Embryos fertilised at the Fertility Clinic of Cambodia. Charlotte Pert
The billion dollar babies
With commercial surrogacy now banned in India, Nepal and
Thailand, the enormously lucrative industry is moving into Cambodia.
However, with its legal and ethical status murky, potential parents are
being warned to stay away.
Any day now, Cambodia’s first baby conceived in a test tube and
implanted in a rented womb will be born in a Phnom Penh maternity ward.
The names of the intended parents are not known, nor that of the
local surrogate. It is not known which agency is being used, or who and
how much was paid.
In fact, nobody really knows if the procedure is even legal in Cambodia.
Recent media reports have claimed that the Ministry of Interior
intends to treat surrogacy as a form of human trafficking, making it not
only illegal but punishable by a prison sentence.
But speaking this week, Health Minister Mam Bunheng said that the matter had yet to be decided.
The proud parents of Cambodia’s first IVF baby with Hor Samnang (left). Photo supplied
“Until now, we don’t have a law to ban or regulate surrogacy and we
are discussing together with the Ministry of Justice to regulate the
industry to avoid problems, but we haven’t finalised the result whether
it will be considered human trafficking or not,” he told Post Weekend,
adding that the government was currently working on a law on IVF and
surrogacy.
The billion dollar trade
With thousands of would-be parents worldwide willing to spend big for a
chance at becoming mothers or fathers, commercial surrogacy has the
potential to be a hugely lucrative trade for developing countries.
Options in richer countries are extremely limited and costly: in
California, one of the few jurisdictions worldwide where surrogacy is
legal, it costs upwards of $120,000 a pop.
Sam Everingham, director of Australian-based advocacy organisation
Families Through Surrogacy and the father of two surrogate baby girls,
said there is a lot of fear and concern amongst intended parents about
using surrogates in far-off locations.
“But these parents are desperate in the sense that they don’t feel like they have very many options,” he said.
“So they’re willing to risk $50,000 or more in the hope that it will work out.”
But even in the developing world, the number of countries where
surrogacy is currently legal is dwindling. India, Nepal and Thailand all
shut down their once sizeable industries over the course of 2015.
Thailand’s crackdown came on the back of two scandals.
The first was the revelation that an Australian couple had left ‘Baby
Gammy’, who had Down syndrome, behind with his surrogate mother after
taking home only his twin sister.
Around the same time, Interpol began investigating a Japanese man who
had fathered 16 children to Thai surrogates. He claimed his motives
were benign, while others accused him of running a “baby factory”.
More than a dozen other surrogacy agencies – most of which previously
operated in Thailand, India and Nepal – have begun offering services in
Cambodia, and at least two more IVF clinics have been established to
carry out the procedure for them.
Their motivation is clear.
Hor Samnang, who in September 2014 started Cambodia’s first in vitro
fertilisation programs at the Fertility Clinic of Cambodia, said that if
legalised, commercial surrogacy could be worth $500 million or $1
billion per year to the Cambodian economy.
“[It would not just benefit] my clinic,” he said. “It’s for Cambodia.
[The intended parents] come for the procedure with other clinics, too.
This money goes to tourism, their flight, their food, accommodation as
well,” he said.
Estimates of the worth of the Indian industry at its peak ranged up to $2.3 billion per year.
Families Through Surrogacy’s Sam Everingham, who visited Cambodia to
investigate developments here last year, said more than 100 families had
signed up for surrogacy services and the first babies were due “around
now”. With contacts in the industry, he was able to get inside
information.
“The first transfers occurred in April to Chinese intended parents,”
he said. “Then the Australians, Europeans and Americans have come
later.”
Hor Samnang, co-founder of the FCC, says the surrogacy could be worth millions to Cambodia. Charlotte Pert
In Cambodia, the customers pay upwards of $30,000 for each pregnancy
with the surrogate receiving up to $10,000, according to documents
obtained through surrogacy agency websites.
Everingham said that while some of the surrogates were Cambodian,
most were Thai women who had been signed up while surrogacy was still
possible in Thailand.
“Because there’s a surfeit of Thai surrogates recruited, they are
being shipped into Cambodia for embryo transfer then back into Cambodia
for birthing, so it’s far from an ideal arrangement,” he said.
Everingham said it was all part of a rush to cash in on the unregulated Cambodian market before it was closed.
“It’s a case of making hay while the sun shines. The industry in
Cambodia has a feeling that surrogacy will probably have a year in
Cambodia before it gets shut down,” he said.
“Because the three major markets – India, Thailand and Nepal – have
all been shut down to foreigners, there’s now huge pressure on the
Cambodian market to take up the slack.”
Behind closed doors
At the moment, the industry players know they are operating in a grey
area. Their response is evasion, or flat out denial of their operations.
This week, attempts by Post Weekend to contact numerous agencies went
unanswered. Intended parents were likewise unwilling to talk. The
European Fertility Clinic and First Fertility, Phnom Penh – both
mentioned as local partners on the websites of different surrogacy
agencies – flatly denied they offered surrogacy services.
Hor Samnang from the Fertility Clinic of Cambodia also denied that
his clinic was already actively involved in commercial surrogacy.
“We don’t recruit surrogates, we don’t find intended parents,” he said.
The New Life IVF Thailand clinic was shuttered last year after the ban on commercial surrogacy. AFP
He conceded the Fertility Clinic of Cambodia had provided IVF
services to a handful of surrogate cases for New Life Cambodia and New
Genetics Global, but he claimed he didn’t know whether the surrogates
had been paid.
“The [surrogate and intended parent] have their agreement without the knowledge of FCC. We just carry out the procedure.”
Griffith University’s Patricia Fronek, who specialises in adoption
and surrogacy, told Post Weekend via email that it was unacceptable for
an IVF clinic not to make inquiries into the circumstances of its
clients.
“And it is a good example of the problems and risks to children and surrogates,” she said.
Fronek said there were a variety of issues IVF clinics should address when dealing with surrogate cases.
They included transparency in relation to profit; quality of medical
care; accurate record keeping for children who may later wish to search
for information on surrogates and donors; truly informed consent of
surrogates; and proper assessments for commissioning parents – including
police and child protection checks.
“There have been reports of falsification of records and abandonment
of disabled or ‘extra’ children and commissioning parents suffering
fraud and financial abuse in some countries,” she said.
“So in my opinion, all these issues and more would require safeguards.”
Everingham said regulation of any potential Cambodian industry was possible and needed.
He said laws should mandate adequate neonatal care for premature
babies, screening for surrogates to ensure they have completed their own
family and are psychologically able to give up a child, education for
surrogates on the implications, legal protection for parents or
surrogates (especially in cases where one party changes their minds) and
provisions for surrogate children to contact their surrogate and/or
donor as they grow up.
A clinician at work at the Fertility Clinic Cambodia . Charlotte Pert
Ethical examination
Fronek said the issue of whether commercial surrogacy should be allowed
at all was complicated and depended on how “commercial” was defined.
“I think surrogacy is one of those phenomena where technology
advances before knowledge generation and ethical examinations,” she
said.
“On one hand, proponents see surrogacy as comparable to IVF – as a
medical procedure that does no harm and faces unnecessary legal
barriers. However, it is more than a medical or technological procedure –
it is also biological, social and psychological and affects multiple
people, not the least the children.
“There are many ethical and social issues and not enough research or knowledge.
“Lobbyists have been pushing hard for commercial surrogacy to be
introduced into Australia for a long time. Many commentators are seeing
this as a way of controlling abuses overseas (babies, surrogates and
commissioning parents). I do not think it is that easy. Profit and
commercialisation should never be mixed with children in my opinion.”
And despite the financial imperative, there remains political and
moral opposition to the surrogacy industry from within Cambodia as well.
CNRP lawmaker Son Chhay, who opposes any kind of surrogacy as
“unnatural”, said he didn’t think Cambodia would ever legalise the
practice and planned to write to Prime Minister Hun Sen urging the
government to outlaw it immediately.
“This is a Buddhist country, and having a woman carry another child
is contrary to Buddhist principles,” he said. “Whoever gives birth to a
child becomes its mother and it’s her obligation to care for it.”
He said the industry might be able to stay out of the public eye for a
while but eventually scandal would strike and the government would be
forced to act, adding that in the meantime, the authorities would bleed
all involved of cash.
“The public will find it unacceptable,” he concluded. “When a mother
does not want to give up a child, people will support the woman.”
But the anonymous women now in the late stages of carrying the first
generation of Cambodian commercial surrogate babies will be praying that
everything goes to plan over the next few months. With no legal
framework in place to monitor the transaction, they’ll have no one to
turn to if it doesn’t.
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