Over the past few decades, a growing number of countries have been allowing women to provide surrogacy services to others who are not able to complete the process of conception, gestation and birth.
Surrogate mothers are impregnated with a fertilized egg from another woman, carrying the baby for nine months, and then handing it over to the biological parents at birth, often in return for a fee.
Advances in medical science have seen the practice spread across the globe, with several countries legalizing it under particular circumstances, including India, UK and some states in the United States.
Now the practice has arrived in Egypt, despite stiff opposition from religious conservatives and a 2001 law that criminalizes the "renting" of wombs.
Various websites dedicated to surrogacy are now carrying advertisements from Egyptians offering surrogacy and fertility-related services in return for a fee. Women have posted ads offering their wombs and eggs, and sometimes their husband’s sperms on a commercial basis.
With surrogacy and IVF treatments costing thousands of dollars in other countries, married couples are increasingly turning to Egypt for a solution. Meanwhile, many cash-strapped Egyptian women see surrogacy as a means of earning much-needed extra income in tough financial times.
A surrogate mother advertises on a surrogacy website
Surrogate mothers linking with would-be parents online
In some cases, Egyptians have set up shop as brokers, putting would-be parents in touch with women willing to carry a fertilized egg through pregnancy to birth.
One company based in Alexandria posted an advert on www.findsurrogatemother.com, saying, “We are a full-service surrogacy agency in Alexandria, Egypt, helping to match. We provide services for surrogacy. Contact us for more information regarding our surrogacy services."
The same website shows another four adverts from women in Egypt offering surrogacy services to parents who are unable to conceive. Most of the adverts show several comments from couples who were searching for a surrogate-mother service, although there is no indication of how many successful deals are made.
Meanwhile, on the shopping website Souq al-Arab a married Egyptian woman offered a range of services. She was willing to provide an egg for sale or to carry a fertilized egg to full term and give birth. She also offered her husband's services: “To any woman who wants to conceive, my husband also can offer sperm due to our bad financial situation."
The advert, published on April 17, included a phone number for the husband and was viewed 591 times on the website. Egypt Independent tried to contact the advertiser in disguise but got no reply.
A tempting offer
Mona al-Sayed, a mother of four, is among those who saw surrogacy as a way to fill the gap in her income, but decided at the last minute not to go through with it.
“I have four kids and my husband works as a microbus driver, a job that does not provide us with a good income. One of my friends told me that a married woman is searching for a surrogate mother because she has infertility issues,” Sayed said.
She explained that she considered the offer due to her severe economic circumstances. Due to her limited education, she said she is unable to find well-paid work.
“In the beginning I agreed, and my husband welcomed the idea too, thinking he could buy a microbus to raise our income. The wife visited us and brought some presents for my children, and they were reassuring me. But I was so concerned,” she said.
Sayed asked a Muslim scholar about how surrogacy is viewed in Muslim Sharia. The scholar said it was not completely forbidden but was viewed potentially leading to adultery, and so she declined the offer.
A surrogate mother calling herself 'Taghrid' appears on a TV show in 2013
Desperate for cash
In 2013, an Egyptian woman stirred controversy when she was interviewed by a TV talk-show, declaring that she was renting her womb because she is desperately in need of money. She called herself “Taghrid” and wore a niqab to conceal her identity
“I’m a widow and I have a little son. We don’t have any source of income after my husband's death," she said.
Taghrid, who graduated from the faculty of commerce, found herself in financial difficulties after the death of her husband. She scoured the internet for work that she could do from home, since she was not able to leave her son unattended. The only thing she found was online marketing work, which paid just LE1,000 per month, hardly enough to cover her needs.
"I searched online for another opportunties," she said. "I found out about surrogacy, and I found that many countries like India, Ukraine and Iran have legalized it. I liked the idea, and I thought about renting my womb a few times to fund a new project that could provide me with a good income. I wasn't sure about its legitimicy according to Islam, but I found a Muslim scholar who said it was permitted."
Taghrid set up a Facebook page promoting her surrgacy service, while making various stipulations, asking the couple's religion and the reason for the surrogacy.
"I’ve received many offers from different countries with attractive proposals. I chose a Lebanese Muslim married couple who have been trying to conceive for 10 years without success," she said.
The lebanese couple were searching for an Indian woman but the offers they received were much pricier than Taghrid's one. They contacted Taghrid and offered her LE40,000, along with LE1,200 monthly salary, covering the nine months of pregnancy. They also offered to pay all medical expenses, including the cost of the delivery itself.
"I searched for an IVF physician who could do it in Egypt. He agreed to do the operation, but he asked for extra money, saying that the procedure is forbidden in Egypt,” said Taghrid.
She was harshly criticized during the show, but she rejected the criticisms, saying that surrogacy is neither debauchery not adultery.
"I don’t think it conflicts with God’s will," she said. "It’s science, and God asked us to benefit from science. Moreover, I don’t believe it's adultery, because my womb will be inseminated with a whole fertilized egg, not only the sperm of a stranger. And if I want to do immoral things, I would have been a prostitute instead, and I would get more money,” she said
Forbidden in law
Muslim scholarly authorities in Egypt have ruled that surrogacy is forbidden in Islam, a fact that has translated into Egyptian law.
In 2001, parliament introduced a new law criminalizing the practice of “renting” wombs, whereby a woman receives payment for carrying another couple’s child to term. Those who break the law face a five-year jail sentence.
The law allows married heterosexual couples to produce a baby using IVF technology. However, it does not allow the donation of sperm or eggs, nor the use of frozen sperm transported from elsewhere.
Dar Al Iftaa, Egypt's official Muslim research and educational body, previously issued a fatwa on surrogacy, ruling that it is un-Islamic. The fatwa was issued after someone asked whether surrogacy was an acceptable option after doctors diagnosed his wife as infertile.
According to the fatwa, surrogacy is forbidden as it conflicts with the true meaning of motherhood according to God’s definition in Quran. Meanwhile, making a commercial practice of bearing a child conflicts with the noble nature of motherhood, which includes craving, nausea and weakness during nine months of pregnancy. These, along with tension, anxiety, weakness, depression and fatigue after birth, and the long period of physical bonding, produce the feeling of motherhood, according to the fatwa.
Moreover, said the fatwa, a child born of surrogacy may suffer from psychological issues as a result of discovering that the biological mother is not the same person who carried it for nine months, feeding the fetus with blood through the womb.
“The newborn would not know who he belongs to, to his biological mother or the surrogate,” the fatwa said.
Malaka Zarar, a professor of sharia, said neither Islam nor any of the Abrahamic religious permit acts such as surrogacy, either for money or as a donation. She described surrogacy as an indirect form of adultery.
Moreover, she said that the civil law confirms any surrogacy contract between a woman and a family is void, because such a contract goes against God's creation, which is human nature.
“Your body is God’s gift to you, and you don’t have the authority to make money from your organs, and surrogacy is even worse than adultery,” said Zarar.
Mohammed al-Rawi, a member of the Islamic Research Academy, said that Muslim scholars reject surrogacy unanimously.
"The fact that the West accepts it doesn't mean Muslims are obliged to accept it too," he said.
He added that Islam permits several solutions to infertility issues, one of which is polygamy.
"If Allah wants a Muslim to be infertile even after they have tried all legal options, this means it is God's will, and nobody except God knows why," said Rawi.
"It's better for you to have no children than to have an ungrateful and impolite son who may increase the family’s worries," he said.
There is some difference of opinion with Christianity regarding the morality of surrogacy. The Catholic and Orthodox Churches forbidden surrogacy, saying it is incompatible with the principle of motherhood. The Vatican banned it in resolution No. 2376, describing it as an “immoral act”.
However, various Protestant denominations permit surrogacy, while the general trend in secular opinion in the West is that the practice is not inherently immoral, although there are potential ethical and psychological complexities.
Among the rare voices in the Muslim community that suppor the practice is scholar Abdalmotty Bayoumi. He has declared that surrogacy is permissible, saying that it would help a great many women who suffer from infertility, while protect thousands of families from breaking up due to pregnancy issues.
He adds, however, that such practices should be restricted to married couples seeking to build a family.
While there appear to be some doctors in Egypt willing to assist with illegal surrogacy procedures, it seems there are many who would refuse, and not only on legal grounds. According to gynaecologists, obstetricians and fertility experts, surrogacy is a complex business, with a range of potential dangers, both physical and psychological.
Because the baby’s DNA is carried only in the sperm and ova, a surrogate mother cannot transfer her DNA to the child she carries. However, diseases carried by the mother as well as unhealthy habits such as smoking or taking drugs might damage the baby. Meanwhile, those women who take up surrogacy as an ongoing means of earning money may be harming their own bodies in the process.
"Frequent pregnancies could harm the surrogate mother, because pregnancy itself is a long, tiring journey, and this may lead to miscarriages,” Dr Amr Hassan, a gynaecologist, told Egypt independent
Hassan said that nobody has come to him asking for assistance with surrogacy, and he feels such practices will not take off in Egypt in any case, due to the risk of prosecution.
“Infertility and IVF medical centers in Egypt are already satisfied with the huge profits they make from married couples who suffer infertility. So they will not take part in illegal operations that could cause them legal troubles," he said.
Dr Yassin Zien, a consultant in obstetrics and gynaecology, told Al-Ahram newspaper that there is no guarantee that a baby born by way of surrogacy will turn out healthy, bearing in mind the potential for diseases carried by the mother being transmitted to the fetus during gestation.
“If the surrogate mother is married, she might get pregnant accidently from her husband in the same month as embryos are transferred for the surrogate baby, and she would become pregnant with twins. How they will differentiate between them?" he said.
While DNA testing could presumably determine the biological parents of each child, the complications could be a source of stress and worry for all concerned.
“Not all the scientific technologies are applicable. We live in a society that respects religion and tradition,” he said.
Medical complications to one side, there remain several question marks over the psychological consequences for any surrogate mother giving up the child she has given birth to. In nations where surrogacy is legal, there have been reports of surrogate mothers either refusing to give up the child after delivery or doing so with great reluctance and then going into a deep depression.
With the spread of surrogacy, sad cases of this sort are also appearing in Egypt, as some doctors testify.
Dr Khaled Khadragy, an Egyptian gynaecologist, posted a story on his Facebook account of a surrogate mother who felt depressed after delivery because she felt that the newborn baby, who she had carried for nine months, was her child.
“A patient visited me in my clinic asking for a report proving that she was pregnant and I was her physician. I could not remember her very well and I was unsure,” he said
The patient, who was a widow and very poor, started to cry and narrated her story. One of her relatives suggested that she agree to act as surrogate mother for a married Libyan couple. The wife was suffering Asherman syndrome, and so could not bear a child.
The patient travelled to Libya and underwent In Vitro Fertilization (IVF) with the ova and the sperm of the Libyan couple. The embryos were transferred to her uterus and they agreed on an amount of money. The one condition of the arrangement was that the mother should forget the baby after delivery and not seek to maintain contact.
“After the birth, I felt it was my son, not hers. I need him, but I don’t have any documents saying that,” the patient told Dr Khadragy.
The doctor said that felt no sympathy for the woman, and if she took the case to court she would be disappointed, because the DNA would prove that she is not the biological mother.