WSJ Sunday, December 12, 2001 Section C.
With an international network of surrogate mothers and egg and sperm donors, a new industry is emerging to produce children on the cheap and outside the reach of restrictive laws.
By TAMARA AUDI and ARLENE CHANG
In a hospital room on the Greek
She won't be keeping the child. The parents-to-be—an infertile Italian woman and her husband (who provided the sperm)—will take custody of the baby this summer, on the day of birth.
The birth mother is Katia Antonova, a surrogate. She emigrated to
The man bringing together this disparate group is Rudy Rupak, chief executive of PlanetHospital.com LLC, a
Mr. Rupak is a pioneer in a controversial field at the crossroads of reproductive technology and international adoption. Prospective parents put off by the rigor of traditional adoptions are bypassing that system by producing babies of their own—often using an egg donor from one country, a sperm donor from another, and a surrogate who will deliver in a third country to make what some industry participants call "a world baby."
They turn to PlanetHospital and a handful of other companies. "We take care of all aspects of the process, like a concierge service," says Mr. Rupak, a 41-year-old Canadian.
Clients tend to be people who want children but can't do it themselves: families suffering from infertility; gay male couples. They may also have trouble adopting because of age or other obstacles.
And they're price sensitive. PlanetHospital's services run from $32,000 to around $68,000, versus up to $200,000 for a
Overseas surrogacy has other advantages. Surrogates in some poorer countries have little or no legal right to the baby. In
The process can bring profound dilemmas. In some cases, clinics end up creating more fetuses than a couple needs, forcing a decision over whether to abort one or more pregnancies. Babies carried to term occasionally find themselves temporarily unable to get a passport.
Mr. Rupak is learning to navigate the uncharted nature of his field—the stateless babies, the ethical complexities. His expansion to
Some of his own clients have faced the abortion decision, Mr. Rupak says. "Sometimes they find the money" to pay for more children than they expected, he says. After all, they went to such lengths. And if they decide otherwise, Mr. Rupak says, "We don't judge."
PlanetHospital's most affordable package, the "India bundle," buys an egg donor, four embryo transfers into four separate surrogate mothers, room and board for the surrogate, and a car and driver for the parents-to-be when they travel to India to pick up the baby.
Pricier packages add services like splitting eggs from the same donor to fertilize with different sperm, so children of gay couples can share a genetic mother. In
Nobody accurately tallies surrogate births abroad, but critics and industry insiders agree the numbers are growing. Since it started offering fertility services abroad in 2007, PlanetHospital has orchestrated 459 births, Mr. Rupak says. Last year, 280 clients hired the company for reproductive services, and that year 210 babies were born—168 of them twins. This year, 200 clients signed contracts, and 75 surrogates are currently pregnant.
“The 'India bundle' buys an egg donor, four embryo transfers into four separate surrogate mothers, room and board for the surrogate and a car and driver for the parents-to-be when they travel to India to pick up the baby.”
Critics say the business is strewn with pitfalls. "The potential for abuse on many levels is big," says Arthur Caplan, director of the Center for Bioethics at the
Laws are vague and can conflict from country to country. In 2008, baby Manji was born to an Indian surrogate just weeks after the divorce of her Japanese parents-to-be. (The family wasn't a PlanetHospital client.) According to a Duke University case study in legal ethics, it led to a tangle of Indian and Japanese law that first prevented the little girl from being issued a birth certificate, and later made it difficult for her father bring her home to Japan. Months went by. To fix the problem,
"This area of law is very unsettled," says Evgenia Terehova, PlanetHospital's lawyer. "There can be all sorts of unforeseen circumstances."
Ms. Terehova says PlanetHospital clients agree to settle disputes using arbitration under
Greek surrogacy is regulated by a 2005 law, but the business takes advantage of a legal loophole. Surrogate mothers are not supposed to act for profit. However, they can accept money for pregnancy-related expenses. Typically, the expenses are set at up to $50,000.
"The judge never asks" about the money, says Maria Kouloumprakis, a surrogacy lawyer in
Egg donors often come from the
Unlike traditional adoption, there is relatively little vetting of would-be parents either by agencies like PlanetHospital, regulators or clinics. There are also fewer restrictions, such as strict age limits, on who can participate.
Mr. Rupak says individual clinics use their own standards to make some of these decisions. He sometimes advises his clients to get a lawyer to be sure they're in compliance with the laws of their home country.
"Our ethics are agnostic," Mr. Rupak says. "How do you prevent a pedophile from having a baby? If they're a pedophile then I will leave that to the
Mr. Rupak says he has rejected clients. In one case, he suspected a woman wanted to use her own eggs and her son's sperm. "Whatever the case was, these people weren't honest. It worried us, so we said 'no.'"
Mr. Rupak, a former screenwriter and movie producer (his credits include "
Conversations between Mr. Rupak and his customers can be an odd mix of frank talk about sperm counts and menstrual cycles and good old-fashioned salesmanship. During one client meeting over tea in
His client, Caroline Lu, smiles. "That's great," she says. Ms. Lu later says she and her husband passed on the teeth-cleaning.
Many factors drive surrogacy's global spread.
PlanetHospital recently launched a website touting "surrogaycy" aimed at gay couples. "In some states you cannot marry, let alone adopt; but not a law in the land can take away a child that is biologically yours," the site says.
"We are so excited, we are just gleaming," says Marc Loeb, a 33-year-old sales director for a women's apparel company in
Mr. Loeb and his spouse, Wolf Ehrblatt, (the two were legally married in
The couple made a $10,000 down payment and decided to try for a child using a college-educated American egg donor and their own sperm.
PlanetHospital steered Mr. Loeb toward
Mr. Loeb says he didn't want to ask. "It's an emotional enough experience," he said.
A few weeks later, Mr. Loeb says, Mr. Rupak called to say, "You're pregnant, man."
The couple made payments as the pregnancy progressed, with the final amount due at birth. Of the $35,000, PlanetHospital keeps around $3,600. Another $5,000 goes to the egg donor, plus another $3,000 or so for travel expenses. The surrogate gets $8,000. The rest, around $15,000, is paid to the clinic.
In the case of gay couples, the surrogate's name appears on the birth certificate as the mother. In the case of heterosexual couples, the adoptive mother's name appears.
Mr. Loeb and Mr. Ehrblatt learned of
The couple will stay in
Mr. Loeb says PlanetHospital arranged for them to live in a modern apartment in
Another gay couple, Jocelyn LaFleur and Denis Doyon of
No country has become a greater magnet for the business than
Suzanne and Thomas Lloyd of
They tried in vitro fertilization with no luck. They also looked into adoption but didn't qualify in many countries because they were either too old or hadn't been married long enough. The Lloyds are college sweethearts who split up after school, only to reunite and marry four years ago.
The couple paid $10,000 to PlanetHospital to try the surrogate route. Mr. Lloyd says there have been some aggravating lapses in communications: Their first contact at PlanetHospital was with a caseworker who would let weeks go by without responding to emails, they say. Since then, he said, Mr. Rupak became their primary contact and communications have improved.
Mr. Rupak acknowledges the communication problem and said he has learned from his mistakes. He recently hired someone in
Surrogacy's complexity can give rise to extraordinarily difficult decisions, such as whether or not to abort. This can happen because clinics sometimes implant multiple embryos into multiple surrogates to improve the odds: If one miscarries, there are still viable pregnancies. However, if several implants successfully lead to pregnancy, clients face ending up with not just one or two children, but many.
At 12 weeks into the pregnancies, Mr. Aki and his husband decided to abort two of the fetuses, one from each woman. It was a very painful call to make, Mr. Aki says. "You start thinking to yourself, 'Oh, my god, am I killing this child?'"
He didn't think of his decision as an abortion, but as a "reduction," he says. "You're reducing the pregnancies to make sure you have a greater chance of healthy children," Mr. Aki says. "If you're going to bring a child into this world, you have an obligation to take care of that child to the best of your abilities."
Today, Mr. Aki and his husband have two 21-month-old daughters. The girls share the same genetic mother. Each man is the genetic father of one of the girls. Next week, Mr. Aki and his husband will officially adopt each other's genetic daughter.
Initially in 2008, Mr. Aki was a
The dispute arose because of poor communication and book-keeping at the clinic, Mr. Rupak says. He has since cut ties with that clinic. "We've improved upon all those things since."
Mr. Rupak says he is vigilant about the risks inherent in a lightly regulated business. He says he stopped using egg donors from
And Mr. Rupak says he is looking to expand into
"It's good that I can help these people have a family, and it's good for my family too," says Mrs. Antonova, who is 40. "I will have this baby, and move on with my life."
—James Oberman contributed to this article.