich., couple hired a foreign surrogate to bear their child. They chose a woman in India, paying less than half the cost for the same service stateside. Fourteen months ago, they welcomed home their son, Connor. “The best part of being a parent is the joy we have in teaching and loving Connor together,” said Victor Hui-Wee, adding that he and his wife have initiated a second overseas surrogacy and are now expecting twins.
Increasingly, couples and individuals who cannot afford surrogacy services in the United States are looking to women in other countries to turn their dreams of parenthood into reality. Advocates say hiring an overseas surrogate to bear a child is a less expensive, safe alternative. Opponents say it’s a form of medical tourism that takes advantage of poor women in less developed countries.
The Hui-Wees arranged for their surrogate on their own, dealing directly with a clinic in India. But Victor Hui-Wee said they encountered paperwork problems when they tried to leave the country with Connor. “The U.S. consulate was vague and uncooperative with paperwork,” Victor Hui-Wee said. “We had to find our way through red tape.”
To help other couples avoid the same problems, the couple formed the company WeeCare Partners USA. The fee-based agency helps would-be parents “navigate the international surrogacy process,” according to its website. It chronicles the Hui-Wees’ odyssey of $45,000 in failed in vitro fertilization treatments and the discovery of the overseas surrogate option on an Oprah Winfrey show. Other U.S.-based agencies assist would-be parents with foreign surrogacies. A Pennsylvania agency known for helping couples adopt children from foreign lands, Adoptions From The Heart, is among them. The agency charges a $2,800 fee to arrange for an infertility clinic in Hyderabad, India, to work with couples. The couples pay the clinic $25,000 for basic surrogacy services, which include an Indian egg donor, in vitro fertilization services, and medical care and housing for the surrogate. In most cases, parents do not have to travel overseas to initiate the surrogacy process because sperm used for in vitro fertilization can be frozen and sent to the clinic. Roberta Evantash, a district administrator, said Adoptions From The Heart has two clients in its Heartbeats Assisted Reproduction Program. Both are from the Greater Philadelphia area and declined to be interviewed, Evantash said.
Evantash said foreign surrogacy is appealing to some couples because of its comparatively low cost. She estimated the cost of surrogacy services in the United States ranges from $60,000 to $100,000, compared with the $25,000 base fee charged by the Hyderabad clinic. Excluding travel fees and extra costs assessed for twins or the need for a C-section, Wee Care USA cites a similar fee structure of $24,500. Cost can vary, depending on clients’ wishes. The Hyderabad clinic charges clients an additional $12,000 to $15,000 for a Caucasian egg donor, according to a fee list provided by Adoptions from the Heart. For multiple pregnancies, the Hyderabad clinic charges $6,000 per additional child, compared with the $4,500 fee charged by the clinic that works with Wee Care.
Rudy Rupak, founder of a California-based agency that has offered the service since 2006, said cost is not the only reason some couples prefer foreign surrogacy. Rupak, of PlanetHospital.com, said gay couples turn to his agency because of numerous legal hurdles in this country. “In some states, gay couples can’t get married, and they can’t adopt,” Rupak said. “So what’s good about this is they can have a child that is their own biologically, and there’s not a law in the land that can take it away from them.” Rupak said the agency has had a steady increase in clients. He cited 344 surrogate births to couples from across the United States, Canada and Europe in the past four years, including 17 in December. Sixty-eight other surrogate pregnancies are under way, he said.
Rupak said his agency works with clinics in India, Panama and Crete. Clinics in Panama are more attractive to some Americans because it costs less for parents to travel there to pick up their newborn. Rupak said a flight to India averages $1,500 and takes at least 16 hours, double the cost and time to reach Panama.
Evantash and Rupak said U.S. couples must go to India to claim their newborns because DNA testing is required to prove a biological connection between parent and child. According to the Department of State, a blood relationship between parent and child must be proven in order to grant the child U.S. citizenship. Some experts say overseas surrogacy raises ethical questions.
“It’s kind of a weird version of medical tourism,” said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia. “It’s weird because normally, when people are going to have a child, they wouldn’t think of trusting the pregnancy to a complete stranger in a poor nation,” Caplan said. “You have a lot of issues about the diet, health and behavior of your surrogate.”
Evantash and Rupak said surrogates are required to stay at the infertility clinic until they give birth so that their nutritional and medical needs are met. The women’s families can visit throughout the pregnancy. Although surrogates are paid as much as $8,000 — equivalent to 15 years of salary in India — Caplan said the money often does not lift the surrogates out of poverty.
“The woman gets some money, but she’ll use it for debts, and end up back in poverty, only with less debt,” Caplan said. “So there is a high degree of exploitation.” Evantash and Rupak indicated that such concerns have been addressed.
Rupak said he has made several visits to the Indian infertility clinic that works with his agency. He said that although the surrounding town “might look sketchy,” the clinic itself is clean and modern. Evantash said the clinic he works with provides surrogate mothers with around-the-clock medical care and counseling during the pregnancy and for at least 30 days afterward.
“Their welfare is not skimped on,” he said.