Surrogacy Overseas Gestational Indian Surrogates - Medical Tourism

Surrogacy for Gay Couples or Singles [CLOSE & RETURN TO PROCEDURE HOMEPAGE]
For Gay couples or single fathers, the process is fairly simple. Choose a donor egg by going to www.planethospital.com/sprofile, go through a routine blood and semen analysis, and then go to India to provide sperm (or you can ship the sperm if you wish). You will be given two surrogates and four IVF attempts, which gives you an excellent chance of pregnancy. Gay surrogacy, single father surrogacy (and donor egg surrogacy itself) has a much higher success rate than gestational surrogacy. Of course, as with gestational surrogacy, costs do increase if there are multiple births or both surrogates get pregnant. Here is a quick breakdown of what to expect in that situation:

This is what you are expected to pay once a pregnancy is confirmed (stage two fees), Please refer to our bundles and pricing section for more specific cost details.

2nd stage fees if one surrogate is pregnant $20000
2nd stage fees if one surrogate is carrying twins An additional $3,000 (so $23,000 total)
2nd stage fees if BOTH surrogates are pregnant An additional $16,000 so ($36,000) or $3,500 for a reduction and surrogate compensation
2nd stage fees if BOTH surrogates are carrying twins An additional $22,000 ($3,000+$3000+$16,000) or $3,500 for embryo reduction

It bears mentioning that PlanetHospital was a pioneer in gay surrogacy . We were the first company to help a gay American couple achieve surrogacy (the first gay couple to get surrogacy in India were from Israel), and we were the first company to help an HIV+ gay man have a baby.

As the saying goes, pioneers do get the arrows -- boy did we get our share of arrows for helping the gay and lesbian community. We routinely receive hate mail, death threats, and the occasional prayer to save our souls from damnation for helping gay men (but curiously not lesbians). We, the founders of PlanetHospital, are a husband and wife couple, and as a protective husband I had to ask my wife, is it worth the hate and threats to continue offering gay surrogacy? She replied, "Don't let the crazies win." Thus, we are proud to continue supporting the Gay and Lesbian community. We know how hard you have struggled to be seen as equal, we know how borderline impossible it is for you to adopt, and we know the challenge your community as a whole faces to have the same rights as a married couple. We feel if you have the desire to have and love a child, then nothing ought to stop you. We have thoroughly researched the laws in the countries we offer gay surrogacy programs and we have made sure you will not have any problems bringing your baby back home, wherever home may be (interesting isn't it that India recognizes the right of a gay man to have a child but is still considered 3rd world)? We will stand by you, we will not be swayed otherwise (and hey, as an inter-racial couple, we understand discrimination all too well).

For those who feel we are doing something wrong, we can respect your views, but they are your opinions and you have a right to them. There are no laws legal or higher, that says a single father or a gay man cannot have a child that is biologically there own. If society prevented YOU from having a child or a medical treatment, we would stand by you and help you in any way that we can.

Not convinced? Take the story of a couple from Missouri, this is an actual email exchange, names had to be changed of course.

May 1, 2008: Atten PlanetHospital, as you know I approached your company some time ago because I needed a liver transplant and while I do admire your pricing and service, I am disturbed by the fact that you are helping gay foks (sic) have babies. My church is raising money for this surgery and they have not been able to raise enough for me to have this surgery in the US so we have turned to you. However I cannot in good conscious ask my fellow congregants to support an enterprise that does business with devients (sic), perhaps you can temporarily take down this from your website until I get my surgery.

This is our reply:

May 1 2008: Dear Mr XXX, I was shocked to read your letter. While I completely respect your views and opinions, they do not sway me. My clients are not deviants, as you call them. They are doctors, lawyers, firemen, policemen, even clergy who are united in their desire to raise a child with all the love that is trapped in their heart longing to be shared with a child of their own. Their lives are already a struggle as it is, and we take tremendous joy in telling them "YES, you can have a child." I wish you can hear the happiness they feel. It was perhaps the same amount of happiness you felt last week when I told you that it does not matter to our doctors in India that your liver was damaged by alcohol (which was the reason your insurance company is refusing to pay for this surgery here in the USA). Are you saying that alcoholism can be forgiven by the lord but homosexuals wanting children cannot? I am sorry you feel this way, but we want to help everyone, come what may.

May 2 2008. Rudy, I don't think you got me, I don't care frankly what you do with your gay clients but my church will be opposed to it and they may refuse to raise money for me, so basically I am saying is for a month or two don't talk about any gay stuff on your website, and then once I get the money to have my surgery, do what you want.

May 2, 2008. Sorry, we cannot and will not do that. We are happy to assist you and all who come to us for help, if your church has issues, they cannot be our issues.

May 2, 2008, Rudy, you are a rude and inconsiderate human being, how do you look at yourself in the mirror? How does your so-called American born wife, tolerate you? I cannot believe you will not help me with my liver surgery. You are not the only one who does this surgery in India. Don't bother to reply, I am not interested in what you have to say any further.

And then we finally received this one:

July 11 2008, Rudy I do not know if you remember me but my liver is taking the turn for the worse, my church has been able to raise only $X towards the surgery and I have the rest of the money (my children are loaning it to me), and when I called your competitors, they were charging nearly double what you were. I said some harsh things. In the grand scheme of things, gay or no gay, the church was only able to raise only a few thousand for me (though they were able to raise a lot more for a garden a few weeks later). Will you still help me in-spite of my hateful letter from the past?

July 11, 2008, Dear XX. Of course we will help you, we are happy to do so. Do not worry about your angry letter, it is forgotten, you reacted because you were scared and upset. I have sent you a passport and visa application form....

We are no longer the only company offering gay surrogacy, our competitors are doing it too. They may or may not be offering the same program we offer which is TWO SURROGATES and FOUR IVF Attempts and they may not have had to go through the same struggles we have had to when we stuck our necks out to help the gay community. We hope you will recognize our efforts and support us as a company that supports the gay community versus a few of our competitors who only "do business" with the gay community without giving back.

Timeline [CLOSE & RETURN TO PROCEDURE HOMEPAGE]

Once you become a client of PlanetHospital we will send you a personalized timeline using googledocs.

Here is a sample timeline:

(http://spreadsheets.google.com/ccc?key=0AlagVe4af4U-dGNmS3Q4UzluUFZEZ25WTF80VEJETHc&hl=en)

Timeline for Intended Parents that do not need a donor:

Step 1: Testing for males and females (Approx. 1-2 weeks for male, for the female, it depends on her cycle, it should take less than 30 days).

Step 2: Clinic Reviews, tests results, determine suitability (Approx. 1 week).

Step 3: Surrogate recruiting starts (Approx. 2 weeks). 
*Surrogate deposit to be paid at this time.

Step 4: Female takes Zoladex 15 days after menses and clinic prepares medication cycle protocol.

*Balance of stage 1 fees due.

Step 5: Female travels to India or consumes medication in her home country. It is preferred that the female remain in India so that she can be closely monitored for greater success (Approx. 16 days if entire medication cycle in india. OR approx. 8 days in female's home country and 8 days in India).

Step 6: Male shows up on the last 5 days or his sperm can be shipped by our partners, Kynesis, for a fee of approx. 1300 GBP.

Step 7: Egg retrieval and IVF performed between days 14 and 16.

Step 8: Chemical pregnancy test, results then sent to parents.

Step 9: Ultrasound test done to confirm pregnancy.

Step 10: Congrats you are officially pregnant!

*Stage 2 fees are now due.

Step 11: Biweekly reports sent to parents.

Step 12: Parents supply PlanetHospital with every possible contact detail they have. (We need to be able to have someone knock at your door at 3am if needed!) In the event of an early pregnancy, we will book your flights and hotels, then contact you for reimbursement.

Step 13: In India, the male must provide a cheek swab. Babies are handed to parents as soon as they are able to leave the neonatal facility. At least one parent remains in India and will experience bureaucratic hell as we wait for confirmation of paternity through your country's embassy and birth certificates.

Step 14: Leave with your baby within 3-6 weeks. Please note that on average most parents have been able to leave by week 4.

Timeline for Intended Parent(s) that need egg and/or sperm donors:

Step 1: Testing for males and females (Approx. 1-2 weeks for male, for the female, it depends on her cycle, it should take less than 30 days).

1a: Choose egg donor.
*$2500 donor fee will be due at this point.
1b: Choose sperm donor.
*1400 Euros will be due at this point, plus shipping costs.

Step 2: Clinic Reviews, tests results, determine suitability (Approx. 1 week).

Step 3: Surrogate recruiting starts (Approx. 2 weeks).

You are in charge of when this process begins. You have 4 months from when you select your egg donor. The male donor must arrive before egg retrieval is done. This can be coordinated with the clinic and PlanetHospital. Please note that sperm can also be shipped. If you are a female requiring a sperm donor, sperm needs to be shipped prior to your arrival.
 *Surrogate deposit to be paid at this time.

Step 4: Female takes Zoladex 15 days after menses and clinic prepares medication cycle protocol.

*Balance of stage 1 fees due.

Step 5: Female travels to India or consumes medication in her home country. It is preferred that the female remain in India so that she can be closely monitored for greater success. (Approx. 16 days if entire medication cycle in india. OR approx. 8 days in female's home country and 8 days in India).

Step 6: Male shows up on the last 5 days or his sperm can be shipped by our partners, Kynesis, for a fee of approx. 1300 GBP.

Step 7: Egg retrieval and IVF performed between days 14 and 16.

Step 8: Chemical pregnancy test, results then sent to parents.

Step 9: Ultrasound test done to confirm pregnancy.

Step 10: Congrats you are officially pregnant!

*Stage 2 fees are now due.

Step 11: Biweekly reports sent to parents.

Step 12: Parents supply PlanetHospital with every possible contact detail they have. (We need to be able to have someone knock at your door at 3 am if needed!) In the event of an early pregnancy, we will book your flights and hotels, then contact you for reimbursement.

Step 14: Leave with your baby within 3-6 weeks. Please note that on average most parents have been able to leave by week 4.

*If you are requiring both egg and sperm donors we have a facility in Europe that can help you. However, this is handled in strict confidentiality. If you require sex selection, we have two clinics who can provide this service. Again, this requires strict confidentiality.

Press & Patient Experiences [CLOSE & RETURN TO PROCEDURE HOMEPAGE]

Here are some articles on surrogacy with our company:

http://online.wsj.com/article/SB10001424052748704252004574459003279407832.html

http://www.nytimes.com/2008/03/10/world/asia/10surrogate.html

http://calabasas365.com/planethospital/

A full version of the articles are posted below the contacts, as are testimonials.

Ready to get started? Please contact Whitney@planethospital.com for references that you can contact.

PlanetHospital has been a member of the Better Business Bureau since 2002 with an A rating with 0 unresolved complaints.

"A Search for a Surrogate Leads to India"

On their third trip to India, Rhonda and Gerry Wile finally heard a sound they thought they might never hear: the heartbeat of their unborn child.
Four nerve-racking months after that joyful ultrasound moment, their son arrived on Aug. 26 at 10:22 p.m. weighing 2.7 kilograms and sporting wisps of dark hair. They named him Blaze Xennon Wile, the middle name chosen from a book of baby names that gave its meaning as "from a foreign or faraway land."
"It seems unreal. We hold him and kiss him a thousand times a day," Mr. Wile says. "It's so lucky that it worked out for us."
For the Wiles, a married couple who live in Arizona, the birth was the culmination of four years of trying to conceive. Theirs was a path marked by wrenching disappointment, a failed pregnancy, many hours on the Internet -- and long airplane trips. The determination to produce a child that is at least partly their genetic offspring led them finally on a high-tech passage to India, where they hired a surrogate to bear their baby.
No official agency keeps track of the number of would-be parents who travel to India for surrogacy. But the proliferation of clinics around the country providing such services gives some idea of the rising demand for surrogates: women who bear children on behalf of other people, often in return for money, a practice that is legal in India.
According to Hrishikesh Pai, a Mumbai-based in-vitro fertilization specialist and vice-president of the Indian Society for Assisted Reproduction, India now has about 350 facilities that offer surrogacy as a part of a broader array of infertility-treatment services, triple the number in 2005. Last year, Dr. Pai says, about 1,000 pregnancy attempts using surrogates were made at these clinics. This year, he estimates the figure will jump to 1,500, with about a third of those made on behalf of parents from outside India who hired surrogates.
Rudy Rupak, president of PlanetHospital, a California-based medical-tourism company, says that in the first eight months of this year he sent 600 couples or single parents overseas for surrogacy, nearly three times the number in 2008 and up from just 33 in 2007. All of the clients this year went to India except seven who chose Panama. Most were from the U.S.; the rest came from Europe, the Middle East and Asia, mostly Japan, Vietnam, Singapore and Taiwan.
Mr. Rupak says that because of growing demand from his clients for eggs from Caucasian women, he's started to fly donors to India from the former Soviet republic of Georgia, where he has connections with clinics. The first woman arrived last month. A PlanetHospital package that includes an Indian egg donor costs $32,500, excluding transportation and hotel expenses for the intended parent or parents to travel to India. A package with eggs from a Georgian donor costs an extra $5,000.
In India, there are critics of surrogacy who contend it treats children as a "commodity" and exploits some women. "They are using the vulnerability of the poor. Making (a woman) a child-producing machine is not acceptable to us," says Ranjana Kumari, president of WomenPowerConnect, a coalition of 800 organizations across India that lobbies government on women's issues. "There should be controls so it is not an open market as it is at the moment."
Since 2005, the practice of surrogacy has been operating under guidelines established by the Indian Council of Medical Research, a government body. But a new law is in the works that aims to regulate the surrogacy industry by standardizing such things as contract terms and surrogate compensation, which currently ranges from about $2,000 to $10,000. To avoid potential legal disputes, it will also govern what parental information is given on birth certificates. What's more, the new law, which could be introduced in Parliament as early as December, would require clinics to register surrogacy cases and report their outcomes. "At the end of the day, we're going to have statistics, which is very important," partly because of the implications for India's burgeoning medical-tourism industry, says Kamini Rao, a fertility doctor in Banglalore who helped draft the legislation.
For the Indian surrogates themselves, it's an experience often fraught with emotional conflict. In most cases, the egg comes either from the woman who wants to become a mother but can't carry a child, or from an egg donor. The egg is then fertilized with sperm from the intended father, or a sperm donor, and implanted in the womb of a surrogate who bears the child. Sometimes, no money changes hands, particularly when a friend or relative acts as the surrogate. Alternatively, it's a commercial transaction, which is almost always the case in India for would-be parents from overseas.
Surrogacy itself is often maligned in India's multireligious society as a peculiar form of prostitution. Fearing social censure, many surrogates hide their pregnancies from relatives and friends by moving away temporarily on the pretext of having secured a job elsewhere. What's more, some doctors prefer to separate the surrogate from her family to insure she gets the proper nourishment, while avoiding risks to the fetus such as sexually transmitted diseases and secondhand cigarette smoke. The family is allowed to visit her in her quarters, but even so it can be a lonely time for the woman.
Still, it's a way to raise money in sometimes desperate circumstances. Take Sudha, a 25-year-old mother of two who now works as a maid in Chennai earning $20 a month. She owes moneylenders about $2,700, borrowed to pay bribes to secure a government job as a streetsweeper, which never materialized. A neighbor told her she could earn about $2,000 at a local clinic by bearing a child for an infertile couple. She gave birth in July 2008 -- and is haunted by the memory. "Whenever I have free time and I lie down, I think about the child. I pray that the child is safe and happy and is taken care of well."
Sudha, who like other surrogates asked that only her first name be used, has reduced her debt to about $600, but the family still struggles to eat. One solution, her husband Umat says, is for Sudha to act as a surrogate again. But he adds that he "won't force her if she says no."
For other women, like 29-year-old Lakshmi, a pregnant surrogate in Chennai who already has an 11-year-old daughter, a 12-year-old son, an alcoholic husband and a $4,000 debt, having someone else's child sounded like a better option than her other plan: selling a kidney. A doctor advised her that with a single kidney left, "I might live for a shorter time. I have a daughter. I have to get her married...I prefer" to be a surrogate, she says.
Some middle-class Indian women, too, are becoming surrogates. In Bangalore, a cash-strapped high-school-educated wife, who earns about $20 a month selling Oriflame brand cosmetics, waits for a call from a local clinic that she has been chosen as a surrogate. Her husband, an office manager, owes more than $30,000, borrowed to start a company that faltered, and the couple can't repay the loan.
For the would-be parents, this passage to India can be stressful, even if they are well organized. Among the foreign couples who began their odyssey on the Internet, some never dreamed that in a world of instant messaging they would be tearing their hair out over delayed transmissions of a scan or fretting about the health of a surrogate halfway around the world. Add to that the unfamiliar environment, language barriers and potential legal risks of doing it in India.
Michael Bergen and Michael Aki, a gay American couple who got married in 2004 and work as graphic designers in Massachusetts, decided to try surrogacy in India after they waited unsucessfully for three years to adopt a child in the U.S. To hire a surrogate, "we looked at Panama and the Ukraine," recalls 39-year-old Mr. Bergen. "But India had better infrastructure, more high-tech facilities and the healthier lifestyle. (Most women) don't smoke, they don't drink and they don't do drugs."
Mr. Rupak's PlanetHospital steered the couple to the Rotunda -- The Center for Human Reproduction, a Mumbai clinic that has been upfront about marketing its services to the overseas gay community. Its Web site highlights a video of a gay Israeli couple who made headlines after taking home a baby from the Rotunda last year.
By email, the American graphic designers chose an anonymous Indian egg donor from profiles provided by the clinic that included the women's education levels and current family status. Then the couple spent four days in India in July 2008. Both wanted to be a genetic father, so they each gave a sperm sample. The pair, concerned that the agreements they were given to sign with the surrogate and the clinic were too vague, spent $3,000 in legal fees to have a U.S. lawyer rewrite them. In retrospect, Mr. Aki, 43, wonders whether the revised contracts would have been honored in India's byzantine legal system anyway. Luckily, the process went smoothly. Using eggs from the same donor so that the offspring would be kin, doctors fertilized them with the respective sperm of the two men and implanted the embryos in two separate surrogates. Both women became pregnant, almost simultaneously, on their first try. This year, Mr. Aki became the father of Rose, born March 24, and Mr. Bergen became the father of Eva, born April 12.
With travel costs, Mr. Bergen estimates the couple spent about $60,000 in all, including compensation of $10,000 for each surrogate. That's roughly half what he thinks the total cost would have been in the U.S.
For others, money is no object. Last year, a former U.S. investment banker in her early 40s, who asked that her name not be used, spent $128,000 to reach her goal. She approached a dozen fertility clinics in India for help. Despite her age, she and her husband wanted to try with her eggs. In the initial attempt, a doctor implanted several embryos in two separate surrogate mothers. That failed. In the second round, the doctor relied on three surrogates. Still no pregnancy. In the third round, he repeated the procedure with two additional surrogates. Bingo. The seventh surrogate gave birth to healthy twin girls.
It's the kind of determination that Rhonda and Gerry Wile understand. She's a 39-year-old blond registered nurse. He's a hefty 43-year-old fireman. Originally from Canada, they married in 2000 and resettled in Mesa, Arizona, three years ago.
The couple started trying to conceive in mid-2005. After several months, Ms. Wile consulted a specialist who found a problem: She has two small wombs instead of a single one. Two months later, though, she was thrilled to find out she was pregnant. But she soon learned the fetus had no heartbeat, and she had to undergo a drug-induced abortion.
Next the couple tried artificial insemination. It failed. They started to consider other options. They ruled out adoption, discouraged by the red tape. A doctor, meanwhile, had recommended surrogacy, and Ms. Wile saw a TV program about surrogacy in India on "Oprah" in October 2007. The Wiles then trawled the Internet for information. In January 2008 they settled on Surrogacy India, a newly established private Mumbai clinic. They liked the quick response to their questions and the clinic's policy of encouraging surrogates to move into designated quarters with their families during the pregnancy, rather than splitting them apart.
"It's been hard for me, being a woman," Ms. Wile said during a trip to India last April. "I've always believed that part of my job as a woman is to have a child." For her, surrogacy seemed as close as she could get to creating a child. The price was also right. "We didn't want to go broke" and "bring a child into the world bankrupt," she added.
The Wiles figured it would cost them between $50,000 and $80,000 for each attempt if they had used a surrogate in the U.S. By comparison, they spent a total of about $50,000 on three attempts in India, including travel expenses for four round trips to India, $550 for the baby's birth and a few days' hospital stay and $5,625 paid to a woman they call "KT," who carried their son.
Initially, Ms. Wile was determined to use her own eggs. From Arizona, over the Internet, the couple picked a potential surrogate and a backup surrogate, just in case, from photos and information such as educational background and family medical history provided by Surrogacy India on a special secure Web site. The Wiles flew to India in April last year, with Rhonda prepped with fertility drugs, a prelude to retrieving eggs from her body. Her eggs were fertilized with Gerry's sperm and transferred to a surrogate but no pregnancy resulted. They tried again in September with a new batch of Ms. Wile's eggs, a second trip to India and a different surrogate. That effort also failed.
"What's more important," Mr. Wile remembers he asked his wife, "having a family, or having a child of your own?"
They decided that if they were to have a family, it would be with a donor's eggs. In October, the Wiles selected an Indian egg donor over the Internet using the clinic's Web site. Then they picked out a new surrogate, KT, a married woman with the Indian equivalent of a seventh-grade education who has two small boys of her own. In her profile, KT described herself as having a "supporting nature" and listed her motivation for becoming a surrogate as "financial, to educate (my) kids." (To lessen any bond the surrogate might form with the child, doctors in India generally discourage the practice of egg donors and surrogates being one and the same.)
Donor eggs fertilized with Mr. Wile's sperm were implanted. This time it worked. The Wiles used Skype from Arizona to talk with the surrogate through an interpreter. In April, the couple made their third trip to India to meet KT face-to-face. "We wanted to see an ultrasound and hear our baby's heartbeat," Mr. Wile says. (Requests to interview KT for this article were declined.)
A month or so before the birth, they finished the nursery in their Mesa home and held a baby shower. Mr. Wile bought the baby a set of golf clubs. Despite the ultrasound, they didn't know whether they would be bringing home a boy or girl; to discourage the selective abortion of girls, Indian law prohibits disclosure of a fetus's gender.
Mr. Wile says: "We've had a very good experience with surrogacy and we're definitely going try it again." They will have to find yet another surrogate, though. Mr. Wile says KT declined to carry a second baby for them.
The couple kept a detailed account of their journey on a blog, which they hope will help others in a similar predicament. "We both plan to let our child know how he was conceived," Ms. Wile says, and that he came from "someone else's tummy."
-Anjali Athavaley contributed to this article.

"India Nurtures Business of Surrogate Motherhood"

MUMBAI - Yonatan Gher and his partner, who are Israeli, plan eventually to tell their child about being made in India, in the womb of a stranger, with the egg of a Mumbai housewife they picked from an Internet lineup.
The embryo was formed in January in an Indian fertility clinic about 2,500 miles from the couple's home in Tel Aviv, produced by doctors who have begun specializing in surrogacy services for couples from around the world.
"The child will know early on that he or she is unique, that it came into the world in a very special way," said Mr. Gher, 29, a communications officer for the environmental group Greenpeace.
An enterprise known as reproductive outsourcing is a new but rapidly expanding business in India. Clinics that provide surrogate mothers for foreigners say they have recently been inundated with requests from the United States and Europe, as word spreads of India's mix of skilled medical professionals, relatively liberal laws and low prices.
Commercial surrogacy, which is banned in some states and some European countries, was legalized in India in 2002. The cost comes to about $25,000, roughly a third of the typical price in the United States. That includes the medical procedures; payment to the surrogate mother, which is often, but not always, done through the clinic; plus air tickets and hotels for two trips to India (one for the fertilization and a second to collect the baby).
"People are increasingly exposed to the idea of surrogacy in India; Oprah Winfrey talked about it on her show," said Dr. Kaushal Kadam at the Rotunda clinic in Mumbai. Just an hour earlier she had created an embryo for Mr. Gher and his partner with sperm from one of them (they would not say which) and an egg removed from a donor just minutes before in another part of the clinic.
The clinic, known more formally as Rotunda - The Center for Human Reproduction, does not permit contact between egg donor, surrogate mother or future parents. The donor and surrogate are always different women; doctors say surrogates are less likely to bond with the babies if there is no genetic connection.
There are no firm statistics on how many surrogacies are being arranged in India for foreigners, but anecdotal evidence suggests a sharp increase.
Rudy Rupak, co-founder and president of PlanetHospital, a medical tourism agency with headquarters in California, said he expected to send at least 100 couples to India this year for surrogacy, up from 25 in 2007, the first year he offered the service.
"Every time there is a success story, hundreds of inquiries follow," he said.
In Anand, a city in the western state of Gujarat where the practice was pioneered in India, more than 50 surrogate mothers are pregnant with the children of couples from the United States, Britain and elsewhere. Fifteen of them live together in a hostel attached to the clinic there.
Dr. Naina Patel, who runs the Anand clinic, said that even Americans who could afford to hire surrogates at home were coming to her for women "free of vices like alcohol, smoking and drugs." She said she gets about 10 e-mailed inquiries a day from couples abroad.
Under guidelines issued by the Indian Council of Medical Research, surrogate mothers sign away their rights to any children. A surrogate's name is not even on the birth certificate.
This eases the process of taking the baby out of the country. But for many, like Lisa Switzer, 40, a medical technician from San Antonio whose twins are being carried by a surrogate mother from the Rotunda clinic, the overwhelming attraction is the price. "Doctors, lawyers, accountants, they can afford it, but the rest of us - the teachers, the nurses, the secretaries - we can't," she said. "Unless we go to India."
Surrogacy is an area fraught with ethical and legal uncertainties. Critics argue that the ease with which relatively rich foreigners are able to "rent" the wombs of poor Indians creates the potential for exploitation. Although the government is actively promoting India as a medical tourism destination, what some see as an exchange of money for babies has made many here uncomfortable.
The Ministry of Women and Child Development said in February that it was weighing recommending legislation to govern surrogacy, but it is not imminent.
An article published in The Times of India in February questioned how such a law would be enforced: "In a country crippled by abject poverty," it asked, "how will the government body guarantee that women will not agree to surrogacy just to be able to eat two square meals a day?"
Even some of those involved in the business of organizing surrogates want greater regulation.
"There must be protection for the surrogates," Mr. Rupak said. "Inevitably, people are going to smell the money, and unscrupulous operators will get into the game. I don't trust the industry to police itself."
He said that the few doctors offering the service now were ethical and took good care of the surrogates but that he was concerned this might change as the business expanded.
Mr. Gher and his partner, who asked not to be named to preserve his privacy, have worked through their doubts and are certain they are doing a good thing.
"People can believe me when I say that if I could bear the baby myself I would," he said. "But this is a mutually beneficial answer. The surrogate gets a fair amount of money for being part of the process."
They are paying about $30,000, of which the surrogate gets about $7,500.
"Surrogates do it to give their children a better education, to buy a home, to start up a small business, a shop," Dr. Kadam said. "This is as much money as they could earn in maybe three years. I really don't think that this is exploiting the women. I feel it is two people who are helping out each other."
Mr. Gher agreed. "You cannot ignore the discrepancies between Indian poverty and Western wealth," he said. "We try our best not to abuse this power. Part of our choice to come here was the idea that there was an opportunity to help someone in India."
In the Mumbai clinic, it is clear that an exchange between rich and poor is under way. On some contracts, the thumbprint of an illiterate surrogate stands out against the clients' signatures.
Although some Indian clinics allow surrogates and clients to meet, Mr. Gher said he preferred anonymity. When his surrogate gives birth later this year, he and his partner will be in the hospital, but not in the ward where she is in labor, and will be handed the baby by a nurse.
The surrogate mother does not know that she is working for foreigners, Dr. Kadam said, and has not been told that the future parents are both men. Gay sex is illegal in India.
Israel legalized adoption by same-sex couples in February, but such couples are not permitted to hire surrogates in Israel to become parents. A fertility doctor recommended Rotunda, which made news in November when its doctors delivered twins for another gay Israeli couple.
Rotunda did not allow interviews with its surrogate mothers, but a 32-year-old woman at a fertility clinic in Delhi explained why she is planning on her second surrogacy in two years.
Separated from her husband, she found that her monthly wages of 2,800 rupees, about $69, as a midwife were not enough to raise her 9-year-old son. With the money she earned from the first surrogacy, more than $13,600, she bought a house. She expects to pay for her son's education with what she earns for the second, about $8,600. (Fees are typically fixed by the doctor and can vary.) "I will save the money for my child's future," she said.
The process requires a degree of subterfuge in this socially conservative country. She has told her mother, who lives with her, but not her son or their neighbors. She has told the few who have asked her outright that she is bearing a child for a relative.
So far, for the Israeli couple, the experience of having a baby has been strangely virtual. They perused profiles of egg donors that were sent by e-mail ("We picked the one with the highest level of education," Mr. Gher said). From information that followed, they rejected a factory worker in favor of a housewife, who they thought would have a less stressful lifestyle.
Mr. Gher posts updates about the process on Facebook. And soon the clinic will start sending ultrasound images of their developing child by e-mail. Highly pixelated, blown-up passport photos of the egg donor and surrogate mother adorn a wall of their apartment in Israel.
"We've been trying to half close our eyes and look at it in a more holistic way to imagine what she would actually look like," Mr. Gher said of the donor's blurred image. "These are women we don't know, will never know, who will become in a way part of our lives."
This article has been revised to reflect the following correction:
Correction: March 24, 2008  An article on March 10 about the business of surrogate motherhood in India misstated the geographic location of Gujarat, the Indian state where commercial surrogacy got its start in the country. It is in western India, not eastern India.

"PlanetHospital: Medicine Beyond Calabasas and America"

A pioneering "medical tourism" company based in Calabasas, CA is gaining nationwide attention for finding "outsourced" surrogates in India.
If you can't have a baby of your own and the prices of surrogacy are too much, you might want to look at PlanetHospital, a Calabasas-based company that isn't a hospital, but a firm that coordinates dozens of different types of medical procedures for people around the planet.
The Wall Street Journal reports that in the first eight months of this year they sent 600 couples or single parents overseas for surrogacy, nearly three times the number in 2008 and up from just 33 in 2007. All of the clients this year went to India except seven who chose Panama. Most were from the U.S.; the rest came from Europe, the Middle East and Asia, mostly Japan, Vietnam, Singapore and Taiwan.
Mr. Rupak, Planet Hospital's President, also told the paper that because of growing demand from his clients for eggs from Caucasian women, he's started to fly donors to India from the former Soviet republic of Georgia, where he has connections with clinics. The first woman arrived last month.
If you're thinking about traveling oversees or interested in optional medical procedures, you can find more information about PlanetHospital [link] here.

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