From the outside, the HRC Fertility clinic in Old Pasadena looks low-key. It occupies a three-floor building with classic reddish-brown bricks. But the interior is luxurious, with a decor that includes a crystal chandelier and bright marble walls and floors. Couples who want children but are struggling to conceive sit on cozy Baroque sofas, awaiting their doctors’ appointments. Some are pursuing a special reproductive service: surrogate pregnancy.
In the reception hall, a middle-aged man in a white shirt sitting on a sofa alone has a different role. His name is Patrick Yu, a surrogacy agent who connects Chinese surrogacy seekers with doctors and surrogates.
There is no such reliable statistics available showing the rising trend of surrogacy in the U.S. But according to CDC’s National ART Surveillance System, the number of gestational carrier cycles increased from 727 in 1999 to 3,432 in 2013 and about 16 percent of intended parents using a gestational carrier were not US residents.
“I guess more than 2,000 Chinese people come here for surrogacy per year,” Yu said. “I can receive about 200 Chinese clients every year and there are definitely more than 10 surrogacy agencies in L.A.”
Yu had previously operated a maternity hotel, where women from China would travel to have their babies with access to American hospitals and medical care.
“It’s a coincidence that I started as a surrogacy agent,” Yu said. “One of my friends commissioned me to ask about surrogacy in California.”
For helping his friend, Yu asked around and learned a lot about surrogacy in California. As the founder of a travel agency in Shanghai before he came to the U.S., Yu sensed a fortune immediately and shifted his focus from maternity hotels to surrogacy business. From each surrogacy case, Yu can earn $10,000 from his clients and $5,000 referral fee for introducing his clients to a surrogate agency.
In China, a Ministry of Health regulation issued in 2001 bans medical institutions and staff on the mainland from carrying out “any form of surrogacy”. Chinese couples get around a ban on surrogacy in China by traveling to the U.S. for the service. The director of the Reproductive Health Center at Beijing Chaoyang Hospital Li Yuan estimates China’s infertility rate is now 10 to 15 percent, while America’s infertility rate is about 10 percent. As India, Nepal, Thailand, and Mexico started enforcing laws to ban overseas surrogacy from 2015, California has become a popular destination for Chinese citizens to seek surrogates.
Jeffrey Nelson, a physician who specializes in Obstetrics and Gynecology, has worked in HRC Fertility-Pasadena for almost 30 years. In recent years, he says he’s noticed a significant increase in the number of Chinese clients in the clinic. The end of the “One-child Policy” in 2015 allows Chinese families to have their second child.
China’s change to a two-child policy “escalated the thing,” Nelson said. “We have patients from all over the world. Probably 50 percent are from mainland China.”
Yu started working with Nelson’s team in 2014. He introduces clients to Nelson, whose reputation and success in shepherding successful surrogacies has led to increasing demand from Yu’s clients.
As a veteran in the surrogacy agency, Yu posted many successful cases and shared his stories on social media platforms. Chinese clients can directly consult with him through social media. He has got much trust from clients.
“Some patients just hear about us word of mouth and contact us directly,” Nelson said. “But a lot of our patients’ introduction to us is facilitated through Patrick.”
To help communicate with Chinese clients, Dr. Nelson has employed bilingual speakers.
The surrogacy clients’ profiles are diverse and the reasons are complicated. Yu said most of his clients were born in the 1970s and are at an age when it is increasingly difficult to get pregnant, and the risk of complications is high. They came when knowing surrogacy is legal in California, where the medical technology is advanced.
“On one hand, as one-child policy ended, many middle-aged people want the second or the third child. Some of them struggled to be pregnant but failed or had abortions,” Yu said. “On the other hand, they can afford surrogacy expense and value their body health.”
Chinese government workers are also the majority of Yu’s clients. They don’t at least three weeks to do in vitro fertilization and implant embryos to their uteruses in the U.S. IVF process will cost them about three weeks. Also, being pregnant hurts their careers in the government.
“Their passports are taken away by the government. It’s not easy for them to take back their passports and stay in the U.S. more than a month,” Yu said. “They are also worried that pregnancy will make them lose jobs.”
Yu said a few young people seek a surrogate because they simply don’t want to endure childbirth.
“These young people just want to keep slim,” Yu said. One client arrived to pick up her newborn baby and immediately handed it over to her mother, Yu said. “The woman’s mom took care of her child. She, together with her husband traveled around the U.S.”
A few of Yu’s clients are gay couples.
The surrogacy expense costs about $200,000 one time. Compared to the cost of underground surrogacy market in China reaching about $15,000, the surrogacy price in California is acceptable to Chinese people.
“Some of my clients didn’t believe me at first,” Yu said. “A little bit higher price, more advanced medical technology, a legal identification and an American passport for babies. They think: that is not gonna happen!”
During the processes of surrogacy, finding a qualified surrogate is the most important and difficult step. A surrogate agency matters to provide surrogates.
Yu has a partnership with Baby Tree Surrogacy where he can find surrogates for intended parents. The agency charges intended parents $30,000 when a surrogate is introduced to them. But an success in surrogacy is not for sure.
“Patrick is our translator. He deals with the intended parents,” The Case Coordinator Breauna Baerresen said. “We are very fortunate because neither Cassie (another case coordinator) nor I speak Mandarin. And that does tend to be a very common language used for intended parents.”
Founded in 2017, Baby Tree Surrogacy is an egg donor and surrogate agency focusing on Chinese families. Located in a business plaza in Hesperia, the agency has a store-size office decorated in light blue and purple.
“We provide the surrogates. Most of them are local to California. California is a very friendly state and there are so many fertility clinics here.” The case coordinator of the agency Breauna Harrison said. “it is definitely more common for a surrogate to be from either California or Texas. Nevada and Arizona are also good.”
Melissa Peppin, 34, is a surrogate for a Chinese couple from Beijing. She has been pregnant for 32 weeks and is due to deliver twins in October. The pregnancy can earn her about $52,000, including singleton pregnancy $40,000, an extra baby pregnancy $7,500 and monthly expense allowance $4,500.
“I have a gift of seeing what life can bring with the child and the joy that can come with it,” The mom of five children said. “And I feel that there are other mothers out there and other fathers that want to feel that gift. So if I’m able to give them that joy, I would love to have them experience.”
This is her first time to be a surrogate. But she said she came up with the idea about 15 years ago. At that time, she wanted to help her friend who couldn’t get pregnant on her own.
“She didn’t end up staying with her husband at the time and they split up. Then she got pregnant with her new husband,” Peppin said. “So she didn’t need me… but I was still wanting to help and give that life to somebody.”
Yu said risks are high when a surrogate is pregnant with twins. Most twins are delivered about two months earlier than the due date and put into incubators. As a matter of fact, the success rate of surrogacy depends. According to Dr. Nelson, the success rate is dependent on many variables and the primary factors are healthy embryos, so good sperm, good eggs, healthier uterus.
“If a woman is, let’s say under 35, her chance of success with IVF is probably close to 70 percent,” Dr. Nelson said. “If she’s 35 to 38, maybe 50 percent, 38 to 40, probably close to 38 percent, 41 above, (the success percentage) drops down to about 20 percent.”
Based on the fact of the success rate, it’s not easy to find qualified surrogates. The basic requirements for a surrogate include having at least one health pregnancy experience, good health records and under 40. Before a woman can be a surrogate, she needs to pass both physical and psychological tests. Even when she has been implanted with embryos, she has to be careful to avoid a miscarriage. As more and more Chinese couples seek surrogates in California, the demand for surrogates parallelly increase but the difficulty of finding qualified surrogates remains.
“I have a bullish attitude to the surrogacy industry here. But now we don’t have enough surrogates for demand,” Yu said. “Where there are surrogates, there are businesses.”