Tang Zhou and his wife are planning to have their second child, a test-tube baby.

His wife had a natural delivery when she was 34 and their first child, a boy, is now 7. The couple, who are involved in a wine-importing business in Beijing, are now hoping to have a daughter through a surrogate mother in the US.

“My wife couldn’t bear another delivery because of her heart condition and her age. Surrogacy helps avoid the risks to older mothers,” Tang said.

“Moreover, our second child will be born in the US and become a citizen there. That is not a bad choice.” The couple spent weeks researching their move, looking for a reliable agency that provides surrogacy services overseas. Surrogacy is still illegal in many countries, including China.

“We will be taking much higher risks by relying on a surrogate mother in China because we are not protected by any regulation or law. You pay a lot of money but may encounter many problems,” Tang said.

“You might not even get your baby back.”

Tang and his wife are part of an increasing number of Chinese couples who are turning to surrogacy services.

Tang also considered surrogacy in Thailand but dropped the idea after recent reports about a baby with Down syndrome who was delivered through surrogacy and allegedly abandoned by the biological parents in Australia.

Instead, Tang chose the California Surrogacy Center agency as his first option after reading the detailed introduction on its website. Compared with many other agencies that he could contact only via e-mail, the centre has a consulting office in Beijing, Tang said.

The couple visited the office on the 11th floor of the Nanyin Building near the West Third Ring Road in Beijing on a Friday morning. A consultant named Liu Jia hosted the couple. She said the office is only for consultations. Other procedures, including health checks, contractual arrangements, surrogacy and delivery of the baby, are done in the US.

“In the past two years, we’ve successfully helped about 40 couples in China have a child through surrogacy, including two gay couples. Most intended parents from China are between 38 and 45 years old,” Liu said.

The centre is in San Diego, California, and has satellite offices in Los Angeles and Beijing. According to Liu, the centre has been operating for more than eight years, and about 100 surrogate mothers live in California.

If the parents supply their own sperm and ova, the centre charges $110,000 to $160,000, which includes the payments to the surrogate mother, the agency’s fee, insurance and legal bills. Generally speaking, overseas parents are required to travel to the US three times. First, they will visit the centre for a one-on-one consultation with lawyers and surrogate mothers. Contracts are signed after a decision is made.

“We have a big pool of surrogate mothers of different races, including Asian,” Liu said. “But usually, I recommend clients choose a white or black surrogate mother because they are stronger and have thicker uterine walls.”

The second visit is mainly for the in vitro fertilization process. During the pregnancy, the centre will check the physical and mental condition of the surrogate mother every week and update the clients on her condition.

“If required, we can also arrange video calls between surrogate mother and intended parents,” she said.

“Ten months after that, the clients fly to the US for the third time and take their lovely baby back. However, travel and accommodation costs are not included in our package.

“About 80 per cent of our clients turned to surrogacy in the US not only with the consideration of being protected by the law but also because the child will be recognised legally as a US citizen. Moreover, the much higher success rate of IVF in the US is also crucial to them since many Chinese female clients are not at their best age for childbearing,” Liu said. Compared with the success rate of IVF in China’s top fertility hospital, at 30 to 50 per cent, the rate in the US is as high as 83 per cent, Liu said.

The Tangs had left the office in Beijing after about an hour, but were still concerned about the centre’s reliability.

“We should pay a visit to California, at least to make sure the centre is there and is legally protected,” Tang said.

Infertility issues

An increasing number of couples in China have been facing infertility in recent years. A report from the China Population Association showed that the infertility rate among people of childbearing age rose from 3 per cent in 1992 to 12.5 per cent in 2012, equivalent to 40 million people.

But in large cities such as Beijing, Shanghai and Guangzhou, the infertility rate is even higher at 15 per cent, which means one in 10 couples of childbearing age have difficulty conceiving.

Peking University Third Hospital, one of China’s leading hospitals for the treatment of infertility problems, receives 1,500 couples hoping for a baby every day.

“Many factors can be blamed for an increase in the infertility rate, including stress, abortion, pregnancy at an older age and environmental pollution,” said Qiao Jie, president of the hospital.

The transfer of sperm, eggs and embryos between hospitals is forbidden in China. In 2001, the Health Ministry issued a regulation on assisted fertility techniques that banned both commercial and altruistic surrogacy.

For wealthy Chinese who want to have a child through surrogacy, destinations such as some states in the US and India, where the service is legally protected, have become safe options.

“Most of the clients we have seen from China are from wealthy backgrounds and have a lot of power within their industries. These clients know what they want and how to get it,” said Barrie Drewitt-Barlow, head of social work at the British Surrogacy Centre of America, a US-based surrogacy centre with offices in California, New Jersey and the UK.

The centre has handled about 800 live births since it was established in 2000. Seventy per cent of them were in the US and the rest in the UK. The clients’ ages range from 35 to 65.

“China has always been a country of great opportunity within the surrogacy world. The number of clients from China has grown steadily and it continues to climb today. Many of our clients wish to try for multiple births and have twins, mainly because of the rules in China on birth control and the numbers of children per family,” Drewitt-Barlow said. In the past five years, the organisation has worked with more than 100 couples from China both from the straight and gay communities, Drewitt-Barlow said. He said China will continue to be a growth area and the group plans to have a branch office in the country within the next five years.

Paying for a woman to carry a child is legal in 19 US states, which have laws that recognise compensated surrogacy. Another 10 allow unpaid surrogacy. Under the existing laws, the names of the intended parents will be directly written on the baby’s birth certificate and they will be legally recognised as the baby’s parents.

Under the rules of the US Food and Drug Administration, donors of eggs, sperm, and embryos have to be tested as a precaution to protect the recipient-the gestational carrier in this case-against contracting any diseases from the embryo.

For surrogate mothers, the same test at the FDA-approved labs and a physiological test are also mandatory, according to a China Business News report. The blood of the spouses of married surrogate mothers is also tested.

But there are still risks involved for the Chinese intended parents.

A surrogacy agency should be registered with the FDA, but “they are not supervised by the FDA or anyone else, and this is why there are so many scams in the surrogacy marketplace”, Liu from California Surrogacy Center said.

The British Surrogacy Centre website contains a detailed price list for surrogacy with or without sperm or egg donations-for example, a $20,000 payment to BSC, legal fees of $10,000 to $16,000, and IVF surrogacy from $23,000 to $37,000.

For intended parents who need surrogacy with a donor’s sperm or egg, an extra fee is charged. If the surrogate delivers twins, extra payment for each baby will be added.

“Because of the large amounts of money in this field, lots of agencies pop up all the time with the aim of ripping off clients from around the world,” Drewitt-Barlow said. “The FBI is constantly looking into the claims from intended parents that have wired money to firms in the US, and those firms have closed down or gone bust.”

To ensure that the surrogacy is legally protected, Drewitt-Barlow said, it is important that intended parents talk to the people involved.

All contracts should be signed in the state that the surrogacy is being carried out, Liu added.

“Never sign a contract or pay the fees in China. If you can’t be in the US for some reason, you should do a notarization in the US embassy,” she said.

Risks at home

But many Chinese parents also turn to the domestic market because of lower costs. Advertisements posted online or via messaging apps are easily found.

Many of these agencies are illegal. They sport fancy websites but can only be contacted through messaging apps like QQ or WeChat. Landline or cellphone numbers are seldom available.

Numerous efforts by China Daily to contact many of these agencies were unsuccessful.

One of them, called International Medical Service, based in Shanghai, responded by saying it has six years’ experience of providing surrogacy services and even invested “millions of yuan” to build their own IVF clinic in Guangdong’s provincial capital, Guangzhou.

A woman surnamed Li from the agency’s customer service department said more than 500 babies have been delivered over the past six years through its services. An ordinary surrogacy costs 450,000 yuan ($73,300). She also introduced another package for “unlimited tries”, promising that the client can have a baby for 650,000 yuan.

“If you wanted to decide the gender of your baby, a total of 850,000 yuan is necessary,” she said.

“We have about 20 surrogate mothers, mainly from South China and aged between 26 and 32. The physicians serving in our agency are mostly from level-three (top level) public hospitals.”

Li gave the reporter a detailed introduction to the agency’s surrogacy services, including photos and resumes of three doctors from three different level three hospitals in Guangzhou.

But checks later showed that the three doctors mentioned could not be found in the hospitals.

“As you know surrogacy is not permitted in China, so we can’t use the true names of those doctors. But you can pay a visit to our clinic in Guangzhou first. We will let you see the doctor after we make the deal,” she said.

Such unreliable surrogacy services without legal protection also pose risks to surrogate mothers-most of whom are poorly educated without any knowledge of legal issues. To them, surrogacy is a 10-month deal that promises easy and fast money.

On Tianya, one of China’s biggest online chat platforms, posts looking for women as commercial surrogate mothers can easily be found.

When contacted via the QQ messaging service, a representative of a surrogacy agency called Angel Surrogacy Center based in Fujian province said its surrogate mothers hail from North and South China but stay in Fujian and Hubei provinces.

These people “don’t want to get pregnant in their hometown to avoid the embarrassment of meeting their friends”, said the representative, who wanted to be known as Chen.

On its website, the agency said it has been operating for four years and has served more than 100 couples. Surrogate mothers can choose to stay in an apartment that the agency arranges (usually three to four surrogate mothers share one apartment) or in a house provided directly by the clients.

“You can get 170,000 yuan for having one baby and the clients will pay all the other costs such as food and household chores. Seventy per cent of the total payment will be given during gestation time, and the remaining 30 per cent will be paid after delivery,” Chen said.

“If you are younger than 35, had virginal delivery experience and a medical check to prove your health, we will hire you.”

But when asked how payment can be ensured and about insurance to cover any possible emergency during the pregnancy, the representative of the agency only reiterated its four years of experience and the trust between its clients and surrogate mothers.

“You know it doesn’t make any sense to sign a contract since surrogacy is illegal in China. Neither clients nor we want to have any conflict with surrogate mothers. So if you can deliver a baby successfully, there should be no worries about the payment,” she said.

But those who turn to the domestic surrogacy market because of cheaper services still run the risk of losing the money they fork out and running afoul of the law.

“The contract will be regarded as invalid because it violates moral principles and is against the law on the commercial trade of human organs,” said Wan Xin, a member of the Beijing Health Law Society.

According to the Administrative Measures on Human Assisted Reproductive Technology by the National Health and Family Planning Commission, medical departments or physicians involved in surrogacy services will receive a warning and fined as much as 30,000 yuan.

If such activity constitutes a crime, criminal liability shall be imposed in accordance with the law.

“This is just a regulation and not punitive enough. There are still loopholes for agencies that are independent of medical bodies,” Wan said.

“Such illegal services will not only bring high risks to surrogate mothers and babies, but may also endanger the legal recognition of the parent-child relationship.”

According to China’s Marriage Law and Inheritance Law, children fall under one of four categories-legitimate, illegitimate, stepchild and adopted child. On the birth certificate, Wan said, the “mother” legally recognised is the person who gave birth to the child.

Due to the lack of related regulations or laws on surrogacy, disputes over child maintenance and inheritance have become more frequent in past years, Wan said.

Wang Guisong, associate professor at the law school of Renmin University of China, said there are no investigations showing the scale of the grey market of surrogacy in China, but demand is clearly booming due to the infertility situation and improving economic conditions.

“The government should face this problem at an early stage, decriminalizing surrogacy and developing policies around the legalization of surrogacy for infertile Chinese couples,” he said.

France Winddance Twine, professor of sociology at the University of California, Santa Barbara, suggested that federal legislation should be made in the US and China that regulates surrogacy and provides more long-term protection and medical insurance for surrogate mothers.

“It could generate a dialogue since the industry remains unregulated in both countries, creating the possibility for fraud, labour exploitation of surrogate mothers,” she said.

“We also need a transnational or inter-country agreement on surrogacy since so many individuals travel from Asia (China and Japan) to the countries, like the US where some states like California allow it, to purchase the services of a gestational surrogate.”

She said the labour market is stratified in the US and given the ongoing gender discrimination in the labour force, surrogacy provides fertile women of child-bearing age with a way to earn money.

“There should be no discrimination on the basis of race, ethnicity, and religion of the ‘gestational’ surrogate mothers who are not genetically related to the child that they birth,” Twine said.

“As more Asian women follow what is happening in the US among professional women, the younger generations who have the financial resources will begin freezing their eggs and banking them. We may see a decrease in future generations of upper middle-class women using surrogacy services.”