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The Royal Fertility and Genetics Hospital advertises Cambodia’s lack of surrogacy legislation on its website.
The Royal Fertility and Genetics Hospital advertises Cambodia’s lack of surrogacy legislation on its website. Athena Zelandonii

Surrogacy industry blossoms amidst a shroud of secrecy

Surrogacy superstar Mariam Kukunashvili says she’s no longer putting all of her eggs in Cambodia. In fact, the founder of international surrogacy agency New Life Global Network claims the entire industry has packed up its bags and fled.

“Everyone left,” Kukunashvili wrote to Post Weekend this week. “All of the Chinese agents moved to Vietnam and all of the Thai agents moved to Laos. We finished all our work in Cambodia.”

But as government officials prepare to draft a law to regulate commercial surrogacy, there are still agencies and clinics operating under a shroud of secrecy, hoping the government will forget their existence.

Commercial surrogacy came to Cambodia about a year ago, when Thailand banned the industry for foreigners after several high-profile scandals. Nepal followed suit, sending waves of desperate prospective parents – many from China, Australia and the United Kingdom – to Cambodia in search of legal wombs.

It is not known how many children have been born in Cambodia through surrogacy, but industry insiders estimate that hundreds of couples have signed up over the past year, and at least 50 embryos have been brought from clinics in Thailand and Nepal.

The ethical implications of surrogacy are ambiguous. Supporters argue that the industry provides some couples, including homosexual couples, with the only chance to have a child with their genetic material. Opponents say the industry makes low-income women victims of unscrupulous agents who offer inadequate compensation, protection or information. In countries like India and Thailand where the industry once flourished, many surrogate mothers were reported to be underpaid and living in squalor.

Surrogacy has blossomed in Cambodia due to a lack of legal framework. The Kingdom does not have a law that directly applies to surrogacy, but three articles of the penal code originally drafted to combat child trafficking make acting as an intermediary between an adoptive parent and a pregnant woman punishable by up to six months in prison.

It remains unclear whether this law applies when the child is genetically related to the adoptive parent, and those running the industry fear that even a small amount of publicity could lead to legislation that would force them to cross borders yet again.

“Every time I talk to clinics in Cambodia they ask me not to talk about this,” says one Thailand-based agent, who requested anonymity. “People will say that they don’t provide surrogacy because they see every newspaper article as a step towards banning it.”

“People are so desperate because they want a kid, and which countries can they use now that there are so few left?” the agent says. “We don’t want to alert the government because the knee-jerk reaction is to shut it down. When it comes to Cambodia, I need to protect my business.”

Fertilised embryos at the Fertility Clinic of Cambodia.
Fertilised embryos at the Fertility Clinic of Cambodia. Charlotte Pert

A common refrain

Most of the Cambodia-based fertility clinics contacted by Post Weekend flatly denied their involvement in the surrogacy industry. The Fertility Clinic of Cambodia (FCC), the first IVF clinic to set up shop in the country, in 2014, said they offer IVF treatment but do not provide surrogacy. Cambodia Fertility Clinic (CFC), another Phnom Penh IVF facility, also claimed not to practice surrogacy.

But the clinics are at least aware of who is running the industry. A receptionist at the FCC punted questions to Kukunashvili’s surrogacy agency, New Life Asia, previously called New Life Cambodia. The receptionist at CFC, who did not give her name, said that women could email that clinic’s director, Nguyen Thi Nhu Tuyet, to find a surrogate.

Meanwhile, Rithy Penh, a Cambodian listed as the local contact person for Thailand-based surrogacy agency New Genetics Global, says he brought foreign couples to the Fertility Clinic of Cambodia for surrogacy in the summer of 2015.

“I was only working for New Genetics Global for around six months,” says Penh, who claims he quit in December because the salary was too low. “During that time, I met only three families. I’m not sure if they gave them information about the risks [of surrogacy], I would just bring them to the FCC.”

People in the industry claim that most agents running surrogacy operations in Cambodia are based overseas, and hire Cambodian staff to run the on-the-ground logistics. Kukunashvili’s company was an outlier in that it ran operations inside the country.

In May 2016, Kukunashvili posted a picture of a baby on Facebook, labelling him “the 20th baby who has arrived with help of our dedicated team of highly qualified professionals” at New Life Cambodia.

Kukunashvili now says that negative media attention and legal uncertainty forced New Life out of the Kingdom in July. She claims that local clinics refused to partner with surrogacy agencies due to negative media reports, and that others refused to invest in an uncertain legal environment.

But Sam Everingham, global director of the Australia-based company Families Through Surrogacy, which connects potential parents with agencies, says that New Life is still operating in Cambodia, and is still the only agency here.

Everingham travelled to Cambodia last year to survey the industry when the agencies his company works with moved to the Kingdom from Thailand and Nepal. “Only one company has a base there, New Life,” he says. “I’m in contact with New Life. Every week I have an email exchange with them.”

Kukunashvili, however, maintains that New Life was pushed out of the country by the clinic her agency collaborated with.

This week, she told Post Weekend via Facebook message that that clinic had changed its name from the European Fertility Clinic to Cambodia IVF clinic, and had moved into the eighth floor of Central Hospital. “I am not 100 [percent] sure weather [sic] they still do surrogacy or not but it’s a fact, they are still there,” she wrote. “But without New Life.”

Surrogacy proponent Mariam Kukunashvili claims that her agency, New Life, and others have begun pulling business out of Cambodia due to issues with local clinics and investors. New Life
Surrogacy proponent Mariam Kukunashvili claims that her agency, New Life, and others have begun pulling business out of Cambodia due to issues with local clinics and investors. New Life

Naret Choy, a receptionist at the Cambodia IVF clinic in Central Hospital, said her employer had never worked with New Life or provided surrogacy services. But Cambodia Fertility Clinic’s Nhu Tuyet also pointed to the Cambodia IVF clinic. She said in an email that she works closely with Central Hospital on fertility treatment, but that surrogacy is not on their list of services, and that her clinic does not provide surrogacy.

However, screenshots of a text message conversation obtained by Post Weekend reveal that Tuyet, who said that she had no knowledge of surrogacy in Cambodia, was once working closely with New Life. The messages show Mariam Kukunashvili’s husband, David Bezhuashvili, in a heated argument with Tuyet about the fate of their joint business and Tuyet’s alleged betrayal of the well-known surrogacy agency.

A booming baby business

A plethora of resources aimed at potential parents point to the industry’s growth in Cambodia. One company, Sensible Surrogacy, warns prospective parents about Cambodia’s ambiguous laws, noting growing popularity despite reports of impending legislation. The website Gay Surrogacy Info, meanwhile, says that Cambodia has become “especially popular” with same-sex couples confronted by the Thai surrogacy ban.

There’s an entire online forum dedicated to the ballooning industry here: the Cambodia Surrogacy Forum, which claims to be for parents “proceeding with surrogacy and egg donor IVF in Cambodia”. (Post Weekend was not granted access to the forum as of press time.)

Several agents, speaking anonymously, admit to recruiting Cambodian surrogates and bringing Thai surrogates into the country for embryo transplants. Representatives of one Phnom Penh clinic said there were eggs from South Africa and embryos from the United States and Europe at the facility. They added that they had 24-hour homecare for their Cambodian surrogates, including a live-in chef.

The agencies charge between $30,000 and $60,000, about $10,000 of which goes to the surrogate mother, agents say. Everingham estimates that between eight and 10 agents are currently sending prospective parents to Cambodia. Once a parent hires an agent, the process is simple. A contract is signed, a down payment made, and the parent flies to Cambodia to provide sperm, egg donations, or both. Afterward, parents return home, where they have minimal contact with the surrogate until the child is born, he says.

Surrogate mothers are often recruited by middlemen hired by agencies.

“We know there are a number of surrogate houses now that are located around Phnom Penh and Siem Reap where the surrogates are supervised,” Everingham says. “Many of them are living away from their home villages for the duration of the pregnancy.”

The Fertility Clinic of Cambodia says it doesn’t offer surrogacy, though at least one agent claims to have brought prospective parents.
The Fertility Clinic of Cambodia says it doesn’t offer surrogacy, though at least one agent claims to have brought prospective parents. Athena Zelandonii

Some agencies contacted by Post Weekend said they would provide a picture of the surrogate to the parents, while others agreed to allow parents to meet the surrogate once a contract had been signed.

Once the baby is born, the surrogate signs legal custody over to the intended parent. Often, the babies are issued a Cambodian passport with which to leave the country, according to Everingham, but the nature of these transactions is often concealed from the Cambodian government.

“As far as the Cambodian government is aware, a foreigner has knocked up a local woman and she’s given custody of the child to the father,” Everingham says.

But not every clinic is secretive about their operations. On its website, the Royal Fertility and Genetics Hospital in Phnom Penh advertises that Cambodia has no law prohibiting surrogacy or egg donation.

When Post Weekend called the hospital, the receptionist said that the clinic wasn’t taking anymore surrogates – it was full. “The deadline for recruitment has already passed,” she said. “We have many Cambodian [surrogate] mothers who already had a health check.”

Legal misgivings

In this legal landscape, experts are raising questions about how the industry should be monitored. Those involved largely agree that regulation is needed to ensure the safety of surrogate mothers and the children.

“As far as the government is concerned, it has three options: no regulation, some regulation, or it brings in prohibition,” says Stephen Page, an Australia-based surrogacy lawyer. “Surrogacy in some countries has been like the Wild West, but there need to be rules to ensure safety. In my view, it would be a good idea to have some regulation in Cambodia.”

Others say laws are also needed to protect prospective parents. One person working for a company that ships embryos overseas, who requested anonymity to protect the company’s relationship with clinics in Cambodia, says the bans in Thailand and Nepal complicated the situation for parents who had embryos stored in those countries.

“We’ve wanted to help couples who have had their embryos essentially held ransom,” the source says.

Clinics occasionally refuse to allow prospective parents to remove their embryos from the country after a law is enacted. “I don’t think the lawmakers meant it to be an outright ban on the movement of embryos, but that’s the interpretation sometimes by clinics,” the source says.

As a result of this interpretation, embryos have been smuggled across land from Thailand to Cambodia, the source explains, leaving prospective parents at risk of paying exorbitant fees for a damaged embryo, or for losing their embryos entirely.

“There is a sense of frustration within the sector because it’s such a taboo subject and it’s pushed underground,” the source says.

But Griffith University’s Patricia Fronek, who specialises in surrogacy and adoption, says the industry almost always moves out of countries when rules are put in place.

“The whole industry lacks transparency, so we don’t know if something nefarious is going on, and that’s the problem with a lack of regulation,” said Fronek. “But the minute it’s regulated, they shift to a less transparent environment.”

There have been no reports of tragedies or scandals from Cambodia’s surrogacy industry so far. Everingham says he believes that surrogates are treated well and that their salaries have begun to rise. But in an unregulated industry, it is difficult to monitor the situation, he concedes.

“You can really only put your trust in an agency based on what you’ve heard in the past,” Everingham says. “It’s hard for a foreigner to know how a surrogate is being treated in a country far away.”

It highlights the difficulty of ensuring good practices in an industry that many argue is exploitative by nature.

Australia recently warned its citizens not to travel to Cambodia to participate in surrogacy, and noted that Australian citizens could be prosecuted for trafficking under Cambodia’s laws.

In late August, various government ministries met with representatives from the Australian and US embassies and the United Nations for recommendations for passing surrogacy legislation.

Speaking with the United Nations Human Rights Council Special Rapporteur in Cambodia on Tuesday, Ministry of Justice spokesman Chin Malin said the government is “studying the technical context” for the creation of a law on surrogacy, but there is no deadline for the law’s completion.

For her part, Fronek recommends that only altruistic surrogacy – surrogacy without financial compensation, practised among close friends or family members – be permitted.

“Once you combine money and children, the politicians are inviting corruption – you may as well throw a party and say come on in and do what you like,” Fronek says.

“There are scandals everywhere where commercial surrogacy exists,” she adds.

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