What is it like to spend nine-plus months carrying someone else’s baby? How can you not get attached to the baby growing inside you? How can you talk yourself through morning sickness, swollen ankles and back pain when you don’t get the ultimate payoff of holding your own precious baby when all is said and done?

I was very fortunate to speak to Alison Adams, an amazing woman who speaks very openly and honestly about her experiences as a surrogate.

1. What made you decide to be a surrogate?

Helping others has always been a deep seeded interest of mine. When I was in my later teen years, I became aware of egg donation.  When I met my boyfriend (now husband), I told him of my desires pretty early on. He thought the idea of it was great, being I waited until after we were done having our own children (I agreed).

2. How do you choose the family?

With my first surrogacy, I met the couple I chose through an agency. With my second surrogacy, I met the couple through Facebook, of all places!

3. What is it like to carry someone else’s baby?

I do the same things – watch what I eat, take my prenatal vitamins, go to my appointments as necessary, rub my belly, talk to the baby, etc. But of course, there’s no preparing for a baby, so that was a bit odd the first time around. It just seemed so strange to be so very pregnant, and not be setting up a nursery or installing a car seat. But how I felt towards my surrogate son was very different – I loved him and cared for him, yes. But I did not love him as I love my own children.

4. Who handles the financial obligation associated with the surrogate pregnancy?

In most all surrogacy journeys, the IPs (intended parents) cover the finances. This could/should include attorneys (for both the surrogate and parents!), insurance copays, etc.

5. Are you financially compensated for being a surrogate?

Most first time surrogates in the US receive around 20k for a first time surrogacy. Some surrogates receive a higher compensation for a second time journey, and some, like myself, opt to receive the same compensation that they received the first time. If you figure it out, it calculates out to under $3 per hour. But as is true for most surrogates, compensation isn’t close to one of the top reasons we choose to do this. It is a nice bonus, though.

6. Do you keep in contact with the family after the baby is born?

Yes, this is actually a requirement of mine. I ask that the family opt to keep up with me and keep me updated on them (not just the baby).

7. How important is the emotional support of your family while you are a surrogate?

Very important. My husband is my rock. He not only has to submit himself to STD testing and sign the contract, he is there with me as I go through the cycling, the pregnancy and the postpartum time. It is not easy on him, but he chooses to support me and hold me up through the hard times. I think I fell in love with him even more after the birth of my surrogate son, just knowing how awesome he was during the pregnancy – a pregnancy that wasn’t even for us, if that makes sense.

Read more about Alison’s surrogacy journeys in her blog.

It used to be said that a mom is always sure it’s her child but a man’s paternity can always be questioned. Not anymore.

Every year, hundreds of thousands of embryos are implanted into women’s wombs during in vitro fertilization (IVF). What are the chances that an embryo is implanted in a womb where it isn’t supposed to be? No, this is not something out of Private Practice. It happened before and it has happened again.

According to this CNN report, when the couple Carolyn and Sean Savage got a phone call informing them of the mistake after implantation, shock is a poor word to describe their feelings. It is not only about the “strange” embryo that is growing in Caroline’s uterus that concerns them. In fact, there are many things one has to consider when one is involved in embryo mix up situation.

Health and Future Pregnancy

If you were the one who is carrying the embryo, how would this pregnancy affect your health? Does it put you at risk for pregnancy complications? Does it jeopardize your chances of getting pregnant again? And as the DNA mom, are you willing to wait out this pregnancy until you try for the next one? Is your age a determining factor?

After going through miscarriages, several failed IVF cycles, health problems and difficult pregnancies, this could be Carolyn’s last chance to have another child. In fact, the doctor has advised Carolyn from getting pregnant again.

Religious Beliefs and Convictions

In cases of mix ups, a termination of the pregnancy is a very likely outcome. How would you feel about an abortion if you were the DNA-mother? If you were the accidental surrogate mother?

Carolyn and Sean, due to their religious beliefs, strongly believe in human life in the embryos. Carolyn is not willing to terminate this pregnancy. To complicate things, the couple still had 5 frozen embryos left over from IVF which they are not willing to destroy or leave frozen forever. They are now looking at surrogacy options for these embryos.

Unintended Surrogacy

What is your attitude towards surrogacy? How would you feel if you became a surrogate mother unintentionally? Would you treat this pregnancy the same way as any other normal pregnancy? A clinic in Wales accidentally implanted the last of a couple’s embryo in another woman. The unwilling surrogate mom decided to terminate the pregnancy and the couple was left with nothing.

Isn’t it ironic that Carolyn and Sean are looking for a surrogate mother for their embryos when Carolyn herself has become an unintentional surrogate mother to somebody else’s embryo?

Custody

Whose child is it? In 1993, a white couple in Australia gave birth to black twin babies after going through IVF. At that time, according to the Australian Human Fertilisation and Embryology Act 1990, a woman delivered the child, even if it is not through genetically hers, is the “legal mother”. Paternity, however, is “open to legal interpretation.” In another mix up case in 2004, an American woman who got implanted with the wrong embryo was sued by the DNA parents for custody after delivery. Laws change but still vary from country to country or even from state to state in the US.

Carolyn is the biological or womb mother but she is not the DNA mother of the child. It is not clear how the law will decide when it comes to a custody battle. Fortunately for the DNA, Carolyn, again due to her strong religious principles, will never put a claim to a child that is not hers despite the ordeal she has to go through. Both sets of parents are talking to each other to find a solution. After all, this was none of their fault. Nor it was that of the unborn child.

Bonding

Mother-child bonding starts at the womb. Will you be able to give up a baby after carrying it for 9 months in your womb? Surrogate moms can do this but Carolyn is not just any surrogate mom. She really wanted, fought for, and risked a lot for this pregnancy.

In the current case, will the DNA mom bond with her baby? She, too, wanted to be pregnant and now she has been denied of the privilege (at least this time around) of carrying her baby in her womb.

Nowadays, mix ups are discovered before delivery. In case of the Australian couple, and another reported case in the Netherlands, they only found out about the mistake at birth. The blow in these cases is much harder since mom and baby have already strongly bonded for 9 months without any doubts about their relationship.

This is not the first case of embryo mix ups. According to American Fertility Association experts, the odds of this happening are 1 in a million, mainly due to human error.

So what would you do if you were involved in an embryo mix-up?

Celebrity parents Matthew Broderick and Sarah Jessica Parker have welcomed two new additions to their family, two baby girls. According to reports online the surrogate who was carrying their twins gave birth on Tuesday morning. The two bundles of joy were born at East Ohio Regional Hospital in Martins Ferry. Reports indicate that the happy couple was in attendance for the birth.

A representative for the couple was quoted as saying, “The babies are doing beautifully and the entire family is over the moon.” Marion Loretta Elwell Broderick weight at birth was 5 pounds and 11 ounces, while Tabitha Hodge Broderick weighed an even 6 pounds. Both baby names are said to come from Parker’s side of the family. Reports also indicate that the babies were named immediately after they came into the world.

Broderick and Parker have a son James Wilkie who is now six years old. They had trouble conceiving again which led to their decision to use a surrogate. Sadly once the story broke it took on a life of its own and the ugly side of celebrity reared its head. Media outlets were practically falling over themselves to find out more about the woman carrying the babies. In the latest twist to this story, Barry Carpenter, Martin’s Ferry’s Police Chief, is being investigated following accusations that he tried to pry into the life of the surrogate mother. He was said to be doing this at the request of a tabloid reporter.

Now that the babies are here, it is hoped that the intense interest will die down, and for the sake of the babies they will be allowed some space. In today’s celebrity obsessed world however, that is probably too much to ask for. At one point some reports pointed to Parker being concerned for the surrogate’s safety.

Other celebrities who have used a surrogate to carry their babies include Angela Bassett and Courtney B. Vance, Karen Duffy, an MTV VJ and actress, Fraser star Kelsey Grammer and his wife Camille.

Congratulations to Sarah Jessica Parker and Matthew Broderick of the birth of their twins. Both parents have demanding Hollywood careers so they can expect to be even busier going forward.

It’s every mother’s worst nightmare: losing a child.

On April 5, that’s what happened to Missy Evans when her son, Nikolas, died. He had been hit in a street fight about a week earlier in a town near Dallas, Texas.. But the punch knocked him to the ground, and Nikolas, 21, hit his head.

Thus ended Nikolas’s dreams of going to college, his love for filmmaking, old movies, music and politics. And alas, his untimely death dashed his hopes for having three sons. “Someone took that away from him,” said Evans, 42.

Now, his mother thinks she has found a solution to helping Nikolas’s dreams live on: she harvested his sperm.

Evans’s plan is to find a surrogate mother to carry her son’s offspring–whom he had already named–but she will raise them herself. “He would love me so much for doing this,” she said.

Experts in medical ethics–and a lot of other people–have raised an eyebrow or two. It’s not uncommon for parents who have lost a child to want to replace him or her with another baby of their own. This is just an unusual twist on that replacement child. Tom Mayo, the director of Southern Methodist University’s Maguire Center for Ethics and Public Responsibility, is concerned about the situation for the child. “That child’s biological father will be dead. The mother may be an egg donor, anonymous or gestational surrogate… This is a tough way for a kid to come into the world. As the details emerge and the child learns more about their origins, I just wonder what the impact will be on a replacement child.” One professor of philosophy and religion says it’s one thing to be certain he wanted children. It’s another thing entirely to assume he would want his mother to raise his children born from an unknown mother.

But Evans doesn’t care if other people disagree with her decision to harvest her dead son’s sperm. She believes it’s what Nikolas would have wanted. And, her ex-husband and other members of the family concurred.

The court agreed that she could do it. And no one officially opposed the plan. So Nikolas’s body was kept at a chilly 39.2 degrees until a urologist from Austin voluntarily collected the specimen, which she believed were mostly viable.

I was surprised to learn that this has been done many times before. According to Art Caplan, chair of the department of medical ethics at the University of Pennsylvania in Philadelphia, harvesting a dead father/brother/husband/boyfriend’s sperm has been done about a thousand times in the last ten years. And there aren’t really any laws about it–just ethics.

And since the decision has to be made so quickly, many of the people who collect the sperm don’t end up using it. They go through the grieving process and realize later that it isn’t a good idea. Right now, Missy Evans doesn’t have the plan worked out–but she is sure she won’t change her mind, even if it takes her last penny to go through with it.

I feel for Ms. Evans. I can’t imagine losing my son. But I would never, ever make such a decision for him. My initial reaction to this story was that she was really bizarre. But now I have relaxed that opinion a bit. I think she must be absolutely distraught and doesn’t know the best way to ensure her son’s legacy. I expect that Ms. Evans will change her mind after she has sorted through her feelings. What do you think?

Back in August I blogged about the increase in numbers of women trying to sell their eggs to make money. The economy was faltering back then, and now we are in a recession, even more women are considering other means to make money.

Selling eggs can net a woman a quick $4,000, and being a surrogate mother can bring over $20,000. Most women say that they decide to become surrogates because of their desire to help other families, because they love being pregnant, because they’ve witnessed other mother’s struggles with infertility and want to do something to help. Most moms don’t mention the money. But still, $20,000 is no small sum of money and applications from women to become surrogate mothers have rocketed.  But the desire to become a surrogate doesn’t mean a guaranteed check.

According to the director of one agency that matches up surrogate mothers to hopeful parents said that out of every hundred applicants, only a few are accepted. Prospective surrogates have to have the right mental attitude, have to have had at least one successful pregnancy, and have to be in good health, so they have to undergo extensive medical and psychological screening before being accepted by an agency.

Most surrogate mothers say that they are not doing it for the money. Out of several surrogate mothers interviewed, only one woman, an experienced surrogate, said that money was a factor. She said that she wanted to become pregnant again to help pay for an expensive operation her husband needs.

Regardless of the health of the economy, women still want to become mothers, so there will always be a demand for egg donors and surrogates. That is, until families stop being able to afford treatment. Hiring a surrogate mother in the USA costs at least $80,000, with around a third going to doctors and medical expenses, another third going to agencies who match up surrogates and hopeful parents, and a third to the surrogate mother.

So that leads to another issue with the economy that has also been in the news lately: outsourcing. Factories in China can produce consumer goods far more cheaply than American factories, and Indian women are prepared to be surrogate mothers for far less than American women. Hiring an Indian woman as a surrogate costs around $10,000 in total, a significant saving.

Women in India who were interviewed for an article about surrogacy were much more open about doing it for the money, as well as the ability to give happiness to a childless couple.

Is being a surrogate for the money wrong? Should surrogate mothers just want to do it for the noble reasons of helping a couple have a baby? Or, is it best to look at surrogacy purely as a womb-for-hire agreement, to emphasize that the baby really belongs to the couple who hired the surrogate, and to lessen emotional ties between the surrogate and baby?

And would you consider selling your eggs or renting your womb?

Ricky Martin introduced his twins to the world in the most recent issue of People magazine. Speaking from his home in Puerto Rico, Martin discussed wanting to be a dad, how he takes care of his children and why he decided to go with a surrogate. The twin boys, Matteo and Valentino, now 4-month old, certainly seem to have brought a lot of joy to new dad Martin. He was quoted as saying, “I’m so happy! Everything they do, from smiling to crying, feels like a blessing. Being a father feels amazing. This has been the most spiritual moment in my life.”

Martin is committed to being a hands on dad. “I don’t have a nanny. I’m doing this on my own because I don’t want to miss a moment. I have a personal assistant who helps me, someone who takes care of me while I’m taking care of them, but I’m the one who changes the diapers, the one that feeds them, the one that bathes them, the one that puts them to sleep.” He went on to add, “For any parent, the first couple of months tend to get a little bit intense.” I think most parents, no matter how many children they’ve had, would agree with that.

Martin also addressed the question that has probably been on the minds of many people. When asked why he chose surrogacy he responded, “Adoption was one option, but it’s complicated and can take a long time. Surrogacy was an intriguing and faster option. I thought, ‘I’m going to jump into this with no fear.” He joins singer Clay Aiken as another celebrity who has chose to go this route. Aiken’s son, Parker Foster was born in August 2008.

Martin enjoys reading to his sons, and playing music for them. According to his interview published in People Magazine, Martin’s desire is to give his sons “…information and raise them with honesty and love, and give them self-esteem and a lot of acceptance” he said. Martin said that the twins have already begun to show very different personalities. “Valentino,” he says, “loves to sleep. I call him ‘Mr. Peace and Love’ because he’s so chill and serene.” Matteo meanwhile “…is more alert and active. He was up at 3 a.m. the other night and just hanging.”

Ricky Martin certainly seems to have adjusted well to being a dad. There’s no word yet on whether he will be looking the start his own group of Latin crooners, but we certainly wish him all the best.

Baby Oliver Patrick was born last month in the UK. The new arrival is a baby brother for Charlie, age three. The brothers are unusual because they don’t just have one mom: they have three.

Alex Patrick was diagnosed with cervical cancer ten years ago. She beat her cancer, but was left infertile. Luckily for her, she has two loving sisters, her twin Charlotte and older sister Helen, who joined forces to give Alex and husband Sean the family she longed for.

Twin Charlotte donated her eggs, which were fertilized with Alex’s husband’s sperm. And because Charlotte had a history of difficult pregnancies, older sister Helen was implanted with two eggs, resulting in baby Charlie, who is now three.

When Charlie turned two, Helen offered to be a surrogate for Alex again, to give Charlie a baby brother or sister. Charlotte’s eggs were still in storage so they repeated the procedure, and last month Helen gave birth to baby Oliver after a traumatic labor resulting in an emergency cesarean section.

Alex says how grateful she is to her sisters to help her complete her family, and Helen and Charlotte talk of their love and joy that they could help their sister have a family. But, especially after Oliver’s difficult birth, the women say they won’t be doing it again!

Last July 25, Louise Brown, turned 30. The day was marked as a major milestone in science and medicine. You see, Louise is the first test tube baby ? the first ever person born through in vitro fertilization (IVF).

Assisted reproduction technology (ART) has come a long way since 1978. Women of menopausal age can now carry and deliver babies. Surrogate mothers or ?wombs for rent? enables women who have undergone hysterectomy to have biological offsprings. Preimplantation genetic diagnostic screening enables parents to screen their embryos for genetic diseases and gender. In April this year, the first ?man? became pregnant and delivered a daughter. So one may ask, where do we go from here?

The 17 July issue of Nature published a special report on ?Making babies: the next 30 years? and interviewed several reproductive medicine experts on what we can expect in the next 30 years. Some of the replies are given below:

• Low-budget IVF – Currently, an IVF cycle can cost thousands of dollars. For the lucky few, it can even be covered by health insurance. There are, however, many countries in this world where IVF is inaccessible financially. By streamlining the procedure and using low-cost drugs, IVF might soon be available to almost anybody.
• Gametes from skin cells – Last year, pluripotent stem cells have been developed from ordinary human skin cells [2]. Research is now being stepped on on the development of gametes from stem cells [3], mainly because of the scarcity of egg donors as well as the legal restrictions associated with egg donations [4]. If this happens within the next 30 years, anybody ? and I mean anybody can have biological offsprings ? and infertility will be a thing of the past.
• Genetic banking – This is the storage of young, healthy cells of people before they start aging and accumulate genetic errors. These cells can be used as ?genetic cassettes? that can be used to correct aging-related errors.
• Artificial wombs – Some researchers are working at the other end of the process ? at delivery. In recent years, premature infants born as early as the 22^nd week of gestation period have been known to survive. The idea of an artificial uterus to carry an embryo to full term is not so far-fetched but can have a lot of ethical and legal implications.
• Cloned babies – According to one expert, reproductive cloning is not that far away although there is no need for it medically.

Louise Brown was a great milestone in science. So was Dolly. I think we can expect great things from reproductive medicine in the coming 3 decades. Maybe even terrible things. But great.

References

1. Nature 454, 260-262 (17 July 2008)
2. Science 318, 1917 – 192021 December 2007
3. Nature 452, 913 (24 April 2008)
4. Nature 453, 828-829 (2008)

Thirty-six year old Latin heart throb and singer, Ricky Martin (Enrique Martin Morales) is the latest celebrity to become a parent since the start of the year. However, not only is he a new father, he is father to twins. According to information published online, the babies, twin boys, were conceived by a surrogate mother.

According to a statement from the singer, ??the children, delivered via gestational surrogacy, are healthy and already under Ricky?s fulltime care.? Martin will reportedly be spending the next few months being a fulltime dad and will be avoiding too much public attention. Additional information about the mother or the babies was not available.

Like Martin, Clay Aiken of American Idol fame, also had his first child recently by a surrogate mother. However, Aiken named his friend, 50-year old Jaymes Foster as the mother of his son, Parker Foster Aiken.

The Latin singer rose to fame as a member of the popular boy band, Menudo. Martin pursued a solo career and hit pay dirt with his 1999 hit Living La Vida Loca.

Congrats, Ricky Martin.

India is fast becoming the surrogacy capital of the world, but laws governing the process are still in their infancy.

A casualty of the Indian legal system and a divorce, is a baby born to a surrogate mother in India who is potentially motherless and fatherless after the couple who paid for her split up.

A Japanese couple recruited an Indian woman as a surrogate mother. The baby girl, born in late July, was conceived with a donor egg, and sperm from the husband, Ikufumi Yamada. The couple split up and divorced while the surrogate mom was pregnant. Mrs Yamada doesn’t want to adopt the baby, and the surrogate mom doesn’t want the baby. The baby’s father wants to bring his daughter home to Japan but Indian law prohibits single men from adoption.

Japanese authorities have hinted that they may be able to approve a visa for the baby girl to come to Japan, and for her to be legally adopted in that country. But currently she’s living in a hospital in the Indian city of Jaipur, where her grandmother, Yamada’s mom, is caring for her.

It’s tragic that there’s such a simple solution that a legal system is preventing. Hopefully sensible heads will prevail, both countries can come to an agreement and the baby can be adopted by her biological father in Japan.

Surrogate Baby Legal Drama

Times have been tough lately. What have you done to economize? I’ve been biking more and driving less, shopping for only seasonal produce, and I had my cable TV disconnected and replaced by a Netflix subscription (update: don’t miss television at all!)

Some women are considering more interesting options to help with their finances. Fertility clinics are reporting increasing numbers of women offering their services as egg donors or surrogate mothers. Donating eggs can pay around $4,000 and being a surrogate mom around $20,000 or more.

Donating an egg requires a couple of weeks of hormone treatments and several doctors visits. Some women have no side effects, but the majority of women suffer from some degree of nausea, cramps, or mood swings. Around 6% develop ovarian hyperstimulation syndrome, where thirty or more eggs start to develop at once, and fluid leaks out of blood vessels, collects in the abdomen, causing nausea, bloating and very occasionally kidney failure or even death.

There’s no real data on the long-term effects of the hormones used in egg donation, which makes experts worry over women donating eggs for money.

Donating an egg or being a surrogate is a wonderful giving act. But women considering donating an egg should also consider their own health before the financial gain.

I don’t think I can.

A woman in Brighton, England has already given away seven babies and is willing to carry and give away another. She was reported to have said that, “I don’t love the baby and I don’t want the baby for myself – the baby is conceived for my couple.”

This is actually baffling for someone like me, who has seemingly loved my unborn children even before I actually conceived them. Heck, before I found someone worthy to conceive them with even.

The Free Online Dictionary defines surrogate mothers as “a woman who agrees to bear a child for another woman, either through artificial insemination by the other woman’s husband or partner or by carrying until birth the other woman’s surgically implanted fertilized egg”. In a lot of countries, surrogacy is legal provided that only the reasonable expenses are paid for by the prospective parents. These expenses include, but may not be limited to, fertility procedures, prenatal check-ups and lab tests, food allowance, vitamins and/or other drugs required by the surrogate mother. Sometimes, this may also cover a minimal allowance for the mother in case she suffers from loss of income due to the pregnancy.

Surrogate mothers come in various forms and shapes. It can be your sister, your sister-in-law, or your mother. It can be a friend or a stranger a surrogacy agency has set you up with. It can even be outsourced now. But whoever they are, they are heaven sent to couples who are unable to conceive on their own.

Now, many say that a child becomes bonded to his host, usually his mother but in this case, his surrogate mother. Firstly, it’s her voice he hears all the time. Secondly, unborn fetuses seem to share the mother’s emotions through the hormones associated with them. Some studies also suggest that mothers who felt no attachment to their unborn child are more likely to have kids with emotional problems.

So isn’t there some disconnect somehow after the baby is given up?

And yet, there have been many adoptive parents who have lovingly cared for children they didn’t conceive, proving that being a psychological parent is the more important thing to be.

Still, I really don’t think I am made of the same mettle as these surrogate mothers. It must take great courage and a really strong self-concept to be able to nurture a child within you, and then have the grace to give it up.

Are you?

Resources:
Ask Dr. Sears

A growing phenomena, largely related to the dearth of adequate and affordable health care in the United States, is what has often been called “medical tourism”. People fly to India, Mexico, Thailand, etc. for all sorts of medical (and often cosmetic) issues including bypass surgeries, knee and hip replacements, dental work, eye surgery, you name it.You can typically cut your cost by about 90% for some procedures and hey, you can work in a trip to the beach while you’re there. There are even businesses that help place you, akin to travel agents – except these are travel/hospital agents. There’s even a website for “medical tourism in Iran”. Seems like a poor idea, but maybe that’s just me.

Then I stumbled across this little nugget which details how medical tourism has grown to include outsourcing surrogate pregnancies. I’m not sure this is what they envisioned when they passed NAFTA.

To summarize, this article details a town in India where dozens of women carry the children of infertile couples mostly from the U.S. and Britain. It appears the going rate is $4500, which is apparently what most residents could hope to make in 15 years. The going rate for surrogacy in the U.S. seems to range anywhere from about $20,000 on up to $80,000.

The women they interview do it for the money first, but also see it as a great service to couples who need their help. However, the article also articulates a more sinister side to the notion of “wombs for rent” – that $4500 is such a drop in the bucket for the uber rich, we may see a day when those who are inconvenienced by pregnancy simply pay for someone to carry their child as if they are paying someone to walk their bratty little Bichon Frise.

Add it to the growing pile of ethical dilemmas to debate…

Impossible? Not in India

Commercial surrogacy also known as ?wombs for rent? is growing in India. In the city of Anand, more than 50 women are pregnant with the children of infertile couples from the United States, Britain, Taiwan and a host of other countries.

The procedure starts with matching the couples with the list of local women ready for surrogacy. The surrogate moms have to be between 18 and 45 years old, have at least one child of their own and be in good medical condition. The couples fly to Anand for the in-vitro fertilization and following that, the fertilized egg is planted on to the surrogate mom?s uterus. The couples return to Anand after nine months for the delivery of the baby. The cost of the entire procedure amounts to $10,000 or less and that includes fertilization, medical care and the fee paid to the surrogate mother. The facility also provides medical care during pregnancy, delivery and counseling after birth.

Wombs for rent have been around in India since 2002. The industry is not regulated by the government. It is now considered the leader in the industry and experts say that the reason why India?s commercial surrogacy is successful in the market is the same reason why a lot of other industries outsource their services: labor pool and low rates.