Thai nationals eligible to apply for board approval for assisted pregnancies in cases related to medical conditions.
TO PROTECT children born via surrogates and prevent problems similar to those that have made recent headlines, authorities have set up strict rules for couples who wished to have a child via surrogacy due to difficulty conceiving a child naturally, and those wishing to provide that service.
Since the Technologically Assisted Reproductive Medicine Surrogate Children Protection Act 2015 has been in effect, the approval committee has approved 149 couples out of 157 surrogacy applications.
All parties involvedwere required to abide by strict rules to ensure the procedures were legal and not for commercial gain.
“Before this law was put in effect, Thailand was known as a hub for unregulated commercial surrogacy, resulting in problems such as the case of baby Carmen whose biological foreign father had a court dispute for parental rights with the Thai surrogate mother,” said director Arkhom Praditsuwan of the Department of Health Service Supports’ Bureau of Sanatorium and Arts of Healing.
A legal surrogacy requires a qualified couple, surrogate mother, doctor and medical facility, Arkhom said.
The applicant couple must be legally married, and at least one of them must be a Thai national. If only one partner is a Thai national, the couple must have been legally married for at least three years.
The surrogate mother must be the couple’s blood relative but not the couple’s parent or child, Arkhom said. The surrogate must be physically and mentally healthy, 20 to 40 years old, of the same nationality as one spouse, already have her own children (up to three children via natural birth or one child via caesarean section) and have her husband’s consent if she is married.
There are 75 authorised medical facilities to provide technologically assisted reproductive medical services – of which 49 are in Bangkok, with the rest in Pathum Thani, Samut Sakhon, Chiang Mai, Chiang Rai, Phitsanulok, Nakhon Nayok, Chon Buri, Khon Kaen, Nakhon Ratchasima, Udon Thani, Nakhon Si Thammarat, Phuket and Songkhla. Arkhom said the doctor who provided the service must be a gynaecologist with certified expertise in reproductive medicine.
“The approval is up to the Committee for Technologically Assisted Reproductive Medicine Surrogate Children’s Protection, which will ensure legality and prevent it from being for commercial gain,” he said.
Applications will be approved on a case-by-case basis and the facility must report updates and results for each surrogacy case to the committee, he added.
The newborn will be the couple’s legal child, but if the parents of the foetus die before the birth, the law allows the surrogate mother to be the child’s temporary guardian until an appropriate guardian was assigned by the court, Arkhom said.
The couple cannot refuse to accept the surrogate child and must notify authorities of the child’s birth under the regulations for children born under technologically assisted reproductive medicine.
The abortion of a surrogacy pregnancy requires consent from both the couple and the surrogate mother, said Dr Krieng Asawarungnirun, a member of the Medical Council. If the surrogate mother refuses consent, the abortion cannot be performed and her agreement with the couple would end. The surrogate mother would then be responsible for the child, but is not obligated to repay pregnancy-related expenses to the couple.
“The council only allows abortion under two key conditions: A necessity due to the surrogate mother’s severe physical or mental problem or as a necessity due to the foetus’s high risk of disability or a severe generic disorder. Such cited conditions must be examined and confirmed by at least two medical experts with the same diagnosis,” Krieng added.
Dr Supakdee Julvijitpong, chair of a reproductive medicine sub-committee under the Royal Thai College of Obstetricians and Gynaecologists (RTCOG), said 70 per cent of the qualified facilities were privately run.
The public-sector facilities are hospitals under medical schools or large hospitals.
With RTCOG training in the field limited to only 15 doctors a year, only hundreds of qualified gynaecologists are available in Thailand.
The equipment is also imported, so services are expensive – about Bt70,000 for a medical school’s hospital or Bt200,000 to Bt300,000 for a private facility. The same service in the United States was two to three times more expensive than in Thailand.
As it is heading towards an “ageing society”, Thailand had a rather low birth rate, Supakdee said, while urging the government to implement child-promoting measures. He said the government should ensure that couples having difficulty conceiving their own child had better access to technologically assisted reproductive medicine.
That could be done through lowering the price, making more facilities available and creating tax incentives, he said.