Why there is always a tragic human cost to this reckless industry
The pitiful story of Gammy, the twin baby boy born to a surrogate mother in Thailand, but allegedly left behind (because he has Down's syndrome) by the Australian couple who took home his baby sister, has thrown a spotlight on what has become shabby big business in some parts of the developing world.
Officially it's known as gestational surrogacy. Unofficially it's poor women renting their womb to rich (by their standard anyway) foreigners.
In the wake of Gammy's case, which has made global headlines, Thailand's military rulers are now said to be clamping down on the country's IVF and surrogacy industry, which has been booming in recent years with demand from Australia and China, in particular.
India, where the surrogacy trade has similarly flourished for years, is also said to be clamping down.
A surrogate mother like Pattaramon Chanbua, who gave birth to Gammy and his sister, can be paid around £8,000 per pregnancy. To a struggling mother like Pattaramon, who has two children of her own, that must have seemed like a fortune.
She may not have been aware, though, that the agency through which the surrogacy was arranged was making a whole lot more from the deal.
She insists that the biological parents, who come from Western Australia, were well aware that Gammy was a Down's child and also that he suffered from health problems, including a hole in the heart and lung complications.
She claims that's why they rejected him. When tests had revealed his condition in the womb, she says, they'd asked her to have a termination. She refused.
The father she says was, at one point, in the same room as Gammy after he was born but refused to look at him. The Australian parents, she maintains, cried on the day they left the hospital with their baby daughter. Proof, she says, that they knew exactly what they were leaving behind. She adds that she loves Gammy, as do her children, and she wants to keep him.
Since the story broke, a fund has been set up to provide the little boy with the medical care he needs. He is surrounded by love and enough money has been donated to cater for his future welfare, so in a way, you could argue, this is a story with a happy ending.
But meanwhile in Australia ...
Gammy's biological parents deny the agency told them of his existence. They say that in the clinic there were problems with interpreters. They had saved every cent they had, they say, to have the child they yearned for. They insist they didn't know their baby girl had a twin and are now, not surprisingly, said to be traumatised.
On its own, it is a case to test any 21st century Solomon. But it is also an example of an unscrupulous trade that preys on both those who are poor and desperate and those who are childless and desperate.
It is easy to condemn the parents as the villains of this piece, but unable to have a child by surrogacy in their own country, the Thai option must have seemed like the answer to their prayers. Australia, like the UK, has strict rules on surrogacy where only reasonable "expenses" are allowed to change hands. It is, unsurprisingly, much more difficult to find a willing surrogate.
But online a few clicks will take you to any number of sites offering a service in countries like India. One operator typically makes it seem so easy. To someone yearning for a child of their own, undoubtedly temptingly so.
"The main objective of this agency is to make your 'surrogacy journey' hassle-free and emotionally rewarding. In order to do so we provide guidance and support to the intended parents throughout the process, starting from the initial inquiry up until they take the baby home!"
Those words have a particular irony in the case of poor little Gammy.
And this one child left behind is hardly the only human fallout from the distasteful trade of which he, his twin sister, his surrogate mother and his biological parents would all seem, in their various ways, to be victims.