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| Nepal Bans Surrogacy, Leaving Couples With Few Low-Cost Options | |
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| KATHMANDU, Nepal — The embryos belonged somewhere, but probably not in this empty fertility clinic in the capital of Nepal. | KATHMANDU, Nepal — The embryos belonged somewhere, but probably not in this empty fertility clinic in the capital of Nepal. |
| For months, they had sat suspended in a tank of liquid nitrogen at the fertility center at the Grande City Clinic and Hospital, which until recently operated a robust surrogacy business that attracted would-be parents from around the world. But the embryos are now stuck in limbo after Nepal abruptly banned surrogacy in September. | For months, they had sat suspended in a tank of liquid nitrogen at the fertility center at the Grande City Clinic and Hospital, which until recently operated a robust surrogacy business that attracted would-be parents from around the world. But the embryos are now stuck in limbo after Nepal abruptly banned surrogacy in September. |
| “We’ve gotten to the point now where it’s shut down and we don’t know where to go,” said Kain Rafferty, a data services officer from Melbourne, Australia, who has embryos stored in the clinic. | “We’ve gotten to the point now where it’s shut down and we don’t know where to go,” said Kain Rafferty, a data services officer from Melbourne, Australia, who has embryos stored in the clinic. |
| Surrogacy may be the only way for some couples to have biological children by implanting an embryo into a woman who carries the child for them. But many cannot afford the process in developed countries like the United States or Canada and have looked for cheaper options in less-regulated countries like Nepal, India and Thailand. Now, one by one, these nations have shut their doors amid concerns over exploitation of the surrogates, oversight and safety, leaving people of less means without many choices. | Surrogacy may be the only way for some couples to have biological children by implanting an embryo into a woman who carries the child for them. But many cannot afford the process in developed countries like the United States or Canada and have looked for cheaper options in less-regulated countries like Nepal, India and Thailand. Now, one by one, these nations have shut their doors amid concerns over exploitation of the surrogates, oversight and safety, leaving people of less means without many choices. |
| “When you look at the global map currently,” said Doron Mamet, a co-chief executive officer of Tammuz, a surrogacy agency based in Israel, “there are only a few options that are open.” | “When you look at the global map currently,” said Doron Mamet, a co-chief executive officer of Tammuz, a surrogacy agency based in Israel, “there are only a few options that are open.” |
| The United States regulates surrogacy on a state-by-state basis, and some states are friendlier than others. California’s laws are among the most permissive, while surrogacy contracts are unenforceable in states like Michigan. | The United States regulates surrogacy on a state-by-state basis, and some states are friendlier than others. California’s laws are among the most permissive, while surrogacy contracts are unenforceable in states like Michigan. |
| The process is allowed in a patchwork of other countries, to varying degrees. Canada, like many places, forbids commercial surrogacy, meaning that pregnant women may be reimbursed only for their expenses. Ukraine is one of the few low-cost surrogacy options available to foreigners, but not to same-sex couples like Mr. Rafferty and his partner, who used an egg donor to create their embryos. | The process is allowed in a patchwork of other countries, to varying degrees. Canada, like many places, forbids commercial surrogacy, meaning that pregnant women may be reimbursed only for their expenses. Ukraine is one of the few low-cost surrogacy options available to foreigners, but not to same-sex couples like Mr. Rafferty and his partner, who used an egg donor to create their embryos. |
| Israel bans same-sex couples from using a surrogate, and many heterosexual couples consider the process too onerous and expensive. Some couples, like Oshri and Anat Gez, have looked outside the country for easier and less costly options. | Israel bans same-sex couples from using a surrogate, and many heterosexual couples consider the process too onerous and expensive. Some couples, like Oshri and Anat Gez, have looked outside the country for easier and less costly options. |
| The Gezes said they came to Nepal after a decade of trying to have a child and four failed attempts with surrogates in India. | The Gezes said they came to Nepal after a decade of trying to have a child and four failed attempts with surrogates in India. |
| They had wanted two children, and were expecting twins through a surrogate in Kathmandu when Nepal imposed its ban. Their leftover embryos would have been expensive to store, especially in a country where they could no longer be used, Mr. Gez said. | They had wanted two children, and were expecting twins through a surrogate in Kathmandu when Nepal imposed its ban. Their leftover embryos would have been expensive to store, especially in a country where they could no longer be used, Mr. Gez said. |
| But the twins were born prematurely, the Gezes said, and one did not survive. The Gezes brought home only one child. | But the twins were born prematurely, the Gezes said, and one did not survive. The Gezes brought home only one child. |
| But by then the couple had already decided to destroy the leftover embryos. Now, the couple must figure out where they can start the process again. | But by then the couple had already decided to destroy the leftover embryos. Now, the couple must figure out where they can start the process again. |
| “We didn’t know,” Mr. Gez said. “We thought we had twins.” | “We didn’t know,” Mr. Gez said. “We thought we had twins.” |
| Mr. Rafferty, the Australian, and his partner are also evaluating their options, and what to do with their embryos. Like many same-sex couples, they turned to Nepal after India closed surrogacy to single people and gay couples. India later shut off surrogacy to all foreigners, and there is a debate over what to do with some of the embryos stored there, too. Complicating matters further, frozen embryos can be more difficult to use successfully than fresh embryos. | Mr. Rafferty, the Australian, and his partner are also evaluating their options, and what to do with their embryos. Like many same-sex couples, they turned to Nepal after India closed surrogacy to single people and gay couples. India later shut off surrogacy to all foreigners, and there is a debate over what to do with some of the embryos stored there, too. Complicating matters further, frozen embryos can be more difficult to use successfully than fresh embryos. |
| India and Nepal share a porous border, and some women who wanted to become surrogates crossed easily into Nepal, where there were fewer restrictions, according to several surrogacy experts. That, critics said, was part of the problem. | India and Nepal share a porous border, and some women who wanted to become surrogates crossed easily into Nepal, where there were fewer restrictions, according to several surrogacy experts. That, critics said, was part of the problem. |
| The process of gestational surrogacy has been criticized for taking advantage of vulnerable women with few financial resources. Prabin Pandak, a legal advocate who petitioned the Supreme Court to ban surrogacy, argued that it was akin to human trafficking. | The process of gestational surrogacy has been criticized for taking advantage of vulnerable women with few financial resources. Prabin Pandak, a legal advocate who petitioned the Supreme Court to ban surrogacy, argued that it was akin to human trafficking. |
| “The chance of exploitation is very high,” said Deepak Dahal, a Nepali journalist who covered the surrogacy debate for the Nagarik News. | “The chance of exploitation is very high,” said Deepak Dahal, a Nepali journalist who covered the surrogacy debate for the Nagarik News. |
| The Internet is littered with ads for surrogacy agencies, some more respected than others. In Nepal, agents typically acted as go-betweens for prospective parents and the clinics on the ground. | The Internet is littered with ads for surrogacy agencies, some more respected than others. In Nepal, agents typically acted as go-betweens for prospective parents and the clinics on the ground. |
| “The problem with those agencies — some of them of course are probably very good and careful — but anybody can do it,” said Lisa C. Ikemoto, a law professor at University of California, Davis, who specializes in reproductive technology. “Basically what they do is they set up a website.” | “The problem with those agencies — some of them of course are probably very good and careful — but anybody can do it,” said Lisa C. Ikemoto, a law professor at University of California, Davis, who specializes in reproductive technology. “Basically what they do is they set up a website.” |
| Surrogates in Nepal often came from poor rural areas of India, and they had few protections if the agency refused to pay them or if they got sick or injured. Critics of surrogacy also worried that agencies and prospective parents had no obligation to take care of ill or disabled babies. | Surrogates in Nepal often came from poor rural areas of India, and they had few protections if the agency refused to pay them or if they got sick or injured. Critics of surrogacy also worried that agencies and prospective parents had no obligation to take care of ill or disabled babies. |
| But proponents say that surrogates can earn life-changing sums of money. “It’s true that they do this for the money,” said Dr. Sahil Gupta, who has overseen surrogacy at the Grande clinic. Dr. Gupta, who is now based in India and is working remotely with Mr. Rafferty, said that he typically arranged for surrogates to earn about $9,000 each, plus room and board. | But proponents say that surrogates can earn life-changing sums of money. “It’s true that they do this for the money,” said Dr. Sahil Gupta, who has overseen surrogacy at the Grande clinic. Dr. Gupta, who is now based in India and is working remotely with Mr. Rafferty, said that he typically arranged for surrogates to earn about $9,000 each, plus room and board. |
| “The thing is, the kind of money that they get out of surrogacy is probably 10 years of their savings otherwise,” Dr. Gupta said, adding that he is hopeful that the government will reverse its position. | “The thing is, the kind of money that they get out of surrogacy is probably 10 years of their savings otherwise,” Dr. Gupta said, adding that he is hopeful that the government will reverse its position. |
| A small handful of pregnant women were allowed to carry their children to term after the ban took effect. One surrogate at the clinic, a shy woman who for privacy reasons wanted to give only her first name, Bibha, said that she earned just a few hundred dollars a year as a seamstress in India. Speaking through a translator who works at the clinic, Bibha said she hoped the Nepalese government would change its mind. | A small handful of pregnant women were allowed to carry their children to term after the ban took effect. One surrogate at the clinic, a shy woman who for privacy reasons wanted to give only her first name, Bibha, said that she earned just a few hundred dollars a year as a seamstress in India. Speaking through a translator who works at the clinic, Bibha said she hoped the Nepalese government would change its mind. |
| Before the ban, Dr. Gupta estimated that roughly 40 to 60 percent of his clients had been same-sex couples. Some went to Mexico, he said, where there was a brief window before banning surrogacy for foreigners, too. | Before the ban, Dr. Gupta estimated that roughly 40 to 60 percent of his clients had been same-sex couples. Some went to Mexico, he said, where there was a brief window before banning surrogacy for foreigners, too. |
| “For same-sex couples, it’s become increasingly difficult,” said Andrew Vorzimer, a lawyer who specializes in reproductive law. | “For same-sex couples, it’s become increasingly difficult,” said Andrew Vorzimer, a lawyer who specializes in reproductive law. |
| Experts also worry that newer, unregulated surrogacy industries will experience the same swift crackdowns of their predecessors. “I am very much in favor of less expensive options for people, but to date there has not been a single place I’ve felt comfortable sending people to,” said John Weltman, the president and founder of Circle Surrogacy, which is based in Boston, Mass. “I would caution dramatically against new and up-and-coming places like Cambodia, and Panama, because the legal framework is not secure.” | Experts also worry that newer, unregulated surrogacy industries will experience the same swift crackdowns of their predecessors. “I am very much in favor of less expensive options for people, but to date there has not been a single place I’ve felt comfortable sending people to,” said John Weltman, the president and founder of Circle Surrogacy, which is based in Boston, Mass. “I would caution dramatically against new and up-and-coming places like Cambodia, and Panama, because the legal framework is not secure.” |