WHEN Ann and Ron (not their real names) moved here five years ago from India and became permanent residents, they could not wait to start a family. But a doctor here gave them some painful news - Ann was born with a small uterus, which cannot stretch enough to hold a growing foetus.
'When we knew about this, we were quite devastated and didn't know what to do. My husband loves children. If I knew about my condition before marriage, I wouldn't have married him just for this reason,' said the 31-year-old IT officer.
 
They were about to throw in the towel after six expensive and unsuccessful in-vitro fertilisation (IVF) attempts, when Ann was told her eggs were healthy enough to have her own child through surrogacy.

She started reading up about surrogacy in her country of birth - India. She read how the rent-a-womb industry there has attracted childless couples from all over the world with its low-cost and high-tech treatment.

Three years ago, she flew back to her hometown in Gujarat. After two unsuccessful IVF cycles, her surrogate is finally pregnant from her third IVF try.

Because surrogacy is illegal here, a steady stream of Singaporeans has been seeking such services in India.

A check with four fertility clinics in India indicates that over the past three to four years, more Singaporeans have been inquiring about renting a womb. A spokesman for Mumbai-based fertility service provider Surrogacy India said it has seen four Singaporean couples - three ethnic Chinese and one Indian - over the past 2-1/2 years.

A spokesman for another clinic in Mumbai, Rotunda Fertility Clinic, said it had received inquiries from about 10 Singaporean couples on surrogacy during its four years of operation. In Anand, in India's western state of Gujarat, the Akanksha Infertility Clinic has seen one or two Singaporeans a year over the past four years.

As a result, two leading fertility doctors have called for surrogacy to be legalised in Singapore on a limited basis - for cases where there are compelling medical grounds - since it has the requisite know-how and facilities.

Dr Jothi Kumar, 53, a senior obstetrician and gynaecologist at O & G Partners Clinic for Women and Fertility Centre, believes the current blanket ban here is 'unfair' to childless couples who have exhausted all other means.

He urged the authorities to permit 'limited surrogacy' to be made available selectively to patients who need it. Each legitimate case can be presented to a government-led review committee, which could then decide if surrogacy is warranted.

'My view is that legitimate couples who need access to this kind of thing are being deprived,' he said, adding that Singapore could lose out on becoming a prime 'medical tourism' destination in the process.

National University Hospital's Department of Obstetrics and Gynaecology senior consultant P.C. Wong, 57, who encounters about two cases a year that he considers to be genuine candidates for surrogacy, echoed Dr Kumar's suggestion.

He said surrogacy should be allowed here for 'medically indicated' cases. These include women who have no uterus, women who have suffered from repeated miscarriages, and women who would be prone to heart disease if they get pregnant. 'For these women, if they don't have surrogacy, there is no way they can have a baby,' he said.

Currently, it is illegal for a woman to become a surrogate mother here. Childless couples are prohibited from seeking surrogacy here. It is also unlawful for local doctors to help in surrogacy.

The Ministry of Health said surrogacy is not allowed to be performed in clinics and hospitals, under the directives for private health-care institutions providing assisted reproduction services.

However, the doctors believe that the authorities are hesitant to legalise surrogacy due to potentially explosive social, legal, moral and ethical issues.

One likely controversy, said Dr Kumar, is if the surrogate mother refuses to give up the child after delivery. Another concern is that career-minded or figure-conscious women might make use of surrogacy as a way to bypass getting pregnant themselves.

Identifying the legal mother of a surrogate child is another problem, said Dr Wong. 'The law states that the woman who gives birth to the baby is the mother,' he said. 'But now that might not be the case.'

Added to that, Archbishop Nicholas Chia, head of the Catholic Church in Singapore, said the Church is against surrogacy.

The Vatican website states: 'Surrogate motherhood represents an objective failure to meet the obligations of maternal love, of conjugal fidelity and of responsible motherhood; it offends the dignity and the right of the child to be conceived, carried in the womb, brought into the world and brought up by his own parents; it sets up, to the detriment of families, a division between the physical, psychological and moral elements which constitute those families.'

But despite this, Ann said she cannot wait to watch her parents' delight when they finally cradle their grandchild in their arms.

'That's going to happen now and I'm very happy. Surrogacy is a godsend to me,' she said.

This article was first published in The Straits Times.