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Saturday, Dec. 30, 2006
Surrogacy hard to take root here
Child-bearing procedure faces wall of resistance, couples find
By JUN HONGO and AKEMI NAKAMURA
A woman in her 30s who returned to Japan from the United States with a new-born earlier this year has kept her experience there secret to avoid losing her legal status as the parent.
If the secret gets out, the kid would be in legal limbo because her child was born through a surrogate mother, a procedure still effectively taboo in Japan.
The Census Registration Law stipulates that a woman must give birth to a child to be recognized as the legal mother. She registered the child as her own in the U.S. so she could do the same in Japan. It'll work as long as she keeps her secret.
"When making the choice to apply for a surrogate birth, I was worried how people would react if they knew," the woman, who lives in the Kansai region, said on condition of anonymity.
Her ordeal began when she contracted cancer four years ago while in her late 20s. Although the disease claimed her womb, the woman chose to keep her ovaries because she had already made up her mind to somehow have a child if the opportunity presented itself.
After contacting a fertility coordination agency in California, she traveled to the U.S. in hopes signing a contract with a surrogate mother.
The procedure wasn't easy. The first attempt to collect eggs failed, and doctors only extracted two on the second try.
"It was a miracle that the surrogate mother got pregnant and the baby was actually delivered," the woman said.
In Japan, there are no laws governing surrogacy, and it isn't illegal as long as children born via surrogate mothers are registered as such. But the issue remains highly controversial here and most doctors steer clear of the procedure.
Experts are divided on surrogate birth, but they at least agree on one point: Japan needs a law on surrogacy.
"Japan should have established a law governing surrogacy by now," said Shohei Yonemoto, director of the Center of Life Science and Society, a private think tank. "Japanese may not think it's an urgent problem. In reality, more couples seem to have come to have children through surrogate mothers."
The debate over surrogacy has drawn huge attention since late September, when the Tokyo High Court ruled that Tokyo's Shinagawa Ward must allow TV celebrity Aki Mukai to register twins born from an American surrogate mother as her sons. The ward filed an appeal in October.
Another case made headlines in October when Yahiro Netsu, director of Suwa Maternity Clinic in Nagano Prefecture, revealed that a woman in her late 50s acted as a surrogate in 2005 for her daughter, who also lost her womb to cancer.
When Mukai announced that her twins were born via a surrogate mother in 2003, the Japan Society of Obstetrics and Gynecology released a guideline prohibiting the practice because it complicates family relations, entails physical risk and "commercializes the female body" through monetary compensation.
An advisory panel at the Health, Labor and Welfare Ministry recommended the same year that surrogacy be banned.
While lawmakers and the government have not made any laws regulating surrogate births, more than 100 Japanese couples are believed to have had children through surrogate mothers, mainly overseas, in the U.S. and South Korea, despite the numerous legal and financial hurdles.
Surrogacy is legally permitted in the U.S. and Britain, but France and Germany have banned it.
According to Hiromi Yoshioka, representative of fertility coordination agency Mirai Network LLC in San Francisco, there are nearly 30 major procedures that must be carried out before a couple can return to Japan with a surrogate-born child. The price for the whole package can be as high 12 million yen.
Clients are required to visit the U.S. repeatedly for nearly two years for tests and fertility drugs. Hiring lawyers in each country to handle the legal matters and accompany the surrogate mother during medical checkups are also recommended.
"Many clients have to give up the procedure because of financial issues," said Yoshioka, who has coordinated six surrogate births since 2001.
Even for those with sufficient funding, there is no guarantee a healthy baby will be born.
A Japanese woman in her 30s from the Hokuriku region applied for a surrogate birth after losing her womb during a miscarriage in her 10th month of pregnancy in 2001. She began getting treatment in the U.S. after winning over her parents and relatives, who had initially disapproved. In the end, the American surrogate mother she hired miscarried in the second month. The Japanese woman gave up a year later.
Five long years after her miscarriage, she opted to adopt. But by that time, the failed surrogate birth had set her back more than 6 million yen.
"I am from a family with a regular income, so money saved up for purchasing a house was used to pay for surrogate birth procedures," said the woman, who also asked to remain anonymous.
Surrogate birth should be legalized because Japan has the medical technology to offer such treatment, said Netsu of Suwa Maternity Clinic. Netsu, an obstetrician, has been involved in five successful surrogate births since 2001, and receives 70 to 80 requests over the past 10 years, he said.
Netsu said the clinic has four rules for allowing surrogate births. First, the woman must be married, not have a womb but must have eggs. Next, the surrogate must be a woman who has a child of her own. Third, no compensation between the two parties is allowed. Lastly, surrogate-born children must be registered as the surrogate mothers' children and then be legally adopted by the couples who requested the procedure.
In the five cases handled by the clinic, those who volunteered to be surrogates were sisters or mothers of the patients, he said. Although the whole procedure costs about 1 million yen, surrogate births should be allowed because they give people who have been robbed of their ability to have a baby a second chance, Netsu said.
"I believe doctors should think about the benefits for the patients first," he said. "If Japan bans surrogacy, (couples) will go overseas."
Journalist Miho Hirai, who wrote a book on surrogacy in March, agreed, saying any government that forces couples to secretly opt for surrogacy ignores the minority and "bullies the weak."
"The problem is that society, government and the Japan Society of Obstetrics and Gynecology have formed their opinions without listening to the voices of those in need of surrogate mothers," Hirai said.
She also claimed that Japanese society has not been supportive of adoption, surrogate births or even single mothers because it has a "fixed idea" about what a family should be.
However, Yonemoto of the Center of Life Science and Society said having a surrogate mother system can disturb the social order.
"Surrogate birth may involve monetary compensation . . . and some people may be forced to become surrogate mothers," said Yonemoto, who is an expert on life ethics. "I think surrogacy should be legally banned, with rare exceptions."
Yonemoto proposes introducing a checking system that would allow women to have surrogate-born children with the permission of a family court. The court would have to verify that the women have no reproductive organs, are not giving money to the surrogates and confirm that surrogate mothers are voluntarily accepting the procedure.
Yonemoto said doctors can judge whether a surrogate birth is safe, but not if it is socially acceptable, because they are more focused on meeting the sometimes "excessive desires" of their patients.
The Justice Ministry and the Health, Labor and Welfare Ministry in November asked for input on assisted reproduction technologies from the Science Council of Japan, an independent academic panel representing 790,000 scientists that makes policy recommendations to the government. It could be the first step to a law on surrogacy.
"Many people have suffered for so long because of infertility," Hirai said, adding that simply recommending adoption instead of a surrogate birth is a cop-out.